HIV/AIDS service providers in Florida say the coronavirus pandemic has further exacerbated health care and economic disparities that many of their clients face.
Tatiana Williams is the co-founder and executive director of Transinclusive Group, a Fort Lauderdale-based organization that serves transgender people in South Florida. Williams is also the co-chair of South Florida FLUX, which advises AIDS Healthcare Foundation on trans-specific issues.
Williams on Aug. 11 told the Washington Blade during a telephone interview from Fort Lauderdale the pandemic “just really highlighted some of the challenges that are happening within the transgender community.”
“A lot of our clients were already dealing with unemployment, dealing with a lack of access to health care, dealing with a lot of these issues,” she said.
Williams said her organization’s Transinclusive Emergency Crisis Fund has been able to provide clients emergency housing and a host of other services that include help paying utility bills and medications.
“You had a lot of our clients working in these nightclubs that were closed down, so a lot of them immediately went into a position of survival mode and not having access to a lot of things,” she said. “With COVID, it just turned their lives upside down.”
Williams said problems with Florida’s unemployment system delayed payments to many Transinclusive Group clients who lost their jobs because of the pandemic. Williams told the Blade they “were behind” once they began to receive unemployment checks, and this delay created “gaps” in their medications.
“A lot of health care providers weren’t working at full capacity,” she said. “A lot of them weren’t even returning calls, so a lot of the clients, especially HIV-positive clients, hadn’t received care, so we had to go into the telemedicine mode and we were linking people back to care.”
Other HIV/AIDS service organizations in Florida have made similar adjustments in response to the pandemic.
Arianna Lint is a Peruvian woman with HIV who founded Arianna’s Center, a Wilton Manors-based organization that serves trans women with HIV.
She told the Blade on Aug. 3 during an interview at her office the pandemic has made her organization’s work “more difficult because we have (had) to invest more time” with teaching clients how to use technology to access health care. Lint said Arianna’s Center has also had to visit clients at their homes.
Stephen Fallon, co-founder and director of Latino Salud, another Wilton Manors-based organization that serves LGBTQ Latinos with HIV, during a July 23 Zoom call with other HIV/AIDS service providers that AIDS Healthcare Foundation organized said the majority of health care providers in his area remained open “to some extent” during the lockdown imposed when the pandemic began. Fallon said testing agencies were closed during this period.
“We were getting deluged with all the folks who needed testing services who couldn’t go anywhere,” he said.
Scott Pridgen is executive director of AH Monroe, an organization that serves people with HIV/AIDS in the Florida Keys.
AH Monroe has offices in Key West, Marathon, Tavernier and Key Largo.
Pridgen on Aug. 12 told the Blade during a telephone interview from Key West the pandemic has forced his organization to operate its offices virtually, “which is new because a lot of our case management, especially our older population that is living with HIV have other co-morbidities that require more of a physical, hands-on type of care versus doing it virtually.”
“We’ve had to take that into consideration,” said Pridgen.
The pandemic began during the height of the Keys’ tourism season, which Pridgen said is “when people make their money to carry them through during the slow season.”
Pridgen told the Blade that AH Monroe has been able to provide short-term mortgage, rent and utility assistance through grants from the CARES Act, the Housing Opportunities for Persons with AIDS (HOPWA) program and the U.S. Department of Housing and Urban Development’s Office of HIV Housing.
“The biggest need due to COVID-19 in Monroe County is housing, paying rent for someone or mortgages,” said Pridgen.
Pridgen added Keys residents “who’ve never asked for anything, ever, ever, (are) in line at the food bank or you’re handing them a bag of groceries.”
AIDS Healthcare Foundation Regional Director Dawn Averill is based in Pensacola, but works throughout Florida and the Deep South. Averill on the July 23 Zoom call echoed Pridgen’s observations about the pandemic’s impact.
“We’re actually seeing a lot of fear,” said Averill, referring to people with HIV/AIDS. “They’re fearful to go to the grocery store. They’re fearful to come to the office, to get their blood drawn, to see their families.”
Averill also noted “significant health disparities” in rural and urban areas that factor into health outcomes for people with HIV/AIDS.
State Rep. Carlos Guillermo Smith, who represents portions of Orlando in the Florida House of Representatives, on Aug. 14 noted to the Blade during a telephone interview that HIV rates in Florida are higher among trans people, people of color, undocumented immigrants and other vulnerable groups. Smith said efforts to curb the coronavirus’ spread have had a disproportionate impact on these populations.
“Quarantines and other COVID-related restrictions are also pushing people with HIV who are already vulnerable into isolation away from friends, chosen family,” he added.
South Florida remains state’s coronavirus epicenter
The Florida Department of Health on Tuesday said there have been 579,932 confirmed coronavirus cases in the state. Statistics also indicate the pandemic has killed 9,758 people in Florida.
Miami-Dade and Broward Counties remain the pandemic’s epicenter in Florida, with 25 and 12 percent of the state’s total cases respectively. Statistics indicate the coronavirus has killed 2,126 people in Miami-Dade County and 1,025 people in Broward County.
The Florida Department of Health reported 15,300 new coronavirus cases on July 12, compared to 3,838 new cases on Monday. A press release notes the rate of positive tests in the state on Tuesday were below 10 percent for the sixth consecutive days.
