Hawai‘i’s Trans and Māhū Communities Stand Proud Amid National Affront

Despite Hawaiʻi’s reputation as a progressive stronghold, the state’s transgender and gender-nonconforming communities are not immune from a rising tide of national animosity.

The climate shifted dramatically on the first day of President Donald Trump’s second term, marked by an Executive Order that explicitly targets intersex, trans and nonbinary people. By recognizing only two sexes and dismissing “gender ideology,” the order seeks to roll back long-standing protections, claiming that acknowledging self-assessed gender identity requires society to “regard this false claim as true.”

This federal denial of gender and sex as distinct concepts has given voice to a deepening prejudice across the country. A 2021 study from the Williams Institute at UCLA states that transgender individuals were more than four times likelier to be victims of violent crime than their cisgender counterparts.

The president’s rhetoric has inflamed an already volatile situation: FBI data indicates that hate crimes motivated by anti-transgender and anti-gender nonconforming bias surged by more than 30% between 2021 and 2025.

Against this backdrop of rising national hostility, Hawaii Business Magazine spoke with four individuals — two trans men, a trans woman and a māhū — to discuss how safe and supported they feel in the Islands, the hurdles of navigating local gender-affirming care, and what they wish more people understood about their lived experiences.

In Hawaiian culture, māhū refers to individuals that embody both masculine and feminine traits.

Different States, Different Climate

Hutchinson says, “Through layered symbolism, the drawing reflects the complexities of self-recognition as a transgender man in 2025.” Artwork: Hiro Hutchinson

Hiro Hutchinson moved from Colorado to Hawaiʻi island in 2020 at age 13. That same year he came out as trans, though he began questioning his gender identity as young as 8. He says that his parents, particularly his father, initially struggled to accept it.

“That definitely affected my mental health when I was younger and still transitioning and figuring out who I was. But he has grown to support me more, because for a long time he didn’t understand me being trans,” says Hutchinson.

But he gives them grace: “Nobody really teaches parents how to react to this kind of thing in those baby manuals. I think it’s important to show empathy to the parents who are also trying to figure it out.”

Now 19 and a student at the School of Visual Arts in New York City, Hutchinson says the cultural climate surrounding trans people is different in all three states he’s lived in.

In his personal ranking of safety and acceptance, Hawaiʻi takes the top spot: “They’re pretty nonchalant about gender identity and sexuality there. It’s just a pretty neutral community.”

In Hutchinson’s view, the mainland presents a more ambivalent environment. While he acknowledges New York as a legendary hub for queer culture, he notes that the “huge amount of support” is met with a “lot of hate.” He felt a similar tension in Colorado, where he observed conflicting attitudes towards the trans community.

Finding the Right Vocabulary

Photo Courtesy of Jess Akau

Every person interviewed said the realization that they were different from their peers came at an early age. For Jess Akau, a māhū from Hawaiʻi island, that difference was obvious long before she had the vocabulary to articulate it.

“Everyone around me could see it, whether it was my voice, the way I walked, the way I talked, the way I expressed myself,” Akau says. “It was very eccentric, flamboyant. All I could recognize is that there was something different about me than all the other boys in school, all the other boys in church.”

Without a “format or a blueprint” to follow, navigating her identity in childhood was a confusing process of trial and error. Akau explains that she initially came out as gay because she didn’t yet understand what it meant to be trans or māhū.

But even the label “woman” never quite fit Akau’s self-perception. While she utilized the word “trans” for a time because it was the best verbiage she knew then, Akau eventually found her home in a traditional Hawaiian identity.

Pre-contact Native Hawaiians recognized three genders: kāne, wāhine and māhū. Akau says she now identifies as māhū, noting that “pronouns really aren’t a big issue for me.” Instead of thinking of māhū as simply a label, Akau describes it as “a way of living. … It’s almost magical. And there’s not a true definition to what being māhū is. It’s just an embodiment of both male and female energy.”

Historically, they were revered as healers, caretakers and keepers of knowledge. “Our māhū folks have had a place in society, and they were valued. They were respected,” says Maddie Sesepasara, a trans woman and Kuaʻana Project Manager. “We had our own traditions, our own values and our own way of life. … Māhū used to be a proud word, until the missionaries came, and then they turned it into such an ugly, derogatory word.”

