In July 2019, Monica Gandhi, MD, and others from the University of California, San Francisco (UCSF), hosted a community planning committee town hall about their efforts to make AIDS2020, here in San Francisco and Oakland in July 2020, the most inclusive international HIV/AIDS conference to date. As part of their presentation, the UCSF folks showed a five-minute promotional video, touting the diversity in the two cities chosen as co-hosts of the conference. The video featured a vast array of Bay Area residents——young and old, male and female, gay and straight, of every color, size, and description , a virtual rainbow of happy shiny people at work and at play.

When the video ended, the crowd of forty or so people responded with polite applause. One of the presenters asked, “Well, what did you think of our video?” After a few seconds, a loud, insistent, clearly angry voice rang out from the front row of chairs in the room.

“This. Is. BULLSHIT!! The whole thing is bullshit, the same old bullshit we are always handed! I don’t see ME in your video! I don’t see any of my trans sisters in your video! Forty years of this stuff and you still can’t get this right?! You still don’t have a trans woman in your video?! Where are we?! Did you erase us? Are you going to erase us from the conference like you erased us from your video?!”

Meet Ms. Billie Cooper, one of the fiercest, strongest, most acerbic advocates for the Black, transgender, and HIV communities you’ll ever meet. Loud, proud, and in-your-face, Ms. Billie has been described, lovingly, as “quite a handful.” She has been kicking butt and taking names in the San Francisco Bay Area for a long time, and she won’t let HIV, cancer, or prejudice slow her down.

Born in Philadelphia, Pennsylvania, in 1958, Ms. Billie was raised along with two siblings by her father, a mechanic, and mother, a licensed vocational nurse. All through her school years, Ms. Billie endured the kinds of taunting and bullying that a lot of effeminate gay boys endure. “I learned early that if I wanted to survive school, feeling and growing up different as I was, I had to be everybody’s friend. I became the class clown. I learned skills to be able to take the focus off ‘Sissy Billie Cooper’ by making people laugh,” she told A&U.
Also like many of us, Ms. Billie knew from an early age that she was not like the other boys in school. “I first realized I was different when I was around ten or eleven years old. Back in those days, the 1970s, there was no mention of the word “transgender.” Instead, what I heard always was ‘Billie is a faggot! Billy is a sissy!’” She continued, “It wasn’t called ‘transitioning,’ it was just ‘Billie is different from the other little boys, always acting like a little girl.’” For Ms. Billie it wasn’t just a psychological or affectional difference, it was physical. “I really didn’t want the body parts I was born with because I wanted to be a little girl! I thought I was a little girl. I remember not wanting or touching my private parts, often asking God, ‘Why wasn’t I born a little girl?’”

Reflecting on those early years, Ms. Billie said, “At the time, I was just ‘gay’ because there was no such word as ‘transgender.’ We were always just ‘gay,’ ‘homosexuals,’ ‘faggots.’ I had to be very careful being Gay and Black. At that time, we were barely ‘tolerated.’ If we were quiet and didn’t cause any problems, we were accepted. I also believe some people felt threatened by my sexuality then.”


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In the early 1970s, “There was no transitioning for a young Black person living in the ghetto in any major city, no one around to help us transition. Once I knew that I was going to transition, I literally had to maneuver the medical system on my own.” But transitioning would come later. In the meantime, Ms. Billie had other issues to address.

Like many closeted gay folks in the 1970s who turned to the military as an antidote to their home- and school-lives, Ms. Billie enlisted in the Navy in 1975 at age seventeen. “I thought leaving Philadelphia would make my life easier,” she said. And in some ways, life did get easier. While stationed at the Pearl Harbor Military Base, as Junior Engineer of Operations on board two different ships, Ms. Billie encountered and befriended many other gay people. “I found many people who were like me going to Hamburger Mary’s, Hula’s, and the Lava-Lava, the most popular clubs in Hawaii. These were people who were being their true and authentic self, while going through growing pains and everyday issues. There were a few issues dealing with people who didn’t or couldn’t understand what I was dealing with, but overall, I was very happy.” She was honorably discharged from duties on June 1982.