Republican Gov. Ron DeSantis nevertheless continues to face widespread criticism over his response to the coronavirus. Many of the HIV/AIDS service providers with whom the Blade spoke noted he has not imposed a statewide mask order and moved too quickly to reopen Florida.
“He’s shown time and time again that he is a politician over everything,” Equality Florida HIV Advocacy Coordinator Alejandro Acosta told the Blade on Aug. 14 during a telephone interview from Wilton Manors. “He makes health care decisions based on his politics and his personal beliefs and that is not conductive for a good public health outcome.”
Smith, who is also Equality Florida’s Central Florida Outreach Coordinator, told the Blade he welcomed DeSantis’ decision in March to lock down nursing homes and other long-term care facilities in order to curb the pandemic’s spread. Smith was nevertheless critical of the governor’s overall response.
“We’re the world’s epicenter of the pandemic and we still don’t even have a statewide mask order, which costs us nothing,” Smith told the Blade.
Smith also expressed concern over the Department of Health’s decision to reassign employees who worked on HIV and STI-related issues to fight the coronavirus.
The Department of Health on Tuesday declined to make anyone available to the Blade for an interview about efforts to protect vulnerable Floridians with HIV/AIDS during the pandemic.
“COVID-19 requires an unprecedented response at both the state and local level,” said the Department of Health in an email.
The Department of Health has yet to respond to a follow-up email about Smith’s concerns.
“We have an HIV workforce in Florida,” Smith told the Blade. “As a direct result of COVID-19, we’re just kind of seeing this trend of diversion of scientific and public attention away from HIV in Florida. That’s what has me concerned.”
“We could come out of the other end of this pandemic and realize that we have another public health crisis on our hands,” he added. “It’s a recipe for disaster if we don’t focus and if we don’t veer course when it comes to staying committed to HIV prevention.”
An Idaho judge has granted an injunction against enforcement of the state’s discriminatory law excluding trans athletes from the student sports teams corresponding to their true gender.
The anti-trans bill, HB500, was signed into law by Republican governor Brad Little in the midst of the pandemic in March, alongside its sister bill HB509 that bars trans people from changing the gender marker on their birth certificate.
In June, a judge ruled that HB509 is a violation of transgender people’s constitutional rights, in a lawsuit filed against Idaho by LGBT+ advocacy group Lambda Legal.
And on Monday (August 17), another lawsuit against the anti-trans laws saw victory as a judge granted an injunction against enforcement of HB500 pending a case against it being heard in court.
District court judge David Nye said that the state’s interest was not justifiable but rather “an invalid interest of excluding transgender women and girls from women’s sports entirely”.
Nye’s order recognises that both HB500 and HB509 were not motivated by legitimate policy goals but purely “motivated by a desire for transgender exclusion”, said the Human Rights Campaign, one of the organisations fighting Idaho’s laws in court.
“Today’s decision is a huge, positive step forward for transgender athletes in Idaho and around the country,” said Alphonso David, president of the Human Rights Campaign.
“Everyone should be able to play sports, and gender identity should not be a barrier to participation.
“We’re hopeful that the court will ultimately make the right decision to strike down HB500 in totality, so that athletes such as Lindsay Hecox and others can continue to excel at the sports they’ve poured themselves into, without having their identities used as a wedge against them.”
Idaho anti-trans laws would put athletes at risk of genital exams.
HB500 would place an outright ban on trans girls and women playing on female sports teams, and would place all female athletes at risk of invasive genital examinations to “prove” that they are not trans before being allowed to play.
Judge Nye’s decision comes as athletes in Idaho begin preparing for the sports season ahead – including Lindsay Hecox, a cross-country runner on Boise State University’s women’s track team and one of the plaintiffs suing Idaho over its anti-trans law.
Before the judge granted the injunction against HB500, Hecox would have been prohibited from participating in the upcoming athletic season.
This would have put Idaho in conflict with the National Collegiate Athletic Association’s own trans-inclusive policy.
As the judge noted, HB500 puts Idaho in “stark contrast to the policies of elite athletic bodies… which allow transgender women to participate on female sports teams once certain specific criteria are met”.
Idaho is the first and only state to categorically ban trans women from participating in women’s sports.
American Gene Technologies, a Rockville, Md.-based gene and cell therapy company, announced on Aug. 11 that it has received approval from the U.S. Food and Drug Administration to begin its first human clinical trial for a unique cell altering treatment that it believes will enable the immune system of people who are HIV positive to permanently eliminate HIV from their body.
“AGT developed a new treatment to repair immune system damage done by HIV and allow natural responses to control the virus,” the company says in a statement announcing the approval for its clinical trial. “From its research, AGT believes a cure is attainable and is now taking the significant step of testing in humans.”
The statement says AGT is conducting its Phase 1 clinical trials at sites in the Baltimore-D.C. area. It says the Washington Health Institute in Northeast D.C., Georgetown University, and the University of Maryland’s Institute of Human Virology in Baltimore will be the three sites for the trials.
According to the statement, the Phase 1 trial will investigate the safety and efficacy of a product the company calls AGT 103-T, “a genetically modified cell product made from a person’s own cells.” It says the product and treatment should work to remove HIV infected cells from the body and “decrease or eliminate the need for lifelong antiretroviral treatment.”
In an online virtual news conference held on Aug. 12, AGT Chief Executive Officer Jeff Galvin explained that the clinical trial involves a multi-step process of extracting blood from an HIV-positive person whose HIV is fully under control through anti-retroviral medication and immediately subjecting the blood to a process of Leukapheresis, which separates a type of white blood cells known as T-cells.