For over a century, the term was weaponized to shame gay, trans and nonbinary people, but the community has gradually reclaimed ‘māhū’ as a title with honor. Today, organizations like the Kuaʻana Project work to reverse that damage by providing resources to the trans community.

The Kuaʻana Project

Founded in 2015, the Kuaʻana Project operates as a vital branch of the Hawaiʻi Health & Harm Reduction Center. “We offer an array of services, from name changes to gender markers [on IDs and birth certificates] to food distribution. If they’re having issues with their landlords, or if they’re having issues with employment, we’re able to send them to our friends that know the trans rights for people and making sure that they’ll be treated fair,” says Sesepasara.

The project also fosters community through specialized support groups tailored to different life stages and goals.

In its 11 years of operation, the organization has provided in-person support to over 350 people at its Honolulu office, reaching many more through virtual services. Based on Oʻahu, the Kuaʻana Project can help those on neighbor islands by referring them to their partner organizations, including Kumukahi Health + Wellness on Hawaiʻi island, the Maui A.I.D.S. Foundation and Malama Pono Health Services on Kauaʻi.

Additionally, she recommends the Sexual & Gender Minorities Resource Hub — an online platform through the state Department of Health that serves as a critical directory for therapy, medical care and information regarding LGBTQ+ rights.

Toxic Workplaces

Sesepasara recalls the ’90s and early 2000s, when employers and landlords could openly refuse service to trans people. “It was easy for employers to say, ‘Oh, we’re not hiring. We don’t like people like you.’ It was easy for landlords to kick you out. ‘Oh, we don’t accept people like you. You can’t live here,'” she says. “It wasn’t until, maybe 11, 12, years ago that we got policies in place for transgender folks to where they couldn’t discriminate against us.”

Despite these policies, the workplace can still be a lonely environment. X, a trans man in the construction industry who requested anonymity to avoid further retaliation, describes a profound sense of ostracization. “I go to work every day. I walk by myself. I go to work. Nobody talks to me,” he says. “I’m not acknowledged, no matter how early I show up, no matter how late I stay.”

Because X joined his union pre-transition, he never had the opportunity to “pass” as male and avoid the targeted hostility of his peers. He recalls one incident on a job site where an ironworker began hurling slurs at him, which then escalated into a physical confrontation. X says after he was called “a dumb faggot” and “a fucking trans,” the worker “squared up” and shoved him.

“I started pushing him back. And, mind you, there’s like, rebar sticking out right in the back of me,” X recalls. “I could have fallen back, you know, like got stabbed in my back.” Rather than intervening, several other workers joined the aggressor. “Nobody’s defending me. It’s just me against five guys.”

Though workers from other trades eventually broke up the fight, X found no recourse with management. When he called his boss to report the assault, X says his response was dismissive: “Figure it out.”

While X acknowledges the construction industry’s generally abrasive culture for everyone, his cisgender peers do not “have to fight for their life every day just to exist in a space like that.” He pushes back on the claim that trans people are “just doing it for fun” or “do it for a trend,” when in reality, “I’m not trying to fit in. I just want to be me.”

He asks: “You think I want to get shit on at work every day? You think I want to go into the men’s bathroom, sit in the stall and not know if someone is gonna grab me from underneath and, like, yank me out and beat me down, because they know that I’m trans? I don’t want that. I just want to exist.”

The Bathroom Dilemma

Illustration: Esther Mohrmann

X says he avoids going to the bathroom on job sites and instead “hold it till I get home from work” or stop at a safer place to use the restroom on his drive back.

Public restroom anxiety is very common among trans, nonbinary and androgynous individuals. “Being trans going to the restroom is sometimes scary,” says Hutchinson. “It’s not exactly a safe world for trans people to enter a bathroom full of people who may or may not accept you for going in there.”

Studies show that which gendered bathroom to use can be a Catch-22. In fact, data from the 2022 U.S. Transgender Survey indicates that transgender individuals are more likely to face harassment or be blocked from restrooms when they try using facilities matching their sex assigned at birth.

For transgender men using women’s facilities, roughly 10% reported being denied entry and 11% faced verbal harassment — nearly twice the rates reported by those using men’s restrooms (5% and 7%). Similarly, transgender women were more vulnerable in men’s restrooms, with 7% facing access issues and 9% facing verbal attacks, compared to 5% and 7%, respectively, when using women’s facilities.

