The comprehensive report, based on The Trevor Project’s 2023 National Survey on the Mental Health of LGBTQ+ Young People, presents alarming statistics and underscores the need for targeted mental health support for this vulnerable group.
According to the findings, nearly one-third of LGBTQ+ young people identify as having a disability. These disabilities range from ADHD and learning disorders to physical and autoimmune conditions, with many respondents reporting multiple diagnoses. The data reveals that LGBTQ+ young people with disabilities experience significantly higher rates of depression, anxiety, and suicidal thoughts compared to their non-disabled LGBTQ+ peers.
The report highlights a concerning trend: Approximately 65 percent of LGBTQ+ young people with disabilities have faced discrimination due to their disability in the past year. This discrimination is closely linked to increased mental health issues. For instance, those who experienced such discrimination reported higher instances of depression and anxiety, as well as a marked increase in suicide attempts.
Another critical study finding is the positive impact of understanding and inclusive therapy. LGBTQ+ young people who felt their therapist understood their disability reported lower rates of suicide attempts. This underscores the importance of disability-informed mental health services.
The report also sheds light on demographic variations. Older LGBTQ+ individuals and those identifying as transgender, nonbinary, or multisexual reported higher rates of disability. Notably, specific groups, such as queer, asexual, and gender-diverse young people, also showed elevated rates of disability.
Additionally, the survey found the critical role of supportive environments in mitigating mental health risks for LGBTQ+ young people with disabilities. Participants who reported having access to affirming spaces, whether in schools, communities, or online, exhibited more resilience and lower levels of mental health distress. This suggests that fostering inclusive environments where LGBTQ+ youth with disabilities feel accepted and understood can significantly impact their mental well-being. It also highlights the necessity for policies and programs that not only address mental health concerns directly but also actively work towards creating safer, more inclusive spaces for these young individuals.
The Trevor Project’s study serves as a crucial call to action for improved mental health support and anti-discrimination efforts for LGBTQ+ young people with disabilities. The organization emphasizes the need for further research and intervention strategies to address these challenges effectively.
In response to these findings, The Trevor Project continues to advocate for comprehensive, accessible mental health services and increased awareness and support for LGBTQ+ youth with disabilities, according to a statement by the group. Through their crisis services team and targeted training programs, they aim to enhance understanding and provide vital resources for this particularly vulnerable community.
If you are having thoughts of suicide or are concerned that someone you know may be, resources are available to help. The 988 Suicide & Crisis Lifeline at 988 is for people of all ages and identities. The lifeline also provides resources to help with other crises, such as domestic violence situations. The Trevor Project Lifeline, for LGBTQ+ youth (ages 24 and younger), can be reached at (866) 488-7386. Users can also access chat services at TheTrevorProject.org/Help or text START to 678678.
LGBTQ+ Victory Fund, the only national organization dedicated to electing LGBTQ+ leaders to public office, endorsed 23 more out LGBTQ+ candidates. Victory Fund has now endorsed 260 candidates running in the 2023 cycle and 43 candidates running in the 2024 cycle.
2023 General Candidates
Damian Pardo (he/him)
Miami City Commission, District 2, FL
General: 11/7/2023
Jenna Yeakle (she/her)
Duluth City Council, At-Large, MN
General: 11/7/2023
Heather Rodenborg (she/her)
Delaware City School Board, OH
General: 11/7/2023
Jess Branas (she/her)
Upper Darby Town Council, District 2, PA
General: 11/7/2023
Khalilah Karim (she/her)
Durham City Council, At-Large, NC
General: 11/7/2023
2023 Unopposed Candidates
Andrea Ditillo (she/her)
Churchill Borough Council, At-Large, PA
General: 11/7/2023
2023 General Candidates
Sylvia Swayne (she/her)
Alabama House of Representatives, District 55
Runoff: 10/24/2023
Paul Sanchez (he/him)
South Salt Lake City Council, UT
General: 11/7/2023
Navarra Carr (she/her)
Port Angeles City Council, Position 6, WA
General: 11/7/2023
2024 General Candidates
Clarissa Cervantes (she/they)
California State Assembly, District 58
Primary: 3/5/2024
General: 11/5/2024
Jennifer Esteen (she/her)
Alameda County Board of Supervisors, District 4, CA
Primary: 3/5/2024
General: 11/5/2024
Ari Ruiz (he/him)
California State Assembly, District 52
Primary: 3/5/2024
General: 11/5/2024
Carlos Guillermo Smith (he/him)
Florida State Senate, District 17
Primary: 8/20/2024
General: 11/5/2024
Joe Saunders (he/him)
Florida House of Representatives, District 106
Primary: 8/20/2024
General: 11/5/2024
Malcolm Kenyatta (he/him)
Pennsylvania Auditor General
Primary: 4/23/2024
General: 11/5/2024
Dave Upthegrove (he/him)
Commissioner of Public Lands, WA
Primary: 8/6/2024
General: 11/5/2024
2024 Incumbent Candidates
Ravi Shah (he/him)
Tucson Unified School Board, At-Large, AZ
General: 11/7/2024
Terra Lawson-Remer (she/they)
San Diego County Board of Supervisors, District 3, CA
Primary: 3/5/2024
General: 11/5/2024
Michele Rayner (she/they)
Florida House of Representatives, District 62
Primary: 8/20/2024
General: 11/5/2024
Brandon Woodard (he/him)
Kansas House of Representatives, District 10B
Primary: 8/7/2024
General: 11/6/2024
Brian Knudsen (he/him)
Las Vegas City Council, Ward 1, NV
Primary: 6/11/2024
General: 11/5/2024
Charles Spain (he/him)
Court of Appeals Justice, Place 4, District 14, TX
Throughout the late 80s, 90s, and early 2000s, Americans became obsessed with anabolic steroid doping – i.e., hormonally altering one’s body to win sports competitions. In 1988, American Olympic sprinter Ben Johnson lost his gold medal from the Seoul Olympics due to doping with anabolic steroids. This was considered a national embarrassment, and after a series of hearings, the Anabolic Steroids Control Act of 1990 was passed as part of the Crime Control Act.
