As use of PrEP continues to grow, epidemiological evidence is starting to show a link between increased use and declines in new HIV infections. A study presented at the International AIDS Conference in Amsterdam shows an association between higher PrEP use and lower HIV incidence in the U.S. These figures highlight ongoing disparities in PrEP use, with some of the groups who need effective HIV prevention being the least likely to use it.
The Food and Drug Administration approved Truvada (tenofovir/emtricitabine) for HIV prevention in July 2012. For the past several years Gilead Sciences has been reporting PrEP use estimates from an ongoing survey of Truvada prescriptions at retail pharmacies.
Data from January 2012 through December 2017 show that the total number of people who have ever started PrEP exceeded 177,000. But PrEP still is only reaching a small proportion of those who might benefit. The Centers for Disease Control and Prevention (CDC) estimates that less than 10% of the nearly 1.5 million people at substantial risk for HIV infection are using it.
PrEP and new HIV diagnoses
Is increasing use of PrEP leading to a decline in new HIV infections? Trends in cities with high PrEP use suggest this may be the case.
In San Francisco, HIV incidence has declined steeply since the widespread adoption of PrEP in 2013, reaching its lowest-ever level in 2016. Dramatic declines in new infections among gay men have also been reported in London and Sydney. But stepped up HIV testing and the “treatment as prevention” effect of starting antiretroviral therapy immediately after diagnosis makes it hard to tease out the contribution of PrEP.
Patrick Sullivan from Emory University’s Rollins School of Public Health in Atlanta and colleagues from Gilead and the Centers of Disease Control and Prevention (CDC) looked at the correlation between PrEP use and new HIV diagnoses, using data from people age 13 and older in all 50 states and Washington, D.C., between 2012 and 2016.
A pharmacy survey examined a representative sample of anonymous prescription data from more than 80% of retail pharmacies in the United States, including independent pharmacies, chain stores, mail-order pharmacies and clinics. It did not include military or university health services or independent closed health systems like Kaiser Permanente.
Nationwide, the overall HIV diagnosis rate decreased significantly, from 15.7 per 100,000 persons in 2012 to 14.5 per 100,000 in 2016, an estimated annual decline of -1.6% per year. During the same period, PrEP use increased from 7.0 per 1,000 eligible individuals to 68.5 per 1,000, an estimated annual increase of +78.0%.
But there were some notable differences between states. The quintile or fifth of states with the highest PrEP use (11.0% of eligible individuals) saw a -4.7% decline in new HIV diagnoses. In contrast, new diagnoses actually increased by +0.9% in the quintile with the lowest PrEP use (3.5% of eligible individuals).
Estimated annual percent change in HIV diagnoses by U.S. states’ PrEP use, Slide: Patrick Sullivan
In an attempt to tease out the effect of PrEP versus treatment as prevention, the researchers also looked at viral load data from a subset of states, finding that PrEP use remained significantly associated with declines in new HIV diagnoses after controlling for levels of viral suppression.
“By documenting significant declines in average new cases of HIV in states where Truvada for PrEP has been most widely adopted, our analysis emphasizes the importance of improving access to HIV screening and a full range of prevention tools, including PrEP, in U.S. states,” Sullivan said in a Gilead press release about the study.
PrEP use among teens
Gilead researchers also did an analysis of PrEP use among young people, a group with a high unmet need for HIV prevention. In 2016, youth ages 13 to 24 accounted for 21% of new HIV diagnoses, according to the CDC. More than 80% of these were among young gay and bisexual men, with more than half among young black gay men.
The latest pharmacy survey numbers indicate that 15.4% of PrEP users are under age 25, with only 1.5% of them being 17 or younger.
People ages 12 to 24 accounted for 17.0% of all PrEP users in 2012. The proportion declined a bit during 2014-2016, as PrEP use skyrocketed among older gay and bi men, but then rose back to about the same level in 2017.
Breaking down the age distribution further, adolescents age 12 to 17 accounted for around 20% of PrEP prescriptions among people under 25 in 2012 and 2013. But, for unexplained reasons, both the proportion and the absolute number then started to fall, plummeting to 3.9% in 2016 and 2017.
