The White House’s recently released 2026 budget proposal, sent to Congress last Friday, includes steep cuts to healthcare programs within the CDC and the National Institutes of Health (NIH). These programs include research into LGBTQ+ communities and HIV prevention initiatives.
The 40-page document was sent out by Office of Management and Budget Director Russell Vought to be reviewed by Congress. The president has vowed to reduce wasteful government spending and waste during his second term. Despite this, his proposed budget appears to relinquish funding from public health programs that help citizens, while also increasing our nation’s military budget by 13% (which many argue is overfunded) and increasing funding towards Immigration and Customs Enforcement (ICE) and Homeland Security.
This increase in military and law enforcement spending can be seen as quite alarming, given the administration’s authoritarianism. If enacted, this budget plan would particularly harm LGBTQ+ people and those who rely on Medicaid by slashing HIV prevention and research programs, transgender healthcare access, and widespread diversity, equity, and inclusion initiatives.
Despite losing out on 26% of its budget, the Department of Health and Human Services (HHS) did get one budget increase of $500 million towards the nonspecific aim to “Make America Healthy Again” (MAHA), a key focus of HHS Secretary Robert F. Kennedy Jr.
The MAHA plan seeks to merge several existing agencies within the HHS while also terminating programs that help LGBTQ+ people. These include the Ryan White HIV/AIDS programs within the Health Resources and Services Administration (HRSA) and LGBTQ+ youth programs and crisis lines from the Substance and Mental Health Services Administration (SAMHSA).
The Ryan White HIV/AIDS programs are initiatives meant to educate the public on HIV prevention to end new transmissions. The programs would lose a reported $74 million in federal funding.
Other key department threats include replacing funding for STI prevention at the CDC with a $300 million grant program, and making it clear in the proposal that LGBTQ+ health priorities will be disregarded entirely.
The National Institutes of Health (NIH) will lose $17 billion. Administration officials have justified the dramatic NIH cuts, citing the institutes’ research into trans people as a reason. However, the NIH would still retain $27 billion for research that “would align with the president’s priorities.”
A common theme among budget cuts repeatedly revoke funding for any groups that allegedly support “gender ideology.”
Other cuts include a 35% reduction to the Office for Civil Rights’ budget and eliminating fundamental equity programs for small businesses and Department of Justice grant programs.
Southern states in the US are “facing a sexual health crisis”, according to a new study.
The study compared sexual health resources, STD prevalence, reproductive outcomes, abortion policy and reproductive rights by state.
A recent study by adult store Lion’s Den analysed and ranked US states based on their sexual risk factors, identifying “where residents may face higher dangers related to sexual activity and highlighting regional disparities in sexual safety across America”. It’s a timely study, given that relationship experts previously predicted the “politicisation of sex” prior to President Trump’s inauguration.
The riskiest state to have sex is Louisiana, according to the study, with the highest STI rates in the country at 795 per 100K people. Louisiana has a full abortion ban, as per the New York Times, and abortion is banned in almost every circumstance.
The second riskiest state is Mississippi, which leads in teen births at 26.4 per 1000 teenagers who were assigned female at birth. The state also has a full abortion ban. Meanwhile, the third riskiest state is Arkansas, which also has a full abortion ban.
The second-largest state in the US, Texas, is the sixth-riskiest state. The Lone Star State has the least sexual health clinics available, with just 0.4 for each 100K residents. As a result of the lack of medical support, the state also has high rates of teenage pregnancies, with 20.4 for every 1000 teenagers assigned female at birth.
Pete Potenzini, marketing director at Lion’s Den, said: “Southern states face a sexual health crisis where residents are three times more likely to contract an STD compared to New England states, with particularly alarming rates in Louisiana and Mississippi.
“Limited healthcare access compounds these risks, as exemplified by Texas, where residents must travel significantly farther to reach sexual health clinics than the national average. These geographical disparities create dangerous ‘sexual health deserts’ where education, prevention, and treatment remain critically out of reach for vulnerable populations.”
This week, Tennessee Gov. Bill Lee (R) signed legislation allowing healthcare professionals in the state to deny care to patients if it conflicts with the providers’ personal morals, ethics, or religious beliefs.
That includes the use of pronouns in a medical setting.
The new law, which applies to doctors, nurses, pharmacists, and insurance companies, went into effect with the governor’s signature.
