When it comes to the immense barriers that trans people face accessing health care in the U.S., we’re not only stuck, we’re going backward. An unprecedented number of State Houses across the country are seeking to ban trans youth from accessing life-saving medical care, most notably in Texas where Gov. Greg Abbott has instructed the state’s Department of Family and Protective Services to prosecute the parents of trans kids as child abusers.
These attacks are not new.
At the U.S. House Financial Services Committee hearing in 2021, “There’s No Pride in Prejudice: Eliminating Barriers to Full Economic Inclusion for the LGBTQ+ Community,” the activist Tanya Asapansa-Johnson Walker made this statement:
“From 1990 through 2010, it was virtually impossible to find doctors or other medical providers to assist with my transition…I’ve been laughed at, misgendered, deadnamed, and at times declared mentally ill. One of my doctors called me schizophrenic and prescribed me pills for a condition I didn’t have.”
Tanya, a U.S. military veteran and trans woman, suffered some of her worst abuse in 2017 after undergoing a second surgery for lung cancer. “The night nurses wouldn’t come into the room. I had to crawl on the floor to clean the room myself. They wouldn’t clean the room,” she says. “They refused to give me my HIV meds and treated me really like I was an animal.”
I spoke with Tanya in 2022 about the immense barriers she’s faced in the U.S. healthcare system, serving in the military, living with HIV, and her experience with survival sex work.
This interview has been edited and condensed.
Jeffrey Masters: I want to go back to when you first joined the military, you were 17 years old. What made you want to enlist at that age?
Tanya Asapansa-Johnson Walker: You know, I was working in a restaurant called Hardee’s, serving hamburgers, and I didn’t want to serve hamburgers the rest of my life for $2.72 an hour, so I had to break out of there.
JM: This was the early ’80s, I believe. 1981?
TW: Yeah, ’81.
JM: And so that was Reagan years, years before Don’t Ask, Don’t Tell. How visible or not was queerness in the military?
TW: It was there. However, most gays and lesbians were in marriages of convenience, living in a two-bedroom apartment off base so that they could live with their partners or engage with their partners, because you weren’t allowed to live off base unless you were married. Plus, you could hide being lesbian or gay in an apartment off base better than you could in the barracks on base. So basically, everyone was in the closet, captains, COs, everybody was in the closet.
JM: People had to find each other to have these marriages of convenience. Was it open secrets or was it very hidden?
TW: It was hidden because you’d be put out. They would discharge you from the military, and nobody wanted a dishonorable discharge. They would give you a dishonorable discharge if they caught you having sex with another gay person, or kissing, anything. They had gay people who were hunting down other gay people to out them and get them discharged.
JM: And so if queerness was so hidden, how were you finding each other then?
TW: Basically, when you got to the gay club, they had gay clubs everywhere you went.
JM: Yu would see other people in the military there?
TW: Yeah, we used to all go to Frankfurt, and they’d be acting all butch and everything. And then the next thing I know, when they get in the club, “Oh, girl, oh,” they would just carry on. They would start flaming in the club.
JM: You were stationed in Germany at this point, as a combat engineer. What exactly does that mean?
TW: In the combat engineers we worked with a lot of explosives. Our job was to delay the enemy, build pontoon bridges, blow up bridges, to keep the enemy from crossing with their tanks and their troops, and we had to build bridges to get our troops and tanks across. We had to blow things up, and we had to bury the dead in mass graves.
Life expectancy in the combat engineers is 10 seconds, in the job I was in.
JM: Is that an exaggeration, or is that something you were literally told?
TW: No, that’s what we were told, 10 seconds. We’re front line, we delay the enemy from getting to the rest of the troops. We have to knock out the bridges. After the bridges are knocked out by aircraft, we have to build pontoon bridges to get our troops across, our tanks and everything across. We build tank ditches so their tanks will fall into ditches, use C4 and blow up these ditches. We were doing stuff like that, we delay the enemy.
