WEST VILLAGE — Crystal meth use is a persistent problem for gay and transgender New Yorkers, but “is often ignored” and services to address it “are lacking,” experts say.
“Over half of the participants in our substance abuse treatment program come here for help around methamphetamine,” said Carrie Davis, chief program officer for The Center, a West Village-based refuge for the LGBT community for the past 33 years.
Tanya Walker, a transgender woman who co-founded New York Transgender Advocacy Group, highlighted a need for drug treatment programs specifically for transgender people, because mainstream centers often aren't equipped to help them.
“When they go there, they’re often mis-gendered, disrespected or forgotten about while they’re there,” she said.
That puts them back on the street where, she said, many go back to the survival sex work that led them to use meth in the first place.
"You have to do it," Walker said of the sex work. "If you don't do it, you don't eat, you don't have anywhere to live, you can't survive."
Davis said drugs like meth “have historically been used in survival sex work,” because they “help keep you going.”
Walker added that it leads to "unprotected sex with lots of people," which is a "problem that's going to keep AIDS going."
One problem with getting funding for drug treatment facilities specific to transgender people is being able to show hard numbers that prove the need is there.
“We’ve always known that transgender people in particular and often transgender women who engaged in sex work have higher use of crystal methamphetamine,” Davis said. “[But] we don’t have good numbers on that. We don't have population level data.
"What we have is sampling from our own programs, which show this is an issue, and that’s not good enough.”
But among the city and state’s recent initiatives to reduce HIV/AIDS is a commitment to track the needs of the transgender community, which medical experts say is crucial to achieving Gov. Andrew Cuomo's commitment to end the AIDS epidemic by 2020.
“Anecdotally, every provider I’ve spoke to feels like there’s increasing crystal meth use in the city, and it’s definitely a driver in HIV acquisition,” said Dr. Demetre Daskalakis, the assistant commissioner of HIV/AIDS for the city’s Health Department.
Part of the problem is that meth is cheap, easy to get and makes the user feel “sort of superhuman,” said Doug Wirth, CEO of the health provider Amida Care NY.
That’s appealing not just for sex workers, but also for young people struggling with their sexual orientation, Wirth said.
“When I think back to being young," he said, "and I’m just discovering who I am, and I don’t know how you’re going to react ... [meth] creates that sense of, ‘I can come over and talk to you.’”
From harassment in school to family rejection and shame about their identity, experts say gay youth face challenges that have have resulted in a higher drop-out rate, higher suicide rate and a greater likelihood of homelessness — and of drug abuse.
LGBT youth are twice as likely to use marijuana, three times more likely to use heroin, and nine times more likely to use crystal meth, Davis said.
The conditions are even worse for transgender New Yorkers, a recent study found, and worse still for transgender people of color — which is why Walker is frustrated.
"When the gay white men were using crystal meth, you had signs" all over Chelsea warning of the drug's dangers, she said. But for the transgender people of color in East Harlem and The Bronx, “I don't see any posters around, any signs."
But recent efforts by the city might signal a shift toward being more inclusive of and focused on transgender needs.
Daskalakis just launched an ad campaign promoting the use of PrEP, a preventive medication given to people who are HIV-free, but at risk of contracting the virus.
Part of the campaign features two trans people of color.
"We work-shopped it to pieces [with] focus groups on gay and bisexual men, transgender women, transgender men," he said. "It was pretty awesome, sort of hearing people's responses and having what they said influence the campaign."
Daskalakis said his collaboration with the transgender community won't end with the #PlaySure campaign.
"We've heard that voice pretty clearly," he said, "and we're going to be that voice at the table in the city especially."