The legislation’s Republican sponsor is a physician who cited the threat of “moral injury” posed to healthcare professionals who may not share their patients’ personal or religious beliefs.
“Patients and providers have rights. Providers should not give up their rights to best serve their patients,” Terry said.
The law could result in women being denied medically necessary abortions and LGBTQ+ people being turned away for preventative care like pre-exposure prophylaxis, or PrEP.
Denying care for any reason is a clear violation of the Hippocratic Oath, which prioritizes patients’ well-being and mandates healthcare professionals “do no harm,” said Dr. Amy Gordon Bono, a primary care physician in Tennessee.
“When legislation is not patient-centered, it’s morally compromised to begin with,” Dr. Bono told WKRN News.
“Politicians need to stop dictating medical care, and this bill allows politicians to take their intrusive efforts even further to dictate medical conscience. In my opinion and the way I like to practice medicine is to honor the patient first. That’s where my conscience lies,” Bono said.
The so-called “conscience clause” does not apply in emergency situations or if an insurance provider is contractually obligated to cover the cost of a specific treatment.
But it could be used in the case of a healthcare professional asked by a patient to share their pronouns.
“I used the term ‘conscientious objection’ to describe my position on the practice of being forced to announce my own pronouns, but this was seen as a barrier to patient care,” said Dr. Jonathan Shaw, an OBGYN who testified before the House Health Committee as the bill made its way through the Tennessee Legislature.
“The ability to do my job was called into question, and human resources were consulted,” Dr. Shaw said. “The implication was clear: conscience needs to be limited — or consider an alternative career path. I decided to look for a job elsewhere.”
Tennessee became the ninth state to enshrine a “conscience clause” for medical professionals into law. Florida Gov. Ron DeSantis (R) signed similar legislation in April 2023.
The anti-LGBTQ+ organization Alliance Defending Freedom (ADF) has been an active proponent in the passage of those laws and several others moving through state houses.
How those laws affect insurance coverage is a question that’s currently under consideration at the U.S. Supreme Court. Last week, the Court heard oral arguments in Kennedy v. Braidwood, a case to decide whether the plaintiff, Texas business Braidwood Management, must provide insurance coverage to employees for PrEP.
The company claims that doing so would conflict with their religious beliefs because the preventative care “encourages and facilitates homosexual behavior.”
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.
“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.”
Janice Goldberg still remembers the first moment she laid eyes on her partner Sue.
It was over 45 years ago in the small beach town of Ocean City, Maryland. Janice had gotten a job waiting tables at an upscale restaurant after spending the first part of her summer in Europe. She wasn’t quite sure what the future had in store for her – then “there she was.”
Sue, who lived in Florida at the time, had travelled up the coast to spend the summer in Ocean City with her then-boyfriend. The two decided one day to treat themselves to a meal at a fancier restaurant, and happened to walk into the one where Janice worked. “The rest is, as they say, history.”
Janice started as Sue’s waiter, but it wasn’t long before she became her lover. Today, she’s her caregiver.
Sue began showing signs of Alzheimer’s disease about ten years ago. Since then, Janice has had to balance her work as both a theater director and a tour guide with caring for the love of her life. She recently agreed to take part in the upcoming PBS documentary Mind Over Matter: My Alzheimer’s to shed a light on her experience – and hopefully help end the “stigma” surrounding it.
“I want people to recognize that it’s a journey. I want people to recognize the difficulty of it, and I want to take away some of the fear that’s involved,” Janice tells The Advocate. “I also think that it’s important for people to see how caregivers and their loved ones can deal with it and what they do to make things manageable for themselves.”
The documentary is the third in a series from award-winning co-directors Anna Moot-Levin and Laura Green that focuses on neurodegenerative diseases. The film follows Janice and Sue’s journey alongside two other pairs of parent and child as they all navigate life with the conditions.
One of the film’s central themes is “how people living with Alzheimer’s and dementia continue to lead meaningful lives where they’re connected to others and connected to activities and things that they enjoy and love,” Moot-Levin says. This doesn’t just mean patients, as “there’s an impact on the immediate family, there’s an impact on the person’s community, and there’s a real loss in the experience of the people who are surrounding the person with that illness.”
“Each of them have such a deeply loving relationship and they find a way to maintain that relationship even as one person changes with dementia,” Green adds. “I think that people are very dismissive of the sort of personhood of people with Alzheimer’s and dementia, and they don’t always see and interact with them. There’s a lot more recognizing the humanity of people living with Alzheimer’s that we need to do.”
