I first came across Kathy Ottersten’s name while researching the history of harm reduction, a framework developed in the 1980s that advocated for safer drug use as opposed to criminalization or abstinence-only models. At the time, one in two people in New York City who used intravenous drugs was HIV-positive. New York state law expedited contagion by making the unauthorized possession or distribution of syringes illegal, forcing people to reuse and share supplies. In response, ACT UP—a queer-led, grassroots group organizing to end the AIDS crisis—arranged a coordinated action where Ottersten and nine other activists were arrested for illegally possessing sterile syringes. The arrests were meant to spur a trial that might legalize needle exchange in New York. Ottersten and their peers risked jail time, but eventually won their case when a judge ruled that the activists couldn’t be punished because they were directly saving lives.
After the verdict, members of the ACT UP needle exchange committee founded the Lower East Side Harm Reduction Center (LESHRC). Since its founding, the center has expanded, continuing its needle exchange, and also offering broader support, including overdose prevention programs and limited medical services. In my four years volunteering at the LESHRC, I learned about the activists who risked imprisonment to make the center possible. In 2021 Ottersten reached out to me after I published an article on New York’s history of needle exchange. They’ve been an important mentor to me ever since.
Ottersten’s activism extends far beyond a single trial. In the ’80s, they were active in both ACT UP (where they were the only out trans person) as well as the pacifist Catholic movement Pax Christi. In that time, they courted arrest, coordinated a soup kitchen, and organized peer groups for trans youth. In 2018, Ottersten ran for Fairbanks City Council, becoming the second openly intersex person elected to public office in the United States, and the first ever in the state of Alaska. I talked to Ottersten about transphobia within ACT UP, the importance of visibility, and how risk-taking can be a form of care.
Hannah Gold: You got involved with both Pax Christi and ACT UP around the same time. How did that happen?
Kathy Ottersten: I joined Pax Christi when I started at Fordham University in 1985, and very quickly I was a coordinator for a soup kitchen in the South Bronx. It was a wonderful introduction to the idea that running a soup kitchen is just as much direct action as protesting in the streets or handcuffing yourself to a building. And I did all of those things within my first year at Fordham. In the spring of ’86, I found myself handcuffed to the front of a building with [anti-war activist and Jesuit priest] Daniel Berrigan right next to me. That was my first arrest.
Because I was a peace and justice activist, and out in New York, I was aware of ACT UP. The first thing I did in ACT UP was join the media committee. In 1985, a Presbyterian minister who worked with the [South African anti-apartheid party] African National Congress told me that “the best thing you can learn to do is to be able to speak your own words and not somebody else’s.” That stuck with me. I used to refer to myself as a “lesbian transsexual” because we didn’t have better words. At the time, doctors declared that trans women were heterosexual, and I was not. Joining the media committee was my way of learning to effectively communicate, to speak what I knew to be true.
HG: You once said to me that you think visibility is a cornerstone of activism. What did this mean to you as a trans person in ACT UP?
KO: When I came out as trans, I didn’t know any other trans people. If you happened to bump into another trans person in a room and you didn’t both arrive there on purpose . . . well, you should have bought a lottery ticket instead. According to medical knowledge at the time, we just did not exist.
So when I went to my first ACT UP meeting, which was the same month I started hormones, I wanted to make sure I was seen. I would wear tight, sleeveless t-shirts, relatively revealing jeans or daisy dukes, and sneakers. The outfit was androgynous, but on me it looked outrageous because I was growing my breasts in at the time. I transitioned on the floor of ACT UP, and I cannot tell you how many times people came up to me over the course of the first couple years and said, “You’re just a self-hating faggot. You can’t accept being a gay man so you’d rather cut yourself apart.” I chose to stimulate that discussion as often as I could. I wanted to be asked questions, that was part of my activism. By transitioning in that space, I was also trying to show that trans people are whole people the entire way through the process, and that I wasn’t ashamed of, or defined by, my transition.
“By transitioning on the floor of ACT UP, I wanted to show that trans people are whole people the entire way through the process.”
HG: It sounds like you were facing quite a lot of transphobia even within ACT UP.
