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Positive Voices

EPISODE #207 - TransHealth


Sharing Spaces: Unpacking the Trans Experience

January 22, 2024. 24:25

“We want our own lane; we’re not here to replace anybody.” And that’s that on that! This week, Tei and Malachi are speaking with Daijah Walters and Dr. Selena Dagnino about the trans community, trans health, and their experiences as trans women. If you take anything away from this episode, remember that trans women know what’s best for them, and they deserve seats at the table to share that knowledge and experience with the world.

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This program contains language and subject matter that some audiences may find triggering or sensitive. Our purpose is to encourage engagement in care and treatment; however, please consider your well-being before continuing.


Dr. Selena Dagnino: I want you to know immediately that I'm trans. I want to be clocked for my safety.
Tei Pearson: What's up folks? I'm your girl, Tei Pearson. I'm here with my co-host.
Malachi Stewart: Malachi Stewart.
Tei Pearson: And we're here for another great episode of Positive Voices. We're going to be talking about the trans community, trans health, and just the trans experience today. So let me introduce our guests, well rather let me have them introduce themselves.
Daijah Walters: Well, I'm Daijah Walters, I am a case manager at Us Helping Us and I'm a Black trans woman of color. I grew up in Baltimore, but I am Jamaican descent and I'm just happy to be here.
Malachi Stewart: Happy to have you baby.
Tei Pearson: Okay, Jamaican descent.
Malachi Stewart: Should I say Selena or doctor? You tell them who you are.
Dr. Selena Dagnino: So my name's Selena. I'm from Phoenix, Arizona. My parents are from Mexico, so I grew up very close to the border and with that culture. I moved out here to New York City mostly for my transition. I think that being supported by a large group of trans women really helped. So professionally, I am a pharmacist, so I work for an HIV nonprofit, I've worn money hats for many times and recently I was a regional director for them, and now I am a pharmacist practitioner, which means that I am kind of leading the way in pharmacists prescribing, but mainly with breaking down barriers for trans health. So I also educate providers on how to prescribe hormones and what to look out for in the ambulatory care setting. So I do that at the university level. I train prescribers, I train students, I train all kinds of people. But yeah, that's pretty much a synopsis.
Malachi Stewart: Wow. Talk about being at the table. Who would know better? You have lived experience.
Dr. Selena Dagnino: I'm like, "That side effect..." It is interesting because when I'm lecturing physicians for example, they're like, well this da-da-da-da, I'm like, "Well, when I take it and I do it and I do..." It's no shade. It's like, you know what I'm saying? So we'll get more into that but I do let them know that trans women, we know best. So a lot of times when physicians are like, "There's no study on this," well we are the study, we've been doing it, we've been on the streets doing this. So it's been a journey and I'm happy to be here.
Malachi Stewart: I can't wait to get into that because there's a wealth of knowledge for both women at the table. Where I want to start, because we don't have this conversation, and I ask for your permission to really just kind of go in, you're here and I want you to both be able to kind of speak for yourselves. Can we start at a place I feel like we don't hear a lot, what was the moment that you reconciled within yourself that you were of trans experience? And what did it look like going from that moment to being able to share that with your collective community, whatever that community looked like? We'll start with you, Daijah.
Daijah Walters: Well, for me, I think my moment was when I was sitting in the middle of my girlfriend's floor and we were injecting each other with substances. We had no idea what it was besides someone letting us know that it's hormones. Ever since then, I've felt like the inner me was trying to come out, but I wanted to be at a certain level when it comes to my appearance. And for you to feel good on the inside about yourself, your inside has to match your outside and that's how I feel. And ever since then, injecting my first hormone that I really didn't know what it was, that's where my journey started at. And I had to grasp reality like, "You are really sitting here doing this." And then it also plays on your mind and sometimes makes you feel like, "Well, am I crazy for doing this? Are the people right about me?" So from that beginning, that one little memory from my beginning has always traveled with me and I kept that with me.
Malachi Stewart: Did you know then when you were doing the injections that, "I'm experiencing a transition or the beginning of my transition"? Or was it like, "I'm experimenting with something and I'll see how it goes"?
Daijah Walters: It wasn't never an experiment for me. It was just always something that I felt like I had to do. It was something wrong and it was the way for me to feel like I was fixing myself.
Malachi Stewart: So you always knew?
Daijah Walters: Yeah, I've always knew.
Malachi Stewart: You always knew?
Daijah Walters: Your parents know too. They probably won't tell you, but no shade.
Malachi Stewart: If nobody knows, mama knows. Your mama knows.
Daijah Walters: So it was always in me that I was this diva, you know what I'm saying? I was this woman. I was this being, this soft being that needed to show on the outside as well.
Tei Pearson: Thank you.
Dr. Selena Dagnino: I love that. So I came out when I was about four years old.
Tei Pearson: Four?