Including Janice and Sue’s relationship also showcases “what an LGBTQrelationship is like in aging,” Green says, which there unfortunately aren’t many examples of in media. The filmmakers wanted to examine the “differences” that arise in later stages of life for queer people, to which Janice asserts, “We’re older. That’s the difference.”
The directors initially connected with Janice and Sue over two years ago through SAGE, an advocacy organization for LGBTQ+ elders that offers support groups for people with neurodegenerative diseases. While Janice greatly appreciates having a group of queer people she can relate to, she says that she never pictured herself ending up in such a group.
“I thought I’d get through my whole life without ‘therapy,’” Janice says. “Turns out you don’t.”
While Janice notes that “the battle is the same for everybody, and it’s vastly different for everybody all at the same time,” all the caregivers she knows have experienced a similar feeling of loss. This isn’t just from the changes in their loved ones, but the changes in themselves that Moot-Levin has dubbed a “transformation of identity.”
“For this particular disease, it’s hard as hell on the caregiver because the person who has the disease oftentimes does not know they have the disease. They think they’re fine, so they can live a peaceful, happy life,” Janice says. “I don’t know any caregiver who lives a peaceful, happy life.”
While Janice knew that the film was an “important project,” she says she mainly wanted to participate because it seemed “fun” – and it was “something good to do with Sue since she needs some engagement.”
Sue was a gracious host even when she didn’t remember that a documentary team was in her home, as Green says that she would frequently offer the crew snacks and refreshments. “She would sometimes forget that we were there and then be surprised that we were there, but still be a consummate hostess with the revelation that there was a camera crew in her apartment,” Green recalls.
What was “remarkable” for Janice about the process was being able to watch the documentary once it was finished and see Sue’s progression. When filming began, Sue was still verbal. Now, Janice says “words are difficult for her,” and that she mostly speaks in “gibberish.”
“To have to watch that, I found very moving and sad, but I was grateful that I saw it so there’s a documentation of that,” Janice says.
Through the film, Janice hopes to draw attention to what people caring for loved ones with neurodegenerative diseases go through. The process is “draining on families,” she says, especially if “you’re under a certain income” or if “ people have to quit jobs to care for people and then there’s no income.”
The filmmakers also hope to erase some of the stigma surrounding such conditions, as Moot-Levin emphasizes “we need to support people through that sense of loss.”
“People often want to hide themselves as they begin to get dementia. People feel shame and embarrassment,” Green says. “Being more accepting so that we can have a society that people are more fully integrated in and less lonely and less isolated really would be wonderful.”Matter of Mind: My Alzheimer’s will debut as part of the Independent Lens series on PBS May 5.
t’s well documented that LGBTQ+ young people are at greater risk of mental health problems and suicidal ideation or attempts than their straight and cisgender peers. Now a new research brief from the Trevor Project shows how economic insecurity correlates with that.
“Overall, economic insecurity was associated with worse mental health for LGBTQ+ young people, even after adjusting for age, sexual orientation, gender identity, race/ethnicity, and census region,” the report notes.
Experiencing food insecurity was associated with 69 percent higher odds of experiencing depression, 68 percent higher odds of experiencing anxiety, 60 percent higher odds of having considered suicide in the past year, and 71 percent higher odds of attempting suicide in the past year.
Ever experiencing houselessness was associated with 47 percent higher odds of experiencing depression, 67 percent higher odds of having considered suicide in the past year, and over twice the odds of attempting suicide in the past year.
Being unable to meet basic economic needs was associated with 50 percent higher odds of experiencing depression, 41 percent higher odds of experiencing anxiety, 42 percent higher odds of having considered suicide in the past year, and 52 percent higher odds of attempting suicide in the past year.
Forty percent of LGBTQ+ young people reported a history of food insecurity, houselessness, or unmet basic needs. Transgender and nonbinary youth had 77 percent greater odds of experiencing food insecurity, 73 percent greater odds of ever having been houseless, and 67 percent greater odds of having unmet basic needs compared to cisgender LGB young people.
The high rates of economic insecurity the researchers saw weren’t surprising, says Derrick Matthews, director of research science at the Trevor Project, but their correlation with mental health issues and suicidal ideation or attempts was. “That was pretty alarming to me,” he says.
