The Kua’ana Project is a trans and sex worker-led program serving the trans and sex worker community of Honolulu, Hawai’i. I am a Samoan trans woman and a former sex worker tasked with leading it. The Kua’ana Project first began when several trans women working for Hawai’i’s oldest and largest AIDS services organization, Life Foundation, came together to support the health and social needs of our trans community. It has now been over a decade since our program began serving the trans and sex worker community of Honolulu.
When the program was first created, trans women were facing a host of challenges that remain omnipresent in our communities and require many to engage in sex work out of necessity. Some of our women have chronic medical conditions, including HIV, viral hepatitis, diabetes and heart problems. Others struggle with intimate partner violence or chaotic families and have histories of sexual, physical and psychological abuse. Even those who are working live well below the poverty line, and some have documented histories in the criminal legal system that impair our ability to find safe and stable housing, adequate nutrition and employment.
Pasifika trans women are prevalent in Hawai’i’s trans community, and what binds us together is our lived experience as trans women. In contrast to normative notions of gender and sexuality that center cisgender and heterosexual majorities, Pasifika cultures made space for gender fluidity before the imposition of Western colonial attitudes and mores. Pasifika culture’s acceptance of gender fluidity gave us the word Kua’ana, which is the Hawaiian word for “older sibling.” It’s been the model of our project to empower trans women with lived experience to mentor other trans women along their life’s path. Native Hawaiian and Pasifika trans women embody resilience and compassion in the face of a social, economic and legal landscape that still treats us as less than equal.
Thankfully we’ve made legal progress. With gender identity now a protected category in our state’s nondiscrimination laws, trans women in Hawai’i are no longer in a position to be arrested and jailed simply for using a public bathroom.
There is a lot of unfinished business, and we are still fighting for increased access to gender-affirming care and mental health resources and the decriminalization of sex work and substance use. Trans- and sex worker–led organizations, like the under-resourced trans and sex worker communities they represent, require sustained investment to support the work. Funding is essential to the pursuit of social and economic justice and to reduce structural barriers in systems that stigmatize queer and trans people and that criminalize sex workers and people with behavioral health problems.
A shift toward more just, equitable and affirming policies for trans people and sex workers simply cannot happen without the steady support of allies. Without funding support, organizations like Kua’ana Project would wither on the nonprofit vine before disappearing entirely, leaving already under-resourced communities fighting for survival and some semblance of dignity in a callous political and social landscape.
The absence of funding for trans and sex worker–led organizations that have decriminalization advocacy in their portfolio ensures that the battle for organizational survival will have to be simultaneously waged on multiple fronts. It’s hard to make meaningful progress over time for a community that is criminalized and castigated. It’s hard to empower trans women with marginalized lived experiences to feel confident enough to engage in the public square, even though they should be at the forefront of discussions around their specific needs. For trans sex workers who are struggling to meet their basic needs, advocacy is all but likely out of the question.
Secured multi-year funding helps us sustain a baseline of support to help our work. Over the 2 most recent fiscal years, Kua’ana Project was able to maintain staffing and services to reach 100s of trans women across Hawai’i with programmatic assistance with a six-figure grant from a private donor. These services included name changes, procurement of identity documents, and connection with medical insurance, behavioral health services, housing opportunities and available government support. Funding allowed us to provide peer support, beauty consultations, resume writing and career assistance.
Yet the needs of our trans and sex worker population are often urgent and outside of the realm of dedicated program funding. Unrestricted funding that enables our program to meet these basic needs is critical to keeping our most vulnerable members safe and healthy. Unrestricted grant funding since the onset of the COVID-19 pandemic has allowed us to assist with medical co-payments, personal hygiene supplies, food, clothes for job interviews, rideshare transportation assistance for medical appointments and tents and supplies for our unsheltered homeless participants.
Committing to unrestricted funding gives trans–led and sex worker-led organizations the means to help re-shape the conversation around the continued criminalization of sex work and behavioral health issues. Funding that is not project specific gives programs like ours the latitude be responsive to meet the immediate direct needs of trans women in their communities while also advocating for systemic change.
Kua’ana Project is housed in Hawai’i Health and Harm Reduction Center (HHHRC), whose mission is to reduce harm, promote health, create wellness and fight stigma. The organization carries forward the work of Life Foundation in providing medical case management services to people living with HIV on Oahu. They also coordinate homeless outreach, housing navigation services and syringe access services, including nasal naloxone and overdose prevention training. HHHRC works at the intersection of many social determinants of health among under-resourced populations and has committed its resources to supporting Kua’ana Project, including the provision of office space and equipment as well as grant writing and accounting services.
With much of HHHRC’s funding coming from government service contracts, the economic fallout of the COVID-19 pandemic and predicted state budget shortfalls placed a significant portion of the agency’s resources at risk. Thankfully the Kua’ana Project had secured the six-figure grant, albeit a program one, to ensure the delivery of services to trans and sex worker communities. The pandemic hit trans and sex worker communities especially hard, with heavy job losses in the service sector and no opportunity to engage in sex work due to gathering restrictions. Additional unrestricted funding would have afforded us greater ability to meet immediate needs and further strengthen networks of support among our resilient yet under-resourced community.
Policy change is not a cookie-cutter exercise, and every state, city and county will have its own roadmap to the decriminalization of sex work. Unrestricted funding allows trans- and sex worker–led organizations to meet their larger community, including its structures of political and economic power, in a manner where progress can be measured in terms of benefit to our communities. This can include the engagement of those currently ready for advocacy and others who could one day be powerful advocates with support and guidance. We’ve seen this firsthand at Kua’ana Project.
Honolulu’s current prosecutor ended prostitution raids and is not interested in prosecuting misdemeanor prostitution cases. This is a welcome development, but it is simply not the kind of systemic change that will center the needs of trans sex workers. As with the larger trans community’s struggle for visibility and increased legal equality, advocates must call for lasting policy changes that take trans sex workers out of the destructive realm of the criminal legal system. Instead, we should at once prioritize the well-being of our most vulnerable members and call for policy changes toward that end.
Perhaps American society can one day get to a point where the foremost public response to a trans woman engaged in sex work is the offer of services with compassion and respect for her agency and autonomy, wherever she may be at that point in time. Those of us who have made long and difficult journeys toward self-acceptance are uniquely positioned to provide support and guidance to those who are struggling today with a range of issues. I am proud that my lived experience as a trans woman and former sex worker can help others in the pursuit of their own well-being, wherever they may be on their journey.
Kua’ana Kua῾ana Project is grateful for the support that we’ve received from private and public sources in recent years. We look forward to continued dialogue with trans– and sex worker––led organizations and those who support them as we envision a more just society that no longer arrests and incarcerates as a matter of course.
Maddalyn “Maddie Ashton” Sesepasara is the Project Coordinator at the Kua’ana Project, and a longtime member of The Hawai’i Health & Harm Reduction Center that serves Hawai’i communities.
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