South Georgia native Octavia Lewis works with Positively Trans (T+), a program within the Transgender Law Center designed to fight stigma and discrimination.
Like much of the U.S., Lewis said, when it comes to the transgender community, there are the “haves and the have-nots,” who are mostly Black and brown. Due to rejection from family, job discrimination, and the high cost of gender-affirming care, some, like herself, turned to sex work, leading to an HIV+ diagnosis.
It was that personal experience that led to a commitment to advocate for others on the margin at a time when access to care and resources are being eliminated.
“We did a research finding on trans individuals living with HIV,” Lewis told Capital B Atlanta. “We talked about the comorbidities that we have. It talks about those of us who were marginally housed or houseless. It talked about our educational level. So it really uncovered a lot about our community. That information used to reside on the whitehouse.gov [site], and the CDC did utilize it for a while up [until] this current administration.”
From racism and unfair laws to changes in Medicaid requirements and the removal of the enhanced premium tax credits for the Affordable Care Act marketplace, Black transgender HIV+ folks in Georgia are under attack.
Advocates say the disparities facing trans-identifying Americans are largely driven by compounding barriers to healthcare, housing, and discrimination that leave transgender Georgians with far fewer resources for accessing HIV prevention and treatment.
Quinton Reynolds, the founder and executive director of Game Changing Men, an Atlanta-based nonprofit that supports Black transmasculine folks, and an advisory board member of Positively Trans (T+), said the battle for care is also being waged in Georgia’s prisons, which has the nation’s highest rates of HIV.
After his own release from prison, Reynolds founded GCM to advocate for the resources he and other trans men were lacking both behind bars and once they resumed their lives on the outside. He said because of the current administration, things have gotten worse, rather than better.
“People don’t have access to things that we had access to or that we had to advocate for,” Reynolds said, referring to gender-affirming undergarments and toiletries. “The overall environment is more hostile, with less communication. It’s definitely different.
“And unfortunately, there’s a lot of people right now, especially trans men, TGNC [transgender non-conforming] folks, who are incarcerated. They are kind of in the middle of hell right now, and they really have no control over anything because when you’re incarcerated, they control everything. And so it is definitely a dark time for folks that are incarcerated.”
The Transgender Law Center, which operates in Atlanta and across the nation, is the largest trans-led nonprofit in the United States.
Chris Chavers, the senior national policy and programs organizer at TLC, told Capital B Atlanta the organization’s legal strategy centers on its Trans Agenda for Liberation, which he called the organization’s “North Star.” The community-led guide is designed to showcase how trans people hold the “knowledge, power, and joy to create a future” for themselves.
One 2025 TLC case involved three transgender individuals incarcerated in federal custody.
In Kingdom v. Trump, the plaintiffs filed a class action lawsuit against the Trump administration and the Federal Bureau of Prisons challenging an executive order and policies from the Bureau of Prisons prohibiting incarcerated trans inmates from accessing gender-affirming care.
The case, filed on behalf of roughly 2,000 transgender people in federal Bureau of Prisons custody, resulted in a preliminary injunction from Senior Judge Royce Lamberth. The judge has since had to renew the injunction multiple times as the Trump administration has continued to attempt to restrict care through new policy guidance.
“People of all backgrounds, races, and genders know that we all deserve the right to live as our most authentic selves,” Shawn Meerkamper, managing attorney at Transgender Law Center, said in a statement. “This executive order endangers lives and is an attack on the rights and dignity of transgender people everywhere. Denying access to the life-saving health care prescribed by BOP doctors is yet another cruel attempt at further harming and discriminating against transgender people.”
The litigation is ongoing.
Healthcare access
Transgender-identifying people make up just 0.6% of Georgia’s population, yet accounted for 2% of all new HIV diagnoses, according to reporting from the state Department of Public Health.
Black and Latino transgender individuals accounted for 88% of all new HIV diagnoses within the trans community in 2024, according to an online HIV-tracking platform based at Emory University.
Reynolds said that when it comes to transgender men living in Atlanta, resources have continued to tighten. Limited access to affordable housing and HIV prevention information, and the struggle to keep health insurance, leave many in dire conditions.
“We’re seeing a lot of folks don’t have insurance now,” Reynolds said. “But I think insurance and housing are some of those key things, and the rollback of services. A few years ago, people were able to have money for HIV testing for free. Now, some people aren’t able to offer free HIV testing.”
One way The Trans Law Center’s Positively Trans (T+) is helping to address healthcare support is through a change in the designation of “MSM,” an acronym for “Men Who Have Sex with Men,” a term widely used by the Centers for Disease Control and Prevention dating back to the 1990s.
“They categorized trans people when they were doing data, as far as the keeping numbers of HIV prevalence and things,” Lewis said. “We were always lumped in with MSM. We never had a demographic of our own. … Now, we are captured as trans individuals living with HIV.”
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