How a Culturally Competent Healthcare Provider Changed the Life of a Trans Woman Living With HIV.

by Ella Jasso

My name is Ella Josefine Jasso. I am from Mexico, Zacatecas, Zacatecas.

So it’s 2016 and I’m on my way to go get tested for a general testing, HIV, STIs. So I go up to the clinic and waiting… waiting for them to call my name. And so they did. I get tested. Right before they gave me my results. I was expecting, You’re negative, but this same, they said, “You’re HIV positive.”

And I just froze everything. Just felt like it was over. I was in… I’d just got out of a bad relationship. I wasn’t really doing well financially. I wasn’t happy where I was living. I… and now this. And I didn’t know what was going to go… go on, where… where I was – what I was going to do, what’s my destination? How am I going to navigate love? How am I going to navigate finding a job or finding friends with this stigma? I just didn’t see a future or anything worth looking forward to after hearing this news and being in the position that I’m in now. And it was a scary place to be.

When they gave me the diagnosis, they said, “Well, you’re going to have a followup. We’re going to send you to another health center.” You know, I get up, I’m going to the followup visit. I walk in, I’m sitting down at the lobby. I’m so nervous. I go in. I see a wonderful provider.

And, you know, the first thing he said, “Hi, you know, my name is so-and-so, what’s your name? And what are your pronouns?” It was the first time someone had asked me that so I asked the provider to repeat himself, and he did. He explained what pronouns were and even though I knew my opponents where she, her and hers, I’ve never really said it out loud. And there was still some fear. So I said Ocean, which is my high school nickname. And that felt empowering, too, where I felt seen for the first time.

And then we started talking about the labs and he said, “Ella, your viral load is going to be very high, so don’t get nervous. That’s very normal. You’re going to get on antiviral medications, which is going to suppress the… the virus to the point where it cannot be detected. And that’s something called “U equals U.”

So I said, “What does that even mean?”

He… he said, “U equals… U means undetectable equals untransmittable.” And he also said, Ella, “You’re also going to be able to live as long as anyone else.” And…. and I thought people who were HIV positive was like 10 years or just things I heard from the eighties, 12 years, 15 years, but never as old as anyone else.

At that point, you know, I got the gift of… of being able to dream again, which just opened up a portal, a new reality, light, hope. Everything just opened up with those words. It was… it was great news to hear that.

So I came back for my follow-up and… and the virus had gone down to undetectable within one month. I would say it here in a hundred percent. I woke up every day and took it as an act of love and said, No, you know, I want… I want to have time and want to take care of myself. I have another opportunity and I’m going to run within and I’m going to do everything I thought I couldn’t do just a week ago.

He asked me again, “What are your pronouns?”

And now it’s like, “Why are you asking me my pronouns? I just told you.”

And he said, “Well, some people are fluid and… and they may change.”

So it’s, you know, and I said, “Well, actually my pronouns are she, her and hers. I have thought about it and thank you for asking again.” And I told them that I wanted to transition.

He said, “Well, there’s after hours tea time for TGNC – transgender, nonconforming individuals to come in, have a sense of community, and there’s providers on site. So I was there early. I signed up, I met other like minded individuals with similar experiences and they gave me my first hormone shot there. And again, another dream. And so I started transitioning.

I went there twice a month, every day, for two years. And they were like, “Ella, you know, we think you should volunteer here.”

So I said, “Sure, what is it about?”

It’s a needle exchange program. We’re going to give out free needles, syringes. Everything for people who cannot afford hormone therapy or anything that goes with it.

So I said, For… yeah, absolutely!”

And after a couple of years of volunteering, they said, “Ella, we think you should apply here.” I applied for different times and I was starting to get a little nervous. And finally, I got an interview and it was for a health educator position and it went well. I ended up getting hired. I’m now testing people for HIV and STIs. I’m now in the position to be able to help others who are scared, just the way I was when I walked in.

So on my first day, I remember thinking there’s going to be people out there that are very nervous and it’s your opportunity to create that space the way the providers and everyone here did for you.

And so I went out and the person I called was fidgeting and, and I was like, Yup, that was me. So I was like, you know, “Come right this way. How are you?” And I made sure that it was… the interactions were heartfelt. And I share my own experience just enough, I hope, so that they know that, you know, someone is thriving and someone who’s dreaming within the same situation, which were one of my biggest fears.

I’m in this position for a year and now someone comes up to me and is like, “Ella, we think you should apply for a medical case manager position.” So I did, and I got the job. So I’ve been a medical case manager now for a year and a half. And the community that I work with are men who are 25 and over, HIV positive.

And to be here now, compared to where I was when I had that diagnosis, where I thought none of this was possible… but it’s possible.

It all started with that support and that support doesn’t just come from family. It come from… it comes from, it can come from anywhere. And in this particular case, it came from my health care center that gave affirming healthcare, and… and poured into me. Poured into me to the point where I’m here now and I’m thriving. And I’m so grateful.

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