Twenty-seven steroids, including testosterone, were classified as Schedule III drugs and subject to imprisonment and fines for possession and distribution. Then-senator Joe Biden was invested in this issue, saying at the time, “I think you are going to see, over the next several years, some real backlash from the public about sports in America… There is a feeling of resentment that is growing, and I do not know how it will manifest itself.”
Unfortunately, moral panic over steroids has always had the criminalization of transmasculine people as collateral damage. Prior to 1990, FTM Newsletter was known to suggest getting around pricey American testosterone by trafficking it across the border. One September 1989 ad read, “Vacationing in Mexico? One of our members asked us to inform any FTM’s visiting Tijuana, Mexico, that he was able to purchase Depo-Testosterone in a 10 ml vial over the counter for $18.”
In contrast, the September 1990 issue of FTM Newsletter informed its readers that they would have to ask their doctors to lie on their prescriptions if they wanted to have a stockpile of extra testosterone in their home – a useful thing to have in the case of shortages or rejections from transphobic pharmacists. These rejections are all too common because many states require people to show their photo identification (potentially revealing one’s dead name and legal sex) and log their prescription in prescription drug monitoring programs (often under one’s dead name) for them to be able to access testosterone.
The criminalization of simple possession and the risk of being accused of encouraging drug trafficking across borders has chilled discussion of trying to get hormones abroad or on the gray market. Do-it-yourself transition communities today, which allow discussions of gray market estrogen, ban discussions of how one might acquire testosterone. The fear of prosecution is not unfounded; transmasculine folks have reported being arrested for possession of testosterone they acquired legally. If law enforcement were to decide that a transmasculine person was possessing testosterone illegally, their first offense could land them up to a year in prison and a $1000 fine.
One would hope that the passage of the Anabolic Steroids Control Act of 1990 would satisfy politicians and a populace obsessed with steroids, but one would be wrong. Between 1998 and 2006, American politicians and NGOs purposefully engineered a second anabolic steroid moral panic. The anti-steroid propaganda many millennials probably experienced as children has roots in a Salt Lake City, Utah Olympic bribery scandal and the way cisgender men in power tried to save face in the aftermath.
The Winter Olympic bid scandal
In 1998, it was revealed that the president and vice president of the Salt Lake City bid committee had allegedly paid a total of over $1 million in cash and gifts to bribe over a dozen International Olympics Committee (IOC) officials in the hopes that their city could host the 2002 Winter Olympics. The president and vice president (who were indicted in 2002 but acquitted in 2003) allegedly also pocketed $130,000 in bribes from the hospitality company Jet Set Sports. Three other Americans were indicted for fraud, and one became a fugitive of the law. Shortly after, the news broke that similar bribery and fraud may have taken place when bidding for the Atlanta, Georgia; Nagano, Japan; and Sydney, Australia games.
It came as no surprise to journalists at the time that the IOC would wish to rebrand itself as an upstanding organization leading the charge against corruption in sports. The IOC looked to the United States for suggestions on how to clean up its image. The Office of National Drug Control Policy (ONDCP) recommended that it create an Olympic anti-drug agency and stated that the US was open to committing $1 million for research into new anti-drug tests.
In February 1999, the IOC unveiled the World Anti-Doping Agency (WADA), which sought to curb the use of performance-enhancing drugs. WADA received $25 million from the IOC to level up its bureaucracy, with hopes that this would eventually be subsidized by governments – though, as Scientific American noted at the time, WADA was “unwilling to put its full support behind experimental tests that might not withstand legal challenge in the Court of Arbitration.”
In 2000, President Bill Clinton created the White House Task Force on Drug Use in Sports, emphasizing that it came from concern for “the health and safety of America’s athletes, in particular our Nation’s young people” and “the integrity of honest athletic competition.” He cited the 1999 Monitoring the Future Study and claimed that it found that “steroid use among young people rose roughly 50 percent among both sexes and across all age groups.” This was a lie. For all young people, the number jumped from 1.4% to 1.9% between 1998 and 1999. But it sounded true enough to give the task force legitimacy.
