Gender Relativism: The Case from Retraction

BackgroundStudies in current literature show high HIV prevalence rates in transgender women all around the world. Transgender women face very high-levels of marginalisation, violence, stigma and discrimination, which in turn...

Disparities in depression and anxiety at the intersection of race and gender identity in a large community health sample

IntroductionTransgender men and women in Nigeria experience many barriers in accessing HIV prevention and treatment services, particularly given the environment of transphobia (including harassment, violence and discrimination) and punitive laws in the country. HIV epidemic control in Nigeria requires improving access to and quality of HIV services for key populations at high risk, including transgender men and women. We assessed how stigma influences HIV services for transgender people in Lagos, Nigeria.MethodsIn‐depth interviews (IDIs) and focus group discussions were conducted with transgender men (n = 13) and transgender women (n = 25); IDIs were conducted with community service organization (CSO) staff (n = 8) and healthcare providers from CSO clinics and public health facilities (n = 10) working with the transgender population in March 2021 in Lagos. Content analysis was used to identify how stigma influences transgender people's experiences with HIV services.Results and discussionThree main findings emerged. First, gender identity disclosure is challenging due to anticipated stigma experienced by transgender persons and fear of legal repercussions. Fear of being turned in to authorities was a major barrier to disclose to providers in facilities not affiliated with a transgender‐inclusive clinic. Providers also reported difficulty in eliciting information about the client's gender identity. Second, respondents reported lack of sensitivity among providers about gender identity and conflation of transgender men with lesbian women and transgender women with being gay or men who have sex with men, the latter being more of a common occurrence. Transgender participants also reported feeling disrespected when providers were not sensitive to their pronoun of preference. Third, HIV services that are not transgender‐inclusive and gender‐affirming can reinforce stigma. Both transgender men and women spoke about experiencing stigma and being refused HIV services, especially in mainstream public health facilities, as opposed to transgender‐inclusive CSO clinics.ConclusionsThis study highlights how stigma impedes access to appropriate HIV services for transgender men and women, which can have a negative impact along the HIV care continuum. There is a need for transgender‐inclusive HIV services and competency trainings for healthcare providers so that transgender clients can receive appropriate and gender‐affirming HIV services.

