Christopher Wiggins

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LGBTQ+ groups face alarming funding crisis as Republican anti-trans attacks mount, new report finds

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Philanthropic support for LGBTQ+ causes is collapsing just as queer and transcommunities face an escalating national crisis. New data from Funders for LGBTQ Issues shows foundation funding for LGBTQ+ organizations in the U.S. dropped sharply to $209.4 million in 2023. That’s a staggering decline of nearly $49 million, or 19 percent, from 2022. When adjusted for inflation, that cut deepens to 22 percent.

Even as the funding picture grows increasingly dire, many philanthropic institutions are opting to remain anonymous. The report omits the names of top funders and grantees for the first time in decades, reflecting a growing trend among donors who fear political retaliation and the increased hostility toward progressive causes under the current administration.

It’s a devastating trend arriving at precisely the moment when a second Trump presidency has declared open political war on transgender people, fueling state and federal policies designed to erase LGBTQ+ existence from public life. The Funders for LGBTQ Issues report makes clear the danger: for every $100 awarded by U.S. foundations in 2023, only 20 cents specifically supported LGBTQ communities, a decrease from 25 cents the previous year.

After the most inclusive U.S. president, President Joe Biden, stepped down from reelection and LGBTQ+ ally Vice President Kamala Harris lost the 2024 contest, President Donald Trump’s return to power has been defined by chaos and an obsessive focus on erasing transgender people from law and society. In the first half of 2025 alone, legislatures in 49 states have introduced 947 anti-trans bills, with 118 already enacted. That tsunami of legislation builds on the record-breaking surge of 701 anti-trans bills introduced in 2024, including an unprecedented 88 bills at the federal level, according to the Trans Legislation Tracker.

These bills range from the cruel to the surreal. Missouri lawmakers proposed felony charges and mandatory sex offender registration for teachers who support a child’s social transition. West Virginia’s legislature declared transgender identity a mental disorder, reminiscent of decades when homosexuality itself was pathologized. Across the country, new laws mandate forced outing of trans students, criminalize gender-affirming medical care, and redefine gender as an immutable biological fact.

The Trump administration has doubled down with executive orders that read like ideological manifestos. One bans trans women from women’s sports. Another order requires the federal government to remove references to gender identity from regulations. Other orders recast gender-affirming medical care as “mutilation” and threaten providers with criminal penalties. These policies don’t merely shift bureaucratic language; they stoke a cultural war that emboldens states to escalate legislative attacks.

Yet, precisely as the scale of the crisis explodes, the lifelines that sustain LGBTQ+ advocacy are drying up. As The Advocate previously reported, the Human Rights Campaign, GLSEN, and The Trevor Project all announced layoffsin the past year, citing shrinking donations and economic uncertainty.

The financial retreat cuts deepest in the communities most at risk. Funding for transgender, gender-nonconforming, and nonbinary communities fell from $48.2 million in 2022 to just $36.4 million in 2023, a 24 percent decrease. Similarly, grants for Black LGBTQ+ communities and causes fell by $14.5 million, a steep 41 percent drop from the all-time high in 2022 that followed the racial justice protests after George Floyd’s murder. Funding for LGBTQ+ youth plunged by 42 percent in 2023 to just $38.4 million, despite rising threats to trans children’s safety and health.

Historically, tragedies like the Pulse nightclub massacre and Floyd’s murder triggered spikes in philanthropic giving. But as Funders for LGBTQ Issues President Saida Agostini-Bostic writes in the new report, no similar surge has materialized to counter today’s unprecedented wave of anti-trans legislation. Private and community foundation funding, the bedrock of LGBTQ+ philanthropy, suffered some of the sharpest cuts, with private foundations decreasing giving by 27 percent and community foundations dropping 39 percent compared to 2022.

Despite grim figures, there are flickers of hope. Lambda Legal recently concluded a $285 million fundraising campaign, surpassing its goal by $100 million, with 95 percent of donations coming from individual donors rather than major foundations. Still, Lambda’s windfall cannot offset a sector-wide crisis, as the vast majority of LGBTQ+ advocacy and services depend on institutional grants rather than individual donors alone.

The crisis has also exposed the fragility of the funding ecosystem. According to the report, the top 10 funders accounted for 46 percent of all LGBTQ+ grants in 2023, but awarded 26 percent less money than they did in 2022.

The top 20 funders collectively slashed their giving by nearly a quarter, with no corresponding increase from smaller foundations to fill the gap. The report warns that this top-heavy structure makes the entire funding landscape volatile—one or two large funders pulling back can destabilize LGBTQ+ organizations nationwide.

As anti-trans bills multiply and federal hostility intensifies, LGBTQ+ communities stand at a crossroads. The stakes have never been higher politically and culturally. The data offers a stark warning, Agostini-Bostic said, writing, “If not now, when? If not us, who?”

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This LGBTQ+ travel company’s mission of inclusivity is radical & ‘You’re more than welcome’

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As the Trump administration escalates its attacks on transgender people’s rights, revoking “X” gender markers on passports (something a federal court has halted), instructing consular officials to deny visas based on gender presentation, and enforcing a binary-only framework, one LGBTQ+ travelcompany is charting a course toward inclusivity for marginalized travelers.

VACAYA, a queer-focused cruise and resort company founded in 2017, has become a sanctuary for those too often sidelined, even within LGBTQ+ spaces: transgender, nonbinary, BIPOC, body-diverse, bisexual, and pansexual travelers.

“In our industry, trans travelers are often trapped, by their passports, by government systems, by legal names that don’t reflect who they are,” Randle Roper, VACAYA’s cofounder and chief experience officer, told The Advocate in an interview. “We can’t overturn federal policy. But we can create joy and freedom onboard, and that’s what we do.”

Patrick Gunn and Randle Roper cofounded VACAYA in 2017.

Unlike successful decades-old legacy brands such as Atlantis Events, which caters primarily to cisgender gay men with circuit-party-style itineraries, or Olivia Travel, which targets lesbians, VACAYA’s leadership said the company intentionally created something different. “Atlantis caters to maybe 3 to 5 percent of our community,” Roper said. “We’re building something for everyone else.”

“We have a really keen eye on the balance of an experience,” Roper said. “There’s no way to push guests seven nights in a row, all night long until noon the next day, and expect people to do that without some kind of enhancement, right? We don’t do that.”

VACAYA’s parties typically wrap around 3 a.m., Roper explained, so guests can sleep, explore ports of call, and recharge.

Co-founding partner Patrick Gunn said that during a recent cruise where the host cruise line, without consulting VACAYA, brought an independent medical care team onboard. “We kind of chuckled,” Gunn said. “We were like, ’wow, you’re going to have a really quiet week.’ And that’s exactly what happened.”

By the conclusion of the trip, the care team, Roper said, reported just one intervention: a Dungeons & Dragons player experiencing an anxiety attack during a fantasy quest. “That was their most tense moment,” Roper said. “I love that story.”

