Why PrEP Matters For Trans People Like Me

Taking that first pill was so much more than just swallowing medication – it was a ceremonial moment for my wellbeing.
Fox Fisher

I think it’s fair to say I had a pretty iconic introduction to PrEP (pre-exposure prophylaxis). It was October 2015, and I unexpectedly found myself sat at a meeting of HIV activists with ACT UP London. Having reformed in 2014, they were looking for the next hot advancement in HIV treatment. Sat around me were about ten gay men, most of whom I had met for the first time that night, and many of them I still call dear friends today. I was in the middle of a minor epiphany about how strange it felt to be in the minority in the room as, at that point, identifying a straight cis woman.

It wasn’t just PrEP I was learning about that night – that ACT UP meeting triggered a tidal wave of self-realisation that helped me come out as queer, trans and non-binary over the two or so years to follow. Just sitting in a room full of politically-charged, queer activists opened up a gateway to a whole community that, at twenty five, had eluded me for years.

Through ACT UP and PrEP I met my closest friends, found my history. I started to understand how integral healthcare was to my community, and by extension to me, how unfairly the balance was tipped in terms of our access to medication we sorely needed.

Whilst I campaigned for PrEP for months and years to come and literally put my body on the line for the right to access a pill that could start to heal the decades of trauma that our community lived with, it took me coming out as trans to consider that it might be something I could take myself.

I’ve always had a ’robust’ sex life, but having been socialised and sexualised as a woman, on reflection it wasn’t always the healthiest. I was easily pressured into having condomless sex by men I slept with, and even though sex as a queer person felt more authentic, it didn’t necessarily feel safer.

PrEP struck a chord with me, because it represented not just a practical tool to help me look after a very important aspect of my sexual health, but an opportunity to take agency over it as well. When I started taking hormones after my top surgery, I started having sex with gay men for the first time – and with that wonderful world now so open to me, I had to think more seriously about my sexual health.

ACT UP had drilled statistics into my head that I couldn’t comfortably ignore, and with the fantastic CliniQ at my fingertips, I thought there was no harm in asking if I could take PrEP myself.

My two main questions about PrEP were would it affect my hormone treatment, and how could I get onto the current NHS England PrEP impact trial? After speaking to a consultant, I found out PrEP doesn’t interact with my hormones and I was enrolled onto the trial that very day.

I took my first pill in front of a cheering crowd later that evening at a bar just a few streets away in Soho, at an event aptly named Let’s Talk About Gay Sex and Drugs. It felt almost ceremonial. Taking that one pill was so much more than just swallowing medication; it was a ceremony that represented a shift in my thinking about body autonomy, agency over my safety, and responsibility for my own wellbeing.

Trans people take note – you can access PrEP right now! Through the England-wide PrEP trial, you can enrol in clinics across the country and is a very quick process. Trans people of whatever gender are considered at high risk of contracting HIV, especially if, like me, you are on the receiving end of penetrative anal or vaginal sex.

Having the kind of sex I want to have in my authentic identity shouldn’t and doesn’t need to come with any conditional fear or risk. PrEP is just one tool that exists to open up stress-free sex for all of us. It’s not something I’ll take forever, and it’s not a solution to all of the risks that come with different sexual behaviours, but it’s there for you to try without fear, risk, or judgement.

It took me years to understand that I deserve to feel unquestioningly safe with the sex I choose to have, and PrEP is a huge boost in helping me live that for myself.

Dani stars in a new short film documenting trans people taking PrEP. The film is a collaboration between iwantPrEPnow, Prepster, My Genderation and Terrence Higgins Trust with funding from Elton John AIDS Foundation, and you can watch it here