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Eli Fitzgerald: Identity, Isolation, Integration

Eli Fitzgerald: Identity, Isolation, Integration

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 SummaryEli Fitzgerald is 26 years old and has never known life without HIV. There is no before and after, he says. There just is. He was taking seven pills a day as a child, alarms set for morning and night, unable to leave for school until he'd taken his meds. When the regime dropped to three pills, it felt life-changing. Those pills became his one certainty, the one thing he had control over.Eli came out as a trans man at around the same time he was navigating adolescence with a diagnosis he couldn't tell anyone about. The waiting list for gender-affirming care was six to seven years. There were no role models, no one to look up to who had been through both. The isolation was profound. In the school playground, friends made jokes about AIDS without knowing what they were saying. Eli kept his secret completely hidden.At some point, the lack of control over everything else led Eli to try to control his HIV in the only way available: stopping his medication, missing appointments. It's explained to him now as similar to how eating disorders work, that same impulse toward self-determination through self-harm. He got through it, found his people through CHIVA and the HIV sector, and eventually turned the isolation into advocacy.Today, Eli works as a peer support integration manager and advocates nationally and internationally for trans people living with HIV. He's clear about what's needed: full integration of gender-affirming care within HIV services. The research shows that trans people with access to hormones and surgery are more likely to stay on medication, more likely to remain undetectable. If we're not allowed to be ourselves, he asks, what makes people think we're going to look after ourselves?Timestamped Takeaways00:02:05 - No before and after. Eli has always had HIV. There's no differentiation between one life and another. He just is HIV positive.00:02:41 - Childhood resilience. When you're very young and know you have HIV, there's an innocence to it. It's just a diagnosis. Then you get older, hear jokes in the playground about AIDS, and realise it's much bigger than you understood.00:04:05 - The secret. Eli never told any school. It was just a secret you kept, completely hidden. But within healthcare, his team became family, always answering questions, making appointments fun even when he was grumpy.00:05:27 - Logical family. HIV clinics work hard to make you feel loved, not in spite of your HIV but because of it. Society tells people with HIV they're isolated, unlovable. The clinic becomes a foundation of trust.00:06:16 - Coming out as trans. Eli came out at fifteen or sixteen. The waiting list for gender-affirming care was six to seven years. There were no role models, no one who'd been through both HIV and transition.00:07:26 - Why role models matter. They give you hope that there's a future, that you'll be okay. Without them, you're stuck in an isolation cycle, thinking you're the only one. It erodes self-confidence.00:09:15 - The pill regime. As a child, Eli took seven pills a day, morning and night. You couldn't leave for school without taking your meds. When it dropped to three pills at night, it was transformative. Those pills became his certainty, his one constant.00:10:32 - The news about life expectancy. Eli was in Liverpool when the news broke that people with HIV can expect a normal lifespan. It was crazy, he says. Suddenly: we're going to be fine.00:11:11 - Normalising mortality. Before that news, Eli had just accepted life might be shorter. You still had things to do. Go to school, watch TV, eat. Nothing really changes in that sense.00:12:00 - Struggling with school. Between sixteen and eighteen, Eli couldn't stick with education while navigating being trans, going to college, working out what came next. His heart was always in advocacy, in wanting more for his friends and peers.00:13:26 - Two stigmatised identities. Being trans and HIV positive felt like sitting on a 3D wobbly fence, or being a ping pong ball. But the only thing you have control over is your HIV.00:14:52 - Stopping medication. When everything felt out of control, Eli turned to the one thing he could control: his HIV. He stopped taking his meds, missed appointments. It wasn't good, but it was his.00:15:31 - Why people stop. There are many reasons. You can't face HIV, life is derailing, you don't want to be a person who takes meds. It works like an eating disorder, that element of control through self-harm.00:16:45 - Pills at parties. As a teenager, Eli would go to house parties with pills wrapped in tinfoil, looking like he was hoarding drugs. He'd sneak off to the toilet so no one would see.00:17:49 - Unanswered questions. Trans people living with HIV ask: will I be okay? Will I be allowed surgery? Can I take hormones? Will I be allowed to be myself? Will HIV stop me reaching my goals?00:19:18 - CliniQ. The trans sexual health and wellbeing service makes you feel seen. They understand, they listen, they have ...
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