Dr. Selena Dagnino: I did. I didn't start my transition at that time, but like I said, I'm first generation here, so I come from a traditional Mexican family that's big into machismo and that stuff. And I'm from Arizona so all these laws being passed in Florida, for example, scaring everybody, we've been had those laws since we were young. So we've been terrorized by ICE and just the culture at that time, now it's a lot better, but at that time was very conservative. So I didn't really know what transness was, had never met a trans person up until college.
And so when I came out, I didn't know that it was a coming out story. I got into one of my dad's big shirts and put on my mom's heels and walked downstairs and I said, "I'm no longer this name. Call me this name." And if I remember correctly, it was like Ty or something. I was like four, I was little, but I just knew I wanted a different name. And I said, "Please stop calling me boy. I'm your daughter." That's what I said. I'm so little and I'm like, how did I know that to do that? And of course I got in trouble and, "Don't do that again, da-da-da-da." And then I grew up in just a neighborhood where there's a lot of punks, so you got to defend yourself. You can't really be openly queer all the time so that's where realness comes in. So a lot of people note the ballroom scene, but realness teaches us how to survive. So I survived until testosterone really started hitting me and I'm like, "I hate this. I hate what I look like."
So then fast-forward, so we talked about education a little bit, so I have a bachelor's in dietetics, a master's in health administration and a doctorate in pharmacy. And so as I'm going through school and I'm learning all this health topics, never once did I get taught about transness, never once did I get taught about any of that. And then even going through pharmacy school, I'm just waiting to get to hormones and we just never got there. So I really relied on the East Coast girls to guide me through there. And so in Arizona, transness was a kiki. It was like, they just really made fun of... To move to New York City and be around such powerful women to me was just so inspirational. And for them to be like, "Do this and not that and don't pump yourself," it was inspirational. So I would say I've always been trans, but I guess the transition took decades, yeah.
Tei Pearson: So if I may, so for one, let me just say, hey, I'm Tei, I am really intrigued and was very much looking forward to this conversation. And I'll tell you why. I have a trans son, biological female, is in process of transitioning, right? So we're at this beginning phase, but he is my wife's biological kid. And I remember when I first started dating her and she was showing me pictures of her kids and she was like, "This is my daughter." And I was like, "That ain't no girl. That's a whole dude, right? That's a whole dude right there." Because even when I saw the picture, I didn't see a female energy, right? And she was like, "No, she just likes to dress like that." So I says, "Okay."
So then I get on board and start talking to Jay, he goes by Jay. And it's like, "What do you want me to call you?" Because it was important for me to know. And first it was, "Oh, what? It don't matter. You can call me whatever you want," because all of these other people got passes. So mom is allowed to call me she, because she's still getting used to it and my dad not really rocking with it, so I am still his daughter. And it was all of these excuses or passes as I like to call them, right? And so it was like, "I don't want a pass. Who are you? What do you want me to call you?" And all of that. And so that was a process. But even for my wife who is like, "I birthed the girl," and so now she's definitely on board and all of that, but it's like the mindset of as a parent doing that transition for us, but then also to watch the person transition.
And so I just want to say thank you, right? So thank you for just being here because I see so much power in the conversation, but also in the work that you all are doing for people like me who's a masculine presenting woman who's a lesbian, but I am parenting a trans son, I'm parenting a pansexual daughter. And so all of these different flag colors that flow through our family.
Malachi Stewart: The flag family, we call y'all.
Tei Pearson: The flag family with the red door. But when we look at Jay and we have these conversations with him about transition and what it looks like for him to be a trans man, there are so many things we don't know. And so if we could use this platform for other people who just may not know of some of the differences. Even when we get into the healthcare, I want to break down the differences of healthcare from me going to a OB versus, not versus, but also a trans man that goes too. And my son, he still has to go to the OB and that's a thing that we have to kind of maneuver every time he has to go.
But if you could just share, and especially you, Daijah, because I heard you say 15, right? So at 15 you were like, "This is who I am. There's no experimenting, this is who I am." And so can you talk to your mindset at 15 to say, "I know this is who I am, and so I'm going to take this in my hand and I don't know what this is, but this can help me reach my journey and so I'm going to do that."
Daijah Walters: Well, I could take it a little further back.
Tei Pearson: Go for it.
Daijah Walters: Well, as I stated before, I am Jamaican descent and it is different strokes for different folks. Everybody's transition and experience is not going to be the same at all. At a very young age, I didn't have those opportunities to pick or ask anyone to call me other than what was given to me at birth. As many may know in the Jamaican ethnicity, they're very strict on who you are and who you are supposed to be and what you're supposed to look like. I've been mentally and physically abused since a young age for just being me, and me not knowing what I was or what this was supposed to be played a lot on my mental.
My mother is just now grasping the fact that she is allowing herself to call me the pronouns that I accept for her to call me. For some people that would be like, "Oh, okay, well all right." But that's for me is a big milestone because my history has a lot of abuse, has a lot of crying, has a lot of bloodshed. When people look at me sometimes, on first approach, they'll be like, "Don't mess with her girl. She got the resting bitch face. Leave her alone, don't look her way." And until they're able to get to know me. And when they get to know me, they find out different. And I feel as though that sometimes my struggle sometimes shows through my feelings, if that makes sense.
