Podcast Summary

A Shot in the Arm Podcast

Episode: Trans Life: How to Survive Trump’s 2nd Administration

Host: Ben Plumley
Guest: Dr. Tatyana Moaton, Director of Strategic Innovation and Partnership at San Francisco Community Health Center
Date: December 10, 2025

Episode Overview

This episode centers on the challenges faced by transgender individuals—especially trans women of color—in the United States’ current political climate, specifically under the second Trump administration. Dr. Tatyana Moaton joins Ben Plumley for an in-depth look at how policies, erasure, and targeted attacks are impacting trans health, access to care, and survival, and how grassroots and institutional efforts are persevering in the face of adversity.

Key Discussion Points & Insights

1. The Role of the San Francisco Community Health Center (SFCHC)

• SFCHC functions as a crucial “safety net” provider with a mission grounded in diversity, equity, and inclusion (DEI), now weaponized and politicized terms.
• The center has evolved from its roots serving the API community in the HIV/AIDS epidemic to becoming a federally qualified health center for all, with a particular focus on marginalized populations in the Tenderloin area.
• “We sit at the intersection...really, what makes up who we are is the richness of the communities we serve.” – Dr. Moaton (04:45)
• TransThrive, a dedicated program for trans and nonbinary individuals, offers wrap-around services including food, transportation, support groups, and the She Boutique, a gender-affirming clothing and personal care resource.

Relevant Timestamps:

• SFCHC philosophy and history: 04:17–06:22
• TransThrive and wraparound services: 07:12–10:10

2. Systemic Erasure & Attacks Under the Trump Administration

• The current administration’s explicit attempts to erase transgender people from policy, research, and public life through funding cuts, data manipulation, and direct legal and administrative action.
• Under Trump’s first term, efforts included stripping rights, criminalizing aspects of trans identity, and erasing research data on trans health at federal levels.
• “If the data does not exist, then we don’t have something to correlate that to…there’s this systematic erasure.” – Dr. Moaton (10:19)

Relevant Timestamps:

• Policy erasure and history: 10:19–12:15, 29:25–34:11
• Examples include revoked CDC grants earmarked for trans community/inclusive health measures and federal directives denying services to transgender individuals.

3. The Historical & Ongoing Struggle for Recognition and Safety

• Dr. Moaton shares her personal journey and contextualizes trans identities as innate—not a recent trend or a confusion—contrary to right-wing talking points.
• Data pre-Trump never reflected meaningful safety for trans people: 44% of Black and Brown trans women at risk of, or living with, HIV.
• Trans women, especially women of color, are shockingly overrepresented among victims of violence and homicide.
• “Every day I step out of my house, I have to say to myself, is today the day I don’t make it home.” – Dr. Moaton (26:29)

Relevant Timestamps:

• Historical context and personal journey: 14:44–19:07
• On violence and fear: 25:23–29:12

4. Barriers in Healthcare Access & the Importance of Affirmation

• Systemic failures have led to higher HIV rates, underemployment, unemployment, and housing instability in the trans community.
• Trans people continue to be misclassified or forced to navigate mainstream medical spaces where they are not affirmed, sometimes subjected to dehumanizing or even abusive treatment.
• “If you don’t see me as a person, how do we have conversations about sexual health and prevention?” – Dr. Moaton (21:22)

Relevant Timestamps:

• Systemic barriers and intersectionality: 20:55–23:47
• Prevention, access, and mistrust: 21:22–23:47

5. The Contradictions and Hypocrisy of Anti-Trans Rhetoric

• The concept of “gender ideology” is used as a political scapegoat; in reality, many figures railing against gender-affirming care themselves partake in appearance-altering procedures.
• Widespread misinformation and disinformation campaigns create further harm and confusion, requiring robust public education and advocacy.
• "Donald Trump’s hair...That is a clear example of gender affirming care." – Ben Plumley (30:21)

Relevant Timestamps:

• Gender-affirming care, societal contradictions: 29:51–36:14
• Disinformation and need for public education: 46:23–50:41