That mindset of balance and care underlies VACAYA’s programming, from DJs spinning “anthem moments of pure joy” to D&D sessions hosted by Magic Academy, Gunn explained.

“You can enjoy this without overdrinking or adding other stimulants,” Gunn said. “The joy is real. And it’s shared.”

Of course, he added, “Vacayans” (that’s what they call their loyal guests) can expect to enjoy world-class entertainment, dining, and unforgettable excursions.

Each trip also features gender-neutral bathrooms, “including for people who sit to pee,” Roper said. Everybody is invited to wear pronoun pins, and for a retreat away from the bustle, a “Transcend Lounge,” a dedicated onboard space for trans, nonbinary, bisexual, pansexual, and female-identifying guests to gather, decompress, or exist.

For Gabrielle “Gabby” Dorsey, a Black trans woman and VACAYA team member, the lounge isn’t a novelty. “It’s a space where you get to be 100 percent yourself,” she said. “No questions, no judgment. If you’ve spent your life hiding or suppressing your identity and you need to connect, that room means everything.” On recent trips, the lounge overlooked a pool deck, allowing those enjoying the lounge to be away without being excluded.

Mason Fitzpatrick, a 34-year-old transgender man who works on VACAYA’s media and guest support teams, echoed that sentiment. “It’s rare to be in a place where no one questions who you are,” he said. “I live in a conservative Trump town. I’m stealthy most of the time for safety. But on that ship, the walls come down. You get to breathe.”

Those opportunities also allow guests to take emotional risks, he said. “You watch people walk differently by the end of the week,” Fitzpatrick said. “Their shoulders drop. Their voices get louder. Something shifts.”

Jamie Hartman, a 42-year-old transgender woman, parent of two kids, and software engineering manager from Portland, Oregon, described a similar experience. “I didn’t have to shield myself or explain myself,” she said.

Hartman now regularly travels with the company, often with her partner of seven years. She’s even been invited to help guide consent-forward programming in the Red Light District, VACAYA’s adult play space.

She said organizers, impressed by her feedback and engagement in spaces like the ship’s red light district and Tantra workshops, asked her to help make the red light district more inclusive. “If you don’t know about the red light district, it’s really kind of like a bathhouse out there at sea,” she said. “I’ll have these opportunities to facilitate organic encounters. Somebody, I’ll just kind of smile on the pool deck, and we’ll strike up a conversation. I’m a hugger. You want a hug? Okay, cool. Maybe the conversation goes in a space where you can practice some enthusiastic consent. You’re in a space where all of the people around you are also feeling liberated and open to, hey, experience some of those yellow zones.”

VACAYA charters entire cruise ships.

For Hartman, those “zones” serve as a way to gauge comfort and safety: green signifies ease and familiarity, yellow signals a stretch into new or slightly uncomfortable territory that can spark growth, while red indicates overwhelming distress or panic to be avoided. At VACAYA, she said, people are encouraged to explore the yellow zone if they wish — pushing boundaries in ways that feel consensual and safe — without fear of crossing into the red.

That goes for conversations, too. Hartman, who appreciates a bit of gender ambiguity, recalled one guest who assumed she was transitioning “in the opposite direction, from female to male.” She said, “It was validating on multiple levels. I got to just be and not perform.”

Related: Yet another passenger dies on world’s biggest gay cruise

That affirmation, Hartman said, matters more than most travelers realize. “At the welcome table, there are pins with your pronouns. Mine says ‘she/they,’ and I don’t feel like I have to choose. I can show up fully.”

Alysse Dalessandro, a plus-size queer woman and content creator, as well as a former inclusivity consultant for the company, helped design the pronoun system after raising concerns on an early cruise.

“It wasn’t just, ‘here’s a rainbow bowl of pins,’” she said. “We had detailed conversations about design, placement, wording, and guest education, because VACAYA wanted to get it right.”

Dalessandro also helped rebrand what had been called “Women of VACAYA” into a more inclusive program for women, trans, and nonbinary guests. “We had a trans man who said, ‘This isn’t for me.’ I said, ‘No, but it should be.’ And we changed it.”

In one memorable moment, she recalled hosting a hot tub night during an underwear party attended mainly by the cisgender gay men onboard. “One guest presented as female on the cruise but male back home for safety. At that moment, they were in a bikini for the first time, in public, with their partner.”

The company offers a diverse range of experiences, from entertainment and cuisine to alluring shore excursions, quiet reading spaces, Dungeons & Dragons nights, book clubs, and wellness workshops.

“They know not everyone wants a fetish party,” Dalessandro said. “So we also played [the sapphic card game] Les Convo over wine one night. It was spicy, but it was our kind of spicy.”

Roper said VACAYA offers roommate matching and no-interest payment plans, with trips ranging from $1,100 resort weeks to $30,000 luxury expeditions. It runs a “Reach Out” program that delivers supplies to local communities and raises funds for LGBTQ+ nonprofits. VACAYA also spent $90,000 in 2025 for WorldPride in Washington, D.C., the company said.

And in February, when guests spotted Cuban refugees adrift in the Gulf of Mexico, and officials brought them aboard, VACAYA staff and travelers sprang into action, providing food, clothing, and medical care until the U.S. Coast Guard arrived. President Donald Trump had recently dictated that the Gulf of Mexico be called the “Gulf of America.”

“It was the Republican nightmare: refugees, gays, and the Gulf,” Roper said. “But it was also a metaphor. This community knows what it means to be adrift, and to be rescued.”

VACAYA travelers

For Hartman, that metaphor holds. “This isn’t a space where you’ll never encounter a misgendering,” she said. “But you’ll never face it alone. You’ll be affirmed and supported. You’ll be reminded you belong.”

Dorsey put it more simply: “No matter where you are on that journey, if you’re just starting into your gender journey, you’re welcome. If you’re 15, 20, or 30 years into that gender journey, you’re welcome. If you’re someone who’s looking for a space to be your authentic self because nowhere else you’re able to do so, you are more than welcome.”

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How a new trans rights PAC looks to rebuild the political playbook with these high-profile endorsements

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The Christopher Street Project, a new political group focused on building support for transgender rights within the Democratic Party, has announced its first slate of congressional endorsements as it moves to equip candidates with political and messaging strategies ahead of the 2026 midterms and the 2028 presidential election.

Named after the New York City street where the 1969 Stonewall uprising began and founded in the wake of the 2024 election cycle that saw Republicans spend more than $200 million attacking transgender Americans, Christopher Street Project is endorsing 16 Democratic lawmakers. The slate includes prominent LGBTQ+ members, parents of trans children, relatives of transgender people, and high-profile allies such as Reps. Sarah McBride, Delia Ramirez, Sara Jacobs, Dina Titus, Katherine Clark, Maxwell Alejandro Frost, Val Hoyle, Mark Takano, Becca Balint, Julie Johnson, Mark Pocan, Pramila Jayapal, Ayanna Pressley, Alexandria Ocasio-Cortez, Jamie Raskin, and Melanie Stansbury.

