A bill signed into law in 2021 now requires private insurance companies to cover gender-affirming care. When R., a transgender man in Fort Collins who asked to be identified by only the first initial of his name for safety and privacy reasons, realized he was transgender and wanted to begin the process of seeking hormone replacement therapy, he knew his options were limited due to his bare-bones insurance, which was not yet required to cover any of his transition process. People shouldn’t be judged for wanting to pursue hormone therapy.” “This is important, and there should be funding for it and access to it. “I wish there was education for everybody so that it was more acceptable and seen as a health issue,” Wilhelm said.
Without friends, Wilhelm said they would feel lost as a nonbinary person in a sea of cisgender people. Many of Wilhelm’s friends are in similar boats - exploring their gender identity after years of not feeling complete - which is how Wilhelm has received education and resources about their options, though they have not begun any process of medically transitioning. “There was no education, so we didn’t know that people could be trans, that people could be nonbinary and we had no language to question our gender.” “I didn’t even know that people were gay until I was like 14, and it was like a crazy revelation,” Wilhelm said. Wulf Wilhelm, a nonbinary person in Steamboat Springs who uses they/them pronouns, did not understand they could begin exploring their gender until they were 25 years old due to the lack of education around gender and sexuality in the rural city. Other transgender residents in rural parts of Colorado shared similar stories, explaining a feeling of not belonging in their assigned gender at birth, and also not understanding other options existed for them. As a Mexican man in a predominately white city, Saenz said his race and gender often intersected and created deeper issues with those around him. Those around him called him slurs while he walked around town, and other doctors refused to respect his new name and pronouns, leading him to seek community connection in larger cities further away to feel understood. While Saenz said the decision to take hormones was immensely helpful for his mental health, he faced even more discrimination than he did when he presented as a woman. Soon after the pride event, Saenz began hormone replacement therapy, the process for transgender people to take necessary hormones to help affirm their gender identity. “I finally had the information that the rest of the world does.” A revelation of understanding “I lived my life not feeling normal, and then finally, it was like ‘this is where I belong, this is who I am,’” Saenz said. Finally, Saenz felt something click for him. The title fit him while he presented as a woman, but he still felt something was missing.Īt a Delta LGBTQ+ pride event, Saenz spoke with a doctor who asked if he knew anyone interested in transitioning. Their resolution, I argue, has occurred in a historically contingent process determined by the political economy of the US HIV prevention arena and the differential structural location of its social worlds.DENVER - As tears trickled down his face, Xavi Saenz asked himself why it took 43 years for him to live authentically as a transgender man.īorn and raised in the small, conservative town of Delta, Colorado, Saenz identified as a lesbian woman for most of his life.
These core contentions reveal less the steady advance of normal science than an arena of actors ensconced in boundary work and jurisdictional struggles over how to engineer behavior change and reduce the scale of the HIV epidemic.
Toward this end, I focus on two fundamental points of contention that lie at the heart of the prevention enterprise and put its social organization in high relief: (1) conceptions of health and lifestyle practices and (2) attributions of expertise. I approach this analysis through the lens of the social worlds framework, focusing on the institutional arena in which HIV behavioral interventions are devised and executed. In this article, I draw from an ongoing ethnographic study of HIV prevention for gay, bisexual, and 'men who have sex with men' to develop an institutional analysis of HIV behavioral intervention science and praxis.