Tei Pearson: It does.
Daijah Walters: As far as the trans individual, the trans man, I feel like the best thing for them is to have the time to figure out who they are and what they want to be and how far they go in it. Without having that opportunity, I feel like you're rushed to make a decision on what you need to do or how you need to do it. And I feel like time is everything. And I say that because, for example, injection, silicone, I wish that I would have never gone to experience being injected with silicone because it messes you up after a while. And trans women are very big on their appearance and their body and their frame, you know what I'm saying? The name of the game is to blend. If you're not blending, you're not doing what you need to do.
Tei Pearson: So is blending like passing?
Daijah Walters: Yeah. So I'm well known in the ballroom scene for walking realness because I am a realness girl, I'm not a blend.
Tei Pearson: And all the way, period.
Malachi Stewart: Sounds across the board.
Daijah Walters: But it's not the same for every trans woman. Some trans women are not passable. Some trans women struggle every day with being passable. Some trans women whom are very passable still struggle with being passable, if that makes sense.
Malachi Stewart: That does make sense. And I don't want to interrupt you, but I want to just break here to ask a question. Does the validity of your trans experience depend upon your passability?
Tei Pearson: Oh, that's a good question.
Malachi Stewart: And I asked it because when I worked at another organization, when I worked for my trans patient, I had trans women like, "I'm not trying to be passable, and," I'm quoting them, "I know that I'm trans. What I look like, I don't even want to stress myself out with what I look like is not a reflection of my gender expression is not necessarily the same as my gender identity."
Dr. Selena Dagnino: But yeah, I'll give you an example. In ballroom to walk realness, a lot of times, I'll tell you, light foundation and lip gloss, right? So when I go outside with no makeup, how I came in with just some pants and a shirt, I look pretty real if you're not looking at my hands and looking at how my voice. But I love to be glam and I love to put two eyelashes on and I love to put more foundation than I need and that's giving femme queen, you know what I'm saying? And then I put the heels on and now I'm over six feet so then I'm really clockable. So it's like some trans women don't want to be clocked... Not don't want to be clocked, don't want to be passable, they want to be a trans woman and I think that's valid as well.
Malachi Stewart: I thank you for saying that.
Tei Pearson: Yes, thank you for that.
Malachi Stewart: Because I think a lot of the assumption is that trans women want to be women or want to take biological women's space, they want to take up space for cis women. I don't see it personally. And when I do see it, I don't see it from trans people of color.
Dr. Selena Dagnino: I think we have our own lane. We're not here to replace anybody. We have our own experiences, our own dating pool, we're not taking up space that we don't deserve, I guess.
Tei Pearson: Yes, speak on that, yes.
Malachi Stewart: No, that's fair to say. Do you think that, and last question on passability, but is it a matter of physical safety?
Dr. Selena Dagnino: Physical safety, yeah.
Malachi Stewart: Or social acceptance or both?
Daijah Walters: For me, it's a matter of both because of the lifestyle I want to live versus a girl who don't mind being clocked, it would devastate me.
Tei Pearson: It's the chest grab.
Malachi Stewart: I knew the way you grabbed your chest there, it meant a lot.
Tei Pearson: That's the clap to grab my pearls.
Daijah Walters: It would devastate me because of the fact that I've worked so hard to get to the level that I am. And for someone to be able to dissect that would be devastating to me. You speak about being a femme queen. Back in my time, it wasn't about being a femme queen, it was about being passable.
Malachi Stewart: What is a femme queen for the audience real quick, for people who don't know?
Daijah Walters: A femme queen is like my sister said, the glamour, the lashes, the heels, the long lengthy hair.
Malachi Stewart: So similar to what people think about when you think about drag?
Daijah Walters: Yes.
Dr. Selena Dagnino: No, not drag. Drag is a persona. Femme queen is in essence you can be a femme queen without any of those things. And then as going back to clock, see I prefer to be clapped because sometimes when the girls are not clockable, it could be also dangerous because men can pull over and hit on you and the second they realize you're trans, oh, they're embarrassed they hit on you, they're embarrassed in front of their friends and now you could face violence as well. So if I'm going to a straight club, I want you to know immediately that I'm trans. I want to be clocked for my safety.
Malachi Stewart: Because people are trans-attracted.
Dr. Selena Dagnino: People are trans-attracted and I think my person is trans-attracted.
Malachi Stewart: Okay, I could imagine. I mean, we know that, but I understand the difference in perspective. I actually do understand what you're saying, not from personal experience, but I could understand that about being clocked. But then I also hear you saying, for purposes of safety, clock me so I'm not harmed.
Dr. Selena Dagnino: I mean, when I'm traveling and all that stuff and I'm in a neighborhood that I don't know, yes, I'm going to take my makeup off and be real.