“Our mission is to build support for the trans community within the Democratic Party and take back the party as one that values people over power,” Tyler Hack, the group’s 20-year-old founder, told The Advocate in an exclusive interview. “We understand that we need to build the playbook for how we win on trans issues over the next decade.”

Hack, who identifies as trans and nonbinary and uses they/them pronouns, said the Christopher Street Project was born from frustration after the 2024 elections, when some Democrats began to distance themselves from trans issues, fearing electoral backlash. Hack noted that since November, they had met with lawmakers who were at a loss for how to counter Republican attacks effectively.

“For all the thousands of PACs in Washington, there wasn’t one dedicated specifically to trans people,” Hack said. “It was really important for us to build up that playbook in a time when Democratic leaders were doing what they thought was right, but were not always given guidance about how to go about that.”

Hack’s vision is clear: Democrats must learn how to respond to Republican attacks and misinformation without abandoning core values. In 2024, Hack said, the party failed by attempting to deflect or move past attacks rather than confronting them head-on. Republicans, particularly the Trump campaign, bombarded Vice President Kamala Harris for her support of the trans community in several attack ads that claimed “Kamala Harris is for they/them, Donald Trump is for you.” 

After the Trump campaign bashed Harris for having expressed support for providing essential gender-affirming care to people in federal custody, Republicans painted her views as extreme. Ads attacked her for supporting “taxpayer-funded transgender surgery for prisoners,” even as Trump initiated that policy during his first administration. However, Democrats did not fight back and dismissed the line of attack.

“We never, as any political party or candidate, won an argument by simply saying, ‘Let’s move on to the next question.’ That’s just not how the American electorate thinks,” Hack said. “People don’t respond to that because it’s clear leaders are being evasive.”

Instead, Hack believes Democrats must call out the realities behind Republican proposals. They pointed to the so-called “Protecting Women and Girls in Sports Act,” warning it would lead to invasive policies like “genital inspections for girls as young as four years old.” Hack added, “There’s no swing voter who wants genital inspections for girls as young as four.”

Hack argued that the Republican focus on transgender athletes is both a distraction and a moral failing, designed to exploit a tiny population for political gain. “Trans-female athletes in the NCAA—we’re talking about fewer than 10 people,” Hack said. “It’s really closer to five. These are actual human beings, and they have real consequences when they become political targets.”

Despite GOP attacks, Hack said Democrats can win if they frame trans rights as part of a broader fight against government overreach and cruelty. “There’s no way to discriminate against transgender Americans without a gross government overreach on all people,” Hack said. “We need to reach people where they’re at, emphasize what these bills actually do.”

Hack stressed that the Christopher Street Project’s goal isn’t to demand that every candidate make trans rights their top issue in competitive districts. 

“Most people are concerned about the cost of living, about their health care,” Hack said. “But when millions of dollars are attacking you, you need to have a response. You can’t just immediately pivot because the electorate doesn’t respond to that.”

The lawmakers on Christopher Street Project’s initial slate, Hack said, have consistently shown up for the trans community, even when it wasn’t politically convenient. “These are people who have been standing up for the trans community time and time again, regardless of when it’s popular or when pundits are telling them to stop speaking about it,” Hack said. “They show up in their districts and do the work.”

Hack pointed to Titus of Nevada as an example of a lawmaker who has defended trans rights in a competitive district and successfully countered Republican narratives. “She has been unwavering in her support of the transgender community,” Hack said. “She’s been a longtime supporter of the Trans Bill of Rights and is showing what it looks like to be a Democratic member who stands up for trans people and wins in their tough races.”

The Christopher Street Project has already raised several hundred thousand dollars, Hack said, and has contributed financially to each of its endorsed candidates. The PAC will file its latest financial report soon, they said. Hack added that the group is working with lawmakers on legislative strategy, messaging, and campaign organizing. “We’re always looking for ways that we can make the biggest impact,” they said, noting the group’s support for candidates like Adelita Grijalva, daughter of the late Rep. Raúl Grijalva, who died in March, in Arizona’s upcoming special election to fill her father’s seat.

Hack also emphasized the Christopher Street Project’s long-term vision of building political power to influence Democratic messaging heading into 2028. “It’s so important that we build this coalition from the ground up with members from across the country with a variety of experiences, and work to build a party that values transgender people, not just for their votes, but for their voices,” they said.

Among those endorsed, Frost of Florida told The Advocate he was honored to receive Christopher Street Project’s support. “They’re doing the work every day to protect the LGBTQ+ community at a time when they’re under constant attack,” Frost said. “What we’re seeing from Trump and MAGA Republicans isn’t just politics, it’s cruelty. Using trans people as political targets is wrong, and I won’t stand by and watch it happen. In Congress, I’ll keep fighting to protect our rights and build a country where everyone can live with safety, dignity, and pride.”

Hack said Christopher Street Project’s mission remains urgent as Republicans prepare to keep transgender issues at the forefront of the culture wars leading into the next elections. “We’re determined to make sure Democrats don’t leave trans people behind, and that they know how to fight back and win,” Hack said.

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Gay U.S. Rep Robert Garcia elected top Democrat on powerful House Oversight Committee

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On Tuesday, Democrats in Washington, D.C., elected U.S. Rep. Robert Garcia of California as the new ranking member of the House Oversight and Accountability Committee, making him the first out gay immigrant to lead the party on one of Congress’ most powerful and combative panels.

House Democrats made the announcement official in a post on X, formerly Twitter, shortly before 11 a.m. Eastern. “House Democrats elect @RepRobertGarcia the Ranking Member of the @OversightDems,” they wrote.

At 47, Garcia is not just the youngest Democrat to lead a major committee — he’s also one of the most outspoken. A former Long Beach mayor, an immigrant from Peru, and an unapologetically queer political figure, Garcia has repeatedly called out far-right extremism and Trump-era authoritarianism. Now, he steps into one of the party’s most high-profile roles at a time when the Oversight Committee has become a central theater for Republican grievance politics.

Garcia’s election follows the death of Virginia Rep. Gerry Connolly, who led Democrats on the committee until stepping down this spring amid cancer treatment. With Connolly’s passing in May, Democrats faced a pivotal choice: maintain the old guard or signal a generational shift. They chose the latter. Garcia’s office did not immediately respond to The Advocate’s request for comment.

Garcia secured the Steering Committee’s recommendation on the first ballot — a surprise to many — and swept the full caucus vote after Reps. Kweisi Mfume of Maryland and Jasmine Crockett of Texas withdrew from the race. His final challenger, acting ranking member, Massachusetts Rep. Stephen Lynch, was unable to match the momentum behind Garcia’s bid.

It wasn’t just about age. Garcia framed his candidacy around lived experience and executive skill, pointing to his tenure running a port city during a global pandemic and his confrontations with far-right members in committee hearings. He positioned himself not just as a fighter but as someone who was already in the ring.

