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Transgender Community Health in California, and displaying the transgender flag colors

The California Department of Public Health (CDPH) values the health of all Californians. There are an estimated 220,000 Trans/Transgender/Gender Non-Binary adults in California.1

Everyone has a gender, a gender identity, and a gender expression. No two individuals experience their gender, gender identity, or gender expression the same way.

Trans/Transgender/Gender Non-Binary

​Inclusive umbrella terms for individuals whose gender identity or expression (masculine, feminine, other) is different from their sex (male, female) at birth, assigned male at birth (AMAB) or assigned female at birth (AFAB).

Gender Identity

Refers to one’s internal understanding of one’s own gender, or the gender with which an individual identifies. 

Gender Expression

A term used to describe individuals’ outward presentation of their gender.

Gender identity and sexual orientation are different facets of identity. Everyone has a gender identity and a sexual orientation, but an individual’s gender does not determine an individual’s sexual orientation. Trans/Transgender/Gender Non-Binary individuals experience their sexual orientation in multiple expressions.


Transgender individuals, particularly transgender women of color, have higher rates of HIV infection. Rates are especially high among African American and Latinx/e transgender women.

Line graph displaying rates of New HIV Diagnoses Among Transgender Individuals in California per 100,000 from 2010 to 2018

In 2018, 86 percent of transgender individuals who received an HIV diagnosis were transgender women. Although rates among transgender individuals are not available, it is estimated that both transgender  women  and  men are disproportionately  affected  by HIV. According to an analysis conducted by CDC scientists, HIV prevalence among transgender individuals in the US is estimated to be 9.2 percent overall, and higher among transgender women (14.1 percent) than transgender men (3.2 percent). 

The higher HIV prevalence among transgender women compared to other high risk groups may be due to many environmental and social contexts including multiple stigmas (transphobia, racism, sexism, HIV, and sex work); substance use; recurrent incarceration and victimization in the criminal justice system; homelessness and marginal housing; relationship and other forms of violence; institutional inattention, indifference, and mistreatment; mental health issues; lack of economic opportunities; and other issues.2

Transwomen are disproportionately affected by the HIV epidemic and are in immediate need of comprehensive HIV preventative services. A recent survey published by the CDC estimates 1 in 4 transwomen are living with HIV. These health disparities are compounded by the intersexuality of racial/ethnic identity. The full CDC report: HIV Infection, Risk, Prevention, and Testing Behaviors Among Transgender Women - National HIV Behavioral Surveillance - 7 U.S. Cities, 2019-2020 (PDF).

HIV Surveillance Reports

The Trans Reality infographic listed below further highlights barriers Transgender individuals experience.

Trans Reality               Trans Reality Infographic (PDF)

STI Prevention: HIV PrEP/PEP & doxy-PEP

What is HIV PrEP?

Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention strategy in which an individual takes a medication to stay HIV negative. PrEP is available as a pill and as a long-acting injection. There are two pill formulations: 1) TDF/FTC (brand name Truvada) and 2) TAF/FTC (brand name Descovy). The long-acting injection (a shot) is called cabotegravir (brand name Apretude) and is administered by a medical provider in-clinic approximately every 2 months. PrEP is available by prescription from a health provider who can review these options with you. PrEP is highly effective when taken as prescribed in addition to being very safe and well-tolerated. Most private health insurance, as well as Medi-Cal and Medicare, covers PrEP. If you need help with paying for PrEP or finding a provider, there are assistance programs that can help. The California PrEP Assistance Program (PrEP-AP)​ helps Californians access and pay for PrEP services​.

HIV PrEP works for women, men, people of transgender experience, people of all sexual orientations and gender identities, youth, and people who inject drugs​.

You can use PrEP alone or in combination with other HIV prevention tools like condoms and U=U to have the sex you want and reduce your chances of getting HIV​!

PrEP for Trans Women | PleasePrEPMe

Results from two California transgender focused HIV PrEP studies to increase HIV PrEP uptake, adherence, retention, and access for transgender communities from 2016-2020 can be found on the Journal of Acquired Immune Deficiency Syndrome's webpage:

What is HIV PEP?