In the early years of the survey, before gay men started promoting PrEP within their communities, a large proportion of PrEP users were women. In part, this reflected the use of PrEP to prevent HIV transmission within serodiscordant couples who were trying to conceive.
Today, the youngest PrEP users are still predominately girls and young women. Although women account for about 18% of PrEP users overall, they make up more than 80% of those age 17 and under. This disparity suggests that awareness of the need for HIV prevention, or willingness of providers to prescribe it, is greater for young women than for young men.
Adolescents ages 12 to 17 received Truvada for PrEP mostly from pediatricians, while family practice and internal medicine doctors provided most prescriptions for those 18 and older. A majority (59%) of PrEP users in the 17 and under age group received coverage through Medicaid, compared with 22% of those ages 18 to 24 and 13% of older adults. Nearly a third of those ages 18 to 24 and 38% of older adults obtained PrEP through commercial insurance.
Based on these findings, the researchers concluded, “there remains an important unmet need to improve awareness and engagement in HIV prevention for adolescents and young adults at risk for HIV.”
An estimated 78,000 transgender Americans may be barred from voting in the upcoming US elections due to strict voter ID laws, according to a new report.
Eight states require voters to provide a government-issued photo ID at polling places, where officials decide whether the ID photo matches their registration information.The rules could prevent trans people from voting in Alabama, Georgia, Indiana, Kansas, Mississippi, Tennessee, Virginia and Wisconsin.
According to the report, there is “no way to predict precisely how election officials and poll workers will treat transgender voters” at the polls if they present identification that does not accurately reflect their gender.
Across these eight states, 57 percent of the transgender voting-eligible population may have no identification or records that accurately reflect their gender, the report data suggests.
“Voter ID laws create a unique barrier for transgender people who would otherwise be eligible to vote. Many transgender people who have transitioned do not have identification documents that accurately reflect their correct gender,” the report authors state.
“In the November 2018 general election, strict photo ID laws may create substantial barriers to voting and possible disenfranchisement for over 78,000 transgender people in eight states.”
The institute, who has monitored the impact of these laws in previous elections, said this estimate is higher than in the past due to increase availability of “better data on the status of names and gender markers among transgender people.”
The report also highlights that trans people of colour, young adults, students, people with low incomes and people with disabilities are likely to be among those facing barriers.
“Some voters may not have the means or the ability to obtain the required voter identification for a variety of reasons, such as poverty, disability, or religious objection,” researchers add.
The report, which uses data from the 2015 US Transgender Survey by the National Centre for Transgender Equality, found 32 percent of survey respondents reporting having negative experiences after presenting ID that did not match their gender identity.
Trans voters said they were verbally harassed, denied services or asked to leave the polling area, with some reporting being attacked or assaulted.
The William Institute report also used data from the 2017 Current Population Survey (CPS), conducted by the US Census Bureau and the Bureau of Labour Statistics.
The international telecommunications company Verizon presented a check on Monday for $250,000 to PFLAG, which advocates for families and allies of LGBT people, at the group’s headquarters in Washington.
PFLAG said in a statement that the donation came at the conclusion of a month-long campaign by Verizon in support of PFLAG that included the release of a moving video available for broadcast that captures LGBT young people coming out to their parents.
“We are proud to support PFLAG in their important work in helping unite LGBTQ individuals and their families,” said Mario Acosta-Velez, Verizon’s Director of State Government Affairs and National President of GLOBE of Verizon, an LGBT employee resource group.
“This contribution is the latest demonstration of our longstanding commitment to support the LGBTQ community and equality,” Acosta-Velez said.
“PFLAG has been providing support to LGBTQ people and their families and allies for 45 years,” the group said in its statement released on Monday. “The PFLAG chapter network – currently 400+ chapters strong and growing every year – covers the entire United States, including Washington, D.C. and Puerto Rico, and recently added a chapter on a military base in Germany,” the group said.
“Thanks to Verizon’s generosity, we will grow and strengthen the PFLAG chapter network, connect and keep families together, further family acceptance and ally activation, and reinforce our chapters’ ability to be a powerful source of peer-to-peer support, education, and advocacy in their communities,” said Jean Hodges, president of the PFLAG National Board of Directors.
“We are grateful for Verizon’s generosity in continuing the next 45 years of PFLAG’s work,” Hodges said.
