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Access to gender-affirming healthcare is vastly different from access to HIV medication or PrEP (historically gay men's issues). Trans individuals face long waitlists for clinics, "gatekeeping" by psychologists, and insurance exclusions for surgeries. In many U.S. states, legislation is actively banning gender-affirming care for minors, a move that major medical associations (like the American Academy of Pediatrics) deem harmful.

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Following Stonewall, Rivera and Johnson founded Street Transvestite Action Revolutionaries (STAR) in 1970. This was one of the earliest organizations dedicated to providing housing and support for homeless transgender youth and sex workers. This history demonstrates that the transgender community has never been an addendum to LGBTQ culture; it has been at the vanguard of its survival. Language, Identity, and Evolution This was one of the earliest organizations dedicated