Shortly after, the US Olympic Committee launched the US Anti-Doping Agency (USADA). USADA launched playclean.org as a hub for propaganda and began producing anti-doping commercials, print ads, and handbooks for coaches that conflated anabolic steroid use with the use of addictive drugs. In 2000, the White House Task Force on Drug Use in Sports met for the first time in Salt Lake City, accompanied by Mitt Romney (then-President of the Salt Lake City organizing committee), Mike Leavitt (then-Governor of Utah), and many other government and NGO representatives and athletes.
Experts who attended the meeting expressed the desire to push the federal government to close loopholes on steroid precursors and prosecute steroid possession and sale more harshly. Both the White House Task Force on Drug Use in Sports and the USADA fixated on how youth might admire athletes who use anabolic steroids and how they might access steroids on the internet.
As usual, this stigmatization came at a cost for transmasculine people. In the Fall 2002 issue of FTM Newsletter, trans man Marcus de María Arana wrote an article called The High Price of Manhood in which he described medical neglect at the UCSF ER that caused him to experience septic shock and lose 25% of his femur after a botched testosterone injection. According to Arana, “[T]he prevailing attitude was that I brought this upon myself by messing around with steroids… I got the vibe from some providers that I had gotten what I deserved for messing with nature.”
The aftermath
In 2004, Utah Republican congressman Orin Hatch and then-Senator Joe Biden cosponsored the Anabolic Steroid Control Act of 2004, which was framed as a way to stop health food stores from selling shady products, to demand an investigation into whether stronger sentencing was necessary, and to award grants to organizations that would distribute anti-steroid propaganda. Considering that Hatch was the architect of a 1994 law that allows supplement companies to avoid federal regulation (which has resulted in deaths), it’s tough to believe that Hatch was more invested in consumer safety than the reputation of the state of Utah. Biden expressed nationalistic concerns at a hearing in March 2004, saying, “There’s something simply un-American about this. This is about values, about culture, it’s about who we define ourselves to be.”
According to Hooton, “When I put three words into the Google search engine: ‘buy, steroids, online,’ over three hundred thousand sites popped up. Senators, all our kids need are a credit card number or a money order to have hardcore prescription anabolic steroids shipped right to their doorstep.”
Joe Biden claimed that half of all children believed that their favorite sports stars used steroids and called it “a devastating idea.” The Anabolic Steroid Control Act of 2004 was passed, and by 2006, sentencing guidelines for steroid possession and distribution became much more severe.
Meanwhile, Joe Biden’s political stock has risen, thanks largely to his reputation as a bipartisan negotiator of bills like the Anabolic Steroids Control Act of 2004.
Biden is sitting President of the United States at a time in which transmaculine folks’ increased visibility has prompted fearmongering books such as Abigail Shrier’s Irreversible Damage: The Transgender Craze Seducing our Daughtersand legislation restricting transition of all kinds. Transmasculine folks are now in the curious position of hoping that recent calls from Senators Ed Markey (D-MA) and Elizabeth Warren (D-MA) to deschedule testosterone will not be ignored by the very man who put those laws in place.
While Biden has made statements nominally supporting transgender folks, they have not extended to removing one of the biggest legal hurdles to transmasculine folks living lives free of fear and harassment, nor have they even acknowledged his own culpability in the situation.
For now, and seemingly for the first time, Biden has chosen to have no opinion on testosterone.
Tennessee’s decades-old aggravated prostitution statute violates the Americans with Disabilities Act, the U.S. Department of Justice announced Friday after an investigation, warning that the state could face a lawsuit if officials don’t immediately cease enforcement.
Tennessee is the only state in the United States that imposes a lifetime registration as a “violent sex offender” if convicted of engaging in sex work while living with HIV, regardless of whether the person knew they could transmit the disease.
LGBTQ and civil rights advocates have long criticized the measure as discriminatory, making it almost impossible to find housing and employment due to the restrictions for violent sex offenders. Earlier this year, the American Civil Liberties Union and the Transgender Law Center filed a lawsuit seeking to overturn the law in federal court.
The department’s findings on Friday are separate from the ongoing lawsuit.
The department is calling on the state to not only stop enforcing the law, but also remove those convicted under the statute from the sex offender registry and expunge their convictions. The agency also says Gov. Bill Lee should introduce legislation to repeal the law.
The ADA is the landmark 1990 federal law prevents discrimination against disabled people on everything from employment to parking to voting. HIV and AIDS are considered disabilities under the ADA because they substantially hinder life activities.
“Tennessee’s aggravated prostitution law is outdated, has no basis in science, discourages testing and further marginalizes people living with HIV,” said Assistant Attorney General Kristen Clarke, with the Justice Department’s Civil Rights Division, in a statement. “People living with HIV should not be treated as violent sex offenders for the rest of their lives solely because of their HIV status.”
The department’s letter was addressed specifically to Attorney General Jonathan Skrmetti, Tennessee Bureau of Investigation Director David Rausch and Shelby County District Attorney Steven Mulroy.