Garcia is the only Democrat who sits on every committee far-right Georgia U.S. Rep. Marjorie Taylor Greene does. He’s matched her culture-war provocations with fact-based, often viral, rebukes. When Greene brandished nude photos of Hunter Biden during a 2023 hearing, Garcia responded in February with an image of Elon Musk — deadpan calling it a “dick pic” — to spotlight hypocrisy and the spectacle that Oversight had become under GOP control during a Department of Government Efficiency subcommittee hearing.

Earlier this year, he led a fact-finding trip to El Salvador to investigate the deportation of gay asylum-seeker Andry Hernández Romero to the CECOT mega-prison after Romero came to the United States legally to attend an appointment the U.S. government gave him. In May, Garcia appealed to Homeland Security Secretary Kristi Noem to request a sign of life to send to Romero’s mother, but Noem refused to engage.

Garcia also called out transphobic South Carolina U.S. Rep. Nancy Mace during a May hearing in which she sat as he outlined her bigoted actions.

Born in Lima and raised in Southern California, Garcia became a citizen in his twenties, earned a doctorate in education, and eventually became Long Beach’s first out LGBTQ+ mayor. When he arrived in Congress in 2023, he was the first out gay immigrant elected to the House. Now, in his second term, he holds one of the chamber’s most visible Democratic roles.

Garcia will serve as a counter to the Oversight agenda of Republican Chair U.S. Rep. James Comer of Kentucky, who has utilized the committee to advance investigations aligned with President Donald Trump’s political interests, including attacks on former President Joe Biden’s family, public health officials, transgender students, and federal workers.

LGBTQ+ political leaders immediately celebrated the vote as a watershed moment. The Human Rights Campaign issued congratulations on social media. Equality PAC — co-chaired by gay New York Rep. Ritchie Torres and gay House Veterans’ Affairs Ranking Member Rep. Mark Takano of California — said Garcia’s election was both an institutional milestone and a powerful symbol of what pro-equality leadership can look like. 

In a statement, Takano and Torres said Garcia’s new role “marks an historic achievement and a powerful moment for LGBTQ representation in Congress,” noting that he joins lesbian Minnesota U.S. Rep. Angie Craig, the ranking member on the House Agriculture Committee and Takano as one of three openly LGBTQ+ members now leading Democrats on House committees.

They added that Oversight “plays a critical role in holding Trump and his administration accountable, protecting democracy, and defending the rights and freedoms of all Americans,” and that Garcia “has been a fearless voice for truth and justice.”

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D.C. police investigate suspected hate crime at bar for queer & trans people of color during WorldPride

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In the early hours of Black Pride weekend in Washington, D.C., someone shattered the front door of Sinners and Saints, cut the power, stole bottles of alcohol, and spray-painted the slur “fa***t” on the wall.

The bar’s mission is in its name: defiance and sanctuary. It’s D.C.’s only venue created by and for queer and trans people of color. And on Friday, as revelers began arriving in the city for WorldPride, someone tried to send a message of fear. Instead, the response was community and clarity.

“We are heartbroken, but we are not broken,” the bar’s team posted on Instagram. “Sinners and Saints is resistance. We will rebuild. We will STAY OPEN. And we will keep our doors—and hearts—wide open for all who need refuge.”

Police are investigating the attack as a suspected hate crime. According toThe Washington Post, an employee at the restaurant above the bar discovered the damage midday Friday and called Blair Nixon, who co-owns and manages the space. Nixon told the Post he arrived to find shattered glass, the power cut, and the back door ajar.

“It’s really disheartening,” Nixon told the Post. “If you have somebody who’s in your space who isn’t supposed to be there, it’s scary.”

“This space exists to protect and celebrate Queer and Trans BIPOC communities,” the bar’s Instagram post read, “and this attack only strengthens our resolve. We will NOT be silenced. We will NOT be intimidated. We will NOT back down.”

According to The Post, D.C. police assigned multiple detectives and an LGBTQ+ liaison to the case. The mayor’s office also reached out to discuss protections. But as Nixon told NBC affiliate WRC, “The current political climate is really scary, and that’s one of the reasons why we care so much about the space, and we try and do everything that we can do to make sure it’s a safe space.”

The Advocate contacted Ryan Bos, executive director of the Capital Pride Alliance, for comment, but did not immediately hear back.

Just hours after the break-in, Sinners and Saints reopened. The dance floor was packed that night for a planned D.C. Black Pride event. Nixon said that decision wasn’t optional.

“It was really important to us to stay open,” he told The Post. “We don’t ever want to send the message that we can be repressed. We don’t want to be shaken, we don’t want to be down, we want to be sure we stick to our mission.”

That mission, Nixon told WRC, is urgent—and still unmet. “What always happens is that the adoption of LGBT people comes first, and then the adoption of the QT-BIPOC. So talking about trans Black people, persons of color always lags behind.”

The Post reports that the damages are estimated to exceed $5,000. Within 24 hours, a GoFundMe launched by the bar raised nearly $1,500. By Tuesday morning, that total had surpassed $7,600. In the fundraiser, the team wrote: “Every dollar raised will go toward recouping what was taken and repairing our space so we can keep our doors open for those who need it most.” Fifteen percent of donations, they said, would be shared with local QTBIPOC support groups.

The response was swift. Neighbors offered to help with cleaning and repainting. Supportive comments poured in. RuPaul’s Drag Race star Laganja Estranja wrote: “Incredible response! I believe in you. Sending so much love and strength.”

The slur is still on the wall. Nixon told The Post the team may frame it as a permanent reminder of what someone tried—and failed—to do.

“To those who tried to harm us,” the bar wrote online, “hate fuels our defiance. To our community: we see you, we love you, and we will continue fighting for you.”

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Why experts say Trump’s budget bill strips health care from nearly all transgender people

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The U.S. House of Representatives has passed a sweeping Republican-led budget reconciliation package — dubbed the “Big Beautiful Bill” by President Donald Trump and the bill’s proponents — that, if enacted, would decimate access to gender-affirming care for transgender people of all ages across the country.

More than a tax bill, the legislation, passed 215-214 in the early morning hours Thursday, couples tax cuts for corporations and the wealthy with profound structural changes to Medicaid and the Affordable Care Act, including provisions that would strip transgender people of access to transition-related care — even when privately insured. It’s a vision of health policy that experts told The Advocate weaponizes bureaucracy and budgetary authority to target one of the most marginalized groups in the country.

What Trump’s budget bill does to trans health

At the heart of the bill are two key provisions targeting transgender health care. The first prohibits Medicaid and the Children’s Health Insurance Program from covering any gender-affirming services — puberty blockers, hormone therapy, surgeries — for people of any age. The second redefines what counts as an “essential health benefit” under the ACA, explicitly excluding transition-related care from private insurance plans regulated by federal standards.

Katie Keith, a scholar and director of the Center for Health Policy and the Law at the O’Neill Institute for National and Global Health Law at Georgetown University Law Center, told The Advocate the bill would “certainly increase health care costs for transgender people, both on those who have Medicaid coverage, but also those who have marketplace coverage as well.”