Galvin said the T-cell samples extracted through that process will be sent to a lab, where they will be genetically altered in a process developed by AGT. He said AGT believes the genetically altered T-cells will make them resistant to HIV infection and enable them to do what HIV has prevented human T-cells from doing during the course of the 40-year plus HIV epidemic – to neutralize the virus and prevent it from harming the human body.
Once the gene altering process is completed and an initial waiting period is used to allow the altered cells to multiply in the lab, the cells will be “reinfused” into the body of the person participating in the trial and from whom the original collection of T-cells was obtained, Galvin said.
AGT has said in earlier statements that individuals participating in the clinical trial will initially continue to take their regularly prescribed anti-retroviral medication while testing of their blood continues to determine whether the newly infused T-cells are killing or neutralizing HIV to a degree that will no longer make the anti-HIV medication necessary.
C. David Pauza, AGT’s chief science officer and the company’s lead researcher in the development of the genetically altered, HIV resistant T-cells, stated at the news conference that under FDA protocol, the process must be shown to be safe and not have significant side effects on the first person to undergo the procedure before the procedure is performed on the second person to participate in the clinical trial.
Pauza said he, Galvin and the AGT team consider the FDA’s approval of the clinical trial an important development brought about by years of research and laboratory testing.
“This is momentous news that we have FDA approval to launch Phase 1 and conduct our first human trials,” he said in a statement. “We are beyond excited to reach this milestone. This brings us closer to our goal of transforming lives with genetic medicines,” he said.
“Based on our successful commercial-scale product manufacturing runs and features of the product observed in our labs, this therapy has a high potential to be effective,” Pauza said.
Galvin told the news conference that the current cost for the complete process of extracting cells from an HIV infected person, genetically altering the cells, and reinfusing the HIV resistant T-cells back into the person’s body is about $200,000. But he said he’s optimistic that the cost of the procedure will go down dramatically as it is used more frequently in coming years. Among other things, he said that the extraction of the T-cells and the genetic alternation process can be done through machines in an automated process that can lower costs.
FDA spokesperson Monique Richards told the Washington Blade the FDA is prohibited by law and regulation from commenting on or acknowledging the existence of an “investigational new drug” application, known as an IND, or whether a clinical trial is taking place.
“The FDA supports the safe clinical development of these products and we are committed to continuing to work collaboratively with industry and the medical and scientific communities to provide the information and guidance needed to help foster the advancement of these promising therapies,” Richards said in an email on Friday.
A gay lawmaker and coronavirus survivor tried to donate plasma to help others – but he was turned away because of his sexuality.
Shevrin Jones, a Democratic member of the Florida House of Representatives, went to a blood drive on August 7 with his mother Bloneva Jones and his father Eric Jones.
The three decided to donate blood because they had recently recovered from COVID-19 and wanted to help others by donating their antibody-rich blood.
Writing on Twitter, Jones said: “I was blessed to get through COVID, and it’s only right that we bless someone else and give them a fighting chance to live also.
“It’s the right thing to do.”
Florida lawmaker Shevrin Jones was told he can’t donate blood because of his sexual orientation.
But Jones’ dreams were quickly shattered when he was turned away by OneBlood because of a government policy that requires queer men to practice celibacy for three months before donating blood.
After he was turned away, Shevrin wrote on Twitter that he was “disappointed” he could not donate blood because of his sexual orientation.
“I was ‘deferred’ for another time. The good news is, my mom, dad, brother and over 20 other people saved a life today!”
He added: “Too bad my blood plasma isn’t good enough.”
To make matters worse, the incident was later turned into a campaign tactic in an anonymous homophobic text campaign.
I was ‘deferred’ for another time. The good news is, my mom, dad, brother and over 20 other people saved a life today!
Jones, who is currently running to become Florida’s first Black gay senator, was shocked to discover that texts were sent out to voters in Senate District 35 last week saying he had been discriminated against for “homosexual contact”.
The text linked to a website set up where an article about his blood donation ban was copied word-for-word.
“It’s a shame that my opponents have stooped to this new low to try and win,” Jones told the Miami Herald.
It had been several years since professor Joseph Palamar had seen that unmistakable “caveman face,” the telltale sign of an imminent overdose of gamma-hydroxybutyric acid, or GHB.
Standing among throngs of concertgoers at a Brooklyn music venue last year, Palamar spotted the bulky man with the contorted face nearby. He was struggling to remain conscious.
“I’ve noticed that when people are meant to pass out and they keep forcing it, they make these very strange, primitive faces,” Palamar, an epidemiologist and associate professor of population health at New York University’s Grossman School of Medicine, told NBC News. “They look like they are in such euphoria it’s almost painful.”
Within minutes, the man succumbed, apparently to the suppressive effects of the drug, and collapsed to the floor. Security staff raced over and carried him away.
The ordeal reminded Palamar of New York’s sweaty nightclubs at the turn of the millennium, the same venues that had sparked his interest in studying drug use. Back then, overdoses, particularly on GHB, were so common that some clubs hired private ambulances to avoid 911 calls and police scrutiny. One club allegedly hid unconscious patrons in a back room without medical assistance.