Shelby County, which encompasses Memphis, was named because DOJ said it’s where the law has been “enforced most frequently.”
Through a spokesperson, Mulroy noted that the allegations stem from cases handled before he took office in September 2022. Mulroy said he agrees with the Justice Department’s findings and his office is fully cooperating.
A spokesperson for the Tennessee investigation bureau said officials were reviewing the letter but had no other response to DOJ’s investigation.
A spokesperson for Skrmetti did not immediately respond to an email requesting comment.
Prostitution has long been criminalized as a misdemeanor in Tennessee. However, in 1991 — as the AIDS epidemic provoked panic and prevalent misinformation over prevention — Tennessee lawmakers enacted an aggravated prostitution statute, which was a felony and applied only to sex workers living with HIV. The law was later reclassified in 2010 as a “violent sexual offense,” requiring those convicted to face lifetime sex offender registration.
Court documents state that more than 80 people are registered for aggravated prostitution in Tennessee.
The DOJ letter details several of the struggles of those with aggravated prostitution convictions. A lifetime sex offender registration can stop people from visiting with their grandchildren, revoke job offers, and severely limit housing options. One person shared that they were barred from taking a course to get a general education diploma because children might be present in the building.
Plaintiffs who had filed a lawsuit seeking to block the aggravated prostitution law in October said the DOJ’s letter only further supports their efforts.
The lawsuit was brought by four unidentified people and OUTMemphis, a nonprofit that serves LGBTQ people.
“OUTMemphis welcomes the DOJ’s findings that, through its outdated and punitive aggravated prostitution law, Tennessee is discriminating against people living with HIV,” said Molly Quinn, executive director, OUTMemphis, in a statement. “We agree, and that’s why we are suing to get the law struck down. Whether this issue is resolved informally or in court, it is long past time to end HIV criminalization.”
A Laramie preacher has won a federal lawsuit against the University of Wyoming (UW). He had sued the university for infringing on his constitutionally protected free speech rights.
Last December, Laramie Faith Community Church Elder Todd Schmidt displayed an anti-trans banner in the UW student union, identifying an individual transgender student by name. The university banned him from tabling for one year, alleging that he was harassing the student.
Schmidt sued UW on First Amendment grounds. He won a preliminary injunction that has already let him return to the student union. Last week, both parties agreed to a judge’s order, bringing the case to a close. UW will also pay Schmidt $35,000 for attorney fees and expenses.
Schmidt’s presence on campus has stirred up other issues. A few days after he posted the sign, he received a trespass warning from police because he showed up in his car outside of a sorority that admitted a transgender student. In February, Schmidt told the Star-Tribune that he was in the area because he was making a DoorDash delivery there. He then rang the doorbell of the Kappa Kappa Gamma sorority house with the intention of having “a conversation” with sorority members. The University of Wyoming listed “multiple complaints,” as one of the reasons for the one year suspension, the lawsuit states.
In our nation, we must accept that we’re likely to hear and read things that are offensive to us — sometimes deeply offensive. I reiterate, and the working group acknowledges, that there are legal limitations to free expression on our campus.
But feeling uncomfortable or offended — and, in many cases, even feeling unsafe — is not, in and of itself, grounds for stopping speech.
We live during a time when political and social divisiveness seems to be tearing apart the very fabric of our society. We can’t let that happen. Nor can we depart from the principle of free expression that has been part of our nation’s foundation from the beginning.
Rafael Franco worked in the GLBT Historical Society archives this summer, helping us process a vital collection of recorded interviews. We interviewed Rafael about his time in the archives, and the surprising material he uncovered.
Can you tell us about your time in the archives?
Rafael Franco: I worked with the Mary Richards Collection, which houses audio recordings she made as a freelance writer for the San Francisco-based LGBTQ newspaper, the Bay Area Reporter. The recordings are from the 1980s and 1990s and touch on topics such as the National March on Washington for Lesbian and Gay Rights, AIDS fundraisers, queer nightlife in San Francisco, Pride celebrations, and more.
I’ve engaged with online materials from the GLBT Historical Society since moving to the Bay Area in 2021, and its contents have enabled me to establish a deep understanding of Northern California’s queer history. This, in tandem with the fact that my research engages extensively with queer theory and queer histories, incentivized me to reach out to discuss my interest in working with the Society.
Why is it important to tell this story?
RF: These files remind us that there is light amidst hard times. In these tapes, there is so much expression of joy amidst a time that is portrayed as solely tragic in films, television, and other media. From dinner parties to the Gay Games to film screenings, queer joy is everywhere in these tapes. While it’s absolutely essential to acknowledge pain and mourn violence against queer people, it’s also important to recognize and celebrate queer joy, as being queer is often equated with being unhappy.
How does your work resonate today?
RF: One lesson that I think will always withstand the test of time is that talking about taboo topics often helps eliminate harmful stigmas. One such taboo topic is sex. In one of the tapes, Alan Selby discusses his thriving leather business. His audio file discusses sadomasochism in relation to AIDS, and provides valuable advice for those who would like to indulge in fetish but still want to partake in safe sex. His discussion is important and proves that opening up avenues for discussions could save lives.