I was in my old station wagon, driving home from teaching my transgender literature course, when I first heard about Danielle Allen's biography Cuz: Or the Life and Times of Michael A. At first, I was only half listening to the author's interview on public radio, focused instead on the events of the day's class. My students and I had been working through Janet Mock's 2014 memoir Redefining Realness, and I'd offered a reading in which Mock's portrayal of her partner Aaron, saturated with the sweetness of heterosexual desire, was an attempt to reach a mainstream audience. Perhaps, I'd said, these romantic scenes are a tactic to connect with the type of white cis women who might be reading Mock's story at a suburban feminist book club. But my students didn't see strategic essentialism at all; they saw outright resistance. It's radical, they argued, to portray a trans woman of color in love. Usually, they told me, they'd only read about trans women of color when they were dead.The representational problem that my students astutely raised—that even within trans studies, portrayals of Black trans women as victims of violence construct narrative frames that are so strong that it's shocking to read about a Black trans woman on a date—is what compels me to write now about a different representational problem, the one raised by Allen's Cuz. Indeed, the detail that knocked me out of my pedagogical replay and made me instead pay attention to Allen's Fresh Air interview was the mention of a trans woman, whom Allen calls “Bree.” Michael, Allen's late cousin and the subject of her intricate and compassionate biography, had met Bree in prison. They had fallen in love. Later, after they had both returned to the outside, Bree had killed Michael. It was this act of murder that spurned Allen, a Harvard professor specializing in political philosophy, to try to account for her cousin's life.While listening to this interview, as powerful and moving as I found Allen's retelling of Michael's story, I also braced myself to encounter transmisogyny. I caught myself expecting the interviewer to ask Allen for more intimate details about Bree's transition, or for Allen herself to offer an explanation for Bree's acts that reflected standard transphobic tropes: of criminal deception or inherent mental instability, hypersexualization or castration. I wondered if the conversation would turn to some hypothetical threat to Michael's masculinity that a relationship with a trans woman might have represented. None of this happened.If it was revelatory for my students to read a Black trans woman in love, it was striking for me to listen to this story of a Black trans woman as the perpetrator, rather than the victim, of deadly violence and hear no attempts to frame her acts as results of her transness. Indeed, I suspect that, if Allen had not had to reveal Bree's trans status in order for the audience to understand that her cousin met his girlfriend within the purportedly single-sex institution of the prison, she would not have done so.An ungenerous reading of the author's decision to treat Bree's gender identity so lightly is that Allen wants to defend her cousin's heterosexuality, even in death, against the type of people who believe that trans women are men. But—having finally gotten out of my station wagon and, a few weeks later, read the actual book—I think there's something else at work. Allen's text throughout is careful, thoughtful, and open-minded about gender and sexuality. It does not assume a defensive posture around Michael and his love. Instead, I see Allen grappling with a complex set of simultaneous representational constraints. As a nonfiction writer, Allen can't exactly alter the events that transpired. It is true that Bree and Michael were in love, and it is also true that Bree killed Michael. Furthermore, she wants her audience, people that include white, suburban, Volvo-driving NPR listeners, to be moved by the tragic story of her cherished cousin, a Black man from South Central Los Angeles who went to prison for an attempted carjacking at fifteen years old. She must both mourn this stolen life and explain the legislative history of the racist drug wars of the 1990s. And—and this is critical, something that matters for the wide public reception of a book published in 2017 in a way it may not have in, say, 1997—she must tell the story of the Black trans woman who killed her cousin without reproducing transmisogynoir.1For the most part, Cuz walked this tightrope with grace. There are a few aspects of Allen's description of Bree, despite her clear care to engage respectfully, that I might flag on a student paper—there's no real need to provide a birth name for Bree, for example, even a pseudonymous one. But Bree is not an evil deceiver or make-believer, as Talia Mae Bettcher has deemed the tropes of the bad trans woman character (Bettcher 2007). Her gender identity is not a metaphor for deception or mental illness; it does not foreshadow Michael's death. Bree's womanhood is womanhood, and her role in a violent relationship with Michael is the role of a troubled girlfriend, not a “trap.” As far as cis writers