JM: Did you wonder if you were going to die every day?
TW: No, I didn’t really think about dying, I didn’t think about dying.
I was just thinking about living my life, getting to the gay club, being around, hanging out, dancing, having fun at the bar.
JM: How aware were you of your transness at this point?
TW: I couldn’t transition in the military. I couldn’t, I didn’t have access to anything. In DC, when I was stationed in Fort Belvoir, Virginia, I would go to the clubs where the drag queens were and all that stuff, because we considered drag queens back then, we weren’t considered transgender, or we were considered transsexuals, and we considered ourselves that in our own mind.
JM: Was that one of your explicit reasons for why you joined the military, that this would make you a proper man?
TW: That’s what I thought. My dad said it would, I would change.
JM: When did you realize that that was not going to happen?
TW: When I got in the gay club in Frankfurt, Germany, and Washington, DC, and New York City. I ran away from it, yeah, for many, many years. Because your family teaches you to hate yourself, in those days, and still today they do that.
JM: You eventually did leave the military, after almost four years, and you moved to New York City. Is that when you first started to find a trans community?
TW: No, I didn’t start right away. I didn’t start dressing, I just came out the military, I was out of my mind, I didn’t know what to do, what’s going on. I wasn’t a civilian for many years, for a few years, so I really started to medically transition in 1989. Everybody was dying from AIDS, they were dropping like flies, and I didn’t know what was going on.
JM: And so that part of your life, you were saying 1986 to 1989, what happened that made you realize, like, “Oh, I can’t run from this anymore”?
TW: When I got in a car accident. I was working as a porter at a hospital, St. Vincent’s Hospital, in Staten Island. I was out with two girls from St. Vincent’s, and we were going out to lunch, and I don’t know what the driver was doing, but she hit a parked Jeep, and we were going like 50 miles an hour, cracked my skull, I still have a dent in my skull to this day. My body was ejected out of the car, I woke up on the ground next to a tree. That’s what made me, I said, “Look, I better live my life, because I might not make it to live my life.” And I said, “I’m gonna do this.” So I started my transition more and more and more after that car accident.
JM: What was the trans community like in New York City at that time? Was it easy to find other girls?
TW: It was easy when you went to the city. A lot of them were homeless, a lot of the girls were homeless, they refused to stay in the men’s shelter, because in the men’s shelter you couldn’t wear your clothes. They said, “This is a men’s shelter, you have to wear men’s underwear, men’s this, men’s that, and you cannot come in here with those women’s clothes.”
So I was homeless at one point, and we lived in abandoned buildings. People were dying from AIDS, our girlfriends were dying from AIDS, we had to take care of them in abandoned buildings, because the hospitals weren’t a safe place for LGBTQ folks, and not only LGBTQ folks, but for trans folks it wasn’t a safe place. People that were sworn to not do harm are working in the medical field, in the hospitals, working today, doing harm to our people, and a lot of us are falling through the cracks.
JM: When we talk about this mistreatment in the hospitals and medical settings, I want people to know that we’re talking about abuse and harassment beyond just not using your correct pronouns. Do you mind giving an example, so people can understand the weight and the gravity of what we’re talking about?
TW: I was really mistreated by the staff, who were misgendering me, harassing me, even by the social workers. When they would be in conversation about me in the room, they would use the wrong gender pronouns, and I’d have to keep correcting them. Even some of my visitors had to correct them, the nurses, and they still did it. The night nurses wouldn’t come in the room, I had to crawl on the floor to clean the room myself, they wouldn’t clean the room, and basically they would just throw stuff in the room, and they refused to give me my HIV meds, and treated me really like I was an animal, in this hospital right here in New York.
I had lung cancer in 2013, but in 2017, when I had lung cancer again, they removed my top lobe, I had surgery again. But there was a gay guy, he used to sneak into my room at night to check up on me, because he knew they weren’t checking on me, and he would sneak into my room at night and he’d be like, “Oh, your oxygen levels are low, I gotta call somebody right now,” because my breathing, oxygen levels were real low. They would not come in the room, the night staff would not come in the room at night.