Daijah Walters: But at the same time it's all about how you carry yourself at the same time. You can't say that you're a woman and you're out flolicking like some type of butch queen, you know what I'm saying?
Malachi Stewart: Unpack that for me. What does that mean?
Tei Pearson: Talk to me about that, what that means.
Daijah Walters: There are some trans women whom consider their self to be women, but they have butch queen tendencies. They still want to vogue, they still want to yayaya and do all the gay stuff and all of that, things like that. And with you saying that, it brings me to another thing too that times have changed. Whereas though I may say, "Oh girl, I'm not doing all that stuff, that is clocky, y'all girls go ahead do that. I'm going to stand over here in the corner and let y'all do whatever y'all do, y'all have a good time." And there's girls that give very much, "I don't give an F, I don't care. It is what it is, I'm the girl and everybody going to call me the girl and I don't care." With that being said, I was never one of those girls and I don't want to be one of those girls.
But I do get where my sister's coming from and I do accept that and I do understand that. Like I said, times have changed. It just wasn't the same for you now as it was for me back then, you get what I'm saying?
Dr. Selena Dagnino: No, that makes sense.
Daijah Walters: A lot has changed and there's a lot of freedom, there's a lot of freedom for the girls and the LGBTQ to do what they want to do now versus I didn't have that freedom. So if I stepped out my door and my hair wasn't in place like it needed to be and my face wasn't contoured the way it needed to be and my voice didn't sound the way it needed to be, I was going to get my ass whooped because guess what? I live in the hood. I live in the hood. There's no way you stepping out your door being free, "Oh, I'm a femme queen." You going to get your whooped. But like I said, times have changed, it is way more acceptable now and I'm loving it.
Tei Pearson: Shout out to evolution.
Dr. Selena Dagnino: But the girls before us is what made it safer, if that makes sense.
Malachi Stewart: We stand on the shoulders of giants.
Dr. Selena Dagnino: No shade. It's like my safety is because of the girls before me, because the girls was fighting down, you know what I'm saying? And East Coast butch queens for example, they have a different culture about the femme queens than West Coast do. And they take care of us a lot more, no shade. I lived on the West Coast before and it's kind of like, I think because they've seen so many girls get murdered, a lot of the boys know girls that have been murdered that if I am in my heels and stuff, it's boys being like, you got your Uber, this and this and that. And when you talk about walking through places, I'm not walking as a femme queen, absolutely. I'm taking my eyelashes off, you know what I'm saying?
Daijah Walters: She said you wanted to run around with them on.
Tei Pearson: Now she put them in apartment.
Dr. Selena Dagnino: And you know what? It was so funny because we-
Malachi Stewart: She said, "No, ma'am."
Dr. Selena Dagnino: We was watching a documentary and there was this New York femme queen and she was like, "You know a New York femme queen if you got a hammer in your bag at all times." And then one of my friends looked at me, he said, "What's in your bag?" And I've actually had a hammer in there.
Malachi Stewart: Your bag?
Dr. Selena Dagnino: And I pulled it out and it's like, it's no shade, we got to defend ourselves to be ourselves.
Malachi Stewart: Absolutely. I'm from Philly and so Miss Cookie Cookie, Ms. Samantha James, the legendary was our example of it. So that's an example of we had trans women that are like femme walk out in the daytime, but also I will take this wig off.
Tei Pearson: And do what I got do.
Daijah Walters: And see what happens.
Malachi Stewart: I didn't grow up experiencing a lot of people who... People actually were afraid of femme butch queens and trans women because they know that they knew that we grew up knocking. So it'll take one, "Was you looking wrong? You looking too long?" on you because we going to have to get you before somebody get us. That was where we kind of grew up.
I want to talk a little bit about what it was like navigating the medical field because you both mentioned two things that I want to hit on. I have questions for you, doctor, about what does safety look like? What if our trans women were able to take PrEP? Does it interfere with their hormone therapy if they're choosing to do hormones or surgeries?
Dr. Selena Dagnino: I have a big smile on my face, so trans women are historically excluded from a lot of studies and so we get a lot of our information from studies and then Black trans women on top of that. So there are a few studies going on now with Black trans women, but there's a lot of things that we don't know. So part of my educating on providers is telling people what we don't know, but what we can assume from other studies. So when we're talking about getting injections and silicone, what is the injectable antiretrovirals which are Cabenuva and Apretude, both names to remember and there's going to be more, but where can I inject that? Can I inject that over silicone? What if I have silicone from here and here because I need to inject it in a large muscle? Can I inject it in the deltoid? Those are things we don't know.
