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The epidemic galvanized LGBTQ+ activism. Trans people, particularly trans women of color involved in sex work, were heavily affected but often excluded from research and care. This period solidified mutual aid and community health networks.

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Conversely, many regions are experiencing a wave of restrictive policies. These include bans on gender-affirming care, restrictions on sports participation, and limitations on discussing gender identity in educational institutions. The epidemic galvanized LGBTQ+ activism

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