Ms. Billie moved to San Francisco in 1982 after her service in the Navy. In May 1985, she received her HIV diagnosis. Like everyone else diagnosed as HIV-positive in the 1980s, “I went through night sweats, high fevers, debilitating body aches and pains, diarrhea, deep deep depression, and the occasional opportunistic disease.” She turned to the San Francisco AIDS Foundation for help. Unfortunately, she discovered that “at that time there were only very limited services for black transgender people. I recognized that my sisters were also dying of this HIV virus just like the boys in the Castro but we weren’t getting services. I had to take care of my sistas who were also battling the virus. I became a more powerful, more vocal transgender activist and advocate for my trans-community.”

That activism hasn’t always been easy, as Ms. Billie struggled with drug addiction in addition to the other problems of being a Black transgender woman living with HIV. “I was still in and out of my drug addiction throughout the 1980s, but in 1990 I entered Walden House Drug Treatment here in San Francisco California and started my recovery journey. It was very tough in the beginning and I slipped more than once in the 1990s. It took some time but in 2002, I finally achieved total clean-and-sober sobriety.” It was time to get serious about helping her communities.

As part of her work with the San Francisco AIDS Foundation, Ms. Billie and others formed TransLife, a weekly drop-in meeting space where transwomen and transmen come together to help each other with life’s daily struggles. The group is multiracial, made up of transgender women and men, old and young, at many stages of transition. TransLife also assists gender-fluid individuals with gender identities that change. Together, they all seek support for issues related to gender, identity, sexuality, drugs, sex work, hormone therapy, gender-affirming surgery, and HIV. It is a group for people looking for a place to belong and a chosen family to support them, including allies, friends, and others who wish to learn and grow with the transgender community.

“I’m very grateful to the San Francisco AIDS Foundation for giving me and my trans-community this platform. It was very tough in the early days. I had to show people in power that my trans-community needed a space we could call our own,” she told A&U. Now, TransLife is one of the vital, thriving services offered by SFAF. Those services include Trans Health, specifically created for trans and gender non-binary, genderqueer and gender non-conforming people. The experienced clinicians at this trans-led program can provide advice and information so that clients can make an informed choice about their individual transition goals; they can prescribe and provide gender-affirming hormones to address the spectrum of trans and non-binary needs and monitor the level of hormones in clients’ bodies to safely assess dosing needs in line with their feminization or masculinization goals. Ms. Billie has helped implement the Trans Health and Translife programs and is proud of her role in their success.

Events of the year 2002 altered Ms. Billie’s life as much as her decision to transition. At the time, she lived on Howard Street in San Francisco’s fabled South of Market district. One night, as Ms. Billie approached her apartment building, a man stood in front of the building’s door. She asked him, politely, to move so she could enter the building. He refused to budge. Instead, he attacked Ms. Billie, knocking her to the ground and pummeling her. “I really didn’t want no confrontation,” she told A&U, “and I was mad because I had on a brand new white jacket and I was scared it would get dirty. Fortunately, the people that lived in my building came to save me. But when they pulled him off me, he threw something that hit me on my left arm.” Although shaken and angry, she was glad to have survived the attack.

The next morning, however, she noticed her left eye was severely bloodshot. When it remained bloodshot for the next three days, Ms. Billie went to see a doctor at the San Francisco VA Hospital. The doctors examined the broken blood vessels. During their examinations, they discovered a tumor in her left eye that had been aggravated by the attack. Over the ensuing months, the tumor continued to grow. Ms. Billie started radiation and chemotherapy at the VA Hospital in 2004. The treatments seemed to work. Until 2007, that is, when the cancer returned. Two more years of radiation and chemotherapy failed to work this time.

“I had to have my eye removed in November 2009. I’ve been doing radiation and chemo on and off since then. In 2015 my cancer came back again, so I had two more surgeries to remove it. I’m still doing radiation and chemo,” she said. As if the gods were conspiring to torture Ms. Billie even more, “I developed another tumor in my nasal passage.” She underwent surgery to remove the tumor from her nasal passage on February 13, 2020. “I’m real worried about it, but I’m a survivor! I’m sad it happened to me, but I’m glad the doctors caught the cancer. If they hadn’t, I could possibly be dead now. So, I want to say thank you to the fabulous doctors at the VA.”