There’s a common misconception that LGBTQ+ people are better off financially than their cisgender and straight counterparts, but research has shown that’s not true, “and being transgender, a person of color, or bisexual are all factors found to be associated with higher rates of poverty,” according to the report. But this research has often excluded youth, and the chief measure of economic security for adults, income level, doesn’t work with young people, Matthews says. So the staff decided to use the factors of food insecurity, houselessness, and inability to meet economic needs to tell the stories of LGBTQ+ youth. “We looked at stories we didn’t have a chance to tell yet,” he notes.
The 2024 survey reflects data was collected at the end of 2023, and now, with cuts to social programs and LGBTQ+ services by Donald Trump’s administration, plus the economic instability caused by Trump’s back-and-forth on tariffs, the situation may well become worse. “I think it’s concerning, to say the least,” Matthews says. He points out the spikes in calls and texts the Trevor Project saw after Trump’s election and then his inauguration.
“Any reduction in support [for LGBTQ+ youth] at the state or federal level is going to have really scary consequences for a lot of young people out there,” he says.
Also, homophobic and transphobic forces are pushing the narrative that LGBTQ+ identity itself causes mental health problems rather than the true cause, “the way society treats us,” says Matthews, a Black gay man.
“There is no 13-year-old in the world who’s responsible for these things,” he says. “This is a failure of society and how we structure policy.”
This atmosphere, however, doesn’t negate the need to push for policies that affirm LGBTQ+ people and alleviate economic insecurity, he adds. “The services that we still do have need our investment and support,” he says. And he notes that research has shown that for LGBTQ+ youth, having even one supportive adult in their life can reduce the risk of suicide. “Show up for young people, and advocate for resources to be restored,” he urges. The report points out the beneficial effect of food and nutrition assistance, housing assistance, and basic cash assistance for both young people and adults. Resources for LGBTQ+ youth experiencing homelessness are available here.
“It’s easy to lose hope,” Matthews says, “but I’m a prisoner of hope.”
If you or someone you know needs mental health resources and support, please call, text, or chat with the 988 Suicide & Crisis Lifeline or visit988lifeline.org for 24/7 access to free and confidential services. Trans Lifeline, designed for transgender or gender-nonconforming people, can be reached at (877) 565-8860. 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.
Attorney General Pam Bondi issued a memo this week seeking to further curtail access to transgender health care for minors. In the memo, Bondi said the Justice Department will use a variety of existing U.S. laws to investigate providers of such care, as well as drug manufacturersand distributors.
She directed U.S. attorneys to use laws against female genital mutilation to investigate doctors who “mutilate” children “under the guise of care” and to prosecute these“offenses to the fullest extent possible.”
“I am putting medical practitioners, hospitals, and clinics on notice: In the United States, it is a felony to perform, attempt to perform, or conspire to perform female genital mutilation (‘FGM’) on any person under the age of 18,” Bondi wrote. “That crime carries a maximum prison sentence of 10 years per count.”
Bondi also directed the Consumer Protection Branch of the DOJ’s Civil Division to investigate potential violations of the Food, Drug and Cosmetic Actby drug manufacturers and distributors who engage “in misbranding by making false claims about the on- or off-label use of puberty blockers, sex hormones, or any other drug used to facilitate” a minor’s gender transition.
And she directed the Civil Division’s Fraud Section to investigate potential violations of the False Claims Act by physicians who submit “false claims … to federal health care programs for any non-covered services related to radical gender experimentation.” (She included as an example of this a physician prescribing puberty blockers to a minor for gender-transition care but reporting it to Medicaid as being for early-onset puberty.)
Robin Maril, an assistant professor of constitutional law at Oregon’s Willamette University, said Bondi’s memo doesn’t change any existing laws. Doctors, she said, will not be breaking the law by continuing to treat trans minors if they live in a state where such care is still legal. She also noted that Medicaid fraud and defrauding the government are already crimes.
“The bulk of this is just showing how they’re going to use resources and investigate,” Maril said. “That’s not a law change. It’s meant to have a chilling effect on physicians providing access to necessary care, fearing that it will be characterized as chemical and surgical mutilation of children.”
She added that the memo’s call on whistleblowers to report “knowledge of any such violations” could further make doctors afraid of being reported.
