How Trump's HHS Cuts Are Another Attack On Trans People

Research on HIV prevention among trans people was already scarce, but Trump's restructuring of the health agency decimates future studies.

The Trump administration’s cuts to the Department of Health and Human Services make the dream of ending the HIV epidemic more unattainable than it has been in years, and public health experts warn it also marks an escalation of the president’s attacks on trans people.

The administration began its drastic overhaul of the HHS last month, which included department secretary Robert F. Kennedy Jr. axing key agencies and federal grants dedicated to HIV prevention, treatment and research. Several initiatives, including funding for HIV services aimed at low-income people and people of color, are set to be eliminated next year, according to a draft HHS budget.

HIV rates have fallen steadily in the United States since the introduction of the preventive medication PrEP, also known as pre-exposure prophylaxis, in 2012. PrEP has the ability to almost completely reduce the risk of HIV transmission, and anti-retroviral medications are able to render the virus undetectable in those living with HIV. Still, almost two-thirds of the 1.2 million people who could benefit from preventive medication are not taking it.

Most of the modern infrastructure for HIV treatment and prevention has been built by and for cisgender white men, while people of color and other LGBTQ+ people often do not have access to the care they need. Trans people make up 0.3% of the United States population, yet they account for 2% of new HIV diagnoses. The World Health Organization estimates that globally, trans people are 13 times more likely to have an HIV diagnosis compared to their cisgender peers. Black and Latina trans women in the U.S. make up the largest share of new HIV infections among trans people overall, according to a study conducted from 2019 to 2021.

The HHS cuts will affect whether trans people can access social safety net programs and exacerbate existing barriers to care for HIV, public health experts say. Trans people already report higher levels of discrimination in health care settings, as well as increased stigma and a lack of health insurance.