JM: You’ve made this an enormous focus of your activism, fighting and working to make sure that nobody has to go through the same thing that you did. As one example, in 2020 you were one of the plaintiffs in a case brought by the Human Rights Campaign against the Trump administration. This was when they rolled back protections in the Affordable Care Act, protections which specifically addressed discrimination against trans people in healthcare settings. Now, after that, a federal judge ultimately did block the rollback of protections.
TW: Judge Block, that was his name, Judge Block.
JM: Do you feel like you had any choice in the matter of becoming an activist, that you were almost required to become an activist in order to just access basic needs like healthcare?
TW: Yes, I did. The youth that are coming up who choose to medically transition, not every trans person chooses to medically transition, I’m looking at these younger folks coming along who are being discriminated against in healthcare already, and older folks, or I should say mature folks, who are being discriminated against in healthcare. I thought that this was a moment for change, to recognize that we are being abused in healthcare settings.
Cancer is very scary, it’s very sobering. You feel like every second you’re gonna die, but you try to be happy, and you try to live, you try to be as productive as you can while you’re above the ground. You just know you’re gonna die. The doctor said, “You have a one in five chance of survival.” So it was really scary for me.
JM: Wow.
TW: I wanted to do art, just draw or keep myself busy, and try not to think about it, as I’m disappearing. Cancer’s like a force outside your body, just sucking the life out of you. That’s what I felt like, this thing was just sucking the life out of me, and it was just outside of my body, just pulling all my energy into it.
JM: Everything that you just described about cancer, this sucking the life force out of you, did you also feel like that when you were diagnosed with HIV?
TW: I felt like everybody was dying anyway. Everybody, most of my friends were HIV positive already, they had AIDS or were HIV positive, and everybody was just dropping dead like flies. We had to take care of people with Kaposi’s sarcoma in abandoned buildings, because they couldn’t go to the hospital for care. People weren’t out with their families, they didn’t know their family member was transgender or gay. So some of the folks we had to take care of in abandoned buildings, right here in New York City, tried to bring them food or do the best care we could while they were dying. Everybody felt like they were dying.
We were just trying to live it up, do some drugs, to try to self-medicate the pain of losing your friends. Some of the families took their bodies to other states or whatever, we didn’t have the money to go. It was a really sad, hard time for us. And some of us were homeless, a lot of us were homeless, we had nothing but the streets.
JM: And you’ve talked a lot about doing survival sex work. Was HIV a big topic of discussion amongst sex workers?
TW: You had to make your money, to eat, to survive, to pay rent, if you were living in a hotel, trying to live in a hotel or whatever, whatever you could afford. So it wasn’t a real topic, but we talked about it. There wasn’t a lot of prevention dollars back then, and there’s really not a lot of prevention now.
JM: And in doing sex work, were you part of a community of sex workers, or did you feel like you were on your own?
TW: We felt like we were a community, we kind of looked out for each other when we could. If one of the girls was out there using drugs, like crack or something, or some other drug, we’d help each other out. She’d be out there starving, we’d take her out to eat, give her money for her pockets, ’cause she couldn’t do the sex work. So we helped each other out the best we could.
JM: Did you have a mentor figure saying, “Hey, this is what you need to do to keep yourself safe”?
TW: Yeah, I did have one, but there was no way to keep yourself safe. You got into cars with strangers, mostly we did street sex work, you got into cars with strangers, you didn’t know whether. But when you do it, you’re in a desperate mode, you gotta have money to buy more clothes, more makeup, blankets to keep warm in abandoned buildings, or if you get a hotel room for a couple of nights, that was good, you could pay for that.
