FAQ: Ryan White HIV/AIDS Program and Gender-Affirming Medical Care Bans

The Ryan White Program, created in response to the AIDS crisis, is named for a teenager who died of AIDS after a blood transfusion. It is the largest federal program focused on HIV care in the U.S.

The Program was created by the federal government because communities, especially LGBTQ+ people and people of color, were being failed by existing health systems. Congress built the program around the reality that HIV was concentrated in certain localities and marginalized populations who needed flexible, community-based care. It has grown to a nationwide program.

Many of the people who rely on Ryan White clinics are trans women of color who, before the Program, could not access critical HIV care. The Program has adjusted over time based on community need and science. Today, for many trans women with HIV, gender-affirming medical care is what keeps them connected to their doctors and to their HIV treatment.

The Ryan White Program and the HIV and gender-affirming medical care it provides are a lifeline for trans women of color.

Today, the Program serves more than half of all people living with HIV who are in care in the U.S., including many LGBTQ+ people, and it is one of the most successful public health laws in America’s history. The Program helped transform HIV from a fatal illness into a manageable condition. The Program provides primary medical care and other supportive services to people with HIV who are uninsured or whose insurance does not cover the care they need.

91% of Ryan White Program patients have viral suppression.

Ryan White clinics provide gender-affirming medical care to transgender HIV patients because that connects patients to clinics so that they keep up with HIV medications  and maintain viral suppression, or a status where they cannot pass HIV to others. Now, the Trump administration is trying to rewrite the Ryan White Program to prohibit gender-affirming medical care.

Since 1990, the Program has:

• Funded HIV medical care for millions of people nationwide.
• Built a nationwide network of HIV clinics and providers that share best practices and strategies for community-based care.
• Reached people in urban, rural, and underserved communities.

As HIV treatments improved, the Program:

• Helped people access new, effective medications.
• Supported regular doctor visits and lab testing.

• 91% of people in the Program’s care reach viral suppression versus the national average of 67%.
• Viral suppression helps people stay healthy and prevents HIV transmission.
• Because of the Ryan White Program, people with HIV are living long, full lives.

A key reason the Ryan White Program is so effective is its foundation in a integrated healthcare approach that addresses the social determinants of health. Gender-affirming medical care is a social determinant to health. Trans women, and especially trans women of color, experience some of the highest rates of HIV in the country. They often face discrimination and do not have access to health insurance. If they no longer can rely on a Ryan White clinic for lifesaving gender-affirming health care, they will lose a key connection point with their medical providers and no longer access HIV treatment.

Covered care includes:

• Doctor visits for HIV care
• HIV medications
• Lab tests
• Mental health care
• Substance use treatment
• Help navigating care through case management
• Transportation to appointments
• Limited housing support
• Food assistance or nutrition services
• Help paying insurance premiums or copays

The Ryan White Program helps people stay healthy and live longer by funding critical medical care and the clinics that provide it. The Program is the primary source of care for many trans women living with HIV. It supports suppression of HIV, which means people do not transmit it to others.

It also removes barriers to other types of care that some HIV patients need, including mental health and substance use treatment, by making that care available at clinics funded by the program.

If gender-affirming medical care is stripped from the Ryan White Program, trans women who rely on these clinics will lose a key connection point to their medical care and be less likely to maintain HIV treatment.