Despite these efforts, the clubs didn’t go unnoticed. After a rash of overdoses across the United States in the late ’90s, Congress scheduled GHB as a controlled substance in 2000. Exposures to GHB reported to poison control centers fell almost immediately.
But 20 years on, a new generation of recreational users — a disproportionate number of them gay and lesbian, according to researchers — has rediscovered the drug. Recent indictments in a Texas federal court reveal that today’s networks for distributing GHB aren’t spread over local dealers but far-flung markets linking buyers to legal businesses with dubious motives. Social media and the world’s largest online marketplace are also tangled in this web. This illicit network generates millions of dollars each year and has spurred a small but growing crisis, for which federal regulators and the medical community appear ill-equipped and unprepared.
Occurring naturally in the body, gamma-hydroxybutyric acid was first synthesized in a lab in the 1960s. Although its application in medicine has always been limited, GHB has had various recreational uses. In the 1980s, health food stores marketed the compound as a dietary supplement. Then, in the ’90s, the drug found its way into American nightlife.
In small doses — mere milliliters — GHB produces feelings of relaxation and confusion and heightens sexual arousal, lending to its allure as a party drug. It can also cause amnesia and hallucinations.
While not particularly addictive, the drug has a steep dose-response relationship, meaning the difference between experiencing euphoria and losing consciousness is a matter of a few drops of the clear, viscous liquid. It is this quality of GHB that gives it the nickname “the date-rape drug,” although the compound is rarely a factor in sexual assault. Overdoses can result in coma and respiratory arrest, which to an unaccustomed observer may appear as if the affected person has only fallen asleep.
GHB overdoses surged in the United States during the 1990s. In 1995, the Drug Abuse Warning Network recorded 145 emergency department visits for GHB-related illness in a single year. By 2000, this number was nearing 5,000. That same year, the American Association of Poison Control Centers logged some 2,000 exposures to GHB and its analogues as well as six deaths.
In reacting to the growing crisis, Congress passed the Hillory J. Farias and Samantha Reid Date-Rape Drug Prohibition Act of 2000, which authorized the attorney general to list GHB as a Schedule I controlled substance. The law, named after two teenagers who allegedly died from GHB overdoses after unknowingly ingesting the drug, also targeted GHB analogues, or chemicals that are “substantially similar” to the illegal compound. Two of these — gamma-butyrolactone (GBL) and 1,4-butanediol (BDO) — were named in the act’s text.
Once ingested, GBL and BDO metabolize into GHB and have similar clinical effects. But unlike GHB, both chemicals have widespread use in industrial manufacturing, which prevents them from being regulated as controlled substances. Under the Farias-Reid act, GBL became subjected to greater control by the Drug Enforcement Administration, while BDO was left unregulated. Even so, under the new law, the sale and distribution of either GBL or BDO could result in criminal prosecution if the seller knew the buyer would consume the chemical.
New market for an old drug
After the federal government targeted GHB, reports of its use began to fall. By 2005, poison control centers in the U.S. only recorded some 550 exposures to GHB and one death.
During that same period, online retail grew to offer new avenues for buying and selling GHB and its analogues under the guise of legitimate business.
In 2002, in its first major action against the sale of GHB, codenamed Operation Webslinger, federal agents busted four drug-trafficking rings that had used the internet to connect with buyers. One of these operations, a mother-son team in Missouri, was accused of setting up a limited liability company called Miracle Cleaning Products to deal BDO online. Through their business, the duo could legally purchase the chemical in bulk from two U.S.-based suppliers and then distribute smaller quantities to their customers throughout the U.S. When law enforcement finally arrested the family, federal agents recovered 2,200 gallons of BDO and seized $300,000 in cash. Ultimately, the court sentenced the mother to 14 years in federal prison and the son to more than eight years.
Congress again took action by passing the Adam Walsh Child Protection and Safety Act in 2006. In addition to establishing the national sex offender registry, the law made it illegal to use the internet to sell GHB or its analogues to any person without a legal prescription to use the drug or any business not authorized to handle the chemical. Anyone convicted of using the internet to sell these compounds to unauthorized buyers could face a fine and 20 years imprisonment.
The new law also authorized the attorney general to develop regulations for record-keeping and reporting by anyone handling BDO. To date, the Department of Justice has not established these requirements.
A spokesperson for the U.S. Drug Enforcement Administration, which is part of the DOJ, told NBC News the it “has not promulgated any regulations that were authorized but not required by legislation,” adding that “1,4-butanediol is produced in large volumes for a multitude of legitimate industrial uses, none of which are intended for human consumption.”
Last month, federal agents raided Right Price Chemicals, a wholesaler in Texas, and arrested nine individuals who were accused of distributing BDO for human consumption beginning in 2015. According to the DOJ, the defendants had used the internet to sell the compound to buyers in 48 states. Some of these buyers then dealt smaller quantities to other users.
In just four years, sales of BDO generated $4.5 million for Right Price Chemicals, according to the Department of Justice. Prosecutors also claim that the product caused at least two deaths.
A lawyer for one of the defendants told NBC News that Right Price Chemicals warned customers on its website and its products that BDO was not for human consumption.
“Simply because people misuse a product does not place criminal liability on the retailer of that product,” Ryan Gertz, the lawyer, said. “Right Price Chemicals is a legitimate business that maintained thorough records, paid taxes, employed experts to advise them about proper practices and openly consulted with the government about its operations.”