We had to risk our lives, you couldn’t be afraid to die, you had to get in those cars, and you had to do what those men wanted, and some of them just wanted you to talk. Sex work is talking as well, sex work wasn’t all about sex, and the dates that weren’t about sex paid the most money. One guy was talking to me about divorcing his wife, should he divorce his wife? Another guy asked me should he commit suicide. I had to talk people out of suicide. Sex workers do a lot of work that people don’t realize, we’re like social workers as well. It’s crazy.
JM: I think that in the public’s mind there’s two opposing views. One, they look down on sex workers, especially folks doing this for survival. And then the other one, they simultaneously glamorize it and think this is just ladies raking in the money. You were not living luxuriously at this point. Were you making enough money to get by?
TW: To get by. Because I also worked in Show World, I stripped in a booth, after I got away from street work. So I stripped in a booth for a few, I think for about a year maybe. And the curtain would go up, and you’d have this bathing suit on and heels and all this makeup and blah, blah, blah, and the guys would come in. Oh, God, some of them were so gorgeous, but you really can’t look at them, you have to perform for them in front of a window when the curtain went up, when they put the money in. After they put the money in, ’cause if they didn’t put money in, the curtain wouldn’t go up, so they couldn’t see you.
JM: And this was a much safer way to engage in sex work, since there’s literally a barrier.
TW: Yes, it was. It was very safe. Show World was pretty safe, yeah, it was pretty safe.
JM: I think that you have an interesting perspective, since you also have run this support group at SAGE for many years, a nonprofit, and that’s for trans women specifically, right?
TW: It’s older trans women, yes.
JM: Older trans women. So for that older age group, what are the biggest concerns and issues that you hear repeated most often?
TW: Well, the majority of the trans women in the group, they transitioned late in life, after they retired, some of them retired, and a lot of them are afraid to die alone. They’re afraid that somebody may detransition them and they won’t die with dignity, or they may end up in an institution or a nursing home if they become incapacitated. They fear that.
JM: When you say that they’re afraid to die alone, do you have that fear?
TW: Not really. I don’t have that fear of dying alone, because I’ve experienced so much horror that I don’t have that fear, but I know how families are. Families, if they’re paying for your funeral, or if they’re paying for you when you’re incapacitated, they will detransition you, misgender you, ’cause it happened to a friend of mine in New Jersey. She had a stroke, she went to live with her family, the first thing they did was cut her hair and gave her a goatee, and they’re dressing her in men’s clothes. She lost bits of her speech and some of her memory. They’re really treating her bad.
And also staff, homophobic staff in nursing homes as well. Everybody in the nursing homes or in care are not LGBTQ, and that includes the staff. So even if you’re gay or transgender in that setting, you could be harassed or called homophobic epithets by other patients or clients, and by staff.
JM: Do you have plans or desires for when you are no longer able to take care of yourself?
TW: Yes, of course, yes. If I had become incapacitated or something, I wouldn’t want my family touching me, ’cause I know they would detransition me, because they’re kind of religious, and I know they would detransition me, and misgender me and all that. I might sign some papers to where they can’t get near my body. And if they’re paying for your funeral, they’re gonna be the ones to say what you’re gonna look like. I’ve seen where they’ve drawn mustaches and beards on the girls and tried to make them look like men, and put them in three-piece suits, tried to bury them as gay men. Even after death, you don’t have dignity.
JM: On the positive side, is there anything you’re looking forward to as you age?
TW: Well, I’m aging, but I still want my own agency. I still want that Equality Act. I fought to get gay and trans panic defense passed. Going to Albany, I get up at 4:00, at 3:00 in the morning, and get the van, and then go meet people in a central point in the city, so we could go to Albany and tell our stories, in front of the staff of elected officials in the Senate of New York State. I would drive everyone up there, and we also got conversion therapy passed, we fought to get that passed in New York State.
Click here to listen to the full interview on the LGBTQ&A podcast.
LGBTQ&A features interviews with the most interesting lesbian, gay, bisexual, transgender, and queer people in the world. Hosted and produced by Jeffrey Masters. @jeffmasters1
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