It has been said that the first Pride was a riot, sparked by the Stonewall Uprising in 1969. The meaning of Pride Month has expanded and evolved since Stonewall and the subsequent first Pride Parade in 1970. Though Pride was established before the rise of HIV and AIDS, HIV awareness and advocacy have stood at the center of Pride since the early days of the illness.
Though HIV is no longer the death sentence it once was, there are still approximately 1.2 million people living with HIV in the United States and over 30,000 new infections every year. The continued prevalence of HIV means that HIV education and advocacy still play an important role in Pride Month.
Pride Month presents an opportunity to spotlight advancements made in HIV prevention and treatment. It also gives advocates a chance to take the world stage and be heard, letting people know that HIV is still a factor in the lives of many, especially those within the LGBTQ+ community. Pride is a time to remember the fight for equality, to celebrate living authentically, and to deepen bonds within the community. It can also be a time for promoting testing, educating the public, and keeping the fight to end HIV alive.
Deepening the meaning of Pride
Since its inception, Pride has grown year by year into a worldwide celebration. During the height of the HIV/AIDS epidemic in the mid-1980s through the early 1990s, Pride celebrations were intermingled with protests and rallies advocating for more attention to prevention and care for those living with HIV and AIDS. Activists pushed for government intervention at a time when many government officials refused to say the word “AIDS” and the spectre of the disease – and the neglect of people living with it – overshadowed much of the Pride movement for well over a decade.
Today, while Pride Month remains focused on justice and equality for the LGBTQ+ community, HIV advocacy should still take a front seat. This is particularly true in the South, which carries a disproportionate burden of HIV infections.
Regional statistics mixed with a persistent stigma and higher rates of HIV infections among groups such as Latino and Black gay and bisexual men compound the need for more attention on HIV during Pride Month. Working to combat the stigma surrounding HIV and AIDS and promoting information about prevention and care can deepen the meaning behind Pride, making the entire month even more impactful.
Promoting community-led care
Pride Month opens doors for inclusive, community-led advocacy and care in 2025, especially for those in areas of the country with higher rates of HIV infections and a greater need for access to prevention methods. HIV advocacy and care in 2025 looks like cultural understanding, expanded accessibility, and leadership in individual communities and the broader LGBTQ+ community. Partnerships between advocacy groups, community leaders, and health organizations are crucial for achieving the goals we must set each Pride Month. These goals should include reducing stigma and expanding educational resources, especially in areas heavily impacted by the disease, such as the Southern United States.
New care models highlighted during Pride Month must be inclusive of the communities most impacted by HIV today and tailored to diverse experiences across those communities. One mission of Pride Month is the building of trust between community leaders, advocacy groups, and health organizations and those who need the most attention, such as those living with HIV or AIDS.
Pride must not only be a month for education and advocacy, but also for recognizing those who have participated in making HIV an increasingly manageable condition. So many in the LGBTQ+ community are living long, healthy lives with HIV. That in and of itself is worthy of celebration.
Honoring the roots of Pride Month
Pride indeed began as a riot – a collective uprising against discrimination, hate, and inequity. As the HIV/AIDS epidemic took hold, the continued need for collective work toward a better future was evident.
Today, Pride is still an uprising. Keeping HIV awareness and prevention at the heart of Pride Month deepens its mission and continues the promise that no one in the LGBTQ+ community will be left behind or forgotten, in June or any other time.
As we celebrate flying the rainbow flag, marching in parades, and participating in all that makes Pride wonderful, it’s crucial to remember that Pride Month can also be a time of deeper significance. The reality of HIV persists, and Pride Month can be a time to shine a greater spotlight on what still needs to be done to protect the LGBTQ+ community and take greater strides toward eliminating HIV once and for all.
By weaving stigma-fighting prevention campaigns and collaborative efforts between community leaders and health organizations into the celebratory mission of Pride Month, more progress can be made in prevention and care.
On June 18, the Supreme Court of the United States (SCOTUS) upheld Tennessee’s ban on gender-affirming care for minors. The 6-3 ruling is expected to have a broad impact as 24 other states have already enacted similar laws, which bar puberty blockers, hormone therapy (HRT) and gender transition surgeries for trans youth.
Uncloseted Media wanted to pass the microphone to the kids and young adults who could be directly affected by SCOTUS’ decision. So we called up Romana, Zavier, Ray, Dylan and Samuel—who are all receiving some form of gender-affirming care—to get their reaction to the decision.
Watch the full interview above or read the transcript here:
Spencer: Hi everyone, I am here with five trans kids and young adults from across the United States. Guys, thank you so much for speaking with me and Uncloseted Media today.
All: Thank you for having us.
Spencer: Last week, the Supreme Court ruled 6 to 3 in a landmark case that prohibits health care providers [and] doctors from administering gender-affirming care to minors. That includes puberty blockers and HRT. I want to know, where were you guys when you heard the news and what was your reaction to that?
Samuel: So I’ve been following this case since November. I think the ruling’s ridiculous. I think it’ll kill kids.
Spencer: When you say this ruling is going to kill kids, that is a really bold statement. Why do you say that?
Samuel: It’s a bold statement. The care that enables so many people to live their lives. I think taking that possibility away from people who need it is incredibly cruel and short-sighted.
Romana: Ifelt disgusted, especially since I think [it’s] just from [the] hate. And I know people who gender-affirming care has saved the life of as teenagers. And I think every kid should be able to have that. And also, this ruling makes me scared that a state might try to ban trans care for adults.
Spencer: It could be a slippery slope.
Romana: Yeah,definitely.
Spencer: When you think about your future as a trans person without the care, what does that look like for you? Why is that so devastating?
Dylan: Because there’s not one.
Samuel: Yeah.
Spencer: Unpack that a little bit more. Why? Like, why do you think there is not one?
Photo courtesy of Dylan Brandt.
Dylan: Personally, now that I have had [testosterone] for almost five years, there would be no way that I would be able to lose everything that I have worked so hard for… And go back to living a life that was not me.
Spencer: Would you compare it to, like, if I were being forced to live as a woman every single day? Is it the exact same thing to you?
Dylan: Absolutely.I mean, if you were forced to be living [as] a woman and you, that was not something that you wanted? Absolutely.
Samuel: I couldn’t do it. I couldn’t do it. When I was younger, it almost killed me then. I couldn’t do it now. I think they’d have to kill me to force me to stop transitioning because it saved my life. I think living as myself, living as Sam, as a man, is so integral to who I am. For somebody to even try to force me to stop that would include stopping me entirely, if that makes sense.
Spencer: Okay, let’s talk about Donald Trump. Trump has tasked several federal agencies to police and ultimately stop gender-affirming care for minors, which he has equated to child abuse and child sexual mutilation. He’s also falsely stated that kids are going to school and coming back with sex changes. I wanna know, as a trans kid, what would you say if you could talk to President Trump right now?
Ray: It’s kind of painful to hear the same argument that he pulls out of his asshole every single time just because he wants to weaponize the fact that we’re a marginalized community and people are afraid of us because they don’t understand so his tactic to basically throw people off is to make us look like we’re indoctrinating kids. We’re coming back from school with surgeries. Which, by the way, you don’t just go to school and be like, “Ah, yes, I would like a surgery please.”
Spencer: Do you guys feel sometimes like you’re being used by adults as political pawns?
Ray: All the time!
Dylan: Yeah, I have been fighting this fight for so long that I’m not even necessarily surprised by what’s said anymore. I think that if I could say something directly to Trump, it wouldn’t be very nice. Because at this point I’m done being nice. At this point I’m just mad, because it has gotten to a point where they’re toying with people’s lives. They are toying with people’s lives making us look like monsters for their political gain. Because if they have people on their side that think that we are everything that they say they are, people are gonna believe ‘em.
Spencer: Especially when most Americans have never even met a trans person before.
Dylan: Absolutely.
Spencer: And trans people represent, as far as we know, less than one percent of the overall population.
Romana: I feel like a political pawn, because there’s so much talk about trans people and so much legislation passed around it and it just feels like we’re being used as a scapegoat and just someone to put the blame on and hate on in society. If I could say something to President Trump, I would proudly say something like, “Just leave us alone.”
Photo courtesy of Romana.
Spencer: It’s hard for me to square away why [Trump] would make trans issues the number one platform of [his] campaign when it’s such a small percentage of the population. It doesn’t really make sense mathematically.
Samuel: I think to your point, it’s exactly because it’s a small area of the population. For a lot of these politicians, the hate is real. But to some extent, it’s like we are the issue they can use right now because we’re such a small community that we’re targetable. It’s the small size of the transgender community and the lack of education that the general public has that is what drives being able to target this group.
Spencer: I think there’s a lot of misinformation in the United States about what gender-affirming health care actually is. So tell me what gender-affirming health care means to you and how did you make the decision to get on it?
Dylan: It took me a really long time to realize or to put words to how I was feeling. And once I did, I spoke with my primary doctor who referred me to the gender spectrum clinic in Little Rock. And I went, had my first appointment with them. And that was a six-month process where you meet with those doctors multiple times. You have to be in therapy. You have to get a psychiatric evaluation to make sure that you are doing this for the right reason. And when I tell people that they’re like, “Oh! I didn’t know that. I didn’t know that there was a process,” and I [would say], “Yeah, I’m not just walking in and saying, ‘Hey can I have it?’” And then with my top surgery too. I had to have been in therapy. I had to get letters of recommendation. I had to get it signed off, basically, by multiple people.