“By stripping federal funding for treatment for gender dysphoria, you’re imposing a whole set of barriers,” she said. “A primary one is cost. But I think it will also have the unintended — or maybe intended — consequence of deterring providers from offering this care at all.”

Keith, who previously served as deputy assistant to the president and deputy director of the White House Gender Policy Council under President Joe Biden, added that the essential health benefits provision could destabilize health coverage even for those outside ACA marketplaces. 

“By proposing to exclude treatment for gender dysphoria from essential health benefits, this care would not be subject to cost-sharing limitations that apply to essential health benefits under the Affordable Care Act,” she explained. “If treatment for gender dysphoria is not considered an essential health benefit, transgender people — including those in job-based private health insurance — could face higher out-of-pocket costs for care that would otherwise be covered.”

Medicaid cuts and their fallout

The bill’s language goes beyond cost containment; it reengineers Medicaid to eliminate federal support for gender-affirming care, even in states that affirmatively cover it. As Adrian Shanker, a former Biden administration LGBTQ+ health adviser in the Department of Health and Human Services, told The Advocate, this would deliver a disproportionate blow to low-income trans people who rely on Medicaid

“Medicaid is the payer for low-income Americans, and it’s an essential safety net program,” Shanker said. “We know that trans people are disproportionately lower income and benefit from Medicaid in a higher percentage than the majority population. We know that’s even more pronounced among trans people of color and trans people who are from rural communities.”

A new study from the Williams Institute at UCLA underscores the scale of what’s at stake. Drawing on federal health data, the May report finds that approximately 1.8 million LGBTQ+ adults — nearly twice the rate of non-LGBTQ+ adults — rely on Medicaid as their primary source of health insurance. The burden is especially acute among transgender people, more than 185,000 of whom depend on Medicaid. These disparities, the authors note, are driven by intersecting inequalities — including disability, parenting responsibilities, and systemic economic disadvantage — that make Medicaid a lifeline for some of the most vulnerable in the LGBTQ+ community.

The bill would, in effect, force states to either self-fund gender-affirming care or deny it outright — something most budgets could not absorb.

The legislation’s ripple effects would be especially catastrophic in states like Colorado, where budget constraints enshrined in the state constitution limit how leaders can respond to sudden federal funding shortfalls. Mardi Moore, executive director of Rocky Mountain Equality, told The Advocate that Colorado’s unique combination of a balanced budget requirement and the Taxpayer’s Bill of Rights (TABOR) would make it nearly impossible for the state to backfill the $10 billion the state receives annually in federal Medicaid funding.

TABOR, adopted by voters in 1992, is one of the most restrictive fiscal policies in the country. It caps state spending increases to a formula based on population growth and inflation — but inflation as experienced by government services, not consumers, Moore explained. TABOR also requires voter approval for any new taxes or tax increases, which means Colorado’s legislature cannot simply raise revenue or allocate extra funds to offset lost federal support without a ballot measure.

“The service gaps are going to widen, especially for LGBT communities, people of color, rural communities, low-income folks, and young people,” Moore said.

Why the bill targets trans health

The bill’s framing — slashing Medicaid to “pay” for tax cuts while targeting trans care — represents what critics have called a cruel calculus: appealing to a political base through culture war flashpoints. “This administration seems obsessed with the idea that their political goals are more important than the health and wellbeing of the American people,” Shanker said.

Moore, a longtime LGBTQ+ advocate, echoed that sentiment. “They know this is a winning issue for their base,” she said of the bill’s anti-trans provisions. “Our movement has not done a great job of getting information out about trans folks. The narrative that gender-affirming care is a choice and not medically necessary has taken hold. ‘Why should my tax dollars pay for your choice?’” she said. “That’s what we’re fighting.”

Related: Trump administration announces end to gender-affirming care for transgender veterans

Even if the bill dies in the Senate, Moore argued that the damage has already been done. “The national narrative is starting to take hold in Colorado,” she warned. “There’s just not enough of us who care about others to make the community well.”

A broader strategy of erasure

Advocates for Trans Equality, the largest trans-led policy organization in the U.S., called the bill a calculated political attack. “This budget proposal is a direct, calculated attack on the lives and dignity of people across the country,” Sinead Murano-Kinney, the group’s health policy analyst, said in a statement. “These cuts clearly aim to make trans people and their healthcare into political scapegoats.”

Murano-Kinney pointed to a 2022 Williams Institute report showing that 21 percent of trans adults rely on Medicaid, likely due to high rates of employment discrimination and economic instability. “Denying access to this care would not only worsen physical and mental health outcomes but would deepen housing insecurity, exacerbate mental health crises, and increase rates of depression and suicidality among trans people.

Related: Why do inmates have access to gender-affirming care? Those Trump ads you keep seeing debunked

“This is no accident — it is part of a broader political agenda driven by anti-trans extremists determined to force trans, nonbinary, and intersex people out of public life,” she added.

Insurance industry raises alarm

Notably, even the health insurance industry has balked at the logistical and financial burdens of carving out gender dysphoria care from essential health benefits. In public comments reviewed by the Center on Health Insurance Reforms at Georgetown, insurers such as the Blue Cross Blue Shield Association warned that banning care for gender dysphoria would create “significant operational burdens” and could inadvertently disrupt access to services used for other conditions, including cancer treatment, menopause care, and birth control procedures like vasectomies.

“This is just health care,” said Keith. “Many of these procedures are medically necessary for cisgender people, too. The only difference is who’s receiving the care.”

What comes next?

Keith said legal challenges are inevitable, but the immediate policy impact is clear: health care for most transgender Americans is at risk.

Related: Trump signs executive order banning federal support of gender-affirming care for anyone under 19

The Congressional Equality Caucus has condemned the bill, with Chair Rep. Mark Takano of California warning that 13.7 million Americans will lose their health insurance if it becomes law. “Attacks on the trans community are just the cherry on top,” Takano said. “Congress should be working to make healthcare more affordable — not banning medically necessary care or pulling the rug out from underneath millions who rely on Medicaid.”

The stakes are no longer hypothetical as the bill heads to the Senate. 

“The word I just use over and over is cruel,” Moore said. “How much more cruel can you be, and what’s the point of this? Is the point really cruelty?”

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How to fight Trump’s anti-trans messaging that’s poisoning public opinion

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As President Donald Trump intensifies his second-term campaign to roll back LGBTQ+ rights, new polling suggests that his relentless attacks on transgenderpeople are gaining traction with the public, despite broad disapproval of his presidency overall. LGBTQ+ advocates say this slide requires accurate media representation of trans lives

Public opinion is shifting to restriction

According to a national survey released Saturday by the Associated Press-NORC Center for Public Affairs Research, a majority of Americans—68 percent—now say gender is determined by sex assigned at birth. Two-thirds oppose public insurance programs like Medicare or Medicaid covering gender-affirming carefor minors. And nearly half of the respondents support banning such care for trans youth altogether, regardless of who pays for it.