6. Impact of Immigration Policy & Safety Concerns

• Policies have created fear and danger not just for trans residents, but also immigrant communities—highlighted by ICE detaining individuals at SFCHC facilities.
• This affects trust, staff, and client safety, and undermines the sanctuary aspect of healthcare.
• "Being trapped in this dark box of knowing deep down inside this is who I am...That’s painful." – Dr. Moaton (51:10)

Relevant Timestamps:

• Immigration policies and ICE: 52:44–56:08

7. Legal & Community Response: Strategies for Survival

• SFCHC and partner organizations (including Lambda Legal and ACLU) are engaging in legal battles to defend critical funding and care access.
• The need for coalition-building, alternative funding, and creative strategies in healthcare delivery (including telehealth, back-end referrals, etc.).
• Emphasis on recognizing the collective humanity and interconnectedness necessary for successful advocacy:
  “The only path forward is together.” – Dr. Moaton (59:50)

Relevant Timestamps:

• Policy/legal battles and advocacy: 37:25–44:05
• Community response, coalition-building, and international ramifications: 44:05–62:13

8. A Call to Action & Hope

• Dr. Moaton urges listeners to support local health centers, donate if possible, join coalitions, and help counteract misinformation by amplifying accurate information and resources.
• Recognition that while the challenge is immense, progress depends on communal solidarity, activism, and remembering the intersections that bind communities together.
• "I am a daughter, I am a mother, I am a teacher, I am a missionary, I am a veteran. And none of that changed the moment I said, I am also trans." – Dr. Moaton (60:37)

Relevant Timestamps:

• Optimism, unity, and next steps: 58:00–63:00
• Specific asks for support: 62:38–64:30

Notable Quotes & Memorable Moments

| Timestamp | Speaker | Quote | |-------------|--------------|--------------------------------------------------------------------------------------------------------------------------| | 04:45 | Dr. Moaton | “We sit at the intersection... really, what makes up who we are is the richness of the communities we serve.” | | 10:19 | Dr. Moaton | “If the data does not exist, then we don’t have something to correlate that to… there’s this systematic erasure.” | | 26:29 | Dr. Moaton | “Every day I step out of my house, I have to say to myself, is today the day I don’t make it home.” | | 21:22 | Dr. Moaton | “If you don’t see me as a person, how do we have conversations about sexual health and prevention?” | | 30:21 | Ben Plumley | "Donald Trump’s hair... That is a clear example of gender affirming care." | | 43:44 | Dr. Moaton | “What world are we existing in where we’re selecting populations of people to say, you don’t matter, you’re invalidated?” | | 59:50 | Dr. Moaton | “The only path forward is together.” | | 60:37 | Dr. Moaton | “I am a daughter, I am a mother, I am a teacher, I am a missionary, I am a veteran. And none of that changed the moment I said, I am also trans.” |

Timestamps for Key Topics

• SFCHC and TransThrive Overview: 04:17–10:10
• Trump Administration’s Erasure Policies: 10:19–12:15, 29:25–34:11, 37:25–44:05
• Historical Challenges for Trans Community: 14:44–19:07, 25:23–29:12
• Structural Barriers to HIV Services: 20:55–23:47
• Immigration and ICE Encounters: 52:44–56:08
• Legal and Advocacy Strategies: 37:25–44:05, 58:00–63:00
• Calls to Action and Ways to Help: 62:38–64:30

Action Steps / How You Can Help

• Support local health centers like SFCHC financially or by sharing their resources and campaigns on social media.
• Join coalition efforts, participate in advocacy, and amplify accurate information to counter disinformation.
• Recognize and affirm trans individuals’ humanity and contributions beyond trans identity.
• Stay engaged on international impacts of U.S. policy, especially on HIV/AIDS funding repercussions.

Tone and Delivery

The conversation is character-driven, candid, and deeply personal—blending analytical critique of policies with lived experience and frontline insight. Both speakers maintain a tone of resilience mixed with clear urgency, combining hope and a call for collective action, even against a stark and hostile political backdrop.

For more resources, policy briefs, and ways to help, visit the San Francisco Community Health Center’s website and follow them on social media.