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“I found my voice by speaking up for many Black and other transgender people who assume they don’t have a voice. I am that voice of the voiceless. I want to leave a legacy.”

[As of this writing, Ms. Billie is awaiting an oncology report to find out whether the surgery successfully removed the tumor. “I’m hoping one day to be cancer-free again,” she told A&U. We too hope that she is finally cancer-free.]

Regarding the photographs accompanying this article, Ms. Billie was adamant about using photos that show her disfigured eye socket. Acknowledging that the photos are “difficult to look at,” she usually wears dark glasses to hide her eye socket. Still, she insisted on showing her real face in these photos. “I’ve come out as gay, I’ve come out as transgender, I’ve come out as HIV-positive — it’s time for me to come out from behind the glasses and live my authentic life,” she said.

Reflecting on her other activism in addition to SFAF’s TransLife program, Ms. Billie said, “Ever since my diagnosis in 1985, I have a been a client or an activist member of many agencies, including the San Francisco AIDS Foundation, the Black Coalition on AIDS [whose name is now the Rafiki Coalition for Health and Wellness (RCHW)], the UCSF AIDS Clinic, and the AIDS Project East Bay. I’ve been involved with many clinics, helping them learn how to treat the transgender community.” Through the course of her activism and advocacy, “I found my voice by speaking up for many Black and other transgender people who assume they don’t have a voice. I am that voice of the voiceless. I want to leave a legacy.”

To help secure that legacy, Ms. Billie recently ran for and won a seat on the Castro Cultural District Advisory Board. Black LGTBQ folks and transgender women have historically had a very strained relationship with other denizens of the Castro, which for decades has been a predominantly gay white male district. “I have lived in San Francisco since the mid-1980s, and I’ve seen that transgender women and men have been unwelcome in the Castro. Businesses there have gone as far as forcing people to show three pieces of identification and to show that they have at least twenty dollars for drinks or food. We have been told in no uncertain terms that ‘your kind is not welcomed here in the Castro.’ I ran for the seat on the Castro Cultural Community Advisory Board to help iron out the problems and to show my community, my Black and transgender communities, that we are as welcome in the Castro as anyone else.

“I’m going onto the Castro Cultural Community Advisory Board to help make the Castro a place where everyone is welcomed and accepted. I’m tired of Black transwomen being mis-gendered, talked down to, and treated like we’re less than human.”

Although she is known for being loud, proud and, sometimes, abrasive as she can be, Ms. Billie occasionally reveals her quieter, more humble side. “I know I stand on the shoulders of many trans women who have come before me,” she said, “For instance, I am very proud to say that one of my dear friends for over thirty-five years is Miss Major Griffin-Gracy. Miss Major took me under her wing in the early days and molded me. She helped make me the woman I am today. To her I say, thank you so much!”

Despite travails that would cripple and overwhelm a weaker woman——prejudice, HIV, repeated bouts of cancer, stigma-based physical attacks——Ms. Billie has grown from that scared, tormented little boy who was called “sissy” and “faggot” most of her young life, into the tough, passionate, hard-boiled, eloquent activist and advocate who fights fiercely for her communities.

These days, when Ms. Billie yells “BULLSHIT!” the people in power sit up and take notice. And the San Francisco LGBTQ communities are all the better for it.

For more information about TransLife, log on to: Follow Ms. Billie Cooper on Twitter @MsBillieCooper2.

For more information about Saul Bromberger and Sandra Hoover, visit: Follow them on Twitter: @saulsandra.

Hank Trout, Senior Editor, edited Drummer, Malebox, and Folsom magazines in the early 1980s. A long-term survivor of HIV/AIDS (diagnosed in 1989), he is a forty-year resident of San Francisco, where he lives with his husband Rick. Follow him on Twitter @HankTroutWriter.