Honoring Resilience: National Native HIV/AIDS Awareness Day & the Intersection of Trans and Indigenous Histories

March 20th marks National Native HIV/AIDS Awareness Day (NNHAAD)—a day to uplift, educate, and advocate for Indigenous communities disproportionately impacted by HIV/AIDS. This day is not just about health statistics—it’s about history, resilience, and the ongoing fight against systemic barriers in healthcare.

For many Native communities, gender diversity has long been recognized and celebrated, yet colonization brought forced erasure, discrimination, and a medical system that continues to fail Indigenous and Two-Spirit people. Today, Indigenous trans and Two-Spirit individuals face heightened risks of HIV exposure, limited access to care, and systemic neglect in both LGBTQ+ and Native healthcare spaces.

This NNHAAD, we reflect on the past, acknowledge the present, and advocate for a future where Native LGBTQ+ and Two-Spirit communities have the affirming, equitable healthcare they deserve.

Long before colonization, many Indigenous cultures across North America embraced gender fluidity and nonbinary identities.

The Erasure of Indigenous Gender Diversity

Long before colonization, many Indigenous cultures across North America embraced gender fluidity and nonbinary identities. The term Two-Spirit (coined in 1990) is an umbrella identity for Native people whose gender identity or role differs from Western binaries, but historically, many tribes had their own names and traditions for gender-diverse individuals.

🌿 Pre-Colonization:
✅ Many Indigenous societies held reverence for Two-Spirit individuals.
✅ They often served as healers, spiritual leaders, and mediators.
✅ Gender was seen as fluid and expansive, not a strict binary.

💥 Colonization’s Impact:
❌ Forced Christianization demonized Two-Spirit identities.
❌ Indigenous children were stolen from their families and forced into residential schools where gender norms were violently enforced.
❌ The introduction of Western binaries led to the erasure of Two-Spirit histories and traditions.

This legacy of colonization continues today in policies that strip trans people of healthcare, legal recognition, and bodily autonomy. The current wave of anti-trans laws mirrors the historical criminalization of Native gender variance, making it clear that the fight for gender justice and Indigenous sovereignty are deeply intertwined.

HIV/AIDS & Systemic Neglect in Native Healthcare

Native Americans experience some of the highest rates of poverty, healthcare discrimination, and HIV/AIDS-related health disparities. According to the CDC, Indigenous people face higher HIV risk factors and lower access to treatment due to:

⚠️ Barriers to care: Underfunded IHS (Indian Health Service) and limited LGBTQ+-inclusive services.
⚠️ Stigma & misinformation: HIV-related stigma prevents many from seeking care.
⚠️ Medical discrimination: Indigenous people are often denied proper care or given inadequate treatment.
⚠️ Intersectionality issues: Many Native LGBTQ+/Two-Spirit individuals experience double discrimination—from medical racism and transphobia.

HIV statistics in Native communities are likely underreported due to a lack of testing and research investment, making it harder to address the crisis effectively.

🛑 This is systemic neglect. This is medical injustice. And this needs to change.

What Needs to Happen?

🌎 Decolonizing Medicine & Restoring Two-Spirit Health

To support Indigenous LGBTQ+ health and combat the HIV/AIDS crisis, we need to:

✅ Increase HIV testing & PrEP access in Native communities
✅ Fund Indigenous-led HIV care & sexual health education
✅ Support Two-Spirit healthcare initiatives
✅ End medical racism & decolonize Indigenous healthcare systems

At True U Clinic, we believe in accessible, affirming care for all trans and non-binary folx—especially those pushed to the margins by systemic neglect. This NNHAAD, we honor the past and fight for a future where Indigenous trans, Two-Spirit, and LGBTQ+ individuals receive the healthcare they deserve.

📍 Want to learn more or find affirming HIV/AIDS support?
🌿 Two-Spirit Dry Lab (Indigenous LGBTQ+ Research) – https://twospiritdrylab.ca/
💙 The Trevor Project (LGBTQ+ Mental Health Support) – www.thetrevorproject.org

💜 Together, we fight for justice. Together, we heal.

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True U Clinic is an online hormone therapy clinic that provides safe and medically supervised hormone therapy to the trans and non-binary community. We utilize modern day technology and the most up-to-date clinical practices. Our goal is to provide this service at an accessible price, all while treating our clients with compassion and respect.

We are dedicated to providing a personalized experience and high-quality care through the convenience of virtual care. Get started with care for exactly who you are, wherever you are, today!