Gender-affirming care, to me, is hope. I graduated last year, and I never thought that I would make it to graduation, and the only reason that I did is because of my gender-affirming care. I’ve been on testosterone for almost five years, and even up until four years ago I was just so unhappy with the way that I looked, with the way I felt. I didn’t want to go out, I didn’t want to go do anything, and now I do.
Sam: I think I resonate with everything Dylan said, from the length of the process to the sort of life-saving benefits. I don’t think I would have made it to 18 without starting care at 14 when I did. I was just so uncomfortable, but the process is long. I think it was two years because my parents weren’t really sure about care at first.
Spencer: I think one of the critiques a lot of adults in this country have on gender-affirming care is that there are irreversible impacts, right? And for things like testosterone, like there are things like facial hair, for example, that you can’t fully go back on, right? Was that decision hard to make when you know that sometimes there will be elements of this that could be not completely reversible?
Photo courtesy of Samuel.
Sam: I can see why it would be a hard decision for a lot of people and I think in some ways that’s like why there’s so many safety checks and it’s also why maybe my parents were so. You know, like…
Spencer: Cautious?
Sam: Nervous, yeah. Especially because they were like, oh, you know my daughter now, you’re no longer my daughter and that was a huge adjustment. But for me, as long as I’ve been out, I’ve known that this is what I wanted to do. Like once I had the language to be able to say, “Yeah, I’m trans,” and knew that that was the path I wanted to go down. So in the end, after considering everything, it wasn’t really a hard decision.
Spencer: And Zavier, you are 11. A lot younger than everyone else on this panel, and it sounds like you are taking blockers, which to any Americans watching are completely reversible and have been given to cisgender girls for things like precocious puberty for decades. Zavier, what does gender-affirming care mean to you?
Photo courtesy of Zavier.
Zavier: Well, when I was 3 years old, I came out and I was wanting to be trans. Once I got older, my parents, they put me on blockers and let me take medicine for it.
Spencer: A lot of people, adults particularly, would say, how could a kid ever know at 3 that they’re trans? What would you say to that? How did you know?
Zavier: I just saw people. I just thought about wanting to be trans and I’ve wanted to be trans ever since.
Spencer: And you’ve always felt like a boy?
Zavier: Yeah.
Spencer: And Ray, how about you? When did you kind of know you were trans or start having feelings that you could be trans and what’s the process for you been like to get on gender-affirming care?
Ray: I’ve known since I was like 6, 7-ish. I’ve always wanted to be the dad, always wanted to be a king. I didn’t want to be a queen, none of that. It took about seven to eight months of doctors visits. First we had to make sure my mental health was good. So they prescribed me like Strattera and other types of medicines to help elevate my levels and stuff. And then they eventually put me on testosterone.
Spencer: And how has that been for you, the transformation? Has that felt good?
Ray Oh, I feel like myself now, finally! I feel like everybody in this call or this meeting feels like themself after they finally take their hormones.
Spencer: So for me, a cisgender gay boy growing up, I’d want to wear my mom’s clothes and kind of act like a girl and do different things that would tap into my femininity. But there’s never been a question that I could be a trans woman, right? What do you think is the difference between how you guys feel versus how I feel about wanting to explore my gender?
Dylan: So in my house, I’ve had both. You know, my brother is a 17-year-old gay man. And when he was little, he did. He put on my dresses and my mom’s high heels and boots and everything. And so we had that, and then we had me. From the time I could dress myself wanting strictly jeans and t-shirts, and nobody was allowed to touch my hair. And there is so much of a difference. My brother was exploring that, and I don’t want to say exploring that as in a hobby, and I was exploring it more as a lifestyle. That sounds wrong to me. But that’s the best way I can explain it.
Spencer: A big difference could be comparing it to some gay guys [who] like to dress up in drag on Halloween. You want Halloween to be every single day for the rest of your life.
Dylan: My entire life, yes, yes.
Spencer: Take me more into your mind about the feelings of wellness, of health, if you are able to live as your gender identity.
Photo courtesy of Dylan.
Dylan: The validation started the moment I cut my hair off. I mean, from that moment, I opened the door for somebody. It was, “Thank you, sir.” We went out to eat with my mom, me and my brother. “What do you boys want?” I mean it was right off the bat. And that’s honestly what made me realize that’s who I was supposed to be, because it made me feel so good. I mean, even to this day, somebody calling me sir or any form of male affirmation, anything, makes me feel so good. Just knowing that these random people in the deep south have no clue who they’re talking to. And if they did, their reaction would be way different. But the fact that these country hicks in the Deep South, who I know voted for Trump, are calling me sir or bub or anything? Makes me feel so good about myself knowing that they have no idea.
Spencer: And Zavier, how about you? You’re the youngest, why is it important for you to transition at such a young age?
Zavier: When I was growing up and people would call me a girl, I would just not feel like I was a girl. And when they said that I would just be like, “No,” inside my head.
Spencer: And do you play on the boys sports teams and do you use the boys bathroom?
Zavier: I do use the boys bathroom and my parents are signing me up for kickboxing.
Spencer: Love it, that’s super cool, yeah. And you feel great since you’ve transitioned. Is there ever any regret or feeling like, “I wanna go back to living as a girl?” No? And that would be the case for everyone here is my sense, right? No regret, no sense of de-transitioning, anything like that, yeah? Do you guys find that when you meet people and actually have conversations with them about who you are and why you need this care, hearts and minds are changed, does that help?
Sam: Yeah.
Spencer: You’re shaking your heads. Yeah, go ahead.
Dylan: [In my] School, everybody knew, I live in a small town. It wasn’t a secret. Even the 60 Minutes episode, I mean, you have no idea how many people watched that and came to me and said, “I am so sorry. I never thought about it the way that you put it. I didn’t understand until I watched that.” Like there were so many people in my school and work that [60 Minutes] truly changed the way that they thought about the transgender community. People have this pre-idea of what the transgender community is. And it’s just not, at all, how it actually is. And you don’t know that until you speak with somebody that is living it.
Spencer: And to your point on misinformation, I mean, if you turn on Fox News, which is the most watched cable news channel in this country right now, misinformation is rampant. There are comparisons that gender-affirming care is literally just bottom surgeries or so-called general mutilation. What do you think those media portrayals of trans kids and gender-affirming care for trans kids does to the mindset of Americans as they see you guys?
Dylan: They see that people are talking about giving 7-year-olds bottom surgery at school. Yeah, that could be scary to somebody that doesn’t understand. You see that, and your brain automatically goes to, “Oh, that’s not right. They can’t do that. That’s not right.”
Spencer: But that’s not happening.
Dylan: That’s not happening, absolutely. But, you see that as somebody that doesn’t know for sure that that’s not happening. And I mean, yeah, I don’t blame them for being like, “Oh, we have to stop this.” But it’s that misinformation of people saying, “Oh this is happening” when it’s not. So they’re scaring people for no reason.
Romana: I definitely agree that they make it sound really scary. And I’ve met people who’ve thought that way. I think the news really paints trans children especially as victims of being trans, which isn’t true. Or like, you’re being groomed into it, which doesn’t happen.
Spencer: Zavier, as an 11-year-old, have you even had conversations about surgeries or anything like that?
Zavier: The answer is no, because I’m only 11 years old, and I started the blockers about a year ago. So, since I’m 11 years old and you usually get surgeries at like 17 or 18, maybe. Nobody’s talked about it to me. Because if I change my mind, which I probably won’t, it’s in like six, seven years.
Spencer: Right, and you started on blockers because it gives you more time to delay puberty so you can still give yourself time to make up your mind. Right? And that’s something that I’m assuming you’re exploring with your family and your doctor to decide what’s best for you, is that right?
Zavier: Yeah.
Spencer: Ray, is it okay if I speak about the experience we had in South Carolina?
Ray: Yeah.
Spencer: Okay, well, we came to film an episode on conservative-minded dads. May your dad rest in peace, I know he passed away, and I’m so sorry about that. When we were filming with your dad, who was a military veteran, who was kind of a redneck—can I say that? From Georgia. I remember him saying to me, “This is completely against Republican ideology, get the government the hell out of my child’s doctor’s office.” Do you guys have anything to say about why it’s all Republicans coming after trans health care when it really is completely opposite to how conservatives see government intervention in family health care and parents’ rights?
Ray: Republicans are really bad at realizing that everything is not their business. We have HIPAA for a reason. They don’t seem to grasp the concept that they don’t to be in everybody’s lives. They feel like they have to protect these children, even though they’re not really protecting them.
Spencer: Is it fair to say that like gender-affirming care can be complicated and it can be nuanced and we need to have conversations about nuance by this but it’s tough to have those when you have people just attacking, attacking, attacking?
Samuel: Yeah, exactly. I mean, it’s medicine and all medicine is complex. Doctors and patients and their families are more qualified than politicians.
Photo courtesy of Ray.
Ray: Politicians, they don’t have like a degree in anything to be able to say, “Oh, this is bad.” Like they’ve never done the research. They do not have a qualification. Until I see them have an MD, they don’t have any qualifications to say anything. And I do believe research should be done. I mean, everything has so many different symptoms for every different person. I believe research is very important.
Dylan: Lawmakers don’t need to be involved in my doctor visits. They have no right. They have no knowledge. I just… They’ve got a lane and they should stay in it.
