This document summarizes the findings of focus groups conducted with 100 transgender individuals in San Francisco to understand their HIV risk behaviors and access to prevention and health services. Key findings include: 1) Sex work was commonly discussed and seen as necessary due to discrimination, though it increased HIV risk. Unprotected sex was also common due to low self-esteem and desire for validation. 2) Participants reported barriers like insensitivity of providers and fear of discrimination prevented access to services. 3) Recommendations included hiring transgender staff and training providers to be more sensitive.