describing trans people go, Allen makes a critically important choice: Bree's gender identity is distinct from her decision making.And yet, the overarching argument of Cuz: The Life and Times of Michael A is that no one's identity can be distinct from their decision making. As Allen's memoir-biography elegantly shows, the conditions of hypercriminalization, the war on drugs, California's three-strikes rule, and racist policing have constrained Michael's choices since he was born.Especially in part 3 of her book, Allen spends time peeling away each onion-like layer of social rot that ensnared Michael: the infiltration of Mafia-run heroin rings in 1940s Harlem, the white-supremacist destruction of Black communities in Omaha and Tulsa, the “Zoot Suit Riots” against Latinos in 1943 Los Angeles, and even the romanticization of gang life in the 1961 musical West Side Story. Readers have a rich tableau of reasons that Michael Allen, a happy child who loved climbing trees and beamed at the camera after his kindergarten graduation ceremony, died at age twenty-nine. But the great love of Michael's life, the love that spurred Michael, in his correspondence college courses that he completed while incarcerated, to write that “desire . . . makes men do things that they probably would not normally do” (124), is not granted such a sociologically rich backstory.Like Michael, Bree too would have been subject to the hyperpolicing of Black people in Los Angeles during the 1990s and 2000s. Had she been visibly gender nonconforming, she might have been suspected of performing illegal sex work, or in fact doing survival sex work, all of which would have increased her encounters with criminal punishment systems. She may have had to rely on informal networks of trans women for economic security, clothing, and medical care. Statistically, she is even more likely to have experienced sexual trauma than Michael or her other male companions within the prison system. Readers do not receive this information directly from Allen. Instead, we get transcriptions of court proceedings that say that Bree “allegedly shot at a man who was at a bus stop with her. The man was laughing and mocking her because he believed she was a man” (54). The state prosecutor introduced this information, even though Bree was never charged for that particular act, to establish a “pattern of acts of violence perpetrated by Bree” (54). Yet it is in this highly mediated moment that readers get a sense of what Bree's everyday experience of life might have been: a minefield of threats ranging from mockery to assault. Bree had been incarcerated in the first place for “assault with a firearm and for threatening injury with the potential to result in death” (55). A trans reader, especially one familiar with the cases of CeCe McDonald or Ky Peterson, might read these narratives of Bree's actions and suspect self-defense. But we have no hint, not even authorial speculation, of motive. What we have instead are cold administrative sentences.It makes sense that Allen would be reluctant to dive into the wreck of empathizing with her cherished cousin's killer. And I also do not believe that marginalized people are somehow exempt from doing harm to others. We simply do not know if Bree believed herself to be acting in self-defense. But within a book that is so determined to make readers grapple with the complex contingencies of Michael's actions, it is hard to miss the context vacuum that surrounds Bree. Sometimes, the delicacy with which Allen handles Bree's portrayal seems to give way to hesitation, as if the social world of a trans woman of color is too alien to be encountered. In Cuz, readers lose the chance to understand that transmisogynoir, too, is a symptom of white America's ravenous desire to criminalize and incarcerate racial and gender difference.Perhaps such a contextualized accounting is too much to demand of a grieving family member. But it's not too much to demand of all of us, as readers and thinkers within trans studies. In our field, we are already beginning to transform our understanding of survival and violence into one that is always contextualized within structural systems: indeed, TSQ has republished CeCe McDonald's prison letters, making them available to a broader audience of teachers and students across multiple continents. But as the tides continue to shift in trans visibility, and nontrans writers like Allen begin to learn the rules to avoid standard transphobic cliches, we have to be more attuned as critics to not just what destructive content is present but what constructive context is absent. As my students pointed out in their reading of Mock, new portrayals of trans people, especially Black trans women, are entering the literary conversation. Some of these are revolutionary in their emotional complexity, while others may appear novel only because they do not rehearse tired scripts. But we can still demand better than mere tolerance. We need to start grappling with how we permit trans people to be written, especially when they are both those to whom structural violence is done, and those from which intimate violence can erupt.

