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Vivian Xie
30 Jul 2024

Women in Pharma: Advocating for trans healthcare in pharma

In our monthly series on women in the pharmaceutical industry, we interview leading experts in the pharmaceutical supply and value chain to discuss the importance of gender diversity in healthcare, the workplace, and beyond. 

This month’s issue follows Alaina Kupec, Executive Director at Gilead Sciences. Kupec is in her third role at Gilead, bringing together prior experience in public affairs, policy, sales, and communications, and previously worked at Pfizer for 23 years. She was co-chair of the board of directors for transgender legal defense and education fund, and last year founded the non-profit Grace Now, which centres and humanises the transgender community. Grace Now have worked with state-level centre-right Republican groups to educate and help them understand policies against the trans community and their effects on trans healthcare rights. Learn more about Kupec and her advocacy here

1. Please can you give some background on yourself and your role? 

I am an Executive Director at Gilead Sciences and lead our company’s portfolio strategy & analytics team for all of virology and inflammation. In my role, I lead our team and we support all the teams working with new therapies we are developing in those areas, along with the executive leadership team in understanding the opportunity for those therapies, the cost to develop, risks involved, and options for development.  

I have been in the industry for 28 years, and had roles spanning sales, sales leadership, marketing, US market access, global market access, public affairs and policy, and communications. I have worked in all aspects of our industry and across all the teams involved in discovering, developing, and commercialising therapies for patients. 

Prior to my career in biopharma I was an Intelligence Officer in the US Navy. I was in a F/A-18 Fighter Attack squadron and deployed in the Mediterranean and Adriatic Seas, along with the Persian Gulf. We supported no-fly zones over Bosnia and Iraq and I spent time in Saudi Arabia in 1994 as the Intelligence Liaison for our battle group when Iraqi troops deployed along the Kuwait border and we had to prepare to defend Kuwait from a second invasion. 

2. Throughout your career, how have you integrated and continue to align your advocacy for trans health rights with your work? 

I completed my public gender transition 11 years ago while working at Pfizer, where I spent 23 years. The first few years I focused solely on my social and physical transition and putting the work into living in a world that was new to me. I no longer had the benefit of presenting as a straight white male and quickly came to appreciate the very different reality that all women have lived – one in which they are expected to show up different than their male counterparts, be less vocal, and wonder why they are getting passed over for promotions when clearly they are the most qualified. The irony is that my contributions in my role and the team’s performance I led only improved after my transition. 

It wasn’t until 2016 when I was living in the State of North Carolina that I became a public advocate for the transgender community. My day job didn’t change. I had to show up and deliver results in my role, and my advocacy was always separate from my role at Pfizer. I think that is critical – our companies pay us to be contributors in our work and deliver results, and making sure that my advocacy never crossed the line into my paying job has always been top of mind for me. 

3. What are some of the biggest challenges or issues for the pharma industry regarding trans healthcare?  

The transgender community is very small. Within the population, we make up between 1–2%. The community suffers from stigma, unemployment, homelessness, and family rejection. While at Pfizer and my current company, there are less than ten total people I know of that publicly identified as transgender. There are likely more, as many people in my community live “stealth”, with no one around them knowing they are transgender. They do this because of the stigma, gossiping by co-workers, and fear of discrimination.  

I have dealt with all of those, at my past company and current company. My gender is a small part of my medical history, it is not who I am or what I am. Yet society has always been fascinated with our medical condition. Additionally, for the last 8 years, politicians have used our condition as a rallying point to sustain their attack on the queer community, doing so because they lost the fight on marriage equality. 

The challenges for trans people at any company are the same: access to transgender healthcare, discrimination, and the opportunity for advancement. I am so fortunate to work for a company that has exemplary medical benefits for me. Since I transitioned, I have had to deal with both outright and subtle discrimination, and it has been demoralising. Companies are just not used to handling these issues and they don’t have the training or experience. Since we are such a small community, it is not an area they are likely to invest. I believe in my executive leadership 1000% and their commitment to me, my community, and doing what is right. But there is a level of leadership between the C-suite down to the lowest level colleagues and that is where the opportunity is for education, setting expectations, and holding people accountable for doing the right thing. When a company has less than five out transgender people, that is not a high priority.  

All C-Suites can benefit from sitting down and talking with someone like me, to understand our community more deeply, the issues we face, the path we have taken to be our authentic selves, and the challenges we have faced. There is a very public attack on all transgender people right now, and executives must balance supporting their colleagues while delivering to shareholders and their board of directors. We don’t see any companies publicly supporting our community right now for fear of backlash. Yet while they may not be able to publicly support the community, they can invest and support non-profits like the one I created, the Gender Research Advisory Council and Education (GRACE), whose narrow focus is in humanising the transgender community and working with leaders and policymakers to better understand the issues from a less politically volatile perspective (www.grace-now.org). Transgender people are just like you or anyone else, we just want to live peaceful lives, contribute to our work, support our families, and be members of the communities where we live. And the more people get to see that we are just like them, these political attacks will fall flat. 

4. What can the pharmaceutical industry and supply chain do to support diversity and equity for all genders both internally and externally with their wider community? 

My eyes were opened after I transitioned, and I see the world completely differently now than I did when presenting as a man. I will tell you that I was blind to the challenges that women, people of color, and different religions faced. It wasn’t until my community came under attack and so many other marginalised communities came to support us that I saw how much we all have in common. I think companies can make efforts to better educate colleagues on what diversity really means. It is not a bad word. It means people from different backgrounds, experiences, race, gender, and religion have different lived experiences that shape who they are, the opportunities they have had professionally, and their ability to contribute to a company’s success.   

Far too many managers hire in their likeness. Companies must ensure that hiring slates are diverse, that team composition is diverse, and that there is a conscious effort to ensure that homogeny is not rampant in a team or organisation. White men reading this may feel threatened because traditionally they have dominated the workplace. That is why we see a backlash to diversity initiatives. But leaders know, and the data supports this fact, that teams comprised of people with different backgrounds are more effective because they can tap into their different experiences when solving challenges. There is synergy when tapping into all that our different colleagues have to offer, so take advantage of it and it will lead to better business results.  

5. How have you seen the pharmaceutical industry and the wider healthcare community change throughout the years to provide solutions for all genders (e.g. technologies, medical innovations, business strategies etc.) 

I am now seeing transgender representation in our company when we do internal training. It specifically calls out that discussing someone’s gender history with others is wrong and an invasion of privacy. That is amazing and so wonderful. I can’t tell you how many times after I transitioned that people knew who I was and that I was transgender long before I could tell them because of the gossip. Please respect our privacy and leave us to out ourselves to who we chose, and don’t take away our ability to decide who and how we come out.  

6. If you could give one piece of advice to the Future Women Leaders of Pharma, what would you say? 

Trust yourself and your instincts, and focus on delivering results. The obstacles you likely encounter are real, they exist, and while it is unfortunate, it is how you show up and navigate those challenges that will define you. Help your colleagues and teams thrive and succeed and you will succeed. 

Importantly, be a woman who supports women. I have encountered some amazing women leaders in our industry. Liz Barret the CEO at Urogen was my fiercest advocate when I transitioned at Pfizer. Merrill Birkner, my current leader, is beyond compare when it comes to supporting women and all colleagues. Yet, I have also encountered women who leave other women behind once they have risen to the executive ranks. My biggest professional challenges have come from some of those women. The bottom line is: do your jobs well, lead with pride, and support those around you – for all colleagues and especially for women.  


Do you have a story to tell about diversity? If you’d be interested in being featured in our Women in Pharma series, please reach out to [email protected].   

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