Trans and gender diverse communities face high levels of stigma, discrimination, and socio-economic marginalization, contributing to disproportionate vulnerability to HIV. While the inclusion of trans and gender diverse people in the global HIV response has improved, these gains are increasingly threatened by a convergence of international donor funding cuts and coordinated anti-gender attacks.
These attacks include hate speech, criminalization legislation, defunding of trans-led health initiatives, and violence against human rights defenders, and are part of a broader anti-rights agenda.
Why is this report needed?
There is currently limited data on the specific impact of anti-gender attacks on trans and gender healthcare access. To address this gap, GATE conducted a survey of trans-led organizations in May 2026.
Attacks on trans communities weaken entire public‑health systems, undermine human rights norms, and threaten global HIV goals that affect all populations.
Therefore, this report provides the evidence needed to demand protection, funding, and accountability to donors, multilateral institutions, governments, and civil society partners.
It is important to highlight that this survey is among the first efforts to quantify the specific health- and HIV-related consequences of anti-gender attacks, using data collected directly from trans-led organizations working on the front lines of service delivery.
The survey’s timing is also significant: its findings were disseminated in three major global health and human rights events in Geneva and New York in 2026: at the Trans Advocacy Week initiative held during the 62nd Session of the UN Human Rights Council, at the UN High-Level Meeting on HIV/AIDS and at the 58th UNAIDS Program Coordinating Board Meeting.
Main Findings
The survey found that anti-gender attacks have a negative impact on access to healthcare, with:
- 92% of organizations reporting impacts on HIV services
- 83% reporting changed provider practices.
- disruptions on access across the HIV prevention and treatment, including reduced access to PrEP (63%), HIV testing (56%), and antiretroviral treatment (56%).
- closure of community-led services in half of the surveyed contexts.
- 89% refering fear of discrimination or violence as the leading barrier to access.
In terms of impact on the trans-rights movement, 89% report reduced funding opportunities, 83% report heightened security risks, and 77% report staff burnout.
Recommendations
GATE recommends that donors, multilateral institutions, governments, and civil society partners:
- Prioritize long-term, flexible funding for trans and gender diverse community-led organizations;
- Ensure direct funding to trans-led organizations, including as sub-recipients within major HIV financing mechanisms;
- Integrate community protection and security funding into HIV programming;
- Address political and structural barriers to long-acting ARV roll-out;
- Invest in mental health support as a core component of HIV programming;
- Strengthen documentation and monitoring systems;
- Engage multilateral human rights and health bodies to formally recognize anti-gender attacks as a barrier to global HIV and health goals.
