A Hidden Inequity: The Life Expectancy of Transgender Women of Color

February 5, 2018
By Kendra Allen

Update: In an earlier version of this blog 31 was used as the life expectancy number. It has been changed to 35 due to an article titled, “The National Transgender HIV Testing Day”, on the UNC School of Medicine website. There is a lot of debate about the number but the intention of this blog was to think about how we can better support Black and brown transgender women to live a full and healthy life in DC.

Transgender women of color reside at a unique intersection of identities, whether they possess privilege of any kind or not. Would you believe me if I told you the life expectancy for transgender women of color in the United States is 35? And all the discrimination – refusing to treat transgender patients, to rent or sell to them, or to employ them – and violence (state and personal) inflicted onto them drives this number so low?

Tyra Hunter

Although the District has a troubled history with the LGBTQIA community, it has especially struggled to support its transgender residents. We can discuss as recent as last year when at least two transgender women of color were physically attacked but their cases aren’t being investigated as hate crimes or as far back as 2001 when the city had to pay a settlement to Tyra Hunter’s family for her death. Tyra Hunter was a Black transgender woman who was refused medical care after being involved in a car crash in 1995.

According to Access Denied: Washington, DC Trans Needs Assessment of 2015, 19% of transgender people living in DC have been denied medical care at least once due to being perceived as transgender. Other barriers to care include poverty, health insurance plans that don’t cover medications or procedures for gender transition and not having culturally competent care.

Cultural Competency vs. Cultural Humility

Recently, officials have taken steps to ensure better care for transgender patients by introducing and passing legislation called the LGBTQ Cultural Competency Continuing Education Amendment. The amendment requires healthcare professionals to participate in cultural competency training related to LGBTQ patients.

Although it has yet to be implemented, the Gays and Lesbian Activist Alliance, a DC nonprofit that defends LGBTQ civil rights, is encouraged by the actions taken by the council and the DC Department of Health. But GLAA staff also believe they could go further.

“GLAA agrees that the conversation should shift from cultural competency to cultural humility. Framing it as cultural humility puts an emphasis on the journey rather than a non-existent endpoint, which encourages health and other service providers to acknowledge their biases and limitations and commit to lifelong cultural growth.”

The Case for Better Data

Ensuring that care is appropriate and accessible is important but we know that our health depends on so much more. The prevalence of poverty in this community (57% of transgender women of color make below $10,000 a year) along with a 55% unemployment rate for Black transgender individuals and the lack of affordable housing in the city, together create an unconscionable life expectancy.¹

The city has the power to address these issues through policies, practices and other tools but not if they don’t have the data. As I was conducting research for this blog, I found little information on the city’s transgender and LGBTQIA population. “This has been an ongoing issue many in the community have raised, especially given the high rates of new HIV infections in the Black and Latino community,” said GLAA staff. “Fortunately, local partners including HIPS, the DC Center for the LGBT Community, Impulse DC, and Mandate have worked to gather this data to identify and address challenges the LGBTQIA community faces in the District.”

GLAA is part of an alliance, which includes the DC Center, Whitman-Walker and others, that advocates for the DC Department of Health and the Mayor’s Office of LGBTQ Affairs to produce a regular report on the health of sexual and gender minorities in DC.

There was a report published in 2016 but advocates felt it did not sufficiently address the roles that race, age and other intersectional identities play in health inequities. “Ms. Ruby Corado, founder of Casa Ruby, pressed government officials present at a recent symposium to go where trans people are to ensure their inclusion in surveillance surveys,” said GLAA staff.

Transgender people are 2.33% of the city’s general population, making it the largest transgender community in the nation. They ought to be counted.

We are grateful to the Gays and Lesbian Activist Alliance for their input and thoughtful answers to our questions.

How is your organization addressing issues at the intersection of race and gender identity? We invite comments below.

1: Access Denied: Washington, DC Trans Needs Assessment of 2015

*Transgender activists in the US often cite a life expectancy of early thirties to mid-thirties. I have not been able to verify the number but I am using 31 because a local activist used this number. 

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