What interesting things have you found in the archives?
RF: I’ve found the importance of congregation very interesting. For example, many people held fundraisers in hopes of raising enough money to travel to Washington D.C. for the 1987 National March on Washington for Lesbian and Gay Rights. One such event was a gala beer bust, which was hosted by the San Francisco Gay Freedom Day Marching Band and Twirling Corps. The importance of organizing and congregating at Washington D.C. doesn’t strike me as something that is as common in our times, especially with the rise of online activism and fundraising. While online activism has its perks, it’s clear that on the ground work also comes with its own benefits, including the formation of a community–something that is especially important in times such as the AIDS crisis.
Can you tell us more about yourself?
RF: Currently, I am a Ph.D. student in Literature at UC Santa Cruz. My research focuses on 19th century gothic literature, with a focus on how queer feelings get defined as monstrous in the heteronormative sphere. Before coming to UCSC, I received B.A.s in English and History from UCLA.
I worked with the Society through the Public Fellows program at UC Santa Cruz, which partners Ph.D. students in the humanities with organizations and companies outside of academia. The goal of the program is for students to exercise their research skills, paving the way for potential career opportunities. My role involved inputting metadata for the Mary Richards Collection, which includes over 300 tapes. The goal of this project was to digitize the recordings and make them accessible to a wide audience.
Lastly, is there anything we didn’t ask that you’d like to share with us?
RF: I think one important thing to note is that archives are never a complete story. There are always narratives that will slip through the cracks and remain untold. In my work, for example, I wondered whether trans people would be present in the recordings only to discover that there is only evidence of a trans person on two out of over three hundred tapes. However, I think this absence says almost as much as the tapes do. Not only do they show us how far we’ve come with trans rights, but they show us how far we still need to go to listen to the trans people who never got the opportunity to speak.
Rafael Franco is a Ph.D. student in literature at UC Santa Cruz. His research is on 19th century Gothic literature, analyzing the way novels often defined their monsters through their race and sexuality. He has worked to promote educational accessibility, including work with Central Valley Scholars and the Educational Opportunities Program at UCSC. After working on some summer projects for the GLBT Historical Society, he found the digitization of archives most rewarding, as it helps ensure people have access to research materials both on and off-site.
This interview has been edited for length and clarity.
Mary Richards Collection is now online!
We are happy to announce that hundreds of interviews by journalist Mary Richards have been digitized and are now available online! This project was supported by a Recordings at Risk grant from the Council on Library and Information Resources (CLIR). The grant program is made possible by funding from the Mellon Foundation.
Photo Credits: Photo of the Mary Richards Audiotapes (#2002-34). Rafael Franco photo courtesy of same.
The Food and Drug Administration’s first-ever approval of an at-home test for chlamydia and gonorrhea could help drive earlier detection and treatment of these sexually transmitted infections amid a ballooning epidemic in the U.S. But some sexual health advocates worry that the FDA’s proposal to begin stepping up regulation of over-the-counter self-testing of STIs could backfire.
The need for new tools to combat these infections is dire.
Diagnoses of gonorrhea, chlamydia and syphilis have soared in the past two decades. Public health experts argue that this is at least partially driven by woeful long-term flat funding of the Centers for Disease Control and Prevention’s budget to fight the spread of STIs during this period.
Some public health officials and advocates expect that greater FDA oversight will help legitimize home STI testing, making it easier to get insurance coverage and actually expanding its use.
Other home tests for these three bacterial STIs are already available over the counter. But the FDA, which has not previously sought to enforce regulation or require that their manufacturers apply for formal approval, cannot vouch for their accuracy.
A consortium of LGBTQ sexual health advocates has objected to a recent FDA policy proposal that, if enacted, would require the companies already offering at-home medical tests, including for STIs, obtain regulatory approval. A central worry is that the expense of meeting the FDA’s demands could drive some companies out of the STI self-testing market and otherwise drive up the cost of the tests.
There are also concerns that the newly approved test does not cover syphilis and is not well suited to address gay and bisexual men’s needs.
The test kit, called Simple 2, does not screen for syphilis, which typically requires at least a finger-prick blood sample. There were at least 177,000 syphilis cases in 2021, a 74% increase since 2017, according to the CDC. Most concerningly, CDC data shows that rates of syphilis in newborns, which can be fatal, rose more than tenfold in the past decade.
Dr. Boghuma Titanji, an infectious disease specialist at Emory University, said that the inconvenience of having to go into a clinic was a major barrier to getting at-risk people tested for STIs.
“Just remove that requirement, that will make the access better for a lot of patients,” she said.
Dr. Leandro Mena, director of the Division of STD Prevention at the Centers for Disease Control and Prevention, believes the new at-home test’s approval will indeed increase testing for gonorrhea and chlamydia.
Self-testing, he said, provides “a tremendous opportunity to empower people to control when, where and how they get tested, and how they learn about their test result, so they can get appropriate treatment for these STIs.”