Among Republicans, opposition to both youth and adult access to gender-affirming care is overwhelming. Independents are more likely to oppose than support, and even among Democrats, 44 percent oppose public coverage of care for minors, while only 30 percent support it. Resistance also extends to transgender adults, with nearly one-third of Democrats and most independents and Republicans expressing disapproval of publicly-funded care.

Yet, in one area, public sentiment is more complex. When asked whether transgender men and women should be allowed to serve in the military, 37 percent of adults said yes, while 26 percent opposed it. Thirty-six percent remained neutral. That split, which shows greater openness than on other trans-related issues, may reflect years of advocacy and public storytelling from transgender service members, especially amid ongoing legal challenges to Trump’s renewed military ban.

A misinformation strategy that’s working

Despite widespread disapproval of his leadership—Trump’s overall job approval stands at 41 percent—his approval rating on handling transgender issues is nearly 10 points higher. That disparity has alarmed LGBTQ+ advocates, who say it reflects the success of targeted disinformation and a coordinated right-wing strategy to scapegoat trans people for political gain.

Caleb Smith, LGBTQI+ Policy Director at the Center for American Progress, said the findings reveal the results of years of manufactured outrage and misinformation. “The poll released by AP-NORC shows much of what we expect to see after years of the right’s relentless, unscientific, partisan attacks on transgender people,” Smith told The Advocate. “While Trump’s approval rating is historically, alarmingly low, it’s easy to look at these numbers and think anti-trans messages are a winning issue for him. In reality, he’s far underwater on most topics, and the slight approval bump Trump may get from targeting transgender people seems to be more of a pool noodle rather than the life raft his presidency needs to get back towards national approval.”

Visibility gap fuels misunderstanding

Smith added that the poll underscores the urgent need for solidarity and continued visibility. “It’s concerning to see any part of the country agree with anti-trans rhetoric, and it’s crucial for us to continue to show strong and vocal support for the transgender community—particularly transgender young people. No poll detracts from the reality that transgender people—just like the rest of us—deserve to be treated with dignity and respect, deserve access to health care, and deserve not to be obsessively targeted by an administration looking for cheap political wins.” 

Part of the challenge, LGBTQ+ advocates say, is visibility. According to GLAAD’sAccelerating Acceptance 2023 study, less than 30 percent of non-LGBTQ+ Americans say they know a transgender person.

The ongoing shift in public attitudes is occurring alongside an unprecedented nationwide assault on LGBTQ+ rights. According to the American Civil Liberties Union, at least 575 anti-LGBTQ+ bills have been introduced in state legislatures across the country in 2025 alone. These bills target everything from accurate IDs and school bathroom access to gender-affirming health care and free speech in classrooms. The ACLU warns that even proposals that fail to pass into law still fuel a climate of fear, spread harmful misinformation, and deepen stigma against LGBTQ+ people.

Executive orders and legal battles

Although he began with transphobic ads during the 2024 election, Trump’s renewed attacks on transgender rights started the moment he returned to power. On Inauguration Day, he signed Executive Order 14183, declaring that the federal government would no longer recognize transgender or nonbinary people. The directive redefined sex in federal policy strictly as male or female based on birth characteristics, and ordered agencies to strip references to gender identity from all guidance, services, and legal protections. Passports, Social Security records, school policies, and shelter access are among the areas now being rewritten to exclude transgender Americans. 

At the same time, his administration has revoked federal funding for gender-affirming health care, moved to bar transgender students from using bathrooms aligned with their gender identity, and resumed enforcement of a military ban targeting trans service members.

In March, U.S. District Judge Ana Reyes blocked enforcement of Trump’s military ban, ruling in Talbott v. United States that the policy likely violates constitutional protections. Reyes called the ban “soaked in animus and dripping with pretext,” and cited the Department of Defense’s data showing that the military spends far more on Viagra than it does on trans-related care. Last week, while considering a stay on a preliminary injunction in a similar case, Shilling v. USA, the U.S. Supreme Court allowed the ban to go into effect while appeals continued, handing Trump a temporary legal victory.

“We can beat back the bullshit”

At a recent EMILY’s List gala in Washington, D.C., U.S. Rep. Sarah McBride—the first out transgender member of Congress—confronted the political strategy behind these attacks. “Every single time they say the word ‘trans,’ look at what they’re doing with their grubby hands,” she said. “They’re trying to pick the pocket of American workers.”

McBride vowed she would not be used as a distraction for the GOP’s broader economic agenda. “I’m not going to let them bait me into a fight that simply rewards their attempt at 15 minutes of fame,” she said. “We can beat back the bullshit. We can win back power.”

GLAAD warns against interpreting public opinion as a legitimate gauge of civil rights. “There are going to be a few problems with a poll that asks people about the human rights of other people,” a spokesperson told The Advocate. “In this country, we are guaranteed the right to be treated equally and not be discriminated against, and that is not up to public opinion.”

The GLAAD spokesperson highlighted that of the few Americans who say they know a trans person, fewer still understand the medical, legal, or familial realities of their lives, especially as right-wing politicians and donors pour resources into misinformation campaigns. 

“The poll shows it remains urgent that media include transgender voices in stories about trans people. The poll shows support for transgender people in the military after months and years of GLAAD and others in the community helping trans troops bravely tell their own stories while they show up every day to capably and honorably serve,” the spokesperson said. “When you meet and get to know people in person or through inclusive and accurate stories, understanding and acceptance grow.”

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Lesbian Minnesota Congresswoman Angie Craig launches historic U.S. Senate bid

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U.S. Rep. Angie Craig, the first out LGBTQ+ person elected to Congress from Minnesota, officially launched her campaign Tuesday for U.S. Senate—setting the stage for a closely watched Democratic primary in a political climate increasingly hostile to queer Americans.

In a campaign video released on President Donald Trump’s 100th day back in office, Craig, a Democrat representing Minnesota’s Second Congressional District, slammed the Republican for “trampling our rights and freedoms as he profits,” accused billionaire Elon Musk of trying to “burn [the government] to the ground,” and called out a “cowardly Republican Party” enabling it all.

“There’s chaos and corruption coming out of Washington, crashing down on all of us every day,” Craig said. “And damn if we don’t have a fight going on right now.”

Her candidacy quickly received a significant boost: Equality PAC, the national group dedicated to electing LGBTQ+ people to Congress, endorsed her Senate bid Wednesday.

“Equality PAC is proud to endorse Congresswoman Angie Craig for U.S. Senate because Minnesotans deserve a tireless, effective leader who puts people first—and that’s exactly who Angie is,” said Equality PAC co-chairs Rep. Mark Takanoof California and New York Rep. Ritchie Torres. “Angie Craig is a proven fighter, and we are confident she will bring that same grit and commitment to the U.S. Senate on behalf of all Minnesotans.”