Review: <i>Transforming Prejudice: Identity, Fear, and Transgender Rights</i>, by Melissa R. Michaelson and Brian F. Harrison

Perioperative considerations for transgender women undergoing routine surgery: a narrative review

Transgender (trans) women experience gender-based violence (GBV) throughout their lives, which impedes their access to services and contributes to poor health outcomes and quality of life. To inform policies and health programs, trans women worked with the United States Agency for International Development (USAID)- and President's Emergency Plan for AIDS Relief (PEPFAR)-supported LINKAGES project, the United Nations Development Programme, The University of the West Indies, and local organizations to document experiences of GBV and transphobia in healthcare, education, and police encounters. Trans women conducted 74 structured interviews with other trans women in El Salvador, Trinidad and Tobago, Barbados, and Haiti in 2016. We conducted qualitative applied thematic analysis to understand the nature and consequences of GBV and transphobia and descriptive quantitative analysis to identify the proportion who experienced GBV in each context. A high proportion experienced GBV in education (85.1%), healthcare (82.9%), from police (80.0%), and other state institutions (66.1%). Emotional abuse was the most common in all contexts and included gossiping, insults, and refusal to use their chosen name. Participants also experienced economic, physical, and sexual violence, and other human rights violations based on their gender identity and expression. At school, participants were physically threatened and assaulted, harassed in bathrooms, and denied education. In healthcare, participants were given lower priority and received substandard care. Healthcare workers and police blamed participants for their health and legal problems, and denied them services. From police, participants also experienced physical and sexual assault, theft, extortion for sex or money, and arbitrary arrest and detention. Participants had difficulty obtaining identification documents that matched their gender identity, sometimes being forced to alter their appearance or being denied an identification card. Service providers not only failed to meet the specific needs of trans women but also discriminated against them when they sought services, exacerbating their economic, health, and social vulnerability. Although international and regional resolutions call for the legal protection of transgender people, states do not meet these obligations. To respect, promote, and fulfill trans women's human rights, governments should enact and enforce antidiscrimination and gender-affirming laws and policies. Governments should also sensitize providers to deliver gender-affirming services.