Since 1989, the LGBT Life Center in Norfolk, Virginia, has built up what CEO Stacie Walls calls a “test and treat” model. For every patient that walked through the doors of their HIV clinic after working up the courage to get tested, there had been the promise that, if they tested positive, all they’d need to do to get treatment was walk down the hallway.
But since the Trump administration’s sweeping cuts to HIV funding took place earlier this year, that’s no longer the case. “The grant money that pays for people who are uninsured is the grant money that they have canceled,” Walls told Uncloseted Media. “That’s so disheartening and scary and goes against everything that we’ve ever wanted to embrace as a nonprofit service agency.”
With these cuts, staff now have to send uninsured patients to the next nearest community HIV program in Hampton, a 30-minute drive away. Walls says they’ve already had to transfer 19 existing patients, including some of their frequent client base of low-income LGBTQ people of color, who are disproportionatelyimpacted by the virus. While the center has been able to shift to covering at least their initial treatment appointment, they are unable to cover further care, and Walls says that even this is not sustainable.
The LGBT Life Center is just one of the many U.S.-based HIV organizations and programs that have fallen victim to the billions of dollars worth of cuts by Trump and his newly created Department of Government Efficiency.
HIV funding has been hit particularly hard: Uncloseted Media estimates that the National Institutes of Health (NIH) has terminated more than $1 billion worth of grants to HIV-related research.1 In addition, the U.S. Agency for International Development (USAID) has terminated 71% of all global HIV grants, and the President’s Emergency Plan for AIDS Relief (PEPFAR) has been the subject of temporary suspension and major proposed cuts.
Additional cuts are also on the horizon, with the Trump administration’s budget proposal for Fiscal Year (FY) 2026 calling for the closure of all Centers for Disease Control and Prevention (CDC) HIV programs.
The effects of these cuts are deadly. Researchers estimate that PEPFAR’s funding freeze alone may already be associated with more than 60,000 deaths in sub-Saharan Africa, and numerous experts say that the entire global health system could be upended if the administration’s HIV cuts continue as planned. Mathematical models show that the worst-case scenario is apocalyptic: nearly 11 million new infections, 3 million deaths, and an infection rate outpacing the virus’s peak in the 1990s.
“This is not something that’s just a matter of the scientists losing funding; the community is losing funding, and in the long term, losing ground in the fight against HIV,” says Noam Ross, executive director at research nonprofit rOpenSci.
The Domestic Impact
Cuts to HIV funding in the U.S. have been a significant casualty of the Trump administration’s efforts to reduce spending and attack Diversity, Equity and Inclusion (DEI). Researchers behind Grant Watch, an independent third-party database of grants terminated by the NIH and the National Science Foundation, have identified HIV-related funding as one of the most common targets for termination. As of June 17, Uncloseted Media has calculated roughly $1.353 billion in HIV-related terminations in Grant Watch’s NIH database, accounting for more than a third of the $3.7 billion in recorded NIH cuts overall.
List of terminated HIV-related grants in Grant Watch’s database | Screenshot
“They’re certainly casting an enormously wide net in this,” says Ross, who is also Grant Watch’s co-developer. “It doesn’t matter that they’re not explicitly saying that ‘it’s a war on HIV’ because if they’re gonna have a war on sexual minorities and transgender people, it’s a war on HIV too.”
The Department of Health and Human Services (HHS) has explicitly told HIV groups across the country that funding was cut because it believes health research for LGBTQ people and racial minorities is unscientific. Researchers across the country have received letters and emails from the NIH with nearly identical statements informing them of their grant terminations:
“Research programs based primarily on artificial and non-scientific categories, including amorphous equity objectives, are antithetical to the scientific inquiry, do nothing to expand our knowledge of living systems, provide low returns on investment, and ultimately do not enhance health, lengthen life, or reduce illness.”
One of the programs subjected to cuts is the Adolescent Medicine Trials Network (ATN), an HIV program that has been active since 2001. Its goal is to prevent, diagnose, and treat HIV in young people.
Research under ATN’s umbrella has seen promising developments, including progress towards a product that could combine PrEP and birth control into one pill as well as new methods for reducing HIV transmission in young men who use stimulants. Despite this, NIH cut $15 million worth of grants to ATN because of its focus on high-risk LGBTQ youth populations. The program’s funds were later restored, but only after ATN agreed to cut off a study on transgender youth of color.
“There are particular issues around Black women, LGBTQ people, [and] the type of treatment that they need … that’s the social side of medicine, which is a very important part of medicine—it’s not just molecules, it’s people,” Ross says, adding that grantees focused on “delivery and participation and how to keep people in care,” such as programs that help vulnerable populations stay on PrEP or undetectable folks maintain their antiretroviral therapy regimen, are “very undervalued by [the] administration.”
“So that stuff feels like it’s faster to get canceled,” he says.
Rowan Martin-Hughes, senior research fellow at the Burnet Institute in Australia, says cutting programs that support prevention and long-term treatment is dangerous.
“With other infectious diseases, you treat people and then they’re recovered; with HIV, people require lifetime treatment,” he told Uncloseted Media. “Most of those people infected with HIV are still alive, and if you take treatment away from them, many people will die. And because treatment is also the best form of preventing transmission, many millions of additional infections will occur.”
Many advocates and lawmakers are pushing back against the cuts. Earlier this month, a federal judge in Boston ruled that the NIH’s DEI-related grant terminations—including many HIV programs—are illegally racist and discriminatory toward LGBTQ people, saying that in his four decades as a judge, he had “never seen a record where racial discrimination was so palpable.” HHS officials say they will consider an appeal.
NIH is far from the only agency issuing massive cuts to HIV. The CDC has terminated large grants to numerous HIV clinics across the country. Los Angeles-based St. John’s Well Child and Family Center lost $746,000, and the LGBT Life Center in Norfolk has lost over $962,000 and could potentially lose a whopping $6.3 million, which makes up 48% of their operating budget. Walls says it’s not just their treatment model that’s taken a hit—the center had to cancel 16 free mobile testing events in June alone, which she fears could cause many more people to contract the virus without knowing, contributing to its spread.
“When we’re out in the community in our mobile testing van, it’s super convenient for people. We’re parked there, they can just walk through, get their test and keep on going, and so that is a low-barrier way to test,” says Walls, who says that easy access is critical for low-income LGBTQ people of color. “[Without it], thousands of people that we test every month or every year are not going to be tested.”
The Vaccine Impact
DEI isn’t the only reason the government has given for HIV-related cuts. The Center for HIV/AIDS Vaccine Development (CHAVD), a consortium of researchers at Scripps Research and Duke University, was informed last month that, after seven years of funding from NIH, their grant would be terminated next year.
Dennis Burton, the program’s director, says they are close to a major breakthrough, with promising technology based on broadly neutralizing antibodies that can disable thousands of different strains of HIV being nearly ready for clinical trials in humans. But without NIH funding, the project may be unable to continue.
“It would put back the development of an HIV vaccine by a decade or longer,” Burton told Uncloseted Media. “We begin to see the light at the end of the tunnel … it’s just the wrong time to stop.”
A senior NIH official told the New York Times that “NIH expects to be shifting its focus toward using currently available approaches to eliminate HIV/AIDS.”
And while Burton says that existing HIV treatment medicine like antiretroviral therapies is “a miracle,” the decision to jettison vaccine research in its favor is misguided.
“The drugs are fantastic … but they’re expensive and people have to take them—the great thing about a good vaccine is that with one or a limited number of shots you can get lifelong prevention,” says Burton. “We want people to live without the fear of HIV, and vaccines are the proven way of preventing viral infections and viral disease.”
The Global Impact
The most sweeping cuts to HIV funding have been to foreign aid. On his first day in office, Trump ordered a 90-day freeze on all foreign aid funding as well as a stop-work order for PEPFAR. While Secretary of State Marco Rubio issued a waiver to continue some critical operations, department memos specifically prohibited funding for PrEP for all populations except pregnant and breastfeeding women.
This move, coupled with the dissolution of USAID and a proposal to cut an additional $1.9 billion from PEPFAR in the FY26 budget request compared to the prior year, has created a perfect storm with staggering results.
The PEPFAR Impact Tracker, a project by Boston University infectious disease modeler Brooke Nichols, estimates that over 60,000 adults and over 6,000 children have died due to PEPFAR-related disruptions between January 24 and June 17. And a survey conducted over the first week of the stop-work order found that 86% of PEPFAR recipient organizations reported that their patients would lose access to HIV treatment within the next month, more than 60% had already laid off staff, and 36% had to shut down their organizations.
The impact hits the hardest in sub-Saharan Africa, the region with the highest HIV concentration, accounting for an estimated 67% of HIV positive individuals globally as of 2021. Numerous long-running and influential LGBTQ health clinics in South Africa have been forced to close, and an investigation by The Independent found that communities in Uganda and Zimbabwe are rapidly being torn apart as more people risk death from lack of access to HIV treatment due to the cuts.
Numerous LGBTQ people told the Daily Sun, a South African digital newspaper, that the closure of long-running clinics like Engage Men’s Health in Johannesburg and Wits Reproductive Health and HIV Institute was devastating.
“I take PrEP, but you can’t go to any clinic as a queer person and ask for it without people looking at you weirdly,” one trans person told the Daily Sun. “At the trans clinic, it was different. Everything was smooth, everything flowed.”