Chlamydia and gonorrhea are the most common STIs in the U.S., diagnosed in 1.6 million and 710,000 people respectively in 2021, according to the CDC. They can often be asymptomatic and are easily cured with antibiotics. However, if left untreated, the infections can lead to infertility and can be especially harmful to women, leading, for example, to pelvic inflammatory disease. They spread disproportionately among adolescents and young adults, gay and bi men, and people of color.
Will FDA oversight help or hinder the STI fight?
On Nov. 15, the FDA granted marketing authorization for adults to use the over-the-counter Simple 2 Test for gonorrhea and chlamydia, from the home-testing company LetsGetChecked. The test kit, currently sold for $99 through the company’s website, can be activated online, where the consumer fills out a health questionnaire before shipping in samples to a laboratory.
If the results are positive, the company would then put the individual in contact with a physician.
Previously, HIV was the only other sexually transmitted infection to have an FDA-approved at-home test.
Other at-home STI tests are available through telemedicine companies and major pharmacy chains. However, these tests exist in a legal gray zone. Because they’re based on samples that are not taken in a lab, they don’t qualify for an exemption from requiring FDA approval that the agency grants to so-calledlaboratory-developed tests.
The FDA has generally not sought to exert control over home-based tests. However, on Sept. 29, the agency opened a two-month public comment period on a proposed new plan to require companies offering medical self-testing kits for any purpose to seek formal marketing authorization for their products. The FDA’s move followed reports of faulty self-tests that led to undertreatment or improper treatment for heart disease and cancer.
The goal, according to the FDA, is to “ensure the safety and effectiveness of these tests.”
In response, a group that includes sexual health advocates and owners of gay dating apps that provide free at-home HIV and STI testing, began circulating a petition that calls for the FDA to exempt such public health programs from the proposed new demands. Gaining approval for existing STI tests, the petition states, would involve a “time-consuming and expensive process.”
“Many public health leaders are concerned that new FDA regulations will create additional barriers to public health testing,” said Jen Hecht, director of the consortium Building Healthy Online Communities.
Dr. Matthew Golden, who leads the HIV and STI control program at Seattle’s public health department, said that the FDA is playing catch-up in an effort to enforce regulation of an industry that has grown fast since Covid.
“At some level, the horse has left the barn,” said Golden, noting that self-testing kits have been widely used for years. However, he said that for “some of those tests, how well they perform is not well known. So cleaning this up makes sense.”
A source familiar with FDA policies and practices told NBC News that if the agency decides to demand that self-testing companies obtain regulatory approval, it would not likely interrupt the availability of existing medical self-tests during the application process.
That said, it is likely that once a critical mass of self-testing companies obtained or otherwise sought approval, the agency would go after any laggards.
Gay men’s needs are left out — for now
The Simple 2 Test is effectively geared only toward STI exposures from vaginal intercourse.
The kit can process a urine sample and a swab of the vaginal area. Chlamydia and gonorrhea infections, however, can be localized in the throat, urogenital area or rectum. A urine sample can detect urogenital infections in men and women. For people who may have otherwise been exposed through oral or anal sex, oral and rectal swabs would also be needed.
David Harvey, executive director of the National Coalition of STD Directors, said that public health experts “expect and need” the FDA ultimately to approve at-home tests for syphilis and for oral and rectal gonorrhea and chlamydia infections, “so we’re also reaching others who are at high risk, including gay men.”
The CDC’s Mena said he hoped that the agency and the FDA will confer with LetsGetChecked or other testing companies about pushing for additional approvals.
The FDA’s authorization for the Simple 2 Test was based on data indicating that consumers could successfully use the home tests, understand the results and then take any necessary subsequent action.
It’s unclear whether the test will be available outside LetsGetChecked website or whether $99 kit will be covered by insurance. The company didn’t respond to requests for comment.
Tristan Schukraft, CEO of MISTR, a telehealth company that provides the PrEP HIV prevention pill, is supportive of greater FDA oversight of home tests, but expressed concern that tighter regulation could increase the cost of testing.
“Labs are going to be required to spend additional money and resources on studies, quality systems, reagents and software systems,” Schukraft said.
In addition, MISTR requires that PrEP recipients undergo testing every three months for chlamydia, gonorrhea and syphilis. At least 85% of MISTR customers on PrEP opt for at-home testing. The company advises people who test positive — about 13.5% of the kits detect at least one STI — to seek medical care and provides assistance in connecting people to care for those who need it.
Schukraft suggested that greater regulation could lead companies to pull such tests from the market.
If so, he said, “the FDA would be doing harm to public health.”
Richmond has once again demonstrated its commitment to LGBTQ+ rights and inclusivity by maintaining a perfect score of 100 in the 2023 Municipal Equality Index, a notable achievement that places the city at the forefront of LGBTQ+ advocacy in Virginia.
The MEI, conducted by the Human Rights Campaign, evaluates municipalities based on their inclusivity in laws, policies, and services for the LGBTQ+ community. Richmond’s consistent performance in this index reflects the city’s ongoing efforts to support and protect its LGBTQ+ residents.