Implementation Strategies for Creating Inclusive, All-Women HIV Care Environments: Perspectives From Trans and Cis Women.

Alarm bells had been ringing well before Canadian investigators published a small study in January that suggested that many transgender patients may be missing out on preventive cancer care, even in relatively welcoming environments. Nevertheless, the analysis, which assessed screening rates for 3 common cancers among 120 transgender patients, was among the first to try to quantify the problem. Researchers from St. Michael's Hospital in Toronto, Ontario, Canada, discovered that, within the hospital system, eligible transgender patients were approximately 70% less likely than cis-gender patients (meaning those whose gender identity matches the sex they were assigned at birth) to be screened for breast cancer, 60% less likely to be screened for cervical cancer, and 50% less likely to be screened for colorectal cancers.1 Among the contributing factors, some physicians neglected to recommend screening for patients whose gender had changed. In other instances, patients opted out of screening due to feelings of gender dissonance, such as discomfort with the Papanicolaou (Pap) test among some transgender men. A 2015 editorial in Lancet Oncology foreshadowed the study's results by raising concerns that cancer screening programs were regularly failing to identify eligible transgender individuals who “remain susceptible to cancers of reproductive organs that are no longer in alignment with their gender.”2 For example, a transgender woman still may be at risk of prostate cancer, whereas a transgender man still may be at risk of breast, ovarian, and cervical cancer. However, due to discrimination, patient unease, a lack of provider awareness, and other obstacles such as misgendering (when a transgender person is referred to in a way that does not reflect the gender with which they identify), those cancer screening messages often are never sent, received, or acted upon, with potentially disastrous results. Indeed, the 2015 US Transgender Survey of 28,000 individuals conducted by the National Center for Transgender Equality suggested that transgender individuals are less likely to receive preventive cancer care due to fear of harassment and discrimination. Approximately one-third of respondents who had seen a physician within the previous year reported at least 1 negative interaction that they perceived as being related to their gender identity. Advocates in the transgender community say the findings, although distressing, are not surprising. According to the deputy director of the National LGBT Cancer Network, Scout, PhD, MA (he uses only one name), a few key factors appear to be driving lower cancer screening rates. “One, providers are not even getting the reminders to treat the body parts that you have,” he says. Two, he continues, patients often are fearful of seeing a new clinician. “Whenever you have to get naked and disclose to a brand new provider, there's a huge amount of concern and resistance to it,” says Dr. Scout, who identifies as a trans man. “I, myself, had to go to a dermatologist but I was putting it off a lot,” he says. “And it wasn't until my partner was like, ‘No, you have to go and get this thing on your back checked out.’ It did end up being skin cancer.” Some providers have told him that they treat everybody the same. “And you can see from these examples how that actually fails for trans people,” Dr. Scout says. “If you're not putting out a flag of welcoming to trans people, then they're going to presume that you could be very discriminatory and bigoted, as much of the health care system has been in the past.” In addition, he says, “If you treat a trans guy the same as a cis guy, then you're not going to give him the screenings that his body needs.” Madeline Deutsch, MD, MPH, an associate professor of clinical family and community medicine at the University of California at San Francisco and medical director for the Transgender Care program at the University of California at San Francisco Medical Center, says transgender patients regularly report discomfort with pelvic examinations for cervical cancer screening and with colonoscopies. Similarly, breast cancer screening can be fraught for both transgender men and women, Dr. Deutsch says. “Transgender men can feel very uncomfortable because breast cancer screening is something that women undergo, and the whole process is very feminized,” she says. Transgender women, meanwhile, may be uncomfortable due to the potential for confusion about their gender presentation when they check in for a mammogram. Charlie Manzano, a transgender man and melanoma patient from Martinez, California, says breast clinics often are folded into women's health clinics and include highly gendered pamphlets, documents, and paperwork. Likewise, electronic health record systems can be less than accommodating. “As soon as I changed my gender to male at my hospital, I was told by a case worker that my gynecologist would be removed from my health care providers' list and I would then be assigned automatically—the system makes it so that I now get a proctologist and a men's health doctor,” Mr. Manzano says. He had to talk to a case manager to ensure that he could retain his gynecologist. “If you treat a trans guy the same as a cis guy, then you're not going to give him the screenings that his body needs.” — Scout, PhD, MA Ruddick, who identifies as nonbinary (a phrase used by some whose gender identity falls outside of the general categories of man or woman) and lives in Medford, Oregon, was diagnosed with ovarian cancer at the age of 18 years. Ruddick uses they/them pronouns and says physicians and other providers routinely stumble over them. “I have doctors that are very, very well-intentioned and they really want to be open to trans folks, but the problem is they just really don't know how,” Ruddick says. “They can accept me as a trans man and call me ‘he,’ but there's just a language barrier with gender-neutral stuff.” Although Ruddick has high praise for their gynecological oncologist, the medical office listed them as “male” in charts because it was the only alternative to “female.” Someone else in the office thought it was a mistake and changed it back. They have been listed as “male” by some physicians' offices, “female” by some, and “other” by some. How should physicians help to ensure that their transgender patients receive cancer screening? “First and foremost, developing a relationship with your patient that involves trust and that allows the patient to feel comfortable exposing very sensitive parts of their body to you is very important,” Dr. Deutsch says. For example, if a patient is overdue for a Pap test, physicians routinely tack it on to other visits. “But the problem is, often that means those things are rushed,” Dr. Deutsch says. To help put the patient at ease, especially if they are overdue because of past discomfort or discrimination, providers always can perform the test later. “Do it next time or do it in 6 months when you've developed a rapport with the patient,” she says. During the process itself, other techniques can aid patients' comfort levels. As part of research at Fenway Health, an LGBTQ health care, research, and advocacy organization in Boston, Dr. Deutsch helped to develop several approaches for relaxing the pelvic floor and engaging the patient. They include talking about the purpose and process of the examination, asking patients if they would like to see and insert the device themselves, and allowing them to choose different positions. The same general principles apply to anal Pap tests, she says, although the procedure is much less invasive. “So there's no rush, and there's a safe word that I give them, which is ‘Stop,’” she says. If a patient expresses discomfort at any point, she will immediately remove all of the equipment. Dr. Deutsch says none of her patients has yet used the safe word. “But I think setting up that dynamic puts the person in charge so that they have the agency to end the exam when they'd like to.” In other words, empowering transgender patients can help to ensure the successful completion of preventive care. Mr. Manzano and Ruddick say physicians can further help their transgender patients by asking more questions. “A lot of doctors are scared to ask questions, which is a huge problem,” Mr. Manzano says. Instead of shying away from saying certain words, he says, “asking what language we prefer is better than not saying it at all.” Being an ally to the underserved transgender community does not require undue effort, Dr. Scout says, yet it can make a huge difference given the cancer screening gaps, continued discrimination, and concern over potential government rollbacks to existing protections. “It's about time for it to end, and it doesn't take that much work to end it,” he says. “You don't have to be the expert; you just have to be someone who's willing to learn.”