The U.S. has historically been the biggest contributor to fighting HIV, accounting for more than 70% of international funding, but they’re not the only ones making cuts. Following Trump’s example, U.K. Prime Minister Keir Starmer announced 6 billion pounds in funding cuts to foreign aid, including HIV, and France and Germany also announced multi-billion euro cuts.
“HIV has received a lot more funding than any other health area,” says John Stover, vice president for modeling and analysis at Avenir Health. “So it’s a likely target just because the money is so large.”
Martin-Hughes of the Burnet Institute thinks these cuts are dangerous for the entire global health system. He co-authored a study modeling the potential impacts of HIV funding cuts from the major global funders, and the results are grim.
In the worst-case scenario, where PEPFAR is discontinued with no replacement or mitigation alongside the proposed cuts from the top five biggest-spending countries, the study projects that there could be nearly 11 million new infections and nearly 3 million deaths by 2030, which would raise the annual infection rate higher than its 3.3 million peak in 1995.
This is not necessarily the most likely scenario, as PEPFAR is expected to be reinstated in at least some form. However, even the most optimistic estimates show that substantial cuts like the one proposed in the Trump administration’s FY26 budget could still put an end to 15 years of declining infection and death rates—especially since prevention and testing would likely be sacrificed first.
“The world has made really amazing progress on HIV,” Martin-Hughes told Uncloseted Media. “That kind of increase [in infections and death rates would be] a major reversal.” He says that major foreign aid cuts would leave programs for at-risk populations, such as gay and bisexual men, trans women, sex workers and people who inject drugs, particularly vulnerable to being shut down.
Cuts to PEPFAR, a program started by Republican president George W. Bush in 2003, have been controversial even among Republicans, with Senate Appropriations Chair Susan Collins publicly opposing them. While many researchers and policymakers advocate for funding and leadership on HIV to shift away from foreign aid and more towards local governments, Stover and other experts argue that that transition can only be possible with support from PEPFAR in the interim.
“Overall, we all have a vision of more local ownership and control over the resources and how they’re allocated,” Stover says. “[But] it takes time to make this transition, so it’s gonna be practically impossible if funding is just cut off abruptly.”
Cuts on All Sides
Walls says cuts are also happening at the state level. Virginia’s Republican governor Glenn Youngkin slashed hundreds of thousands of dollars for HIV programs, and Walls’ center recently lost multiple corporate donors, including Target, due to pressure from the Trump administration to roll back their DEI efforts.
She says that the fear of backlash for supporting LGBTQ initiatives is so pervasive that even some of their continued donors are now requesting that their contributions remain anonymous.
“Now, if Target was to advertise that they were giving money to the LGBTQ community center in their neighborhood or city, they would have consequences from the administration or even shoppers,” she says. “They’re not gonna take that risk.”
Meanwhile, Walls says the LGBT Life Center is staying afloat thanks to the local community stepping up, with an unprecedented number of people signing up to be volunteers and local restaurants and other businesses providing their assistance, whether that’s by participating in citywide fundraising events or offering to help paint the clinic.
“It is amazing to see, and I know that through all of this the community will help carry us through, because we have brought value to this community for 36 years and I feel confident that people see value in our services,” she says.
Still, experts, advocates, and infectious disease modelers agree that if HIV funding doesn’t continue, the effects will be devastating.
“I think it’s hard for people to look at these numbers and not feel like it’s important to prioritize,” says Martin-Hughes. “There needs to be, to avert these worst-case scenarios, sufficient funding for those programs.”
This story was originally published in Uncloseted Media. For all their LGBTQ-focused journalism, consider becoming a free or paid subscriber at UnclosetedMedia.com.
The Booksmith recently posted a notice letting customers know that they would not be selling the series anymore in light of Rowling founding “an organization dedicated to removing transgender rights ‘in the workplace, in public life, and in protected female spaces.'”
“With this announcement, we’ve decided to stop carrying her books,” the store wrote. “We don’t know exactly what her her ‘women’s fund’ will entail, but we know that we aren’t going to be a part of it.”
Rowling said in May that she would be starting the “J.K. Rowling Women’s Fund” using her personal fortune. The website for the group states that it “offers legal funding support to individuals and organisations fighting to retain women’s sex-based rights in the workplace, in public life, and in protected female spaces.”
It is not the first time Rowling has used her over $1 billion net worth to influence legal cases involving so-called women’s sex-based rights — a dog whistle used by herself and other anti-trans activists to exclude trans people from public spaces and reduce women to their genitals.
Rowling donated £70,000 (roughly $88,200) to the anti-trans group For Women Scotland in 2024 after it lost its challenge to a 2018 Scottish law that legally recognized trans women as women. The group appealed its case to the U.K. Supreme Court, which ruled last month that trans women aren’t considered women under the nation’s Equality Act.
Rowling responded to the decision by posting a picture of her having a drink and smoking a cigar, with the text “I love it when a plan comes together.” The post was widely criticized, including by The Mandalorian and The Last of Us star Pedro Pascal, who called it serious “Voldemort villain s—” and referred to Rowling as a “heinous loser.”
The Booksmith included in its announcement a list of fantasy and young adult books to read instead of Harry Potter. It wrote, “As a group of queer booksellers, we also had our adolescents shaped by wizards and elves. Look at us, it’s obvious. If you or someone you love wants to dive into the world of Harry Potter, we suggest doing so by buying used copies of these books. Or, even better, please find below a list of bookseller-curated suggestions for books we genuinely love that also might fit the HP brief for you and yours.”
The Supreme Court on Friday granted the HIV-prevention field a historic win — yet with a major caveat — as it upheld a federally appointed health task force’s authority to mandate no-cost insurance coverage of certain preventive interventions, but clarifying that the health and human services secretary holds dominion over the panel.
The 6-3 decision in Kennedy v. Braidwood Management, Inc. essentially leaves in place a popular pillar of the Affordable Care Act, which mandates that most insurers cover various task force-recommended preventive screenings, therapies and interventions, with no out-of-pocket costs imposed on patients. The case reached the high court after a group of Christian businesses in Texas objected to being compelled to cover certain drugs used for HIV prevention, known as PrEP, given their claims that it “promotes homosexuality.”
“Since our efforts to address HIV in the U.S. are under attack on so many levels, preserving insurers’ requirement to cover preventive services, including PrEP, will help ensure access to people who need it,” said Carl Schmid, executive director of the HIV + Hepatitis Policy Institute, a patient advocacy group in Washington, D.C.
But the court clarified the scope of the task force’s independence, thus potentially compromising its impact. Addressing concerns that the 16-membervolunteer task force’s power over insurers was unconstitutional, the justices asserted that the health secretary holds the authority to appoint and dismiss the panelists and to block their new recommendations from mandating insurance coverage. The secretary could also possibly direct the panel, including one stocked with his or her own hand-picked members, to revisit previous recommendations that have already gone into effect.
Given the unpredictable nature and unconventional approach to health policy of the current health secretary, Robert F. Kennedy Jr., HIV advocates are concerned that he might undermine the task force’s current or future endorsements of HIV-prevention medications, known as PrEP.
The ruling “is a victory in the sense that it leaves intact the requirement to cover task-force recommendations,” said attorney Richard Hughes, a partner with Epstein Becker Green in Washington, D.C., who represented a group of HIV advocacy organizations in submitting a friend-of-the-court brief in the casel. “It was always going to be a double-edged sword, as the political accountability that salvaged its authority comes with the ability to alter its recommendations.”
The U.S. has secured only a modest decline recently in HIV cases, and HIV advocates stand at a crossroads amid the Trump administration’s dramatic withdrawal of support for their cause.
Promisingly, the Food and Drug Administration last week approved a long-acting injectable form of PrEP, Yeztugo, made by Gilead Sciences. Injected every six months, Yeztugo overwhelmingly bested Truvada, a daily-pill form of PrEP also made by Gilead, at lowering HIV transmissions in clinical trials.
But Yeztugo has debuted as the Trump administration is gutting the Centers for Disease Control and Prevention’s HIV-prevention division and after it canceledscores of HIV-related research grants.
The plaintiffs’ initial religious-liberty complaint was ultimately dropped from the case. The court more narrowly considered the constitutionality of an ACA provision that lent effective authority to a longstanding volunteer medical task force to mandate no-cost insurance coverage to preventive interventions that the expert group rated highly, including PrEP.
The plaintiffs argued that because the task force was not appointed by the president and confirmed by the Senate, granting it such power over insurance markets violated the Constitution’s appointments clause. The justices grappledwith the task force’s balance of independence versus accountability. In particular, they sought to determine whether the task force members were appointed by the Senate-confirmed Health and Human Services secretary.
In addition to PrEP, the task force has issued high scores, for example, to screening for lung cancer, diabetes, and HIV; treatment to help quit smoking; and behavioral counseling to prevent heart disease.
Had the Supreme Court fully sided with the plaintiffs, insurers would have been free to drop such popular benefits or, at the very least, to impose related co-pays and other cost sharing.
Writing for the majority, Justice Brett Kavanaugh found that the health secretary has the power “to appoint Task Force members, and no statute restricts their removal.” He was joined by an ideological mix of colleagues, including Chief Justice John Roberts and Justice Amy Coney Barrett on the right, and Justices Sonia Sotomayor, Elena Kagan and Ketanji Brown Jackson on the left.
Concerns and uncertainty about Kennedy
HIV advocates expressed concern that Kennedy might undo the task force’s recommendation for PrEP, or at the least deprioritize ensuring that Yeztugo receives a clear coverage mandate.