Chase Strangio, the first transgender attorney to argue before the Supreme Court, with supporters on Dec. 4, when the court heard the case of U.S. vs. Skrmetti. Marvin Joseph / The Washington Post via Getty Images
It’s unclear what type of procedure would be considered female genital mutilation “under the guise of care” according to Bondi’s interpretation of U.S. law. The FBI defines it as “partial or total removal of the external female genitalia or other injuries to the female genital organs for non-medical reasons.”
Transition-related care for minors can encompass a range of treatments, including talk therapy for younger children, puberty-blocking medications for adolescents and hormone therapy for older teens. Bondi’s memo specifically mentions gender-affirming surgeries, which are not recommended for minors. In rare cases, older teens can receive a double mastectomy, or removal of the breasts.
It’s also unclear ifBondi’s directives would conflict with federal and state anti-discrimination laws. A provision in the Affordable Care Act, for example, prohibits physicians who are providing federally funded services from discriminating based on sex. The Biden administration issued a notice interpreting that provision to include protection based on gender identity, but the Trump administration rescinded that notice in February. Some advocates argue the provision’s protections and some state nondiscrimination laws still apply.
Despite this, Bondi’s memo refers to this type of care as “radical gender experimentation,” and it cites research conducted by an advocacy group that opposes gender-affirming care for minors. That group found that, from 2019 to 2023, 14,000 children received treatment for gender dysphoria — the medical term for the distress caused by the misalignment between one’s gender identity and sex assigned at birth — and 5,700 had surgery.
However, trans advocates have noted that the rate of breast surgeries among adolescents who are cisgender, meaning not transgender, is much higher. For example, in 2011, more than 14,000 breast reduction procedures were performed in the United States on adolescent boys to correct gynecomastia, a benign condition that causes enlarged breast tissue, according to the American Society of Plastic Surgeons.
Bondi’s memo is the administration’s latest attempt at restricting trans health care. Just over a week after his inauguration, President Donald Trump signed a sweeping executive order aimed at curtailing transition-related care for minors by prohibiting federal funding for such care and threatening to withhold grants from hospitals and medical universities that provide the care, among other restrictions. At least two judges have temporarily blocked that order from taking effect.
Over the last few years, 27 states have enacted measures restricting access to transition-related care for minors. The Supreme Court is expected to issue a decision soon in a lawsuit against such a restriction in Tennessee, which could affect minors’ access to care nationwide and potentially care for trans adults under federally funded health programs.
Planned Parenthood’s Arizona branch will resume providing gender-affirming healthcare to transgender patients. The chapter had previously paused the treatments in response to the Department of Health and Human Services (HHS) sending out a memo warning federally funded healthcare institutions against providing gender-affirming care.
The Arizona branch faced public pressure after news publications began reporting on its decision to end trans-related healthcare. Patients receiving gender treatment at the branch told news outlets they had received voicemails late on Friday, April 11, informing them that their upcoming appointments were being cancelled.
One of these patients, a 23-year-old trans woman from Mesa, Arizona, recounted receiving this call to the trans journalism website Erin in the Morning.
“We are hoping that this is a temporary pause for the next week,” a branch representative said in a voicemail to the patient. They told her the office would reach out upon being able to reschedule.
Planned Parenthood Arizona added a banner to its website explaining the situation. In the explanation, the branch said it had been sent a letter from the Center for Medicare and Medicaid Services (CMS) directing them not to provide gender-affirming care services using Medicaid funding. In response, the Arizona branch decided it would indefinitely discontinue gender treatment for trans patients.
The Arizona branch seems to be the only Planned Parenthood branch currently to pause its gender treatment as a result of this threat. The reported cancellations caused the branch to face public backlash, as many trans people, especially those in rural communities, rely on Planned Parenthood to access their healthcare.
NPR interviewed various representatives from Planned Parenthood last August after an arsonist attacked one of their facilities in Knoxville, Tennessee. In this interview, they discussed the impact that closing its facilities would have on trans patients.
Dr Bhavik Kumar, the medical director of primary and trans care at Planned Parenthood Gulf Coast, told NPR that over 35,000 patients nationwide had sought gender-affirming hormone replacement therapy in 2021.
By Tuesday, April 15, the Arizona facility rescinded its decision and updated its website to feature a new banner that reads: “Planned Parenthood Arizona deeply values and is dedicated to the LGBTQIA+ community, which includes our patients, supporters, and staff. We recognize how critical it is for our patients to have certainty to access essential services, including Gender Affirming Care.”