And then as far as, so I get injectable PrEP and I had a BBL so I didn't do injections and it hurts a lot, a lot. It hurts me a lot. So whenever I get my injection, for about a week my whole thigh hurts. And so I'm like, "Okay, do I go back to pills? What is going on? What's the distribution between...?" Then there's also distribution in your body and protection and all that stuff. So like I said, there's a lot of things we don't know, but there's a lot of things we do know, if that makes sense. So I guess if somebody came in and said, "I have silicone," many providers might say, "Oh, you're not a candidate for injectables." And then I'll be like, "Uh-uh, you there, based off of X, Y, and Z study, you can inject it here and there and there."
So yeah, it does make a difference being trans. But it just also is terrible because I feel like we're the ones educating our providers a lot of times. We're teaching them and I'm teaching them what my testosterone levels should be at and I'm teaching them. It's exhausting, it's exhausting. And then when you talk about trans men for example, I feel like when we talk about healthcare, a lot of times it's trans women and we're excluding the trans men. So whenever trans men are going in and they're possible UTI and they're not checking for that and they go visit after visit and no one can figure it out and it's a UTI. So there's a lot of, I guess, awareness and education that needs... I guess what I was trying to do for a while is instill trans health curriculum into pharmacy schools. So I started getting invited a lot and then slowly but surely, hopefully, but it's not there yet, it's not where it need to be.
Tei Pearson: You set the groundwork though, you laid the groundwork for the foundation.
Daijah Walters: For me, on the topic of hormones, I've been taking hormones all my life and towards becoming a more seasoned woman, I can't take them as much as I used to because the side effects will turn you. And a part of my side effect is when I do take an injection, a hormone, I'll swell up, my body will swell up. I feel like trans healthcare starts with the correct primary care provider. If you don't have a primary care provider that you can have this open relationship with, you're not going to get anywhere. All they're going to do is give you hormones, tell you your blood work is whatever it is, and send you on your way. I feel like the health community, the medical community need a compassion check because where there's not enough compassion when it comes to healthcare and trans women, I feel like down to the surgeries that they are allowing us to have the option to get now, it was not much thought put into it.
It is giving very much, "Lay down, we're going to put these bags in you because you feel like a woman. So here take that and go on because girl, we really don't see it. But being as though we think y'all crazy and we don't want y'all going off to kill y'all self here, take these bags, take these hormones and you want to sex change too? Come get that, we'll do you and send you on your way." There's never much thought in the aftercare when it comes to mental health, when it comes to physical health. It's not much thought in that at all. And I really just feel like when it comes to trans health care, it needs to have much more thought put into it.
Dr. Selena Dagnino: Yes, I agree with that.
Malachi Stewart: And much more empathy. I am going to briefly just share this experience because I want your reactions, but I remember working in direct care and we were going out in the street finding people, doing medical visits where we had to, and one of the places we went was a place that helps people survive. And I was going to that place and we were actually there to see other patients and I looked over, it was me and a medical provider and we looked over and we saw our patient, a trans woman, I've never seen her out of her jushe. So she was there with no hair on and so I was like, "Okay," with a blank stare looking forward.
And as you got closer you could see blood, dry blood running there. We got her into a medical room, we're having a conversation. Turns out the night before she had been assaulted for no reason, clocked and someone walked up before she could turn around and hit her with a brick. She woke up in the hospital far from home with her head gashed open and they were bringing orderlies and nurses in like, "Yo, look at it, see what it is. No, look, we took her gown." They had changed her from her gown so they clocked her.
And they treated her so badly that they put her out the hospital before treating her. They didn't give her any medication. She had an open wound when we saw her so it was still open, sepsis could have set in, I mean, all kinds of things. They wouldn't even give her a cab back home so she walked across the Virginia line to get back to DC. And when we saw her, she was literally in shock, literally just standing there in shock. I had to put her in my own car, break policy, ask one of our psych nurses to stay behind because I can't even treat you medically until I know you're okay. This is the medical field for trans women. It's been my experience. I'll leave that there and let you speak to it.
Dr. Selena Dagnino: I've seen that in real life. So at my undergrad job, I was an ER technician to help pay for school and we had a patient come in, trans woman got beat with a crowbar, blood everywhere. She was positive. So they put her in a room and no one would step foot in there. No one would treat her. And this wasn't even my zone, we're divided by zones and no one would clean her up, no one would go in there. And so I walked over there and I said, "Well I'm going to clean her up then." "Oh no, she's got AIDS." And I'm like, or no, "He's got AIDS," is what they were saying.
Malachi Stewart: He, yeah.
Dr. Selena Dagnino: "He's got AIDS." And I'm like, "So you put gloves on. Do you have cuts on you? What would you do with somebody that was negative that is bleeding out? You just put gloves on and a gown and you're fine." So I went in there and cleaned her up and she was appreciative, but I'm like, had another trans woman not been there, and at the time I was a butch queen, but I'm like...
Daijah Walters: It's the way worse with the police system.
Dr. Selena Dagnino: The police.
Tei Pearson: Let's talk about it.
Daijah Walters: I've witnessed plenty of times, I ain't going to tell you how I got there, but I've witnessed plenty of times while being incarcerated trans women were being neglected and abused in it as well. In the prison system, you are not trans. You are who you are, you are who you are. Whatever your mom and your daddy named, you.