Earlier this month, Kennedy dismissed the entire CDC Advisory Committee on Immunization Practices, or ACIP, and replaced them with his own hand-picked selections, including one notable anti-vaccine activist. At the first meeting of the newly formed committee this week, ACIP dropped recommendations for some flu vaccines over claims, widely debunked by researchers, that one ingredient in them is tied to autism.
Mitchell Warren, executive director of the HIV advocacy nonprofit AVAC, expressed concern about “what happened with the CDC ACIP this week, as it could be a harbinger of what a secretary of HHS can do to twist committees and task forces that should be composed of experts guided by science to ones that are guided by ideology and politics.”
In an email to NBC News, Carmel Shachar, faculty director of the Health Law and Policy Clinic at Harvard Law School, characterized Kennedy’s potential approach to overseeing the health task force as unpredictable.
“RFK has been skeptical of the medical approach to HIV/AIDS in the past, and that may color his attitude to revising PrEP guidance,” Shachar said.
A spokesperson for HHS said in an emailed statement that Kennedy “supports science-based public health policy and remains fully committed to HIV prevention.”
“Under his leadership, critical HIV/AIDS programs will continue as part of the newly established Administration for a Healthy America (AHA),” the spokesperson added.
In 2019, the health task force granted Truvada as PrEP a top rating. The drug was already widely covered by insurers. But under ACA rules, the task force’s recommendation meant that by January 2021, insurance plans needed to cease imposing cost-sharing for the drug.
The Centers for Medicare and Medicaid Services, or CMS, then clarified that insurers were also forbidden to impose cost sharing for the quarterly clinic visits and lab tests required for a PrEP prescription.
A CDC study published in October found that about 200,000 people were using PrEP at any point in 2023.
In 2019, the FDA approved another Gilead daily pill, Descovy, for use as PrEP. In late 2021, ViiV Healthcare’s Apretude — an injection given every two months — was also green lit.
The health task force gave top ratings to both of the newer forms of PrEP in 2023, which triggered a mandate for no-cost coverage to begin in January.
A generic version of Truvada emerged in 2020 and now costs as little as $30 per month. The list prices of the three brand-name PrEP drugs range from about $2,200 to $2,350 a month.
How the court’s ruling could play out for HIV prevention
Were Kennedy to appoint task force members who ultimately voided the PrEP coverage mandate, generic Truvada, at the very least, would still likely remain widely covered by insurance. But insurers would be free to demand cost-sharing for all forms of PrEP, including for required clinic visits and lab tests. And they could restrict access to the more expensive versions, including by imposing prior authorization requirements and higher cost sharing.
Research suggests that even a small increase in monthly out-of-pocket costs for PrEP can depress its use and that those who accordingly forgo a prescription are especially likely to contract HIV.
Johanna Mercier, Gilead’s chief commercial officer, said even before the health task force’s 2023 insurance mandate for Descovy went into effect in January, the drug’s coverage was still pretty solid. Private insurers provided unrestricted coverage of Descovy for PrEP to 74% of commercially insured people, and 40% of prescriptions for the drug had no co-pay. After the mandate went into effect — including after CMS released a clarification on the PrEP-coverage mandate in October — those rates increased to 93% and 85%, respectively.
This experience, Mercier said, has left the company optimistic that an increasing proportion of health plans will cover Yeztugo during the coming months.
Health-policy experts are not certain whether the existing PrEP rating from the task force automatically applies to Yeztugo, or whether the drug will require its own rating to ensure coverage comes with no cost sharing.
If Apretude’s history is any guide, a requirement for Yeztugo to receive a specific rating could delay a no-cost insurance-coverage mandate for the drug from going into effect until January 2027 or 2028.
It’s also possible that CMS could release guidance clarifying that the existing mandate for PrEP coverage applies to Yeztugo, which would likely have a more immediate impact on coverage.
However, Elizabeth Kaplan, director of health care access at Harvard’s Health Law and Policy Clinic, said in an email that “given this administration’s and RFK’s stated priorities,” the publication of a guidance on Yeztugo coverage by an HHS division “appears unlikely.”
Voters in two states won by Donald Trump in last year’s presidential election have been revealed to watch gay porn much more often than the national average, according a study by Pornhub.
The porn site’s latest Pride Insights research revealed that North Dakota topped the charts in terms of hours of gay porn watched in the past year, with Wyoming not far behind. Both are notorious for implementing anti-LGBTQ+ legislation and both have Republican governors.
North Dakota’s proportion of gay porn fans seemingly exceeded the national average by 43 per cent, and Wyoming by 29 per cent. Other states with a higher-than-average interest included Vermont, Rhode Island and Pennsylvania.
The research gave an insight into the top states for gay porn viewership. (PornHub)
When it comes to top categories, Wyoming viewers were big fans of men with big…. well, you know! California, South Dakota, Alaska and Iowa residents had the same tastes. North Dakotans, meanwhile, much preferred twink porn as did people in Arizona, New Mexico and Oregon.
North Dakota, The Roughrider State, can crown itself king of the daddies, because more people there watched daddy porn than in any other state. Wyoming was the top state for military-related adult videos.
By way of comparison, Democratic strongholds Oregon and California had lower-than-average viewership figures, with -16 per cent and -4 per cent respectively. However, Delaware – also a “blue” state – was well above the average (+30 per cent), the figures showed.
Since 1989, the LGBT Life Center in Norfolk, VA has built up what CEO Stacie Walls calls a “test and treat” model. For every patient that walked through the doors of their HIV clinic after working up the courage to get tested, there had been the promise that, if they tested positive, all they’d need to do to get treatment is walk down the hallway.
But since the Trump administration’s sweeping cuts to HIV funding took place earlier this year, that’s no longer the case. “The grant money that pays for people who are uninsured is the grant money that they have canceled,” Walls told Uncloseted Media. “That’s so disheartening and scary and goes against everything that we’ve ever wanted to embrace as a nonprofit service agency.”
With these cuts, staff now have to send uninsured patients to the next nearest community HIV program in Hampton, a 30-minute drive away. Walls says they’ve already had to transfer 19 existing patients, including some of their frequent client base of low-income LGBTQ people of color, who are disproportionatelyimpacted by the virus. While the center has been able to shift to covering at least their initial treatment appointment, they are unable to cover further care, and Walls says that even this is not sustainable.
The LGBT Life Center in Norfolk, VA. Photo courtesy: Corey Mohr.
The LGBT Life Center is just one of the many U.S.-based HIV organizations and programs that have fallen victim to the billions of dollars worth of cuts by Trump and his newly created Department of Government Efficiency.
HIV funding has been hit particularly hard: Uncloseted Media estimates that the National Institutes of Health (NIH) has terminated more than $1 billion worth of grants to HIV-related research.¹ In addition, the U.S. Agency for International Development (USAID) has terminated 71% of all global HIV grants, and the President’s Emergency Plan for AIDS Relief (PEPFAR) has been the subject of temporary suspension and major proposed cuts.
Additional cuts are also on the horizon, with the Trump administration’s budget proposal for Fiscal Year (FY) 2026 calling for the closure of all Centers for Disease Control and Prevention (CDC) HIV programs.
The effects of these cuts are deadly. Researchers estimatethat PEPFAR’s funding freeze alone may already be associated with more than 60,000 deaths in sub-Saharan Africa, and numerous experts say that the entire global health system could be upended if the administration’s HIV cuts continue as planned. Mathematical models show that the worst-case scenario is apocalyptic: nearly 11 million deaths, 3 million new infections, and an infection rate outpacing the virus’s peak in the 1990s.
“This is not something that’s just a matter of the scientists losing funding; the community is losing funding, and in the long term, losing ground in the fight against HIV,” says Noam Ross, executive director at research nonprofit rOpenSci.
The Domestic Impact
Cuts to HIV funding in the U.S. have been a significant casualty of the Trump administration’s efforts to reduce spending and attack Diversity, Equity and Inclusion (DEI). Researchers behind Grant Watch, an independent third-party database of grants terminated by the NIH and the National Science Foundation, have identified HIV-related funding as one of the most common targets for termination. As of June 17, Uncloseted Media has calculated roughly $1.353 billion in HIV-related terminations in Grant Watch’s NIH database, accounting for more than a third of the $3.7 billion in recorded NIH cuts overall.
List of terminated HIV-related grants in Grant Watch’s database.
“They’re certainly casting an enormously wide net in this,” says Ross, who is also Grant Watch’s co-developer. “It doesn’t matter that they’re not explicitly saying that ‘it’s a war on HIV’ because if they’re gonna have a war on sexual minorities and transgender people, it’s a war on HIV too.”
The Department of Health and Human Services (HHS) has explicitly told HIV groups across the country that funding was cut because they believe health research for LGBTQ people and racial minorities is unscientific. Researchers across the country have received letters and emails from the NIH with nearly identical statements informing them of their grant terminations:
“Research programs based primarily on artificial and non-scientific categories, including amorphous equity objectives, are antithetical to the scientific inquiry, do nothing to expand our knowledge of living systems, provide low returns on investment, and ultimately do not enhance health, lengthen life, or reduce illness.”
One of the programs subjected to cuts is the Adolescent Medicine Trials Network (ATN), an HIV program that has been active since 2001. Its goal is to prevent, diagnose and treat HIV in young people.