The defendants in the case have pleaded not guilty and attest that they only distributed BDO for legitimate, legal purposes. If convicted, they face a minimum of 20 years, and up to life, in federal prison.
Right Price Chemicals is not the only business that has cashed in on BDO. Companies purportedly based in Europe, China and India market the compound on English-language websites. Stateside, companies have also found success by selling BDO on Amazon, the world’s largest online marketplace. As of last week, two third-party sellers offered consumer-sized quantities of BDO on Amazon (Amazon removed these products after NBC News reached out to the company for comment).
In the interest of public health, NBC News has chosen not to name the companies or share their websites and social media accounts.
One of these sellers markets its products as an “organic reagent” and “heavy-duty cleaner” with multiple at-home uses, though the Drug Enforcement Administration maintains that 1,4-butanediol “has no household applications.”
On Amazon, the companies’ products were much pricier than traditional cleaning supplies. Whereas most heavy-duty cleaners on Amazon retail for about $15, BDO of a comparable size went for over $100.
Both sellers are legally registered in different Midwestern states as limited liability companies. The name of one suggests it is a chemical wholesaler; however, it only distributes 1,4-butanediol. The other began as an all-natural soap company in 2015 but switched to selling BDO via its website and Amazon last year.
Prior to early August, buyers could also purchase BDO through the website of one of the sellers using cryptocurrencies, like Bitcoin.
One seller included a legal disclaimer on its Amazon product page stating that its BDO was not for human consumption. Nevertheless, commenters on several blogs, including Reddit, have discussed purchasing BDO as a GHB substitute through Amazon.
NBC News attempted to contact multiple people who allegedly purchased BDO from one of the third-party sellers on Amazon. Only one agreed to speak on the condition of anonymity. This buyer confirmed purchasing 1,4-butanediol on Amazon in order to ingest it and said the seller did not ask for justification when placing the order. The buyer said that the day after consuming the BDO, they felt “absolutely terrible.” The compound, this individual said, caused them to feel fatigued, nauseous and confused.
Shortly after NBC News began contacting these alleged buyers, the third-party seller removed images of BDO bottles and packaging labels from its Instagram account. The company also removed its offering of BDO from its website and instead provided links directing customers to its product pages on the Amazon and Walmart marketplaces.
Amazon prohibits third-party sellers from using its marketplace to sell scheduled controlled substances, like GHB, and List I chemicals, like GBL. BDO is neither. Still, Amazon specifies that its list of restricted products is “not all-inclusive” and the sale of “unsafe” products is strictly prohibited.
“Third party sellers are independent businesses and are required to follow our selling guidelines when selling in our store. Those who do not will be subject to action including potential removal of their account,” an Amazon spokesperson told NBC News. “The products in question are no longer available.”
Walmart also prohibits third-party sellers from selling controlled substances and “products that are subject to regulatory action or criminal enforcement.” Like Amazon, Walmart removed 1,4-butanediol products from its website following NBC News’ request for comment.
In a statement, a Walmart spokesperson said: “We strive to make our third-party Marketplace a trusted destination for safe, high quality products. We require our third-party sellers to comply with all applicable laws and our prohibited products policy. We removed the product 1,4-butanediol from Marketplace and have taken steps to prevent sellers from listing similar items going forward.”
NBC News tried to contact both companies that formerly sold 1,4-butanediol on the Amazon and Walmart marketplaces. Neither responded.
One of the sellers, however, appears to have moved to another major online marketplace after being removed from Amazon and Walmart.com. This marketplace, whose name NBC News will not publish in the interest of public safety, makes sellers’ purchase histories publicly available and shows the seller earned over $2,670 in just 48 hours this week from selling 35 units of BDO.
The comeback of a ‘party drug’
As the online market for GHB and its analogues has grown in recent years, researchers have seen an uptick in the drugs’ recreational use.
From 2016 to 2019, Palamar and Katherine Keyes, an epidemiologist at Columbia University, surveyed adults at electronic dance music parties in New York City to track relative changes in drug use. In that three-year span, they found that the rate of GHB use increased from one in 100 to roughly one in 25, a relative increase of 300 percent.
But for certain demographic groups, the use of GHB is far more widespread. In another survey taken from 2016 to 2018, Palamar and a group of researchers at NYU and Rutgers University found that both gays and lesbians at electronic dance parties were at higher odds for GHB use than straight patrons. According to the study, gay men were nearly 12 times more likely than heterosexual men to self-report GHB use within the past year. Lesbians were nearly seven times more likely than straight women. While gays and lesbians reported comparable or higher rates of use across most surveyed drug types, the difference in GHB use between gay and straight attendees was by far the greatest.
It was in nightlife that Jon, who spoke on the condition of anonymity to protect his privacy, discovered GHB.
As a newcomer to New York City in 2013, Jon, like many young gay men, found a community in nightclubs where he began taking GHB with friends. At first, the drug was only a cheap weekend indulgence.
After drinking one glass of water mixed with GHB, “I wouldn’t need to drink for the rest of the night,” Jon said. “That’s a very attractive selling point.”
But the party didn’t always end on Monday. What had started as only a weekend exploit soon became a weekday occurrence and eventually a physical dependence on the drug.
For several years, no one — including Jon’s boyfriend at the time — knew of this dependence. Even when Jon acknowledged his problem to himself, he still didn’t reveal it to others.