Craig, 53, flipped her suburban and rural swing district in 2018 and has since defended it in some of the nation’s most competitive House races. With her Senate run, she leaves that seat open in a critical election year. She told the Star Tribune she would not endorse a successor but believed Democrats could keep the district.

Craig joins a Democratic field that includes Lt. Gov. Peggy Flanagan, who would be the first Native American woman in the Senate, and former state Senate Minority Leader Melisa López Franzen. While Flanagan has already picked up high-profile endorsements, Craig enters with strong name recognition and over $1.2 million in campaign cash, MinnPostreports.

The outlet noted Craig’s messaging signals a more progressive tone than her House record, where she’s known as a centrist. While she has voted for bipartisan measures—including the controversial GOP-backed Laken Riley Act—Craig has remained a vocal advocate for LGBTQ+ rights.

In her video, Craig recalls growing up in a mobile home park, working her way through college, starting out as a newspaper reporter, and eventually leading a major Minnesota manufacturing company. “No one gave me much of a chance to win a Republican congressional seat either,” she says. “Well, they keep underestimating us—and we keep winning.”

In an interview withThe Advocate in 2024, Craig spoke about using her personal story—raising four sons and two grandsons with her wife, Cheryl Greene—to humanize LGBTQ+ families in a divided Congress. “We’re no different from anyone else,” she said. “I keep trying by example.”

She has criticized House Speaker Mike Johnson as “the most anti-LGBTQ House speaker in American history” and denounced efforts to restrict gender-affirming care for transgender youth. “This is not a conversation that a politician should be anywhere near,” Craig told The Advocate. “There’s no reason to fear, to hate.”

At the start of the current Congress, Craig became the first LGBTQ+ woman elected by House Democrats to serve as the ranking member of the powerful Agriculture Committee.

If elected, she would become only the second out lesbian ever to be elected to the U.S. Senate, joining Sen. Tammy Baldwin of Wisconsin. California Gov. Gavin Newsom appointed former California U.S. Sen. Laphonza Butler, who is also a lesbian, to fill Sen. Dianne Feinstein’s seat after the longtime senator died in 2023. She did not seek reelection.

Editor’s note: A previous version of this story inaccurately stated that Rep. Angie Craig would become the second out lesbian to serve in the Senate. She would be the second lesbian elected to the Senate.

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Trump HHS posts ‘so-called report’ pushing conversion therapy for trans kids

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The Trump administration escalated its assault on transgender youth Thursday with the release of a controversial new report from the U.S. Department of Health and Human Services that promotes conversion therapy and discredits gender-affirming care. Advocates and experts have said the report is filled with misinformation about both. 

Commissioned under President Donald Trump’s January Executive Order 14187, the 409-page report falsely claims medical transition is harmful and unproven, and promotes “exploratory therapy”—a rebranded version of conversion practices widely condemned by major medical associations.

The order directed HHS to attack WPATH’s standards of care, revoke federal funding for transition-related treatments, and reshape public health policy to align with Trump’s political agenda.

NIH Director Dr. Jay Bhattacharya, who has no background in gender-affirming care, introduced the report. Bhattacharya rose to prominence during the COVID-19 pandemic as a co-author of the controversial Great Barrington Declaration, which pushed to lift lockdowns and allow widespread infection to build herd immunity—a position sharply rejected by public health experts. 

The HHS report claims that gender-affirming care lacks evidence of benefit, but makes this argument by dismissing peer-reviewed research and reframing therapeutic approaches as medical risks. It labels the gender-affirming care model as experimental and portrays puberty blockers and hormone treatments as unethical interventions pushed by activists rather than doctors. While the document stops short of issuing policy mandates, critics say it lays the groundwork for future federal restrictions.

Notably, the report endorses what it calls “gender exploratory therapy,” which it positions as an alternative to what it derides as “affirmation-only” approaches. But experts say this is simply conversion therapy under a new name. “They can call it whatever they want,” said Kellan Baker, executive director of the Whitman-Walker Institute. “The idea is the same—it is a practice with a predetermined goal: to try to change who someone is. That is the definition of conversion therapy.” Baker warned that the rebranding is a deliberate attempt to avoid the legal and political liabilities now associated with a discredited and widely banned practice.

In its press release, HHS emphasized that the report’s authors would remain anonymous. While unnamed authorship on agency reviews is not unprecedented, a former HHS official told The Advocate it is highly irregular for the department to spotlight the anonymity.

Medical and legal experts immediately denounced the report’s implications.

“Today’s report seeks to erase decades of research and learning, replacing it with propaganda,” said Shannon Minter, legal director of the National Center for Lesbian Rights. “It promotes the same kind of conversion therapy long used to shame LGBTQ+ people.”

GLAAD President and CEO Sarah Kate Ellis called the document “discredited junk science.”

“A report in the suggestion that someone’s authentic self and who they are can be ‘changed’ is discredited junk science,” Ellis said in a statement. “This so-called guidance is grossly misleading and in direct contrast to the recommendation of every leading health authority in the world. This report amounts to nothing more than forcing the same discredited idea of conversion therapy that ripped families apart and harmed gay, lesbian, and bisexual young people for decades.”

Janna Barkin, author of He’s Always Been My Son and A Grand Love, has a 27-year-old transgender son who transitioned as a minor. In an interview with The Advocate, Barkin called the report “deeply troubling” and “extremely disappointing.”

“My child was struggling, depressed, and anxious until he received thoughtful, lifesaving care,” Barkin said. “We found medical professionals who helped guide our decisions, and after he got the care he needed, his light came back. He was able to live fully and happily as the man he is.”

She warned that this kind of government interference not only undermines science but endangers lives.

“I feel like trans people are being used to push an agenda that seeks to eliminate not just trans people, but other marginalized communities as well,” Barkin said. “It is terrifying. Trans kids are waking up afraid. Trans adults are afraid. This administration’s focus on erasing people is not about protecting children—it’s about control.”

The Trevor Project warned the report may further endanger trans youth, who already face high rates of suicide. Research consistently shows that gender-affirming care improves mental health outcomes, while conversion efforts increase the risk of depression and suicide.

Related: Doctors warn of ‘terrifying’ effects as Trump creates snitch line to report gender-affirming care patients

“It is deeply troubling to see the country’s top authority on health publish a collection of recommendations that seemingly have no basis in following established health care best practices, science, or input from providers who actually administer the type of health care in question,” director of law and policy at The Trevor Project, Casey Pick, said in a statement. “This report not only rejects health care best practices for transgender people — it goes a step further by recommending conversion therapy, though under a new, rebranded name, ‘exploratory therapy’. Despite the report’s claims, this is, in fact, the same harmful practice of conversion therapy, just using friendlier language.”

Baker, a nationally recognized, Johns Hopkins-educated expert on health equity, told The Advocate the HHS report is “a political document pretending to be science.”

“This is conversion therapy under a different name,” Baker, who is trans, said. “It is a cynical, dangerous attempt to rebrand a practice that’s been proven to harm people and dress it up as ‘exploration.’ But the intent is the same: to deny trans youth the care they need.”