Research under ATN’s umbrella has seen promising developments, including progress towards a product that could combine PrEP and birth control into one pill as well as new methods for reducing HIV transmission in young men who use stimulants. Despite this, NIH cut $15 million worth of grants to ATN because of its focus on high-risk LGBTQ youth populations. The program’s funds were later restored, but only after ATN agreed to cut off a study on transgender youth of color.
“There are particular issues around Black women, LGBTQ people, [and] the type of treatment that they need … that’s the social side of medicine, which is a very important part of medicine—it’s not just molecules, it’s people,” Ross says, adding that grantees focused on “delivery and participation and how to keep people in care,” such as programs that help vulnerable populations stay on PrEP or undetectable folks maintain their antiretroviral therapy regimen, are “very undervalued by [the] administration.”
“So that stuff feels like it’s faster to get canceled,” he says.
Rowan Martin-Hughes, senior research fellow at the Burnet Institute in Australia, says cutting programs that support prevention and long-term treatment is dangerous.
“With other infectious diseases, you treat people and then they’re recovered; with HIV, people require lifetime treatment,” he told Uncloseted Media. “Most of those people infected with HIV are still alive, and if you take treatment away from them, many people will die. And because treatment is also the best form of preventing transmission, many millions of additional infections will occur.”
Many advocates and lawmakers are pushing back against the cuts. Earlier this month, a federal judge in Boston ruled that the NIH’s DEI-related grant terminations—including many HIV programs—are illegally racist and discriminatory toward LGBTQ people, saying that in his four decades as a judge, he had “never seen a record where racial discrimination was so palpable.” HHS officials say they will consider an appeal.
NIH is far from the only agency issuing massive cuts to HIV. The CDC has terminated large grants to numerous HIV clinics across the country, including a $746,000 cut to Los Angeles-based St. John’s Well Child and Family Center and a whopping $6.3 million termination to the LGBT Life Center in Norfolk. Walls says it’s not just their treatment model that’s taken a hit—the center had to cancel 16 free mobile testing events in June alone, which she fears could cause many more people to contract the virus without knowing, contributing to its spread.
“When we’re out in the community in our mobile testing van, it’s super convenient for people. We’re parked there, they can just walk through, get their test and keep on going, and so that is a low-barrier way to test,” says Walls, who says that easy access is critical for low-income LGBTQ people of color. “[Without it], thousands of people that we test every month or every year are not going to be tested.”
The Vaccine Impact
DEI isn’t the only reason the government has given for HIV-related cuts. The Center for HIV/AIDS Vaccine Development (CHAVD), a consortium of researchers at Scripps Research and Duke University, was informed last month that, after seven years of funding from NIH, their grant would be terminated next year.
Dennis Burton, the program’s director, says they are close to a major breakthrough, with promising technology based on broadly neutralizing antibodies that can disable thousands of different strains of HIV being nearly ready for clinical trials in humans. But without NIH funding, the project may be unable to continue.
“It would put back the development of an HIV vaccine by a decade or longer,” Burton told Uncloseted Media. “We begin to see the light at the end of the tunnel … it’s just the wrong time to stop.”
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A senior NIH official told the New York Times that “NIH expects to be shifting its focus toward using currently available approaches to eliminate HIV/AIDS.”
And while Burton says that existing HIV treatment medicine like antiretroviral therapies is “a miracle,” the decision to jettison vaccine research in its favor is misguided.
“The drugs are fantastic … but they’re expensive and people have to take them—the great thing about a good vaccine is that with one or a limited number of shots you can get lifelong prevention,” says Burton. “We want people to live without the fear of HIV, and vaccines are the proven way of preventing viral infections and viral disease.”
The Global Impact
The most sweeping cuts to HIV funding have been to foreign aid. On his first day in office, Trump ordered a 90-day freeze on all foreign aid funding as well as a stop-work order for PEPFAR. While Secretary of State Marco Rubio issued a waiver to continue some critical operations, department memos specifically prohibited funding for PrEP for all populations except pregnant and breastfeeding women.
Photo: Screenshot/ DW News
This move, coupled with the dissolution of USAID and a proposal to cut an additional $1.9 billion from PEPFAR in the FY26 budget request compared to the prior year, has created a perfect storm with staggering results.
The PEPFAR Impact Tracker, a project by Boston University infectious disease modeler Brooke Nichols, estimates that over 60,000 adults and over 6,000 children have died due to PEPFAR-related disruptions between January 24 and June 17. And a survey conducted over the first week of the stop-work order found that 86% of PEPFAR recipient organizations reported that their patients would lose access to HIV treatment within the next month, more than 60% had already laid off staff, and 36% had to shut down their organizations.
The impact hits the hardest in sub-Saharan Africa, the region with the highest HIV concentration, accounting for an estimated 67% of HIV positive individuals globally as of 2021. Numerous long-running and influential LGBTQ health clinics in South Africa have been forced to close, and an investigation by The Independent found that communities in Uganda and Zimbabwe are rapidly being torn apart as more people risk death from lack of access to HIV treatment due to the cuts.
Numerous LGBTQ people told the Daily Sun, a South African digital newspaper, that the closure of long-running clinics like Engage Men’s Health in Johannesburg and Wits Reproductive Health and HIV Institute was devastating.
“I take PrEP, but you can’t go to any clinic as a queer person and ask for it without people looking at you weirdly,” one trans person told the Daily Sun. “At the trans clinic, it was different. Everything was smooth, everything flowed.”
The U.S. has historically been the biggest contributor to fighting HIV, accounting for more than 70% of international funding, but they’re not the only ones making cuts. Following Trump’s example, U.K. Prime Minister Keir Starmer announced 6 billion pounds in funding cuts to foreign aid, including HIV, and France and Germany also announced multi-billion euro cuts.
“HIV has received a lot more funding than any other health area,” says John Stover, vice president for modeling and analysis at Avenir Health. “So it’s a likely target just because the money is so large.”
Martin-Hughes of the Burnet Institute thinks these cuts are dangerous for the entire global health system. He co-authored a study modeling the potential impacts of HIV funding cuts from the major global funders, and the results are grim.
In the worst-case scenario, where PEPFAR is discontinued with no replacement or mitigation alongside the proposed cuts from the top five biggest-spending countries, the study projects that there could be nearly 11 million new infections and nearly 3 million deaths by 2030, which would raise the annual infection rate higher than its 3.3 million peak in 1995.
This is not necessarily the most likely scenario, as PEPFAR is expected to be reinstated in at least some form. However, even the most optimistic estimates show that substantial cuts like the one proposed in the Trump administration’s FY26 budget could still put an end to 15 years of declining infection and death rates—especially since prevention and testing would likely be sacrificed first.
“The world has made really amazing progress on HIV,” Martin-Hughes told Uncloseted Media. “That kind of increase [in infections and death rates would be] a major reversal.” He says that major foreign aid cuts would leave programs for at-risk populations, such as gay and bisexual men, trans women, sex workers and people who inject drugs, particularly vulnerable to being shut down.
Cuts to PEPFAR, a program started by Republican president George W. Bush in 2003, have been controversial even among Republicans, with Senate Appropriations Chair Susan Collins publicly opposing them. While many researchers and policymakers advocate for funding and leadership on HIV to shift away from foreign aid and more towards local governments, Stover and other experts argue that that transition can only be possible with support from PEPFAR in the interim.
“Overall, we all have a vision of more local ownership and control over the resources and how they’re allocated,” Stover says. “[But] it takes time to make this transition, so it’s gonna be practically impossible if funding is just cut off abruptly.”
Cuts on All Sides
Walls says cuts are also happening at the state level. Virginia’s Republican governor Glenn Youngkin slashed hundreds of thousands of dollars for HIV programs, and Walls’ center recently lost multiple corporate donors, including Target, due to pressure from the Trump administration to roll back their DEI efforts.
She says that the fear of backlash for supporting LGBTQ initiatives is so pervasive that even some of their continued donors are now requesting that their contributions remain anonymous.
“Now, if Target was to advertise that they were giving money to the LGBTQ community center in their neighborhood or city, they would have consequences from the administration or even shoppers,” she says. “They’re not gonna take that risk.”
Meanwhile, Walls says the LGBT Life Center is staying afloat thanks to the local community stepping up, with an unprecedented number of people signing up to be volunteers and local restaurants and other businesses providing their assistance, whether that’s by participating in citywide fundraising events or offering to help paint the clinic.
“It is amazing to see, and I know that through all of this the community will help carry us through, because we have brought value to this community for 36 years and I feel confident that people see value in our services,” she says.
Still, experts, advocates and infectious disease modelers agree if HIV funding doesn’t continue, the effects will be devastating.
“I think it’s hard for people to look at these numbers and not feel like it’s important to prioritize,” says Martin-Hughes. “There needs to be, to avert these worst-case scenarios, sufficient funding for those programs.”
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JD Vance has become the most blocked account on Bluesky just two days after joining the social media platform.
The vice president signed up for the site, a competitor of X/Twitter, on Wednesday. Vance used his first post to mock transgender people by sharing part of Supreme Court Justice Clarence Thomas’ opinion in U.S. v. Skrmetti, in which he incorrectly said that gender-affirming care relies on “questionable evidence.”
“Hello Bluesky, I’ve been told this app has become the place to go for common sense political discussion and analysis,” Vance wrote. “So I’m thrilled to be here to engage with all of you.”