Malachi Stewart: Whatever you were assigned at birth?
Daijah Walters: That's who you are. You are stripped of everything when it comes to jail. I've sat there and watched trans women be overlooked after being assaulted and battered and the police officers would just shove us in the room and leave us there for dead with no care in the world. As far as sex work, I am a ex-sex worker and through my experience being a sex worker, it's no walk in the park as a trans woman. Here it is, you're trying to survive to either pay for your night in a hotel because you ain't got nowhere to live, feed yourself or be able to get yourself together to be able to go and do it another night. And with having to do these things, you're going to come across law enforcement. And when you come across law enforcement, they're not passionate about anything. You are just another Black guy.
Malachi Stewart: And that's not the term they're going to use. We can't say that here on Positive Words, what they say.
Tei Pearson: They understand.
Daijah Walters: But you are just another Black individual. All that trans stuff is out the window. So with my experience with the medical and the police force, all those systems are all the same when it comes to us, and that's just how I feel. They don't have enough awareness and they could care less.
Tei Pearson: And I think those biases are spread across a couple different ones, right? And so as you all are talking, I'm putting myself in the space of this Black lesbian woman. And even, Malachi, when you were talking earlier, I'm like, "Yeah." And so the way that I present, some men assume that I want to be a guy. And so I get that shoulder, the bumping, the aggressive energy, especially if I'm out with my wife. Then it's like, "Oh, so you think you a dude? So let me show you because I'm a dude," and it's the bumping. I'm like, "I'm just wearing a bow tie, I am just coming at the bar trying to get a little drink for me and my wife." And so I sit in that space a little bit with you all.
But I also did street outreach in DC down on K Street and I would see exactly what you described. So when you said it, it took me back to those spaces because I would file reports, I would file reports on police because particularly if I was out looking for a missing kid and it's a trans youth, and so I know where the trans youth do the work and so let me go and sit and do that and then call in like, "I'm sure this child is 15, I have a picture of them, they're missing. They're right here on the corner of so-and-so and so-and-so, and can y'all come and recover this child?" The police pull up and I'm watching and the police put the person in the front seat. Now some of us done took rides in police cars, but it ain't never been in the front. But they pull up and they go and they gone for 15 minutes. The police car come back, I'm still there waiting with my team to kind of see what's going to happen because we knew what was going to happen. They circled the block and came back and then the person got out the car, police went on. So I'm sitting in a space of like, "Wow, okay. So the protect and serve is not always protect and serve?"
Daijah Walters: The protect and serve is out there trying to get him some too.
Tei Pearson: That part, right? But if they get called out-
Daijah Walters: He's trying to get him some too, I can tell.
Tei Pearson: And got some and got some, yeah.
Daijah Walters: How many police cars I've been escorted in the front seat instead of the back.
Malachi Stewart: No tea no shade.
Tei Pearson: It's the S-code for me in the front seat, yeah. But those are the same people, like you both said, that are in a position to make some changes, that are in positions to have some good conversations about policies and all that stuff. But why?
Daijah Walters: But if you don't give a F, you're not going to make no changes or anything.
Tei Pearson: That's it, that's it.
Daijah Walters: Especially if you feel like it doesn't have anything to do with you although you're Black and you live in America, right?
Tei Pearson: That part, we started with the first one. So as we kind of do a little wrap, right, if you all just give us a little bit, what do you think needs to shift? What do you think needs to shift within the conversation? Like this is the wish list, right? So we're going to do the wish list. So what do you think needs to happen within just conversations to make it a better... Not transition, to make the journey a little more smoother for trans individuals to have seats at tables that directly impact them? And I'm asking you that because they asked me the same thing as a lesbian woman of what would have to shift. And so I would be intrigued to hear.
Dr. Selena Dagnino: I don't know, I kind of just want healthcare. So when we talked about survival sex work, you can see somebody like me and be like, "Oh, you have three degrees and you can get a bunch of jobs," and it's like, "Well, I still don't have trans healthcare, so I am working my 9:00 to 5:00 and then pulling coins after that so I could get my surge." So it's like we're still in the survival work. And then substance has come up a lot as well because I personally, I feel appreciative that I am able to do sex work, but for me it is traumatic. So I drink a lot whenever I'm doing sex work, and I try to not, but it is what it is. And so a lot of the girls fall into into drugs as well, and it's just part of our community. We know a lot of people that have passed away from that. So I mean, we can dive deeper, but the basic thing that I just want is healthcare.
Tei Pearson: Healthcare.
Malachi Stewart: Healthcare.
Daijah Walters: Here, here on the healthcare part, which you're speaking of. Some substance abuse come from your medical provider as well.
Tei Pearson: Oh, hello.
Daijah Walters: You get a fresh set of bags, what they do? "Here, have some Percocets."
Tei Pearson: Just some oxys.