Post-exposure prophylaxis (PEP) is a biomedical HIV prevention method that commonly consists of a 28-day course of antiretroviral medications taken after an HIV exposure. HIV PEP is most effective when taken as soon as possible after an HIV exposure, and adherence is crucial to the drug therapy’s success. When taken as prescribed, PEP can reduce HIV transmission by 80%. Despite the timing of taking PEP being crucial to its success, many barriers to accessing PEP prevent people for receiving the drug therapy in a timely manner. The California PrEP Assistance Program (PrEP-AP) has Immediate Access assistance that can help Californians access and pay for PEP. Another option is to already have a prescription available, “PEP in Pocket or PIP.” For someone who could have an HIV exposure but cannot routinely be on PrEP, this is a reasonable back-up plan​.

What is doxy-PEP?

Doxycycline post-exposure prophylaxis (doxy-PEP) is a bio-chemical way to prevent bacterial sexually transmitted infections like chlamydia (CT), gonorrhea (GC), and syphilis.3 Sexually active persons take a single, 200 mg dose of the antibiotic, doxycycline, after having condomless oral, anal, or vaginal sex to significantly reduce catching CT, GC, and/or syphilis. It is best taken within 24 hours (but can be taken up to 72 hours). No more than once dose per day (24 hours) should be taken. It can be used in combination with HIV PrEP, HIV PEP, and/or gender-affirming hormonal therapy​.

More Information on STI Prevention​

Significant Dates

International Transgender Day of Visibility

Observed each year on March 31, this day is dedicated to celebrating transgender individuals and raising awareness of discrimination faced by transgender individuals worldwide, as well as a celebration of their contributions to society.

National Transgender HIV Testing Day

Observed each year on April 18, this day is an opportunity to recognize the importance of routine HIV testing and status awareness, as well as HIV prevention and patient-centered care for transgender and gender non-binary individuals.

International Non-Binary People’​s Day

International Non-Binary People's Day is observed each year on 14 July and is aimed at raising awareness and organizing around the issues faced by non-binary people around the world. The day was first celebrated in 2012, started by Katje van Loon. The date was chosen for being precisely midway between International Men's Day and International Women's Day.

California Transgender History Month​

California's State Assembly voted in favor of House Resolution 57 establishing that August will be recognized as Transgender History Month starting in 2024 — and making it the first state to honor trans history with such a designation​.​

Transgender Awareness Month

The month of November celebrates the transgender and gender nonconforming communities and raises awareness for the community through education and advocacy activities.

Transgender Awareness Week

Observed November 13 – 19 each year, people and organizations around the country help raise the visibility of transgender individuals and address issues members of the community face.

Transgender Day of Remembrance

Transgender Day of Remembrance is an annual international observance on November 20 that honors the memory of the transgender individuals whose lives were lost in acts of anti-transgender violence and transphobia that year.

National LGBTQ Health Awareness Week

The Annual LGBTQ Health Awareness Week, a nationwide event that promotes the unique health and wellness needs of the lesbian, gay, bisexual, trans, and queer/questioning (LGBTQ) community.

International Day Against Homophobia, Transphobia, and Biphobia

The International Day Against Homophobia, Transphobia, and Biphobia is observed each year on May 17th. It was created in 2004 to draw attention to the violence and discrimination experienced by lesbian, gay, bisexual, trans, intersex people, and all other people with diverse sexual orientations, gender identities/expressions, and sex characteristics.

International Pronouns Day

Observed the 3rd Wednesday of October, International Pronouns Day seeks to make respecting, sharing, and educating about personal pronouns commonplace. Referring to people by the pronouns they determine for themselves is basic to human dignity.

International Day to End Violence Against Sex Workers

The International Day to End Violence Against Sex Workers is held annually on December 17th by sex workers, their advocates, friends, families, and allies. The day calls attention to hate crimes committed against sex workers worldwide, as well as the need to remove the social stigma and discrimination that have contributed to violence against sex workers.


Centers for Disease Control and Prevention Resources

​New Reports: HIV Prevention and Care Among Transgender Women

Other Reports

Other Resources

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