Within just one day, Vance became the most blocked account on Bluesky, according to Clearsky, the platform’s unofficial data tracker. As of publishing, Vance has been blocked by over 117,500 accounts, more than 29,000 of which blocked him in the past 24 hours. He has only gained 10,000 followers since joining the site.
The title formerly belonged to anti-trans journalist Jesse Singal, whom GLAAD has criticized for spreading misinformation harmful to LGBTQ+ people. It took 12 days for Singal to become the most blocked account, with users even starting a petition asking the site to remove his account. He is currently blocked by over 81,000 people.
“The only thing I’ve ever accomplished in my life, gone, all because being vice president wasn’t enough for JD Vance — he needed more,” Singal recently posted on X/Twitter in response to the news. “We are in hell.”
The U.S. Supreme Court ruled 6-3 Wednesday that Tennessee‘s law banning gender-affirming care for trans youth – while allowing the same treatments for youth who aren’t trans – does not constitute sex-based discrimination, and therefore does not violate the Equal Protection Clause of the 14th Amendment.
In the snippet of his opinion shared by Vance, Thomas asserted that the Court should not listen to “so-called experts,” accusing medical professionals of allowing “ideology to influence their medical guidance.” He then falsely claimed that “there is no medical consensus on how best to treat gender dysphoria in children.”
Justice Sonia Sotomayor argued in her dissenting opinion that the law explicitly discriminates on the basis of both sex and gender, as it “expressly classifies on the basis of sex and transgender status,” since “male (but not female) adolescents can receive medicines that help them look like boys, and female (but not male) adolescents can receive medicines that help them look like girls.”
The decision “does irrevocable damage to the Equal Protection Clause and invites legislatures to engage in discrimination by hiding blatant sex classifications in plain sight,” Sotomayor wrote. “It also authorizes, without second thought, untold harm to transgender children and the parents and families who love them. Because there is no constitutional justification for that result, I dissent.”
Back on Bluesky, Vance was met with , with one person asking, “Why pick such a polarizing issue if you want to have a real discussion, and why not something relevant to more Americans?”
To which another replied, “It’s only a polarizing issue because ignorant bigoted child abusing superstitious sadists like Vance want to pretend that they know more than doctors.”
Earlier this month, the Defense Department told transgender service members that they had to choose whether they would voluntarily or involuntarily separate from the military.
Four trans service members who are now in the process of separating said nothing about their decisions feels voluntary at all.
“Nobody feels like this is voluntary,” said Emily Shilling, a commander in the Navy and the president of SPARTA, a nonprofit group that advocates for trans service members. “This is coercion. This is under duress.”
President Donald Trump signed an executive order a week into his administration prohibiting trans people from enlisting or serving in the military. Trans service members sued, and a federal judge temporarily blocked the order from taking effect. Then, last month, the Supreme Court allowed the Trump administration to enforce the order. Days later, the Defense Department issued guidance requiring active duty service members to voluntarily self-identify as having been diagnosed with gender dysphoria, which is the distress that results from a misalignment between one’s birth sex and gender identity, by June 6 and reserve service members to self-identify by July 7.
After that, the guidance said, the military will find trans service members who didn’t self-identify through medical readiness programs and begin involuntarily separating them. Affected service members “are eligible for an array of benefits,” the guidance said, including separation pay, “which will be higher for those who self-identify and agree to a voluntary separation.”
However, many details are still unknown, such as what benefits trans service members will be able to access and whether they will all receive honorable discharges. It’s also unclear how many service members will be affected. Just over 4,000 transgender people currently serve in the military, according to Defense Department data, and the department said last month that about 1,000 trans service members have begun the separation process from the military after voluntarily identifying themselves. The department said Tuesday that it does not have an updated number of affected service members.
“Characterization of service will be honorable except where the Service member’s record otherwise warrants a lower characterization,” a U.S. Defense official said in a statement to NBC News. “Military Services will follow normal processes for administrative separation.”
The four trans service members who spoke to NBC News all emphasized that they are speaking in their personal capacity and not on behalf of their respective branches. The biggest question they all face is what comes next.
Bree Fram
On June 30, 2016, the day then-Defense Secretary Ash Carter announced that transgender people could serve openly in the military, Bree Fram, who was then a major in the Air Force, came out to her teammates in an email as a trans woman and then went to burn off her nerves at the gym.
Col. Bree Fram served for 22 years and said she planned to serve “for many years to come” because she loved her job.Courtesy Bree Fram
When she returned to her desk later, she said her colleagues approached her one by one, shook her hand, and told her a version of “It’s an honor to serve with you.”
Fram, who is 46 and now a colonel for the U.S. Space Force at the Pentagon, said that scene repeated earlier this month with leaders from other branches of the military when she told them it would be her last meeting with them. An officer sitting next to her asked where she was going, and she said, “I’m being placed on administrative leave because I don’t meet this administration’s standards for military excellence and readiness.”
Fram said there was a moment of silence before it seemed like her colleagues realized which policy she was referring to — because, she said, trans service members don’t “walk into a room and lead with our identity.”
“I walk into a room and someone sees a colonel, and they see the uniform, and they see all the things that represents about my experience and my expertise,” said Fram, who is one of the highest-ranking out trans officials in the military.
Then, Fram said her colleagues walked over, one by one, and shook her hand and said, again, that it had been an honor to serve with her.
Fram, who served for 22 years until she was placed on administrative leave on June 6, was the director of requirements integration for the Space Force. She helped to identify future technological capabilities the military will need and provided those to developers who built them. She said she planned to serve “for many years to come,” because she loved her job and the team that she worked with.
Fram said she doesn’t know what she’ll do next, but she expects she’ll work in public service.
“I believe in this country, even though it may not believe in me right now,” Fram said. “The oath I swore and the ideals that are embedded in the Constitution still matter to me, and I believe they are worth fighting for.”
Sam Rodriguez
Sam Rodriguez, 38, was recently commissioned as a Medical Service Corps officer in the Navy and was supposed to begin officer training school and then a two-year clinical fellowship in San Diego to become a licensed clinical social worker. However, about a week after the Supreme Court decision allowing the trans military ban to take effect, Rodriguez, who uses they/them pronouns, said the Navy canceled those orders.
Lt. Junior Grade Sam Rodriguez, left, with Lt. Rae Timberlake, center, and Parker Moore, an electronics technician in nuclear power, right. All three of them are trans and nonbinary service members in the Navy.Courtesy Sam Rodriguez
“It was really gut-wrenching to receive that news,” Rodriguez said. They enlisted in 2015 and planned to serve for 15 or 20 years, when they would’ve left the Navy as an experienced licensed social worker. However, now they will leave with their master’s degree in social work, and they will have to look for an employer who is willing to provide supervision for them to receive their clinical license, which will be more difficult.
They submitted their resignation earlier this month and requested a separation date in the fall. They said they don’t think they’ll be able to find an entry-level job as a civilian that’s going to match their current salary, housing allowance, health care benefits and the stipend that they and their wife get to pay for child care for their two children.
They plan to move their family from San Diego to Washington, D.C., so they can become more involved in policy advocacy. Outside of work, they are a board member and membership director for SPARTA.
“People need to realize that this is a national security issue,” Rodriguez said, pointing to research from the Modern Military Association of America, an advocacy group for LGBTQ military members and veterans, which found that 73% of trans service members have between 12 and 21 years of experience.
“We’re not going to be one-for-one swapped tomorrow, and some people it will take two decades to replace,” they said.
Emily Shilling
Shilling, 42, is the highest-ranking out trans person in the Navy after having served for nearly two decades, including in over 60 combat missions in Iraq and Afghanistan. She was also one of the lead plaintiffs in a lawsuit against the administration’s ban.
After Trump was elected, she requested to retire in the fall. Her intention was to rescind that retirement because she expected that the ban on trans troops serving would be blocked, but with the policy taking effect, her last day was June 12, and she will officially retire in September.
Emily Shilling is the highest-ranking out trans person in the Navy.Leah Millis / Reuters
“I am deeply heartbroken that this is how my career has ended, but also deeply proud of what I’ve done,” Shilling said. “I lived my dream. I did everything I ever wanted to in the Navy and I did it honorably, and I stood proud. I might be getting out of the Navy, but it’s not me quitting this fight. I’m just choosing to take on this fight in a different way.”
Shilling said the Navy invested $40 million in training her, and as a result she has many desirable skills and has already accepted an offer to work in defense technologies and advanced development. However, she said her story is rare among trans service members, thousands of whom will be looking for private sector jobs for the first time.
Shilling said the lawsuit against the ban will return to the 9th Circuit Court of Appeals for a hearing in October, but by that time, most trans service members will be out of the military.
“The irreparable harm is done now,” she said.
Alex Shaffer
Alex Shaffer, 48, joined the military as a combat medic in the Oregon Army National Guard in 2007. His mentors in the guard convinced him to go to school to become a physician’s assistant, and he now also works in a private family practice as a PA.
Alex Shaffer, center, with two of the soldiers who are part of the platoon he oversaw.Courtesy Alex Shaffer
“In all of the military, it’s a family,” Shaffer said of what he’s enjoyed about serving in the guard.
Shaffer said he planned to stay in the guard “until I could no longer physically serve or they kicked me out for being too old.” He was in the process of trying to commission as an officer. However, his last drill was June 7, because he began the process to medically separate from the National Guard as a result of the ban. (The National Guard only provides retirement benefits to service members if a medical evaluation board deems them physically unfit for duty.)
