Community-Building as Resilience-Building: The Power of Support Groups for HIV-Positive Trans Mental Health Services

June 5, 2023

Ms. Billie CooperMs. Billie Cooper knows exactly when she was diagnosed with HIV (human immunodeficiency virus). It was May 15, 1985. “I’m a walking testimony for HIV and AIDS [acquired immunodeficiency syndrome] because I was there in the early days,” she says. “I’ve cried, but in my long life I had to move on.” Now at 64, a proud Black transgender woman living in San Francisco, she’s a living example of the resilience and activism in the trans community. For decades, she has been a part of the fight for services the trans community, especially trans people of color, deserve and has helped bring those services to the San Francisco AIDS Foundation (SFAF)–a health justice organization that works with communities most impacted by HIV. She had been a client since the mid-1980s and had seen an evolution in the way people with HIV were treated. “We [Black people living with HIV] were not getting the same treatment as the White men,” she says. It’s how she began her activism to help be the voice for Black people living with HIV and to make sure they had a seat at the table. She continues that fight with her trans community. She saw the potential for SFAF to be the incubator to create the support services her community needed.

“I was chasing employees around the AIDS Foundation begging and asking and pleading to give my Black marginalized people a place where we can come and meet and talk and just be in community with each other.” And her persistence paid off when she developed the TransLife group at SFAF in 2010 that is still going strong 13 years later.

The TransLife group is a weekly support group that began specifically to serve Black, trans people living with HIV and AIDS. “I started TransLife out of a necessity for community and wanting to bring together and showing us that we’re more alike than different and letting Black people know they are not the only ones going through what they're going through,” says Ms. Cooper. Over the last 13 years, TransLife has evolved and is a core part of SFAF programming. “TransLife is for anyone and everyone in the transgender non-conforming community,” says Asia Stephens, SFAF’s Black Health program assistant. “But we mainly see trans women of color and nonbinary folks.”

A group of around 15-40 people meets weekly to connect and discuss relevant topics (such as a recent discussion on writer and activist, adrienne maree brown’s concept of “pleasure activism” ). While some of the topics can be heavy, trained facilitators are prioritize creating a joyful space for people. “Folks have lived long lives and we accumulate trauma as we get older, so we don’t want to leave the space feeling worse,” says Stephens. “We also see TransLife as a break, not necessarily from reality, but it’s supposed to be a breath of fresh air for folks.” Stephens helps create that space by posing silly questions at the beginning of meetings to shake things off or bringing in joyful music after a heavy discussion. They see joy as revolutionary. And joy is essential to combat the mental health challenges that come along with being in a historically marginalized group.

“I don’t think there’s a lot of trans mental health services out there,” says Stephens. “I think that so many people have experienced so many things due to their gender that it is really difficult to feel safe in those spaces and talk about those things.” One way SFAF and TransLife have been able to support the trans community in this way is to have mental health providers on site. In addition to TransLife, there’s a mental health group led by a licensed clinical social worker that meets twice a month. The mental health programming combined with the SFAF support groups are exceptionally complementary in meeting their needs for community and mental health services.

The COVID-19 pandemic put a halt to a lot of in-person services at SFAF and the support groups especially. Stephens says Zoom didn’t really work for the TransLife group because many members didn’t have regular phone or internet access. So, the loss of these vital support systems created another level of isolation. “People were already going through their mental health issues, depression, suicide ideation, being excluded from life, excluded from families, excluded from agencies,” says Ms. Cooper. And the pandemic amplified that isolation. But both Ms. Cooper and Stephens highlight the resilience among people living with HIV. “They already have been living in a pandemic,” says Stephens, meaning the HIV pandemic. “They’re still here and they’re still thriving.”

“We’ve definitely seen more people getting interested in TransLife because there’s more diversity with staff,” says Stephens. And now that the group is back meeting in person, it’s an important reminder of that resilience both Stephens and Ms. Cooper highlight.

“I think one of the biggest highlights from the trans community is that folks come in and let us know that they are survivors,” says Stephens. “With all the advancements in medical care, people can live the lives they want, they can be happy and healthy just like anyone else.”

Ms. Cooper recognizes the power that comes from being in community and understands that she is a part of something larger. “I stand on the shoulders of many Black people and transgender people that have come before me,” she says. “My DNA includes all my community. My DNA runs through my body. The blood that runs through my body is the blood of a progressive, strong, Black person. My DNA is my community.”