“After a brief pause, we are pleased to announce the continuation of our Gender Affirming Care services,” the message continued. “This pause occurred out of an abundance of caution after threats to the Medicaid services in our state.”
“The onslaught of attacks on sexual and reproductive health care services in Arizona and across the country is alarming and is a clear, continued effort to shut down Planned Parenthood,” the message added. “This will not be the last threat that aims to deny people medically sound, essential health care, needlessly putting them at risk and unnecessarily creating chaos and confusion around the accessibility of services.”
After the president signed his executive order “Protecting Children from Chemical and Surgical Mutilation,” which threatened to deny federal funding to hospitals providing gender-affirming treatment to individuals under 19 years of age, many hospitals located in sanctuary states for trans people began complying in advance by ending their trans-related healthcare offerings.
Since then, a federal judge has issued a nationwide block on the order’s enforcement, meaning that the federal government cannot withhold funding to hospitals providing gender affirming care. There is very little information to verify that the decision has since been appealed as of writing.
However, it is worth noting that the presidential administration is facing criminal contempt charges for defying a court order to cancel a deportation flight. It remains to be seen if administration officials will attempt to defy the court’s ruling against the president’s ban on gender-affirming care.
Self-defense classes geared toward LGBTQ people can be found sprinkled across the United States, and instructors and students say the skills these classes provide are giving attendees a boost of confidence and a sense of community in a fraught political environment.
“Pretend someone’s coming for you. How would you kick them if you were fighting for your life?” an instructor at Queer Fight Club in St. Louis asked attendees during a recent self-defense class.
Tori Lohmann, who is nonbinary, was among the nine students in the class. Lohmann said they never imagined joining a self-defense group but found themselves drawn to Queer Fight Club six months ago because of a lack of self-confidence stemming from the current political climate.
“I just felt so angry all the time about the state of the world,” Lohmann, 26, told NBC News.
Tori Lohmann, 26, has been taking self-defense classes at Queer Fight Club in St. Louis since January.Courtesy Anna Escoto
Lohmann’s concerns come at a time when heated rhetoric, federal policies and state legislation targeting the LGBTQ community — and particularly transgender and gender-nonconforming people — are on the rise. The American Civil Liberties Union has tracked 569 anti-LGBTQ state bills in 2025 so far, and since coming into office in January, President Donald Trump has signed several executive orders aimed at the trans and nonbinary community, including one that proclaims the U.S. government will only recognize two unchangeable sexes, male and female.
Since attending Queer Fight Club twice a month starting in January and learning skills like a two-punch combo, various kicks and how to block hits, Lohmann said they “feel so much more confident in myself.”
“Not just my ability to protect myself, but also to protect my community members,” they added.
‘You need to be prepared’
Mixed martial artist Mad Green, who founded Queer Fight Club in 2023, said they were inspired to create a self-defense group specifically tailored to LGBTQ people after observing a lack of self-defense skills in the community. They wanted to share their knowledge and prepare other queer people for potential altercations.
“A lot of people, if they haven’t been in a physical altercation, don’t necessarily think it’s going to happen,” Green said, adding that it might be more likely than many people want to believe. “You need to be prepared for it.”
According to crime data published by the FBI last year, violent crime in the U.S. decreased by an estimated 3% from 2022 to 2023, while hate crime offenses increased by about 3.7% during the same period. Sexual orientation and gender identity were the third and fourth most common bias motivations in 2023, after race/ethnicity and religion.
Queer Fight Club has a “pay what you can” policy, but Green said they ask those who can afford it to pay $15 a class to help pay for equipment and the cost of renting out a gym space.
For the first year, Green said, there were about 20 people taking their biweekly self-defense classes. Since the November election, however, there’s been increased interest in self-defense from the local queer community due to a “refreshed fear” around personal safety, and they’ve had about 300 new people join at least one of their classes, Green said.
“My favorite thing about fight club is seeing someone come in for the first time, and then they throw a punch, and they’re like, ‘I didn’t know I could do that,’” Green said. “Just letting people know that they can is really empowering by itself.”
‘Space for everyone to feel welcomed’
Andrew Degar and his wife, Sarah, founded the nonprofit Third Ward Jiu-Jitsu in Houston in 2019 after noticing a need for a more inclusive mixed martial arts space.
“We were both coaching at an MMA gym and just hated the toxicity of the culture, and we wanted to open a space for everyone to feel welcomed and included,” Degar said.