KO: Yes. Many within ACT UP opposed my identification as a woman. There was an area where women mostly sat, and I was not allowed to sit there. I was asked out of a lot of queer women’s groups. But I don’t want to portray that as universal. When one person gave me a hard time at a meeting, others would come up to me and say, “Don’t take it personally, they don’t get it.” And I just couldn’t hate them for it, because I was in an organization where people were going through the worst grief of their lives every day. They were challenging the world, and I was challenging them. That’s something Pax Christi taught me: Even when you know in your heart that you are correct, you have to give somebody else the grace to be wrong, because you’ve also been wrong before.
HG: You were the only openly trans person who participated in—and was arrested at—the St. Patrick’s Cathedral action, where ACT UP interrupted a Catholic mass to protest the church’s response to the AIDS crisis. But when the protest was depicted on a 2019 episode of the TV show Pose, Black trans women were centered in the portrayal. Historian Sarah Schulman has since written about this inaccuracy. How do you make sense of this change in how ACT UP is being remembered?
KO: I wish young trans people of color could have been prominent in the movement in the ’80s and ’90s. But that wasn’t the case. Pose wasn’t accurate in that regard. And I do appreciate Sarah Schulman, as a historian, depicting ACT UP as it was.
The flip side is that no history is accurate; it’s all popular history on some level. So does it really matter that I be accurately represented on Pose as the only (white, middle-class) openly trans person at St. Patrick’s—when, instead, we could give somebody else the possibility of watching and going, “Oh, maybe I could do that”? For me, that’s a big part of being an activist: knowing when to get out of the way. And frankly, the world could use a lot more representations where white activists are not out in front—because it was a function of white privilege that I was able to do what I did.
HG: You have often leveraged that privilege to take risks that others could not. You were one of the ten people arrested for the 1990 needle exchange action. If you had lost the trial, which you were expected to, you would have gone to prison. Can you talk about your decision to do that?
KO: Without needle exchange, drug use was basically a death sentence. That’s the way I thought about it: the potential for me to get jail time versus the ongoing deaths. I didn’t have children, I didn’t have a spouse, I didn’t have somebody I was supporting. All around me people were losing their partners. So if somebody had to put their body on the line, I thought it might as well be me. At the time, I was a full-service sex worker, and I knew other sex workers—mostly young trans people—who’d been up and down at Rikers, so I was already learning how I could get by in prison.
To this day, it hurts me that people think taking that kind of risk is special. I know we need to celebrate the fact that people took risks, but I wish risk-taking was understood as a base part of human compassion. You take the risk to save lives. Maybe that’s how you love people.
HG: Your work with the needle exchange committee was controversial even within ACT UP, many of whose members didn’t always want to associate with drug use. And yet ACT UP allowed the committee to work toward the common goal in its own way. Sometimes, the left can become preoccupied with moral or political purity. What can we learn from ACT UP’s model of simultaneous tactics?
KO: ACT UP recognized that people can be at different levels within your organization while working toward common goals. We disagreed on so many things, but we had to agree to disagree or we wouldn’t have made it three months.
You had to run on dual tracks. At big street demonstrations, for example, sometimes I got arrested, but other times I marshaled, which meant working with the cops, the city, and the government. It worked if you knew what your goal was. At a demonstration, your goal was not to clash with cops, just as at ACT UP meetings, your goal was not to clash with each other. In any situation, enough people were ready to say, “I’m okay with you doing this even though it’s not my thing,” that a committee could be formed. And that’s maybe the secret sauce: knowing that people can disagree without all being your enemies.
HG: You say that one of the most important things for an activist is to know their own history, but you are also learning from younger generations. How have young activists inspired you?
KO: I am in love with the people behind me. I just adore how open their conception of gender is. They are able to conceive a world that I can’t even imagine. Maybe I helped build the space for their imagining, but they’ve taken it and expanded it, and I’m inspired to learn from them. So I’m going to stand back and ask, “What can I do to help you get to that world?” And if I’m going to be of any help to anybody, I better listen to their voices. That’s really the lesson of being an activist: If you’re not listening, you’re not really effective.
Hannah Gold is a writer based in Brooklyn. She co-edits Berlin Quarterly and teaches writing at Columbia University.
