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Calvin Fleming
On behalf of California HIV/AIDS Policy Research Centers
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FOR IMMEDIATE RELEASE
California HIV/AIDS Policy Research Centers Release Two Landmark Studies on Transgender Violence and the Impact of Anti-LGBTQ+ Legislation on HIV Prevention
New Research Documents Fatal Violence Against Black Transgender Women and Highlights Higher PrEP Use Increases in Regions with Protective LGBTQ+ Legislation
San Diego, CA – November 19, 2024 – The California HIV/AIDS Policy Research Centers (CHPRC) have released two major studies addressing urgent health and safety concerns facing LGBTQ+ communities. Both conducted by CHPRC’s California Center for HIV Syndemic Policy Research, the first study examines the disproportionate rates of fatal violence affecting Black transgender women in the United States, while the second study reveals how both progressive and discriminatory policies at state and local levels shape HIV prevention outcomes among sexual and gender minoritized (SGM) youth. These findings underscore the urgent need for both protective legislation and culturally sensitive public health interventions to safeguard marginalized communities.
Find more information about both studies at www.chprc.org.
Study 1: Fatal Violence Against Transgender Women in the United States
The first study, Halliwell et al., 2024, led by Pamuela Halliwell, MA, LMFT at The San Diego LGBT Community Center and Laramie Smith, PhD at UCSD, documents the devastating violence that disproportionately impacts Black transgender women. Findings reveal that Black transgender women accounted for 78% of all transgender women murdered in the U.S., with gun violence as the leading cause and Southern and Midwestern regions showing the highest rates of violence, linked to structural racism and anti-transgender policies.
“This study reflects the deadly impacts of systemic inequities and the urgent need for policy changes to protect transgender women of color,” said Pamuela Halliwell. “At a time where the incoming administration is threatening to remove rights and erase the identities of trans and nonbinary folx, our findings show how discrimination in housing, employment, and healthcare compounds the vulnerability of Black transgender women, reinforcing the need for equitable protections.”
Key Findings from Study 1:
- Black transgender women (including Afro-Latinas) are disproportionately murdered in the US: During the years 2013-2021, there were 229 documented acts of fatal violence against transgender women in the US, and Black transgender women account for 78% of those murdered.
- Policy environments amplify Black trans women’s vulnerability to fatal violence: Specifically, Black trans women are significantly more likely to be killed at a younger age by gun violence in the Southern and Midwestern US.
- The average age of Black transgender women at the time of death was 28, five years younger than the average age of non-Black transgender.
- 4% of Black transgender women were fatally shot vs. 37.9% of non-Black transgender women.
- Most fatal acts of violence occurred in regions with greater anti-transgender legislation, fewer commonsense gun laws, and greater structural racism
- Violence prevention efforts must also reduce the risk of perpetrating acts of violence against transgender women in the US: A perpetrator was identified in 58% of murders. Most of the perpetrators identified were known to the victim; 61% were their sexual or romantic partners and 32% were non-romantic acquaintances or family.
- While most perpetrators were Black cisgender men, this does not mean that Black men are the issue but likely reflects similar challenges across the communities where perpetrators and victims live that increase the risk of perpetuating acts of violence that are more fatal (e.g., lower economic opportunities, increased access to guns, anticipated threats to their masculinity by being with a transgender woman)
Study 2: The Relationship Between Anti-LGBTQ+ Legislation and HIV Prevention Among Sexual and Gender Minoritized (SGM) Youth
The second study, Kelly et al., 2024, led by Dr. Nicole Kelly from UC San Diego with co-authors at the University of North Carolina, examines the profound impact of state and local LGBTQ+ policies on HIV prevention among young SGM people, especially Black youth. The study highlights that PrEP (pre-exposure prophylaxis) use among young people significantly increases in regions with protective LGBTQ+ legislation, while discriminatory policies hinder access to life-saving prevention tools.
Key Findings from Study 2:
- Progressive Policies Drive Higher PrEP Use Nationally: SGM youth in states with progressive LGBTQ+ laws showed notably higher PrEP usage compared to those in states with more discriminatory policies, demonstrating the public health benefits of inclusive legislation.
- Local Politics Matter Just as Much as State Policies: In addition to state-level protections, local politics at the county level had an equal impact on PrEP usage. “Voting in local elections matters.” Dr. Kelly emphasized, “We’re seeing an increase in anti-LGBTQ+ legislation and rhetoric throughout the US, but focusing on implementing protective local policies can have meaningful public health impacts even when these protections don’t exist nationally.”
- Impact on Black SGM Youth: The relationship between LGBTQ+ policies and PrEP use was strongest among Black youth, suggesting that protective LGBTQ+ policies could have the greatest potential for improving HIV prevention services for Black SGM populations.
- California’s Policy Climate as a Model: California, with one of the most progressive LGBTQ+ policy landscapes, is a positive example of how state-level protective legislation can reduce HIV risk among young people. However, disparities persist in areas with conservative local governance, highlighting the need for protective policies at both state and local levels.
A Call to Action
These studies underscore that discriminatory anti-LGBTQ+ policies are a structural public health threat, likely exacerbating the HIV epidemic among youth and widening ethno-racial inequities in HIV prevention and leading to fatal violence against Black and Brown trans women across the country. Protective policies at every level—national, state, and local—are essential to increasing PrEP access and ensuring the safety and health of LGBTQ+ youth and adults alike. Legislative and organizational policies that work to reduce anti-Black discrimination and transphobia, reduce fatality through common sense gun laws, and reverse anti-transgender initiatives are the best strategies to protect lives.
About California HIV Policy Research Centers
Three collaborative California HIV/AIDS Policy Research Centers, funded by the California HIV/AIDS Research Program, support research and policy analysis that addresses critical issues related to HIV/AIDS care and prevention in California. The work of the research centers focuses on a “rapid response,” which involves short-term research projects designed to quickly address questions that emerge in a dynamic health policy environment.
California Center for HIV Syndemic Policy Research
The California Center for HIV Syndemic Policy Research (CalCenSyn) is led by Dr. Laramie Smith (UCSD) and Dr. Orlando Harris (UCSF). CalCenSyn seeks to expose the root causes of HIV and syndemic conditions, such as tobacco, substance use, and socio-structural barriers to treatment through its community-academic collaborative
Southern California HIV/AIDS Policy Research Center
The Southern California HIV/AIDS Policy Research Center, led by Dr. Ian Holloway (UCLA) and Dr. Jamila Stockman (UCSD), celebrated a successful year of collaboration. Their collective work includes academic manuscripts, policy briefs, infographics, conference presentations, consultations with the California Board of Pharmacy, and has garnered additional state and federal funding. In 2024, the Center is examining the implementation of the California Healthy Youth Act, California’s comprehensive sex education law; the intersection of HIV and intimate partner violence; and strategies to implement integrated HIV prevention and treatment services, especially for women experiencing violence.
Northern California HIV/AIDS Policy Research Center
The Northern California HIV/AIDS Policy Research Center is led by Dr. Emily Arnold (UCSF), Dr. Sandra McCoy (UCB), and Laura Thomas (San Francisco AIDS Foundation). In 2024, the Northern California HIV/AIDS Policy Research Center is planning to examine the impact of staffing shortages on the HIV healthcare system and is looking forward to working collaboratively with the other PRC on rapid response research addressing syndemic factors that contribute to HIV in California.
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