Since 2007, the Philippine Integrated HIV Behavioral and Serological Surveillance (IHBSS) still lump the transgender (TG) women population with men having sex with men (MSM), which is a socio-political issue...

ObjectivesHIV prevalence and incidence are higher among key populations including Men who have Sex with Men (MSM) and transgender women in low and middle income countries, when compared to the general population. Despite World Health Organisation guidelines on the provision of services to key populations recommending an evidence-based, culturally relevant and rights-based approach, uptake of HIV services in many resource-limited and rights-constrained settings remains low. Médecins Sans Frontières (MSF) has been offering health services for MSM and transgender women in Beira, Mozambique since 2014 using a peer-educator driven model, but uptake of services has not been as high as expected. This qualitative study aimed to learn more about these key populations in Beira, their experiences of accessing MSM- and transgender-friendly services and their use of face-to-face and virtual networks, including social media, for engagement with health care.MethodsIn-depth interviews were carried out with MSM and transgender women who were 1) enrolled in, 2) disengaged from or 3) never engaged in MSF’s programme. Purposive and snowball sampling were used to recruit the different groups of interviewees. Interviews were conducted in Portuguese, transcribed and translated into English before being coded and manually analysed using a thematic network framework.ResultsNine transgender women and 18 cisgender MSM participated in the study. Interviewees ranged in age from 19 to 47 years, with a median age of 29. Three main themes emerged from the data: perceptions of stigma and discrimination, experiences of the peer-educator driven model and the use of face-to-face and virtual platforms for communication and engagement, including social media. Interviewees reported experiencing stigma and discrimination because of their gender or sexual identity. HIV-related stigma and health-care setting discrimination, including gossip and breach of confidentiality, were also reported. Although the presence of the peer-educators and their outreach activities were appreciated, they had limited visibility and an over-focus on health and HIV. The face-to-face networks of MSM and transgender women were small and fragmented. Virtual networks such as Facebook were mainly used for flirting, dating and informal communication. Most interviewees were at ease using social media and would consider it as a means of engaging with health messaging.ConclusionsMSM and transgender women have challenges in accessing health services due to being stigmatised because of their gender identity and their sexual behaviour, and often experience stigma at home, in health-care facilities and in their communities. Peer-driven models of engagement were appreciated but have limitations. There is an untapped potential for further expansion and engagement with face-to-face and virtual platforms to reach MSM and transgender women in settings with a high HIV burden, and to provide them with essential information about HIV and their health.

Social media platforms offer the opportunity to develop online social networks. Use of these platforms has been particularly attractive to younger sexual and gender minority individuals as well as those living with HIV. This cross-sectional study examined the perceived level of social support and associations with social media use among youth and young adult cisgender men who have sex with men (MSM) and transgender (trans) women living with HIV and examined these associations by gender identity. The study drew from baseline data collected from 612 cisgender MSM and 162 trans women enrolling in one of 10 demonstration sites that were part of a Health Resources and Services Administration Special Projects of National Significance initiative. The individual projects were designed to evaluate the potential for social media/mobile technology-based interventions to improve retention in care and HIV health outcomes. The data used in this study came from baseline surveys completed when participants enrolled in a site between October 2016 and May 2018. Results demonstrated that a significantly greater proportion of MSM than trans women participants reported the use of social media platforms (e.g., Facebook: MSM = 86%, trans women = 62%; Instagram: MSM = 65%, trans women = 35%). Furthermore, increased social media use improved perceptions of social support only among MSM participants (direct adjusted OR = 1.49) and not trans women participants (gender identity interaction term adjusted OR = 0.64). These results revealed that MSM participants perceived greater social benefit from the use of social media platforms than trans women, which could be a result of generalized online transphobia experienced by trans women. More nuanced data on various social media platforms, that is, anonymous versus profile-based, and group differences, are needed to better understand how social media platforms can be best utilized to optimize health care outcomes among sexual and gender minority youth and young adults living with HIV.

This study examines the link between self-rated health and two aspects of gender: an individual’s gender identity, and whether strangers classify that person’s voice as male or female. In a phone-based general health survey, interviewers classified the sex of transgender women ( n = 722) and transgender men ( n = 446) based on assumptions they made after hearing respondents’ voices. The flawed design of the original survey produced inconsistent sex classification among transgender men and transgender women respondents; this study repurposes these discrepancies to look more closely at the implications of voice-based gender classification for the health of transgender men and women. Average marginal effects from logistic regression models show transgender men who are classified as women based on their voices are more likely to report poor self-rated health compared to transgender men who are classified as men. Conversely, transgender women who are classified as men are less likely to report poor self-rated health than are transgender women who are classified as women. Additionally, Black transgender men are more likely than any other group to be classified inconsistently with their gender identity, suggesting a link between race/ethnicity and gender perception.

