Practical Steps to Center Trans and Non-Binary People in Harm Reduction Spaces

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Written by:

Brooke Alexandria Paine (she/her), Program Assistant

with editorial support from,

Nathalia Gibbs (they/them), LGBTQ Coordinator & Lill Prosperino (they, them), Southern States Regional Organizer


We were hoping to wish our trans and non-binary siblings a happy Trans Day of Visibility today. But the mood is far from celebratory, given the renewed slew of political and legal attacks that are being waged on young, poor, Black, brown, Indigenous, and undocumented trans and non-binary communities across the so-called United States. We’re feeling a bit too visible these days, and yet even more thoroughly erased. So we decided to shift gears a bit, and offer some specific ways that allies and accomplices can meaningfully uplift marginalized trans voices at every level of the movement. Constructing safe spaces encompasses everything from being inclusive in Harm Reduction movement building, to maintaining a welcoming environment at brick and mortar drop-in centers.

This guide was created as a small collaborative effort by some trans people at NHRC. We’ve tried to bring the nuance and wholeness of our lived experience that covers a wide range of roles as both providers and participants. To this end, we put together a broad selection of tips for harm reductionists on both ends of that spectrum. These tips are neither universal nor exhaustive. This is merely a snapshot of our experiences, general beliefs, and suggested best practices across the fluid and intersectional positions we occupy in the Harm Reduction movement. It is not meant to serve as a definitive model or toolkit. For now, this is what we came up with.


We can’t really start without acknowledging the ways in which misrepresented people are uniquely and disproportionately harmed by the war on drugs, settler-colonialism, ableism, racism, sexism/misogyny, homophobia, transphobia, whorephobia, and xenophobia. Structural violence can only be understood from an intersectional framework. Furthermore, all queer liberation is tied to the liberation of trans people who use drugs. We are able to center queer, trans, and non-binary experiences only because of the foundations laid by Black and brown transgender activists who used drugs and engaged in sex work. We stand on the shoulders and in the shadows of freedom fighters like Marsha P. Johnson, Sylvia Rivera, and Stormé DeLarverie, among others.


The absolute basics:


These are some of the building blocks that you need to understand in order to respectfully interact with queer and trans people.


When talking to or about someone, use whatever name they give you — exactly how they give it. The name we introduce ourselves with should override any other information you have, including whatever is on our ID.


If you or someone else slips up on pronouns, make a quick correction and move on. Drawn-out apologies center the feelings of the offending party, and usually put trans and non-binary folks in the unfair position of having to hold space for and relieve guilt.


Leave people alone no matter what bathroom they choose and don’t be a jerk to anyone for using the bathroom, including what you assume people who use drugs are doing in the bathroom. Don’t be nosey towards people in the bathroom. Mind your business.


Trans people’s relationships to their bodies is NOT your business. Don’t assume we hate ourselves or all or any parts of our bodies – you’re setting us up to feel bad.

In your day-to-day:

1. Correctly gender (and name, if appropriate) the people around you.

2. Use your platform to vocally defend trans communities against personal, professional, and legislative bigotry

3. Don’t offload all the labor onto trans staff/participants


Make every effort to create a safe and welcoming space where people feel comfortable being themselves, and be sure to lay the groundwork before they walk in. Your inclusivity must be proactive, rather than reactive. The first step to being part of a community that is safe for trans and non-binary people is to learn to be comfortable having conversations about queer and trans issues. Allow trans people to decide what is and isn’t okay to discuss about ourselves. These boundaries are more important than your curiosity. It is unacceptable to press trans people about our previous name or sex at birth. Asking about our anatomy is insulting and dehumanizing.


Share your own pronouns in introductions, and do so unprompted. It can make us feel uncomfortably singled out if you make a big deal of asking our pronouns, especially if you only do so to people who you perceive to be visibly trans. Making a practice of sharing pronouns gives trans and non-binary people the opportunity to show up in whatever way we feel comfortable, without pressuring us to out ourselves or drawing attention to our identity and presentation.


This work can’t just be internal though. Queer and trans folks deserve to be supported in every space they enter. People and organizations must not only contribute to make spaces safer, but should also use their privilege and platforms to defend us as well. When you step in to correct a misgendering or share your own pronouns, don’t limit this to just when asked. Commit to doing this online, in school, at work, and with your family.  When someone says something transphobic or shares a meme at the expense of people’s humanity, say something about it. As more and more legislators attack the trans community and attempt to take away the few rights we have, get informed. Call your representatives, and understand deeply that attacks on the autonomy of trans people are attacks on your autonomy as well.