“I wanted to detox without anyone knowing, because at that point I knew I was only doing it for maintenance,” he said. “I was only doing it to curb the withdrawals.”
These were often debilitating. If Jon didn’t ingest GHB on a regular basis, his body would begin to show symptoms akin to alcohol withdrawal. He would sweat and shake. His anxiety would soar to the point of confusion. As a young person trying to make something of himself in New York, Jon needed to maintain his dependence on GHB. The alternative — abruptly stopping his GHB use — was to risk a coma and even death.
So, Jon continued to consume 1.25 milliliters of GHB every two hours for three and a half years.
When he finally sought help at a rehabilitation center last summer, Jon encountered a different problem altogether.
“They had never heard of the drug,” he said of the rehab’s staff. “They had no idea what it was. They didn’t know how to treat it. They didn’t know how to deal with it. Nothing.”
Ultimately, Jon’s doctors treated him with diazepam, which has been shown to be effectivein treating GHB dependence. As of today, Jon has been in recovery for over a year.
The ignorance around GHB that Jon experienced in rehab is not unique to a single health care provider or institution. It pervades the entire society.
“It’s called ‘generational forgetting,’” said Palamar, using a term coined by the social psychologist Lloyd Johnston. “One generation could be fully aware of the potential adverse effects of a drug, but then the next generation just doesn’t know.”
This “forgetting” may also contribute to the apparent rise in GHB use among gays and lesbians.
“In the gay community, people don’t tend to go out for a very long period of their lives,” said Guy Smith, producer of the popular gay Pines Party on New York’s Fire Island. “A gay generation in nightlife is about 10 years, so the conversation that people have about a drug in any particular place will only last that long. There is no conventional wisdom.”
Like Palamar, Smith came of age in New York nightlife at the turn of the millennium when GHB overdoses spiked. In recent years, Smith said, use of the drug has started peaking again.
Spurring this rise are industries, like online retail and social media, which came of age in that same timeframe and which therefore lack experience with the drug.
In such a lax environment, the front lines for addressing GHB abuse have shifted to unlikely places. Several nightclubs and parties, including Guy Smith’s events, now enforce a zero-tolerance policy on GHB. The move is not without its naysayers.
But Smith and Palamar stress that these policies save lives.
Both men witnessed GHB devastate New York nightlife when clubs ignored problematic drug use in the early 2000s. Young opponents of zero-tolerance policies, Palamar said, were “not around when people were dropping like flies” and “not there with all the deaths.” And he hopes they never will be.
Idaho officials’ latest attempt to ban transgender people from changing the gender on their birth certificates violates a court order issued two years ago, a federal judge said.
U.S. Magistrate Judge Candy Dale first ruled in 2018 that a law barring the birth certificate changes was unconstitutional, and she banned state officials from implementing it. Earlier this year, Republican lawmakers passed new legislation that did largely the same thing.
That law signed by Republican Gov. Brad Little went into effect on July 1. It set strict criteria for changing gender on a birth certificate, including a requirement that a person first obtain a court order, and only allowed people to seek the court order if the sex listed on their birth certificate was mistakenly entered, entered fraudulently or under duress.
As a result, the state Department of Health and Welfare created procedures to implement the new law, including revising an application form and the department’s instructions for changing the sex listed on a birth certificate.
In her order Friday, Dale said the new procedure does the same thing as the old one by effectively preventing transgender people from changing the sex on their birth certificates.
“The plain language of the statute, as quoted, forecloses any avenue for a transgender individual to successfully challenge the sex listed on their Idaho birth certificate to reflect their gender identity,” Dale wrote.
Lambda Legal represented two transgender women who filed the original lawsuit that led to Dale’s first ruling. The advocacy group successfully argued the state’s ban on birth certificate changes for transgender people violated their constitutionally protected right to privacy, liberty and freedom from compelled speech.
“It is astonishing that the Idaho Legislature and Gov. Little plowed forward with resuscitating this dangerous and archaic ban in direct defiance of multiple court orders that repeatedly ordered the government to stop discriminating against transgender people,” said Nora Huppert, an attorney with Lambda Legal. “What was discriminatory in 2018 remains discriminatory today.”
Spokespeople with the Department of Health and Welfare and the governor’s office did not immediately respond to requests for comment.
Another anti-transgender law passed this year also is being litigated. It bars transgender and intersex girls and women from competing in women’s sports. Boise State University student Lindsay Hecox is suing the state in federal court, contending the law is discriminatory and would prevent her from trying out for the women’s cross country team because she is transgender.
Two transgender teens sued Arizona’s Medicaid agency Thursday, alleging their civil rights are being violated by the state health insurance program’s ban on gender-affirming surgeries.
The suit, filed Thursday in an Arizona federal courthouse, seeks to establish a class action on behalf of the teens — known only as John Doe, 15, and D.H., 17, and other transgender Arizonan Medicaid recipients under age 21 who seek chest reconstruction as treatment for a diagnosis of gender dysphoria. The complaint estimates there are at least 100 Arizonans who would be affected by the suit.
The suit defines the class as “individuals who have been unable and will be unable” to obtain coverage through the Arizona Health Care Cost Containment System “for medically necessary male chest reconstruction surgery because of the [ban], and as a result, have faced or will face delayed or denied access to these medically necessary treatments.”