Baker emphasized that “every major U.S. medical association supports gender-affirming care because it saves lives and affirms dignity.”

“This document does the opposite,” he said. “It undermines trust, spreads misinformation, and leaves families and providers wondering if they’ll be prosecuted for doing the right thing.”

“It’s gaslighting, plain and simple,” said Barkin. “They’re trying to paint care as danger and danger as protection.”

The Endocrine Society, the world’s oldest and largest organization of hormone researchers and clinicians, also weighed in. “Representing 18,000 members who treat and research diabetes, obesity, fertility, bone health, hormone-related cancers, as well as gender dysphoria, the Endocrine Society believes in access to health care, and that medical decisions should be made by the clinician and the patient’s family based on scientific evidence,” the organization said in a statement to The Advocate. It is currently reviewing the report.

Adrian Shanker, former Deputy Assistant Secretary for Health Policy in the Biden administration, criticized the administration’s approach: “Trans people, like all Americans, deserve the highest quality health care and deserve to know the science behind our health decisions, which is why this report is so concerning—it’s a compilation of junk science parading as a scientific report.”

Shanker also highlighted procedural issues, noting that the report’s conclusions were predetermined by the executive order: “This administration has missed no opportunities to remove the rights and health of trans people, and they’ve really proven just how far they will go for an anti-trans agenda.”

Shanker emphasized, “Efforts to change a person’s sexual orientation or gender identity have been attempted for decades, and in every instance they’ve caused harm. Conversion therapy doesn’t convert anyone, and it’s not therapy; it’s just harm.”

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Doctors warn of ‘terrifying’ effects as Trump creates snitch line to report gender-affirming care patients

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The Trump administration has cleared the way for people to report doctors who provide gender-affirming care to minors — and now says they can do so without violating federal medical privacy laws.

In new guidance issued Monday, the U.S. Department of Health and Human Services announced that health care workers, clinic staff, and even third parties may file complaints against providers offering gender-affirming care and, in many cases, even disclose protected patient information under HIPAA’s whistleblower provisions. Under HIPAA, the Health Insurance Portability and Accountability Act, medical professionals must keep a patient’s health information confidential. The guidance, issued under President Donald Trump’s January 28 executive order titled “Protecting Children from Chemical and Surgical Mutilation,” establishes a new federal portal to collect these reports.

Civil rights and LGBTQ+ health advocates say the move weaponizes patient privacy law against the very people it was designed to protect — and targets providers in a sweeping campaign to scare them out of delivering medically necessary care.

“At a time when trans health is already becoming more and more difficult for patients to access, this guidance is a page out of the anti-abortion activism playbook,” said Adrian Shanker, a national LGBTQ+ health policy expert and senior HHS official under the Biden administration. “That’s the clear goal: to instill fear among providers of best-practice transgender medicine. That’s unfortunate — but it’s also dangerous for the needs of transgender patients who rely on qualified providers with specializations and training to provide that care.”

The new policy doesn’t stand alone. It follows a sweeping federal letter issued just days earlier by the Centers for Medicare and Medicaid Services advising state Medicaid agencies that they may restrict or eliminate coverage of gender-affirming care for minors. The CMS letter explicitly referenced federal sterilization regulations — originally created to protect against coerced sterilization—as justification for blocking puberty blockers and hormone therapy. Advocates called it a dangerous distortion of the law.

The online complaint form from HHS invites users to name doctors, identify hospitals or clinics, and describe the alleged “mutilation of children” — a term the administration uses to refer to evidence-based gender-affirming care. The department encourages people to cite the executive order and offers guidance on reporting providers to multiple federal agencies.

Shanker said the real consequence isn’t theoretical — it’s already happening. “It’s two sides of the same coin because it’s diminished access to care — period,” he told The Advocate. “If providers become fearful of providing the care, fewer providers will offer it.”

For those on the front lines, that fear is palpable. A pediatric gender-affirming care provider at a major children’s hospital in the Midwest told The Advocate that they’re seeing the trust that underpins medicine unravel in real time.

Related: New Trump Medicaid directive attacks trans people’s access to gender-affirming care

“It feels very chilling,” the provider said, speaking on the condition of anonymity due to security concerns. “We’ve been under the microscope for a long time, but now it feels like they’ve got a free pass to do whatever they want. It’s terrifying for our patients, and it’s terrifying for us as providers.”

The provider said colleagues were asked where their “line in the sand” was at a recent staff meeting—what it would take to stop practicing.

“All of the prescribing providers said, ‘Jail, I guess,’” they said. “That’s my line in the sand. And it feels like we’re inching closer to that every day, especially with this new hotline to report things.”

Even inside their own hospital, they no longer feel safe.

“I know there are people who work here who don’t support the gender program. I’ve heard them say things like, ‘This is over the top — why don’t these kids just get therapy?’ And now they could call this hotline and report me. What does that do to my license? To my safety as a provider?”

The guidance, legal experts say, is both sweeping and unlawful.

“This is blatantly unlawful for multiple reasons — because it discriminates against transgender people because it violates statutory and constitutionally protected medical privacy rights, and because it has no legal basis and is therefore arbitrary and capricious,” Shannon Minter, legal director of the National Center for Lesbian Rights, told The Advocate.

He added that the policy deliberately distorts the concept of whistleblower protection. “This is stretching the definition of a whistleblower to absurd lengths and is plainly designed to encourage the harassment of doctors and others providing needed medical care to transgender people.”

The provider said the guidance only deepens patients’ mistrust of the medical system. Many already wait a year or more to be seen.

“Our waitlist has never been shorter than a year,” they said. “By the time patients get to me, they’ve often had multiple suicide attempts. Nobody walks in and gets hormones. And I’ve never had a minor patient undergo genital surgery—ever.”

Still, the damage is done. “I don’t tell people what I do anymore. I used to say I worked in pediatrics and gender health. Now, I just say pediatrics. I’ve scrubbed all my public social media. The network of providers I refer to has gotten smaller — I only trust people I know personally. That’s what it’s come to.”

When asked what they wanted the public to understand about the care they provided, the provider didn’t hesitate.

“These medical treatments are lifesaving. I’ve seen adolescents go from depressed and suicidal to just thriving and living their best selves. If anyone saw what I see in clinic every day, they’d know this is care that works.”

The guidance claims whistleblowers are protected under several federal laws, including the False Claims Act and the Church Amendments, and outlines how HIPAA’s whistleblower provisions can shield those who report providers to oversight agencies or law enforcement.

However, medical experts and legal advocates point to a glaring omission: gender-affirming care is supported by every major medical association, including the American Academy of Pediatrics, the American Medical Association, and the Endocrine Society.

“Evidence-based policymaking would rectify this,” Shanker said. “Instead, they’re using political rhetoric around so-called mutilation rather than following the science.”

Minter is confident that if enforced, the policy would be struck down. “This is yet another example of this administration overreaching and seeking to dictate private medical decisions that belong to families and individuals — not the government.”

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