Daijah Walters: You don't know if this person has a history down the line where their parents were addicted to this type of drug. They're not asking those questions. You're not even asking the right questions to ask before you give me these medications. All you know is that you gave me a set of bags and you're giving me this medication and you're telling me to go on about my business. For me, I feel like what needs to change in the conversation before the conversation even starts, people need to learn how to share their space.
Tei Pearson: That's a good one. Share space.
Daijah Walters: Learn how to share your space, learn how to be comfortable in the space that you're in enough for you to be able to share it with others. Yes, you are cisgender woman, yes you are. But since I'm here too.
Tei Pearson: Hello, come on now.
Daijah Walters: I'm here too. No, I'm not trying to be like you girl. No, I don't want to take your space. No, I don't want the cramps, I don't want to have to give birth, I don't want all that pain. I'm not trying to take your space. So I really feel like in conversations before the conversation even starts, sis, you need to learn how to be able to be comfortable in yourself enough to share your space.
Tei Pearson: Yes, hello, share space. I'm here for that. I'm here to share, I'm here to share, I'm here to share. Thank you so much for that, both of you. I thank you. Malachi, what you think?
Daijah Walters: I appreciate you all both being here. It's a conversation for me that's never easy. I'll just say that really quickly, it's never easy conversation for me. And I'll just say because of this one reason, when I was telling the story about the patient, a lesbian woman who is masc presenting, two trans women, a gay male who is femme presenting, there was a collective sigh of empathy because we all knew that place, we knew that story, we knew that person. And that is the reason why I go so hard and why I sometimes jump out the window in my defensiveness because it is not fair for people to be born and for no reason other than their existence feel like they can't be safe, they can't get medical care, they're excluded from tables, they're excluded from conversations. As a collective, we just have to do better and I'll leave that there.
Tei Pearson: And I think it's all the way around, right? And so we definitely have two beautiful trans women here with me, two women, okay? Period, because I'm sharing my space, two women. But I think even like the trans men because I'm a parent of a trans boy who's going to be a trans man, a man, that's my son and I don't see it any other different. But I also know he went through struggles. He got bullied a lot, they had to move a lot. He got beat down and had to physically defend himself. What ended up him being charged as a 14-year-old kid with six felonies charged as an adult because they attacked him for his presentation. And it was 19 kids totaled only my son, my oldest daughter and his white best friend and they were attacked by 16 white people at a school playground.
Dr. Selena Dagnino: And they got the charges?
Tei Pearson: And we tried to press charges on them because they were adults and all charges were dropped from our side, but they locked my 14-year-old son up with adult women, even though he passes as a boy without T, which I told him it's a privilege so we sit in that space. But they put him in adult jail and we had to get constitutional lawyers and defense attorneys to say this kid was defending himself. These people threatened him on phone, they pulled guns on him while he was minding his business skateboarding and cornered him where he couldn't go anywhere. But no charges were filed.
And it was very much, very quickly because I know we're wrapping up, we listened to the witness tapes and they gave us all for the discovery. And I have a criminal justice background, so I'm in it, and so I'm listening and I'm trying to pull stuff out and what hit me the most was when the police were talking to the two victims at the hospital and no one passed, I just want to say that, but my son had to protect himself and I stand by his decision and we all do. But what I pulled out from them conversations that the police were having with the victims was, and so then that girl, the female who he ended up stabbing because she was jumping on him, she says, "Well, I was talking to the girl or boy or whatever," that's what the witness says. The police responds and says, "It doesn't even matter." And the conversation continues. And we're listening, we're like, but that was the point of this attack, right? Because no one cared, no one had the empathy, no one had the compassion and people was just minding other people's business. My son's skateboarding had nothing to do with you, it was not a threat to you or the biological boys that were skateboarding, just mind your business.
And so I thank you both for setting the platform, setting the foundation, and we talked about evolution and where things were when you first started transitioning into where things were when you first started doing the outward transition. And so I just appreciate it. We appreciate you all of just the groundwork that you guys are laying, the foundations that are being laid. And you're in the science, you're in the medical field. And so that push for trans health, you're leading, you're one of the leading folks in that.
Dr. Selena Dagnino: But it still becomes exhausting because-
Tei Pearson: I bet, yeah.
Dr. Selena Dagnino: I'll give you an example. I got in an argument yesterday with our CEO, literal CEO, argument me and him, because our logins don't represent our chosen names. So I legally changed my name a while ago, but since I worked at that company before it changed, it's always reverting back. So then I get really exhausted in the corporate workspace just because of all these microaggressions. And so we founded the trans committee at where I work at, and we are just there to support each other through different things. So there's a trans man transitioning and he's trying to use his name at work and it's just not going well. So it's really difficult to make changes or the changes that we want to when we can't even log into our logins.
Tei Pearson: Yeah, simple things.
Dr. Selena Dagnino: So simple things like that or getting our medications approved or just the really basics. But just as my transition has been easier because of the girls before me, Gen Z's will be better and it'll get better over time. So I don't think in our lifetime that the corporate space will be inclusive, I think, but hopefully in the future, things like this will help bring awareness, and I don't know, things will get better hopefully.