Reflecting on this achievement, Mayor Levar Stoney told The Advocate, “When I became mayor, I think we were at 42, and over the last four or so years, we’ve been able to raise it to 100, a lot of workers involved.” This improvement underlines the city’s proactive approach to enhancing LGBTQ+ rights and support.
Key initiatives contributing to Richmond’s high score include legislation supporting a ban on conversion therapy, implementing transgender-affirming policies for local homeless services, and adapting health care policies for the city’s workforce to include gender-affirming care.
Stoney emphasized the importance of these policies.
“We now will cover gender-affirming care for our transgender community [in our] health care policy,” he said. “I thought that was very important.”
Richmond’s score stands in contrast to Newport News, which scored the lowest in Virginia with 66, showing that the commitment to LGBTQ+ equality does vary by city and town.
Stoney believes that Richmond’s progress serves as a model for other cities, underscoring the benefits of inclusive policies.
“We have a competitive advantage here in the South by being more welcoming and more inclusive,” he remarked, highlighting the positive impact of such policies on the city’s culture and values.
Richmond’s achievement in the MEI is not only a testament to the city’s commitment to LGBTQ+ rights but also a call to action for other municipalities to follow suit.
“We are writing a new chapter here in Richmond, our chapter that is inclusive and welcoming for all people,” Stoney said.
As the city celebrates its success, Stoney also acknowledged the efforts of various stakeholders in the community.
“We’ve always worked with the Nationz Foundation, Zakia McKensey, who is one of our number 1 stakeholders in our community,” he noted. The foundation’s mission includes LGBTQ+ rights and HIV prevention.
This collaboration with local nonprofits and community organizations has been pivotal in addressing the specific needs of the LGBTQ+ community, particularly in areas of education and awareness for city employees and law enforcement.
Richmond’s approach extends beyond policy to include tangible support for vulnerable groups within the LGBTQ+ community. Stoney highlighted initiatives focused on the city’s youth and unhoused populations.
“A lot of our focus has been on homelessness services because we know the challenges that may occur in the LGBT community, specifically our transgender residents,” he said.
Looking to the future, Stoney emphasized the importance of building upon these achievements.
“I will always stand up, stand against any sort of bigotry, but also marginalization of our transgender and LGBT community,” he said.
In the larger context of the HRC 2023 Municipal Equality Index, Richmond’s perfect score is a beacon of hope amidst a challenging national climate for LGBTQ+ rights, especially as state legislatures attempt to rollback LGBTQ+ rights. Kelley Robinson, president of the Human Rights Campaign, highlighted the significance of this year’s MEI.
“This past summer, for the very first time in our history, the Human Rights Campaign declared a State of Emergency for LGBTQ+ people in America,” she said in a letter accompanying the report.
This statement underscores the critical role local governments play in safeguarding LGBTQ+ rights, especially in the face of over 500 anti-LGBTQ+ bills introduced in state legislatures nationwide.
Richmond’s achievement is not an isolated success but part of a more significant trend of cities striving for inclusivity.
Fran Hutchins, executive director of the Equality Federation Institute, noted, “This year, a record-breaking 129 cities — over 25 percent of all MEI-rated cities — earned the highest score of 100, up from 120 in 2022.”
Cities like Richmond are leading the way, demonstrating the profound impact local policies and protections can have on the lives of LGBTQ+ individuals. These high-scoring cities serve as examples for others, showing that progress toward equality is achievable and crucial locally.
Richmond’s achievement in the Municipal Equality Index is particularly noteworthy given the state’s political landscape, especially under Republican Gov. Glenn Youngkin’s administration. As the state capital, Richmond’s steadfast commitment to LGBTQ+ rights contrasts with broader attempts to roll back such rights in Virginia.
Youngkin, since taking office, has pursued policies and supported legislative efforts that are seen as detrimental to the LGBTQ+ community. His administration has been marked by actions that many view as undermining LGBTQ+ protections. For instance, there have been moves to restrict the rights of transgender students in schools, including limiting their participation in sports and access to facilities aligning with their gender identity. Additionally, the Youngkin administration has been criticized for policies that could potentially restrict discussions around LGBTQ+ topics in educational settings, echoing the controversial “don’t say gay” bill in Florida.
These actions have sparked significant concern among LGBTQ+ advocates and allies, who argue that such measures not only discriminate against LGBTQ+ individuals but also contribute to a hostile and unwelcoming environment. The contrast between Richmond’s proactive actions to enhance LGBTQ+ inclusivity and the state-level efforts to limit these rights underlines the growing divide in approaches to LGBTQ+ issues within Virginia.
Police searched venues across the Russian capital, including a nightclub, a male sauna, and a bar that hosted LGBTQ+ parties, under the pretext of a drug raid, local media reported.
Eyewitnesses told journalists that clubgoers’ documents were checked and photographed by the security services. They also said that managers had been able to warn patrons before police arrived.
The raids follow a decision by Russia’s Supreme Court to label the country’s LGBTQ+ “movement” as an extremist organization.