The claims say the state’s 1982 ban on “gender reassignment surgeries” violates the Affordable Care Act’s anti-discrimination provisions, the Medicaid Actand the Equal Protection Clause of the 14th Amendment to the U.S. Constitution.
According to the suit, the two came out as transgender years ago and since then have faced significant challenges as puberty began to change their bodies. It also states the reliance on chest binders to create a more masculine appearance forced D.H. to abandon his beloved hobby of dance and resulted in John Doe wearing a heavy hoodie through Arizona’s sweltering summers.
Both teens’ physicians recommended chest reconstruction surgery, and the state’s 1982 ban on Medicaid funding for “gender reassignment surgeries” means that as Medicaid recipients, they are ineligible for the medically necessary surgery even if a doctor recommends it, according to the suit.
Asaf Orr, an attorney working on the case and the director of the National Center for Lesbian Rights’ Transgender Youth Project, said there is “no legitimate justification for Arizona’s refusal to provide this critical care to transgender Medicaid recipients.”
“Instead, excluding that care creates unnecessary barriers that prevent transgender young people from thriving in every aspect of their lives and can cause lifelong harms,” he said in a statement.
In June’s landmark Supreme Court decision Bostock v. Clayton County, Georgia, the high court found that the Civil Rights Act’s ban on employment discrimination “on the basis of … sex” also bans employment discrimination on the basis of sexuality and gender identity.
“In Bostock, the United States Supreme Court unequivocally held that the definition of ‘sex’ under federal law includes discrimination against transgender people,” Orr wrote in an email to NBC News. “By maintaining and enforcing a categorical exclusion for surgical treatment for gender dysphoria, AHCCCS is impermissibly discriminating against transgender Medicaid recipients on the basis of sex and, as a result, the Court should enjoin AHCCCS from denying coverage under that exclusion.”
The suit notes that Medicaid requires that recipients under age 21 receive “Early and Periodic Screening, Diagnostic and Treatment” so that major “medical, vision, dental, and hearing” problems are diagnosed and treated early in life. It then states that “[s]urgery to treat gender dysphoria, including male chest reconstruction surgery” is such a service.
Heidi Capriotti, a spokesperson for the Arizona Health Care Cost Containment System, declined to comment.
President Trump’s own HIV/AIDS advisory council adopted a resolution Thursday urging his administration not to implement a new regulation that would enable discrimination against transgender patients in health care.
The measure, which the Presidential Advisory Council on HIV/AIDS adopted unanimously, cites as reasons to scrap the anti-trans rule the recent U.S. Supreme Court decision in Bostock v. Clayton County, which found anti-LGBTQ discrimination is a form of sex discrimination under the law, and the Trump administration plan to beat HIV/AIDS by 2030.
“Be it resolved, in light of the recent Supreme Court ruling, PACHA urges the Secretary to apply the same definition of discrimination ‘on the basis of sex’ to healthcare and not move forward with implementing OCR’s rule changes to Section 1557 of the Affordable Care Act that are slated to go into effect on August 18, 2020,” a draft copy of the resolution says.
In the event the Department of Health & Human Services moves forward with the rule, the resolution calls on the Office of Civil Rights to “have a clearly defined system” to report instances of LGBTQ people being denied care.
Days before the Bostock decision in June, HHS made the rule final, vacating protections under a 2016 Obama-era rule prohibiting discrimination in health care and health insurance on the basis of sex stereotyping and transgender status. The Obama-era regulation was based on Section 1557 of the Affordable Care Act, which bars discrimination on the basis of sex in health care.
PACHA adopted the resolution with limited discussion. Carl Schmid, co-chair of the Presidential Advisory Council on HIV/AIDS and executive director of HIV+Hepatitis Policy Institute, said he’d “fully support” the measure.
Justin Smith, an Atlanta-based HIV/AIDS activist and director of the Campaign to End AIDS, introduced the measure and said it came about based on previous talks with the HHS Office of Civil Rights, which gave the council vague assurances in a written response deemed insufficient in light of the Supreme Court decision.
“There have been some really important changes in our legal landscape,” Smith said. “So, back in June, the Supreme Court ruled that under Title VII of the Civil Rights of 1964, that employment discrimination against lesbian, gay, bisexual and transgender folks on the basis of sex is actually against the law, which could have some profound implications for this proposed rule change to Section 1557.”
In a legal sense, nothing had practically changed with the Trump administration’s rollback because U.S. District Judge Reed O’Connor in Texas in 2016 issued a nationwide injunctionbarring the U.S. government from enforcement of the Obama-era rule. The Trump administration later declined to appeal that court order before deadline.
Roger Severino, director of the Office for Civil Rights at HHS, defended the rule change as necessary in response to the 2016 court injunction in a statement last month to media outlets.
“The gender identity and termination of pregnancy provisions of the 2016 rule were held unlawful and unenforceable by a federal court in December 2016 and a court vacated that language in October 2019,” Severino said. “Further, it was the Obama, not Trump, administration that decided to exclude sexual orientation as a protected category in this health care rule a mere four years ago.”
But the final rule, nonetheless, prompted a flurry of lawsuits from LGBTQ legal advocates who say vacating the protections contravenes the law, not just on the grounds of the Bostock decision, but constitutional claims of equal protection and due process.