To avoid these situations, many trans people report frequently avoiding public restrooms due to fear of harassment, resulting in “holding it” for prolonged periods of time and restricting food and drink intake, which can cause serious physical health issues, including dehydration, kidney and urinary tract infections, as well as other kidney issues.

“I’ve heard stories about people who literally hold it all day because they’re that afraid to go to the bathroom. It’s sad. I wish people could just take a piss when they wanted to take a piss,” says Hutchinson, who thinks implementing more all-gendered restrooms is “definitely a great solution.”

Navigating Gender-Affirming Care

Access to and quality of gender-affirming care varies greatly state by state. For Akau, who began her transition in Montana in 2010 before returning to Hawaiʻi island in 2021, the comparison was surprising. Despite Montana’s reputation as a “red” state, she found gender-affirming care there to be “actually better than Hawaiʻi.”

Akau recalls a structured, three-month psychiatric evaluation period in Montana before receiving any prescriptions. “They monitored my blood content. They monitored everything about me,” she says, noting that the providers were “actually very specific about what they wanted to see” regarding her health markers and would frequently call to follow up on how she was doing. In contrast, she describes her current care in Hawaiʻi as more “standard” and less rigorous, with annual check-ups that feel routine rather than personable.

Sesepasara points out that there are currently “less than five” doctors offering gender-affirming care in the Islands. This scarcity is exacerbated by a national climate of hostility toward LGBTQ+ healthcare. Sesepasara explains that due to “all these attacks on gender affirming care, a lot of these doctors are afraid to provide services.”

To combat this, advocates are pushing for HB 1875, a “shield bill” designed to protect providers, parents and patients from out-of-state litigation or interference. “We need to make sure that this bill is shielded, so all of that hate doesn’t affect us here in Hawaiʻi,” Sesepasara says, adding that the legislation is “almost at the finish line.”

Even within the state, a disparity exists between the resources available on Oʻahu and those on the neighbor islands. Hutchinson, who grew up on Hawaiʻi Island, notes that while some clinics existed, “they’re mostly on like Oʻahu.”

The geographic isolation of Hawaiʻi, combined with being a minor at the time, created significant barriers for Hutchinson. “I wasn’t able to access a lot of care when I was in Hawaiʻi because it’s such an isolated place from the rest of the world,” he says. Without a support system or professional resources, he turned to “DIY” methods, including chest binders that “weren’t actually safe” for his body.

Hutchinson ultimately waited until he reached adulthood and moved to New York City to begin hormone therapy. “In Hawaiʻi, I wasn’t able to really find any kind of insurance that could cover it,” he says, noting that he would have been forced to pay out of pocket. In New York, better coverage allowed him to access his gender-affirming care for free.

Workplace challenges also complicate the recovery process for those who do access care. When X underwent a breast reduction a few years ago, he found his employer unwilling to accommodate the necessary recovery period. “You’re supposed to take off for at least three to six months after you get top surgery,” he explains.

Despite this, his boss pressured him to return just one week after the procedure: “I was so caught off guard that they called me back, like, a week later, and they’re like, ‘You got to come back to work.’ I still had my drains in.”

The resulting physical strain made his job both painful and hazardous. “So, my scars didn’t really heal [properly] … because I was constantly doing overhead work,” X says. “I could have gotten infected.”

‘A Seat at the Table’

To be a better ally, Sesepasara suggests supporting local trans programs and advocating for legislation like HB 1875. She also emphasizes the need for being vocal in the community: “If you want to be an ally, a true ally is we need folks to come out and speak up in spaces where we’re not invited… We need you to take the hits, because trans folks are so tired. We’re always getting hit. We’re always being attacked.”

X echoes this fatigue, asking only for basic human recognition. “I just wish that people were kind enough to be like, ‘okay, you can exist with me. We can all exist together,'” he says.

In contrast, Akau says she doesn’t feel “vulnerable” being māhū in Hawaiʻi, and she certainly doesn’t want pity: “I don’t live a sad life, like I’m actually pretty celebrated where I’m from. I have a seat at the table.”

Sesepasara believes Hawaiʻi’s history of respecting māhū provides a blueprint for the rest of the country. “I think that’s why in Hawaiʻi, we’re a little bit more accepting because… we have a better understanding that all our people belong, all our people have a place,” she says. “And I feel Hawaiʻi needs to lead, lead the world, because we live by aloha. And to me, aloha is embracing and loving all your people, no matter who they are.”