The ruling, which was made in response to a lawsuit filed by the Justice Ministry, is the latest step in a decadelong crackdown on LGBTQ+ rights under President Vladimir Putin, who has emphasized “traditional family values” during his 24 years in power.
Activists have noted the lawsuit was lodged against a movement that is not an official entity, and that under its broad and vague definition authorities could crack down on any individuals or groups deemed to be part of it.
Several LGBTQ+ venues have already closed following the decision, including St. Petersburg’s gay club Central Station. It wrote on social media Friday that the owner would no longer allow the bar to operate with the law in effect.
Max Olenichev, a human rights lawyer who works with the Russian LGBTQ+ community, told The Associated Press before the ruling that it effectively bans organized activity to defend the rights of LGBTQ+ people.
“In practice, it could happen that the Russian authorities, with this court ruling in hand, will enforce (the ruling) against LGBTQ+ initiatives that work in Russia, considering them a part of this civic movement,” Olenichev said.
Before the ruling, leading Russian human rights groups had filed a document with the Supreme Court that called the Justice Ministry lawsuit discriminatory and a violation of Russia’s constitution. Some LGBTQ+ activists tried to become a party in the case but were rebuffed by the court.
In 2013, the Kremlin adopted the first legislation restricting LGBTQ+ rights, known as the “gay propaganda” law, banning any public endorsement of “nontraditional sexual relations” among minors. In 2020, constitutional reforms pushed through by Putin to extend his rule by two more terms also included a provision to outlaw same-sex marriage.
After sending troops into Ukraine in 2022, the Kremlin ramped up a campaign against what it called the West’s “degrading” influence. Rights advocates saw it as an attempt to legitimize the war. That same year, a law was passed banning propaganda of “nontraditional sexual relations” among adults, also, effectively outlawing any public endorsement of LGBTQ+ people.
Another law passed this year prohibited gender transitioning procedures and gender-affirming care for transgender people. The legislation prohibited any “medical interventions aimed at changing the sex of a person,” as well as changing one’s gender in official documents and public records.
Russian authorities reject accusations of LGBTQ+ discrimination. Earlier this month, Russian media quoted Deputy Justice Minister Andrei Loginov as saying that “the rights of LGBT people in Russia are protected” legally. He was presenting a report on human rights in Russia to the U.N. Human Rights Council in Geneva, arguing that “restraining public demonstration of nontraditional sexual relationships or preferences is not a form of censure for them.”
The Supreme Court case is classified and it remains unclear how LGBTQ+ activists and symbols will be restricted.
Many people will consider leaving Russia before they become targeted, said Olga Baranova, director of the Moscow Community Center for LGBTQ+ Initiatives.
“It is clear for us that they’re once again making us out as a domestic enemy to shift the focus from all the other problems that are in abundance in Russia,” Baranova told the AP.
As Republican-led legislatures have limited or banned access to gender-affirming care for trans people across the country, states like New Mexico are witnessing a large influx of “gender refugees” seeking healthcare.
Over the past two-plus years, nearly two dozen states have instituted limits or bans on gender-affirming health care for trans youth and adults. While trans people in red states seek out alternative sources of care and places to live, larger states and metropolitan areas like San Francisco and New York can prove prohibitively expensive.
So smaller states like New Mexico, Minnesota, Colorado, Vermont, and Washington, with prohibitions on restricting gender-affirming health care and a lower cost of living, are attracting a crush of trans patients seeking care.
They’re being met with waiting lists.
“I feel really excited and proud to be here in New Mexico, where it’s such a strong stance and such a strong refuge state,” Molly McClain, a family medicine physician and medical director of the Deseo clinic, which serves transgender youth at the University of New Mexico Hospital, told CBS News. “And I also don’t think that that translates to having a lot more care available.”
The strain is affecting new patients and longtime New Mexico residents, as well.
“With the influx of gender refugees, wait times have increased to the point that my doctor and I have planned on bi-yearly exams,” said Felix Wallace, a 30-year-old trans man and longtime resident.
Anne Withrow, a 73-year-old trans woman and Albuquerque resident for over 50 years, sought care from a new provider at the University of New Mexico after her doctor retired.
“They said, ‘We have a waiting list.’ A year later they still had a waiting list.”
A year after that, Withrow managed to get care from a local community-based health center.
As of October, UNM’s Truman Health Services clinic still wasn’t taking new patients.
At the Transgender Resource Center of New Mexico, T. Michael Trimm says the center used to field two or three calls a month from people out-of-state considering a move.
“It has steadily increased to a pace of one or two a week,” he said.
“We’ve had folks from as far away as Florida and Kentucky and West Virginia,” as well as families in Texas “looking to commute here for care, which is a whole other can of worms, trying to access care that’s legal here, but illegal where they live.”
In New Mexico, the problem is compounded by a physician shortage.
A 2022 report revealed New Mexico lost a staggering 30% of its physicians in the previous four years. The state is on track to have the second-largest physician shortage in the country by 2030, with the oldest physician workforce.
Despite the obstacles, Trimm says “trans folks can be very resilient.”
While a waitlist isn’t ideal, he says it’s easier to endure “than the idea that you maybe could never get the care.”