Daijah Walters: While, we're wrapping up. I just want to say to any other trans woman that may view this, girl, hang in there and do what you need to do. I remember having to sex work, work a regular job, go to college and maintain a home of children at the same time. And I feel like if I can do it, you can do it too. And that goes for all my trans brothers and sisters. Just hang in there and continue to do what you need to do.
Malachi Stewart: Ashay. And listen, on that note, if you are watching this at home, and I hope your takeaway if nothing else, no matter what your belief is, no matter what your thoughts are, no matter what your opinion is to at least be wondering what can you do? What can you do to make the world a safer place for everyone, yourself included?
Listen, if you are in need of resources, you can go to Type in your zip code and you will see resources in your area for any type of resources. You may need trans health resources, you may need help with your rent this month, you may need transportation assistance. Whatever the resources that you need, you'll be able to find that there at If you want to hear other conversations that we've had last season, things coming up this season, just join the conversation, take a survey, you can visit us at and check us out there. Also, wherever you're watching this, like, comment, share, and definitely let us know, join the conversation on whatever platform you see this on because we definitely want to hear from you and hear your thoughts. Thank you and until next time, from Malachi.
Tei Pearson: And Tei.
Malachi Stewart: Have a great day, great weekend. Bye.

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Meet the Guests

Selena Dagnino

Selena Dagnino-Santamaria, PharmD, MHSA, AAHIVP, HIV PCP, is an HIV pharmacist dedicated to making a positive impact in the fields of HIV, Public Health, and advancing access to Trans healthcare. As a Mexican-American trans woman, she brings a unique perspective and unwavering commitment to inclusivity and accessibility in healthcare. She holds a BS in Dietetics, a Master in Health Services Administration, and a Doctor of Pharmacy. She is proudly certified by the American Academy of HIV Medicine and Health HIV as an HIV Pharmacist and Prevention Certified Provider. In 2018, she was the recipient of the Excellence in Public Health Pharmacy Award, awarded by the Pharmacist Professional Advisory Committee of the United States Public Health Service (USPHS), recognizing her commitment to public health service. Throughout her career, she has worn many hats, notably serving as a Pharmacist Practitioner and Regional Director for the AIDS Healthcare Foundation. In these roles, she implemented protocols allowing pharmacists to prescribe PrEP/PEP in the ambulatory care setting, along with breaking barriers to provide access to Hormone Replacement Therapy. Sharing knowledge is a passion of hers, and she has had the privilege of lecturing on Gender-Affirming Pharmacotherapy at Howard University and the University of St. Joseph School of Pharmacy. Selena believes in the power of community insights in shaping effective public health strategies and loves sharing her journey, insights, and advocacy.

Daijah Walters

Daijah Tiffani Walters, a Black Trans Woman of color. Born of Jamaican descent and raised in Baltimore Maryland. Daijah, a Washingtonian of 20 years and the oldest of 7 siblings whom she loves dearly. Daijah is also a Medical Assistant graduate from Fortis College. Upon graduating from college, Daijah was then offered an Internship position as Medical Assistant at Whitman Walker Health. She then followed her heart with a passion for helping others in need.She accepted an offer to become a HIV Tester/Peer Educator at The Women Collective Organization under Billie Tyler RN supervision. Daijah then became a Medical & Non Medical Case at Casa Ruby LGBTQ +  non profit organization years. She is known for her work in HIV prevention/awareness, Trans Visibility & Advocacy. Working closely with LGBTQ + youth and adults within the community. As well as networking with other well known organizations such as HIPS, Us Helping Us, SMYLES, Damien Ministries, DoH, just to name a few. Ms Walters had the privilege of working closely with well known White House candidates and federal donors. Ms. Walters has been advocating for transgender rights, awareness, and visibility throughout the DMV area for the last 20 years. Advocating for those in the community with a voice. She has also had the honor of speaking at the World AIDS conferences, spoke on panels USCHA, bringing visibility to transgender violence and trans awareness throughout the USA . Ms Walters is also a part of Ballroom Culture, shea a Mother within the Captivating house of West, where love  and supporting one another is definitely our flex. Filled with so many talented individuals she calls her West Babies. Where individuals display the art form of vogue (dance) effortlessly, fashion,  along with many other well known talents displayed throughout our very own LGBTQ + community. When Daijah isn’t nurturing her chosen children. She is continuing to do the work in our community as the Case Manager at Us Helping US which focuses on the needs and heath care of the LGBTQ+ community. With a passion for HIV healthcare, transgender advocacy, HIV prevention, and awareness. She continues to fight trans equality and fill in the gaps where she is able to on ending the HIV epidemic through her expertise and being able to relate to the community asa Black TransWoman of color from the Hood. Ms Walters says she strives daily to save and change lives for the betterment of our community’s future.

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