Ugandan Transgender Advocate Demands Inclusion in HIV Response – ‘Stop Leaving Us Behind’ #Aids2024

Munich, Germany — “I want all human beings to be safe, to be treated with dignity, and to have equal rights,” said Jay Mulucha, a trans man from Uganda and the Executive Director of FEM Alliance Uganda, an organization formed in 2012 to promote fundamental rights and human dignity for a stigma-free Uganda.

Mulucha is the first trans man to provide opening remarks at an International AIDS Conference.

“I’m here in Munich, but I still live in Uganda, so I need to consider my safety in what I share with you, as my life is still in danger every day at home. I will share about what trans men in Uganda living with HIV experience, but I will not name names. I hope you hear this and understand me,” said Mulucha.

Mulucha has worked on the frontlines against Uganda’s anti-homosexuality act, which outlaws sexual relations among people of the same sex and imposes the death penalty for so-called “serious homosexual acts”. The country’s Constitutional Court upheld the anti-gay law that allows the death penalty for “aggravated homosexuality” despite widespread condemnation from rights groups and others abroad.

The judges supported their decision saying that the law does not violate the Constitution, citing that homosexuality was already illegal in Uganda under a colonial-era law criminalizing sexual activity “against the order of nature”. President Yoweri Museveni signed the controversial bill into law in May 2023.

Rights groups have reported the new law has led to a surge in abuse against LGBTQI+ people, including torture, rape, and evictions, primarily by private citizens. According to Amnesty International, at least 33 out of 55 African countries still criminalize consensual same-sex sexual activity, which contradicts established African Union and international human rights standards. In 2023, six countries, Kenya, Ghana, Namibia, Niger, Tanzania, and Uganda took steps to strengthen their anti-homosexuality laws, with other countries potentially following suit.

It is no longer safe for us to gather together as a community

Mulucha said that the challenges that trans men already faced massively increased as their lives became even more endangered as the result of the controversial anti-homosexuality act.

“It is no longer safe for us to gather together as a community, and so we have become even more vulnerable and isolated than we were before, making us feel completely alone,” he said. “This isolation has led many of us to experience suicidal thoughts, as our situation can seem completely hopeless. The anti-homosexuality act has had devastating effects on the trans community. We are the face of the LGBTQI+ community, as we are the most visible members, so the impact of this act has particularly performed on us.”

He added that the act has had a huge impact on the services that we provide to our community members. They were recently from the building where they provide shelter for homeless trans people after they had moved the homeless shelter to their office. This meant that not only would their service users be forced into homelessness again, but they were also unable to continue to provide access to essential HIV services, including HIV testing and provision of ART medication, as well as a psychosocial support center for mental wellness.

“The sanctions and penalties being placed by the international community on the Ugandan government are working, but the lifting of these sanctions needs to be contingent not on policy changes but on evidence of changes in implementation. For this, you need to listen to the communities and hear what we are saying. We are still suffering and need your support more than ever, so the funding that is being denied to the government should be funneled directly into LGBTIQ organizations and communities in Uganda,” said Mulucha.

“As you can imagine, as the leader of the  FEM Alliance Uganda organization, the impact of these evictions on my health, both mental and physical, was extremely distressing,” he said. “But I had to put the needs of my community before my own. I had to find solutions to the problems that not only I was facing, but that every trans person in Uganda was now facing.”

“We needed solutions to ensure continuity of access to health care services, including vital HIV medication, but no matter where we turned, we were not getting support from anyone. In the end, it was through Global Action for Trans Equality that we managed to secure some funding, which came from the Global Fund. Through this support, we were able to reinstate our healthcare services to our community members, said Mulucha.

In addition, he addressed the many misconceptions about HIV infection among trans men.

“People still don’t believe it,” he said. “Many trans men are living with HIV despite the myths and misconceptions that we are not at risk of acquiring it.”

They make us fearful of accessing services and of disclosing our statuses

“In Uganda, when we go to access HIV services as trans men, we are always discriminated against, and we face transphobic health care workers who ask us, how did you get it? They assume that we are in the same sex relationship with our female partners, and they don’t believe that we can be HIV positive. They don’t know that sexuality is fluid and diverse. The fact is that many trans men, not only in Uganda but across Africa and the world, face both corrective and corrective rape.”

How can we speak about such experiences when we are being discriminated against? he asked.

“These questions and the transphobic treatment that we receive make us give away. They make us fearful of accessing services and of disclosing our statuses. As a result, many of us self-medicate, which is extremely dangerous,” said Mulucha.

“As a board member of Global Action for Trans Equality (GATE), and as a member of the International Trans Men and HIV Working Group, I’m proud to be working with trans people from around the world, and I know that the situation that we face in Uganda is not unique. Trans people around the world are facing violence and discrimination, and are at a much higher risk of acquiring HIV than the general population. Trans men are excluded from HIV programming and implementation in every region of the world,” he said.

“…Everything that I do in my work as an activist at the global level is informed by my experience of being a trans man living in Uganda.”

“Trans people around the world are being discriminated against and killed simply for being ourselves. But there is hope on the horizon,” Mulucha said. “The World Health Organization will be publishing the gender-affirming care guidelines later this year, and this is a step towards ensuring the health rights of trans people in my country and across the world.”

“Trans people, and trans men specifically, have been left out of HIV programming for far too long. I am asking you to ask yourselves, why? Why have trans men been left so far behind in the global HIV response?” said Mulucha. “The theme for AIDS 2024 is putting people first, so let’s think about putting all people first, not just some people. As a trans man from Uganda, I’m asking you to stop leaving us behind.”