In my article in Radical History Review 138, “The Very Quintessence of Persecution: Queer Anti-Fascism in 1970s Western Europe,” I argued that “transgender and gender-nonconforming people and cisgender lesbians” led the way within 1970s European LGBT+ movements in connecting queer liberation, anti-fascism, and anticapitalism, and developing what I argue was a uniquely queer anti-fascism.1 I would like to clarify after publication that this was also the case for West Germany’s Homosexuelle Aktion Westberlin (HAW). On page 69 of my article, I referred to HAW queer anti-fascists as “trans and cis lesbian feminists,” “lesbians and trans people,” and “trans and cis feminists.”2 I intended to include gender-nonconforming activists in these formulations (within a broad notion of trans), but I have since received feedback that my formulation was confusing and led some to believe I was calling the Homosexuelle Aktion Westberlin’s Feminist Group (Femnistengruppe) a transgender women’s group or a cisgender lesbian’s group, neither of which would be accurate.The Feminist Group is an example of how gender-nonconforming queers led the way, along with transgender women and cisgender lesbians, in developing queer anti-fascism within HAW and in other European queer movements. The Feminist Group was founded as an organizing and social space for gender-nonconforming femmes who embraced revolutionary Marxism and reclaimed the German term Tunten for themselves. Tunten is historically a German slur, similar to English words such as sissy, used against effeminate queers. It connotes that the person being verbally attacked is specifically an effeminate man and is therefore usually used against gay men and as a transphobic slur against trans women and non-binary people. Members of the Feminist Group wore femme clothes and took femme names but most did not identify as trans women at this time. That does not say or mean anything about how they may have identified later. It is of course possible that some may have later come out or identified as trans women, trans*, non-binary, genderfluid, or another gender identity. This question is beyond the scope of my research here, but the Feminist Group itself was not founded as a trans women’s group. The Feminist Group was also not a cis lesbian group. Cis lesbians mostly, but not exclusively, organized within the HAW Women’s Group (Frauengruppe).3The members of the Feminist Group saw their own femme gender presentation as a challenge to bourgeois morality and therefore capitalism itself because they argued that fixed gender roles were a product, at least in part, of heteropatriarchal capitalism. They rejected gender roles and expectations all together in a way that they understood to be revolutionary and confrontational.4 They were not the only group where queer anti-fascists organized within HAW. Cis lesbian anti-fascists organized within the Women’s Group before queer socialists and intersectional activists were pushed out, and HAW’s explicitly revolutionary communist political position meant that queer anti-fascism was a part of discussions at regular plenary and group meetings at least before the cis male majority moved the organization away from political radicalness in the mid-1970s.Defining the gender and sexual identities of historical queer groups is never simple. Transgender studies problematizes rigid definitions of gender and distinctions between transsexuality, gender nonconformity, and gender variance today and in the past.5 I understand the members of the Feminist Group to be gender nonconforming, and in this paragraph on page 69 of my article, I attempted to include them under the umbrella of “trans” in line with what Susan Stryker has called “transgender phenomena,” which she has used to get at diverse gender practices including “transsexuality and crossdressing, some aspects of intersexuality and homosexuality, cross-cultural and historical investigations of human gender diversity, [and] myriad specific subcultural expressions of ‘gender atypictality.’”6 However, I regret my formulation here because it caused confusion and was out of step with the relatively clearer formulation I had used in my introduction and elsewhere (“transgender and gender non-conforming people and cisgender lesbians”7) and which I further defined in endnote 4 where I clarified that “transgender, lesbian, and gender-nonconforming are not exclusive terms. The reference highlights the contributions of overlapping identities marginalized within the LGBT+ movement.”8

We sought to characterize the cardiovascular disease (CVD) risk factor profile of transgender women with HIV identified through a U.S. healthcare database. Compared with age- and race-matched cisgender men with HIV, transgender women with HIV had an increased prevalence of anemia and lower absolute hemoglobin levels. HIV control was sub-optimal and prevalence of HCV co-infection was high among transgender women. Further study of non-traditional CVD risk factors/immune activation among transgender women with HIV is warranted.