This essay makes the case for neurotrans, which names the nexus of neurodivergence and trans as an epistemic source, a place from which neurotrans people think neurotrans thoughts to pursue a neurotrans world. Bringing the interwoven histories of mental disability and trans experience to bear on HIV/AIDS, the author argues that HIV has long served as a racialized weapon of the state to subjugate neurodivergent and gender variant people, especially those of color. The AIDS crisis, following the rise of antipsychotics in psychiatry, offered the medical industrial complex and the criminal punishment system a new opportunity to surveil and control disabled and trans populations. In addition to racializing gender variance and neurodivergence as threats to white supremacy, the state could now use HIV to justify incarcerating neurotrans people, although carceral spaces, such as hospitals, mental institutions, and prisons, are largely responsible for facilitating HIV transmission. Drawing on the life and activism of Black mad and trans activist Marsha P. Johnson, this essay illuminates the entanglement of mental disability and gender nonconformance and the necessity to center mental disability in trans studies, prioritize neurodivergent people in HIV prevention efforts, and advocate for the participation and leadership of neurotrans people in AIDS activism.