In response to one lawsuit filed by Lambda Legal, U.S. Judge James Boasberg in D.C., an Obama appointee, held a hearing Monday to consider a preliminary injunction against the measure. Boasberg, who asked parties whether HHS’ hands were tied in issuing the anti-trans rule, said he’d wait for the U.S. government to file an additional brief before rendering a decision, which he said will likely not come down before the rule takes effect on Aug. 18.
According to the 2015 U.S. Transgender Survey, transgender respondents also encountered high levels of mistreatment when seeking health care. One-third of those who saw a health care provider in the past year said they had at least one negative experience related to being transgender, such as being verbally harassed or denied treatment.
Additionally, 23 percent of respondents said they didn’t seek necessary health care due to fear of being mistreated as a transgender person, and one-third didn’t go to a health care provider when needed because they could not afford it.
Meanwhile, lawsuits are continually filed against hospitals, many of them religiously affiliated, for refusing to grant transition-related care, such as gender reassignment surgery, to transgender patients. Just last month, the American Civil Liberties Union sued University of Maryland St. Joseph Medical Center in Baltimore for cancelling a scheduled hysterectomy for a transgender patient as part of a transition plan.
Assistant Secretary of Health Brett Giroir addressed the council before the adoption of the resolution, expressing a commitment to continue the Trump administration plan to beat HIV/AIDS by 2030. He didn’t mention the anti-trans rule, nor was he asked about it.
“We are constantly looking for ways to expand the HIV message, all throughout my offices and throughout the agency,” Giroir said. “This is really, as we said, it’s not owned by one specific group, it’s got to be a whole of government, and really a whole of society approach.”
Giroir announced HHS will expand the program for free PrEP access to the underinsured with TrialCard, which will be responsible for current and new enrollees starting Nov. 1. Additionally, Giroir said HHS will launch online Aug. 17 the first national HIV epidemic analysis dashboard to keep track of progress toward reaching the goal of ending the epidemic.
The AIDS council during the meeting also unanimously approved two other resolutions. One calls for increased uptake in the “Ready, Set, PrEP” program, a Trump-era plan that providesfree PrEP to the uninsured, as well as data collection on the location, race, ethnicity and LGBTQ status of the estimated 1,000 users. The other resolution seeks increased funds in the time of COVID for entities seeking to help with HIV, including Ryan White programs, state and local government and HIV testing.
Trans prisoners in a New York county were delivered a stunning victory Wednesday (August 5) when a roster of LGBT+ activist organisations secured them a vital but simple right: To be incarcerated as the correct gender.
The landmark legal settlement was described by activists as having secured some of the most “robust policies in the country” to better protect trans folk in custody in the western Steuben County.
The case was brought forward after 43-year-old trans military veteran Jena Faith was sentenced to a month in Steuben County Jail in 2019. While initially kept in the women’s division of the jail, she was later transferred to the men’s where she experienced weeks of verbal and physical humiliation and abuse from inmates and guards alike.
Trans woman tossed in men’s jail: ‘No one should ever be subjected to the cruelty and harassment I endured.’
Faith filed a lawsuit with the TLDEF after her rattling experience in a men’s facility. Trapped in the tight, cramped cells with male prisoners, she detailed in a report to the American Civil Liberties Union (ACLU) how inmates harassed her, guards misgendered her, and told of how she was denied hormone therapy.
These range from housing inmates in line with their gender identities and training prison staff to respect inmates’ pronouns to giving access to clothing, toiletry and grooming products and appropriate medical care.
Transgender Legal Defense & Education Fund (TLDEF) and the New York Civil Liberties Union hope that the new policies will offer a blueprint for other prisons across the state and the US.
“No one should ever be subjected to the cruelty and harassment I endured.
“Everyone housed in detention facilities deserves to be treated with dignity and respect, including transgender people. I hope my case will help others, not only in Steuben County, but also across New York and beyond.”
Efforts by the Obama administration to ensure trans convicts were protected from sexual abuse and assault were unwound by president Donald Trump in 2018.
The multinational investment bank Citigroup is being sued by a gay man who claims he was demoted and discriminated against because of his sexual orientation.
The allegations by gay banker Thomas Krauss appear to counter Citigroup’s proud ranking as the most LGBT-inclusive financial services employer in the Stonewall Top 100.
Krauss joined the firm in 2010 and until recently led the firm’s capital introduction group for the Americas, Bloomberg reported.
He says he was targeted when he uncovered complaints of sexual harassment made against a new hire on his team, Deutsche Bank veteran Joseph Genovese.
Concerned that Genovese’s hiring could put Citigroup at risk of creating a “hostile and offensive work environment,” the suit says Krauss disclosed what he learned to senior Citigroup managers, who later withdrew the offer made to Genovese.
Although Krauss made the disclosure in confidence, he claims that several executives pushed to find out who “blew the whistle” on Genovese.
Once they learned it was Krauss, they allegedly began a campaign to punish him which eventually resulted in him being demoted.
Sadly the retaliation didn’t end there: despite receiving consistently positive evaluations, Krauss’s 2019 year-end review reflected a decrease in his leadership rating, which led to a pay reduction and “effectively destroyed his Citi career,” according to the complaint.
Krauss also alleges that he was denied a promotion to managing director because of his sexual orientation and for extra work he did on behalf of the company’s LGBT+ initiatives.
“It is easy to say you are not tolerant of discrimination but action, as is true with Citi, speaks louder than empty words,” said Krauss’s lawyer Daniel Kaiser in a statement Monday (3 August).