The couple has been providing free self-defense classes to those in the Houston area since they first started their organization. They added classes specifically geared toward the LGBTQ community in August 2023, and Degar said they now have queer people from around the state who travel to take them.
Third Ward Jiu-Jitsu founders Andrew and Sarah Degar started a self-defense class for the LGBTQ community in August 2023.Courtesy Andrew Degar
“People are looking for a safe space,” Degar said. “They’re looking for trustworthy people, and we are recognized as a resource in the queer community in Texas.”
Degar said Third Ward Jiu-Jitsu incorporates various scenarios during self-defense classes that focus on de-escalating conflicts while ensuring readiness in a variety of situations.
“We go into how you may be feeling unsafe from someone you don’t know, then we will even go as far as someone who’s trying to harm you. Here’s how we can attack back,” he said.
‘Protecting ourselves and each other’
Even in a state like New York, which is known to be among the most progressive when it comes to LGBTQ rights, reported hate crimes have surged in recent years. A report published by the Office of the New York State Comptroller last year found reported hate crimes increased nearly 70% from 2019 to 2023, with anti-LGBTQ crimes among the most common.
Groups like Fearless Queers, which has been organizing self-defense pop-up classes throughout New York City since 2022, want LGBTQ people — and particularly trans people, who are more likely to be victims of violent crime — to feel less vulnerable in this environment.
Co-founder Chrissy Rose said she also wants those who attend a Fearless Queers session “to see capable queer and trans fighters leading their class.”
“I want them to see the possibility that they can defend themselves and above all that they are worth that fight,” she said.
Rose and her co-founder, Tara Bankoff, who are both experienced in martial arts, said they’ve seen demand for their classes rise this year, and they now serve hundreds of New Yorkers every month.
Their main priorities, Rose said, are to ensure their classes are accessible and free, and to encourage attendees to trust themselves.
While the group hosts various pop-ups for self-defense fundamentals and open-mat sessions for drills and solo practice, Rose said classes focus heavily on verbal techniques to avoid both victimization and criminalization.
“Trans women are stereotyped as being aggressive, meaning that if they defend themselves, they have a much higher risk of being criminalized or just socially punished for doing so than, say, a cisgender woman does,” Rose explained. “We deprioritize striking and emphasize grappling and verbal self-defense in our curriculum for that reason.”
New York City resident Alexis Gee, who is nonbinary, said she reached out to Fearless Queers in November after feeling afraid and unprotected.
“In communities like ours, we have to be vigilant about protecting ourselves and each other, and I didn’t feel like that was something I was equipped to do,” Gee, 32, said.
In January, Gee had the courage to attend her first Fearless Queers class and has been going consistently since then.
“We don’t have to be alone in our fear, and we don’t have to be aggressive and angry in order to feel protected,” Gee said. “We just need to know who our allies are and how to reach them.”
The U.S. Department of Health and Human Services will remove gender dysphoria from disabilities protected under federal law, but it’s still unclear whether 17 Republican state attorneys general will continue a related lawsuit that could dismantle federal protections for all people with disabilities.
Last fall, Texas GOP Attorney General Ken Paxton sued the federal government over the Biden administration’s addition of a gender identity-related disorder to the disabilities protected under a portion of federal law known as Section 504.
Republican attorneys general from 16 other states joined the lawsuit: Alaska, Alabama, Arkansas, Florida, Georgia, Indiana, Iowa, Kansas, Louisiana, Missouri, Montana, Nebraska, South Carolina, South Dakota, Utah and West Virginia.
But they faced a swift backlash earlier this year. Disability advocates pointed to parts of their lawsuit that asked the court to find all of Section 504 unconstitutional, not just the update that included gender dysphoria.
If the court agrees, advocates fear that schools, workplaces, hospitals and other entities could refuse to provide disability accommodations they’ve been required to provide for the past 50 years.
AGs hurried to distance themselves. Arkansas Republican Attorney General Tim Griffin, Georgia Republican Attorney General Chris Carr and others adamantly denied that interpretation and said their only goal was to remove protections for people with gender dysphoria.
The new HHS ruling seems to achieve what the AGs said they wanted. It essentially declares that the Biden update adding gender dysphoria to disability law can’t be enforced.
But the broad language of the lawsuit leaves open the possibility, some experts say, for the court to strike down the entirety of Section 504 protections.
The state AGs’ position should become clearer in a few days. They’re scheduled to file an update with the court on April 21.