“I’m devastated,” Shaffer said. “It’s a loss of identity to me. I’ve been a soldier for so long, and it’s a part of who I am.”
Over the past five years, corporate America has abandoned diversity, equity and inclusion (DEI) practices en masse, with the crusade to roll back these efforts only ramping up since Trump’s reelection.
While it may seem like there are many forces behind these proposals, they were all submitted by the National Center for Public Policy Research, a conservative think tank commonly referred to as the National Center.
Although not very well known, they are effective: Since receiving their proposals, half of the companies listed above have watered down or abandoned their DEI practices, with Apple, JPMorganChase, Costco, Kroger and Coca-Cola standing firm.
And although the National Center has been trying to dismantle DEI for nearly two decades, they’re experiencing enormous success today due to the rise of the conservative crusade against “woke capitalism” and so-called “viewpoint discrimination.”
Jason Stahl, a historian and researcher specializing in right-wing think tanks and populism in the U.S., says the National Center’s newfound success reflects a renewed desire for socially conservative populist movements. “Think tanks prime themselves to respond to the American political culture in a populist way and to present themselves as for the people.”
“We’ve got Flint, Michigan without clean drinking water, we’ve got the flooding that occurred in Appalachia and North Carolina, we’ve got the fires in California and in Hawaii. Why aren’t we talking about all this?” he says. “Politics should be about the improvement of people’s lives,” but dominant powers in the U.S., including the National Center, want people to be fighting over DEI—a debate that detracts “from the material reality of people’s lives.”
How the National Center Is so Effective
Through shareholder proposals, the National Center—along with anyone who owns a high enough stake in a publicly traded company—can attempt to influence its governance.
In their proposal to Apple, the National Center submitted a “Request to Cease DEI Efforts,” writing, “Apple likely has over 50,000 [employees] who are potentially victims of this type of discrimination.” In their proposal to Alphabet, Google’s parent company, they came after the Human Rights Campaign’s (HRC) Corporate Equality Index (CEI), calling it “hyper-partisan, divisive and increasingly radical.” Their supporting statement included disinformation about transgender people, claiming the HRC uses the CEI “to force [corporations] to do the political bidding of radical activists, which seek to sow gender confusion in youth, encourage permanent surgical procedures on confused and vulnerable teens, and effectively eliminate girls’ and women’s sports and bathrooms.”
And in their proposal to Goldman Sachs, they requested a “Racial Discrimination Audit,” citing a Supreme Court case that alleged Harvard University’s affirmative action policies discriminated against white students.
While the Goldman proposal failed, with just 2% of shares voting in its favor, the company still dropped their diversity and inclusion policies. But even these losses are often considered wins by the National Center, who have said that “the true aim of these proposals is to negotiate with companies and convince them to amend their equal employment opportunity policies to add protections against viewpoint discrimination.”
R.G. Cravens, a senior research analyst at the Southern Poverty Law Center, says the anti-DEI movement is part of a bigger campaign to maintain the status quo in corporate America. “A lot of the rhetoric the hard right uses to describe DEI is based on racist and white supremacist narratives about people of color. For example, saying that DEI means unqualified people get jobs, they mean people of color who aren’t qualified to hold positions,” he says. “DEI policies are designed to interrupt systemic inequalities, and they do a lot beyond just what the hard right tends to caricature them as doing.”
In principle, DEI is meant to close wage and opportunity gaps in the workforce. LGBTQ workers earn 90 cents to every dollar earned by the average American worker, and women make 85 cents to every dollar earned by men. Meanwhile, Black and Latino workers make 24% and 28% less than white workers, respectively. Trans women, who are the most demonized in the crusade against DEI, earn just 60 cents on the dollar compared to the typical American worker.
Mary Wrenn, a professor of economics specializing in capitalism and neoliberalism at the University of Cambridge, says the crusade against DEI uses a similar strategy to that used against the civil rights movement of the 1960s. “There were a lot of economists and politicians who said that we should not force desegregation because the free market will take care of it. Of course that’s not true: We had to have legislation in order for the cultural and social spheres to catch up.”
The National Center’s Free Enterprise Project and the Rise of Stefan Padfield
While the anti-DEI movement has only gained momentum in the last few years, the National Center has been around since 1982, when Amy Moritz Ridenour, a former campaign coordinator for Ronald Reagan, founded it.
In the 1990s, they successfully campaigned against the Clinton healthcare plan that would have provided universal healthcare to all Americans. Throughout the early 2000s, they campaigned to limit the amount that businesses which knowingly sold deadly asbestos products must pay in compensation to victims.
One of the National Center’s major initiatives is the Free Enterprise Project (FEP). Launched in 2007, they claim the FEP is “the original and premier opponent of the woke takeover of American corporate life and defender of true capitalism.”
Through the years, the FEP has campaigned against attacks on conservatives, pharmaceutical company support for the Affordable Care Act, and government initiatives to cap corporate carbon dioxide emissions.
But in recent years, the FEP’s focus has been to use shareholder activism to force a shift in corporate America. In 2021, they launched the Stop Corporate Tyranny coalition, which aims to “[expose] the Left’s nearly completed takeover of corporate America” and provide “resources and tools for everyday Americans to fight back against the Left’s woke and censoring mob in the corporate [world].”
The National Center’s funders include anti-LGBTQ hate groups like the Alliance Defending Freedom; religious donor-advised funds like National Christian Foundation; mainstream charitable funds like Fidelity, Schwab and Vanguard Charitable; and corporations such as ExxonMobil.
“Free enterprise is just a mask for social conservatism because they want small government, but only with respect to business—they don’t want it with respect to people’s lives,” Wrenn told Uncloseted Media. “It’s about controlling the cultural conversation and our social norms, and that’s very tied up with white supremacy, patriarchy and capitalism as an economic means by which to forward their personal agendas,” says Wrenn.
Stahl says President Trump’s positioning as a right-wing populist plays well into the National Center’s strategy. “They’re populist projects that say the liberals are out of touch and against your values. Over the decades, the messaging is the same but different issues get plugged in and we’re seeing this really come to its full flowering because [of] Trump,” he told Uncloseted Media.
In 2023,Stefan Padfield joined the FEP, quickly becoming the deputy director. The following year, the project convinced the U.S. Court of Appeals to overturn a Nasdaq board diversity rule that had required any Nasdaq-listed companies have—or explain why they don’t have—at least two “diverse” directors, including at least one woman and at least one other person who identifies as an underrepresented minority.
Padfield has also penned articles for RealClearMarkets, such as “A Question for Goldman Sachs: What Is a Woman?” in which he claims, “Transgenderism is one of the most divisive issues today,” reducing trans women to men who “become [women] simply by saying so.”
In an email to Uncloseted Media, Padfield says he has “no disdain for trans people or the wider LGBTQ community.” He says he wants to see all people have equal opportunities for maximum flourishing. “Having said that, if someone claims, for example, that they need to be permitted to surgically mutilate minors behind the backs of their parents in order to feel affirmed in their belief that children can be born in the wrong body, then I will be on the side of those defending those children.¹”
The Belief That America Should Be Governed as a Christian Theocracy
The National Center’s mission is reflective of a larger network of conservatives who claim to be protecting so-called viewpoint diversity. Last year, they launched an app to help shareholders identify conservative proposals that would help “hold woke corporations accountable.” The app also provided users with “neutrality v. wokeness” ratings of certain companies.
Cravens says that “viewpoint discrimination” has replaced “political correctness” as conservative buzzwords. “It’s this innocuous-sounding phrase like ‘We need to protect First Amendment speech and maintain pluralism’ … [this false notion] that conservatives and people who oppose anti-racist policies and LGBTQ-inclusive policies are discriminated against. But that is so reductionist because it ignores how white people have claimed and maintained power against communities of color through wealth inequality, racist corporate policies and banking practices,” he says.
He says there’s a rhetorical connection shared across these groups that Christian supremacists have been using for decades. “You say you’re concerned about children and trying to strengthen the family—that’s a totally different kind of marketing than ‘We are evangelicals and we’re here to take over.’ It’s been described as a stealth communication strategy to articulate the same message in secular terms in an effort to reach all Americans.”
What This Means for LGBTQ People
The National Center’s successes have a very real impact on LGBTQ communities. “I think they risk losing their jobs ultimately,” says Cravens. “One of the goals is to drive queer people back into a closet and dismantle any notion that it’s okay to be [openly] queer. They want to turn a group of people toxic so they won’t get service, they won’t get jobs and they won’t be part of society anymore.”
While powerful institutions try to sow division, advocates say it’s critical the LGBTQ community works together to push back against organizations like the National Center.
“It’s always been a minefield,” says Ben Greene, a transgender inclusion consultant and author of Good Queer News.
Greene urges LGBTQ people to stick together. “[We] are going to be our best antidote to [DEI setbacks]. ‘You had a bad experience?’ That needs to go on Glassdoor or your local LGBTQ social media page.” It is going to be an increasingly hard time but there is incredible solidarity between the LGBTQ community and other marginalized groups. “We can’t write off those little moments because that is what will get us out of this,” he says.
Cravens underscores the need for corporate America to have a backbone to push back against organizations like the National Center in an effort to create fair and inclusive workplaces. “A lot of companies advise against anti-DEI shareholder proposals already because they know it’s irresponsible and unprofitable to try to turn back the clock on civil rights. … They should recognize that there is value in diversity and vote down these policies inspired by hateful ideologies.”
