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Furthermore, the intersectional challenges of healthcare, safety, and economic stability cannot be ignored. Black transgender women face disproportionately high rates of violence and discrimination. For those who embody a "thick" aesthetic, medical bias can be an additional hurdle, as "fatphobia" in the healthcare system often leads to poorer quality of care or the dismissal of health concerns. Despite these systemic barriers, the "thick" Black trans community continues to lead movements for social justice. Many of the pioneers of trans liberation were Black and brown women who did not conform to the "respectability politics" of their time, using their presence to demand space and dignity for all.

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