Within your organization:

4. Educate yourself and your staff beyond competency

5. Hire trans people

6. Engage meaningfully with LGBTQI+ organizations in your network


One of the most effective ways to make sure trans voices are heard is to give us an actual seat at the table. In an organizational setting, this means hiring trans and/or non-binary people. If you are a large nonprofit and you don’t have any trans employees (that you know of), it might mean that your organization either:


  • Is not an environment where trans and non-binary people feel safe applying. This can also lead to people choosing to remain in the closet during or after the hiring process.
  • Is not providing meaningful career opportunities for trans and non-binary people.


A lack of visible representation can become a self-fulfilling prophecy that discourages us from applying in the first place. The populations your organization claims to serve should be represented within staff, at all levels. And if marginalized people with lived experience are concentrated at the bottom of your hierarchy, it could be a sign that we aren’t being afforded the same mobility or consideration as other staff. This includes not only trans people, but also sex workers and people who use drugs (and we often inhabit more than one of these categories).


Already have meaningful representation throughout your staff? Excellent! As mentioned in the “day-to-day” section, be mindful of the labor that you ask people with lived experience to perform. The difference between centering and tokenizing our voices often lies at the intersection of consent and compensation. Are you adding significant responsibility or emotional labor to our plate? If so, did we volunteer or otherwise have a reasonable option to say no? If not, you should ask yourself whether your request is reasonably within our job description, or if you are only asking us because of our identity. Meaningful inclusion of marginalized people means centering our voices, not our faces. Requiring that trans or non-binary staff members take on excess work that is not grounded in their desire or expertise to carry it out is tokenization. And don’t single out the one trans person who is in favor of your opinion, listen to all of us.


If your organization is part of a larger community that also includes queer- and/or trans- focused programs, there are a variety of ways to collaborate. It is very unlikely that your two organizations’ services will overlap completely in type, mission, scope, capacity, location, or even operating hours. Together, as providers, you can compensate for each other’s service gaps, and broaden the range of opportunities available to members of your shared community. It’s important, then, to ensure that the relationship is truly collaborative.


While ‘warm handoffs’ and referrals to LGBTQI+ organizations are a part of creating a comprehensive care network, they are generally not an acceptable alternative to implementing your own trans-friendly services if you have the resources and capacity to do so. Queer-led organizations are generally safer for trans and non-binary people, but we deserve to be safe everywhere. Keep in mind that we might not always be safe as people who use drugs in LGBTQI+ programs that do not practice harm reduction.

During Direct Service Provision:

7. Institutionalize respect for names and gender identity

8. Stock the right supplies!


Just as people who use drugs generally face stigma and exclusion in healthcare, so too do trans and non-binary people. In the same way, experiences of marginalization and transphobic discrimination drive us away from accessing services. In clinical or drop-in settings, avoid shouting legal names into the waiting room. Communicate participants’ correct (chosen) names, and only those names, to staff who will be interacting with them. This will prevent people from being publicly deadnamed or otherwise outed.


If your program has demographic reporting requirements that include sexuality and gender identity, you should probably be asking every new participant for their answers. As people with experience accessing and providing harm reduction services, we know that it’s tedious, and at times awkward. In the end it’s up to you how much of a stickler to be on the questionnaires, but be aware that guessing on demographics will almost certainly undercount the queer, trans, and non-binary populations in your community. If the data directly impacts funding or needs assessments, it could negatively impact us to simply eyeball it.


In order to properly address the health and harm reduction needs of trans and non-binary people, it is important to take the time to learn about trans and non-binary people. For example, some people who are medically transitioning choose to inject hormones. Hormone injections are typically subcutaneous or intramuscular, and may require different syringes or harm reduction techniques. If your outreach program lacks the proper supplies or knowledge, trans and non-binary people may avoid it, leaving them without safe supplies, services, community, and opportunities for referrals. There are lots of suggestions out there for SSP/SAP’s providing services to trans and non-binary people, read them and implement them!

Putting your money where the hurt is:

9. Donate!!

Give money directly to trans women of color and trans women who engage in sex work. Donate to a trans womens’ self defense fund (if you don’t have money, donate time). Pay land tax to two-spirit Indigenous people. Put some money on the books of an incarcerated trans person/write letters to incarcerated trans people, make sure to use their deadname on the envelope but their *real* chosen name when addressing them in the letter. Pay trans sex workers well. Learn trans peoples’ needs during arrest/incarceration. Support the liberatory work of trans people in your life.