“I think that as we have seen in the news a growing presence of ICE in communities—despite San Francisco’s status as a sanctuary city—we are also seeing a growing trepidation and hesitation as people are seeking care,” said Liliana Schmitt, recruitment and retention coordinator for Clínica Esperanza at Mission Neighborhood Health Center.
Schmitt, who works with new clients at the clinic, said there are a variety of barriers that people from other countries seeking HIV care may face, but that clinic staff focus on making entry and retention in HIV care as easy as possible.
“We work with clients to figure out how to document things like identity, proof of income, residency, and insurance status—which can be difficult for many of our clients. Luckily, we have a lot of ways we can qualify that documentation. We don’t need official pay stubs, or an official lease or utility bill, for instance.”
HIV care staff at Clínica Esperanza and other HIV navigation and care centers in the Bay Area also work successfully with clients to figure out medication needs (for example, to find a similar medication to one the person had access to in another country), troubleshoot issues around traveling safely with HIV medications, and figure out how to pay for medications.
“These should not be limiting factors if you need HIV medications or PrEP,” said Schmitt. “It’s really important for people to know that many community sites and clinics in San Francisco—including ours—have payment programs and eligibility programs to help pay for HIV medications regardless of immigration or payment status.”
There are HIV care resources and protections for people of any immigration status in the Bay Area.
“It doesn’t matter what your immigration status is,” said Marco Partida, an HIV services navigator at San Francisco AIDS Foundation. “We are able to serve people regardless of what their immigration status is. We help people start or continue HIV care, get emergency supplies of medications, figure out how to pay for medications, and more.”
HIV navigation options in San Francisco
Navigation services help people living with HIV connect to any clinic or provider in the San Francisco Bay Area.
San Francisco AIDS Foundation staff provide services to all people living with HIV including people who are undocumented, people living with HIV and hepatitis C, transgender and gender non-conforming people, people who use drugs, and gay, bi and queer men. The team can help establish health care coverage and there are no insurance restrictions.
Call 415-602-9676 or 415-487-3000 and ask for the health navigator. Email [email protected] with questions.
St. James Infirmary provides navigation support for people who use drugs, current and former sex workers, and transgender and gender non-conforming people. Call 415-554-8497.
Shanti provides HIV navigation to all people living with HIV, including women, people who use drugs and people who are living with HIV and hepatitis C. Call 415-674-4760.
Glide provides HIV navigation to all people living with HIV, including people who use drugs, people living with HIV and hepatitis C, and transgender and gender non-conforming people. Call 415-674-6168.
HIV care options in San Francisco
The following clinics offer wrap-around care that includes medical care, benefits support and other social services.
Clínica Esperanza at Mission Neighborhood Health Center provides services for all people living with HIV, and specializes in care for Spanish-speaking and Latinx communities. Call Liliana Schmitt at 415-552-1013 x2234. http://www.mnhc.org/
Positive Health Program at Ward 86 provides HIV care for any person living with HIV. Call 415-206-2400.
San Francisco City Clinic provides care for people living with HIV including people who are uninsured or not currently in care. Call Andy Scheer at 415-487-5511.
New legislation introduced on Tuesday by Rep. Kathleen Rice (D-N.Y.) seeks to improve the screening process for transgender passengers, who report a high level of invasive practices at security checkpoints.
The bill, known as the Screening With Dignity Act, would require the Transportation Security Administration to develop procedures to screen transgender passengers that take into consideration their particular needs.
The legislation would require that the TSA begin conducting in-person training of all officers on the screening procedures for transgender passengers and whenever possible with the participation of transgender rights groups.
Rice said in a statement she introduced the legislation because the transgender community “deserves to be treated with fairness and respect in all aspects of life, including travel.
“Maintaining high safety standards and screening all passengers with dignity should not be mutually exclusive,” Rice said. “It is clear that TSA needs to reassess its technological capabilities and improve its screening procedures to be more inclusive and ensure that no American is ever humiliated or discriminated against while going through security.”
Rice announced in a statement Monday she’d introduce legislation and a spokesperson confirmed the bill was introduced Tuesday.
In the 2015 U.S. Transgender Survey, 43 percent of respondents reported having at least one problem related to being transgender in the past year.
One respondent is quoted as saying a TSA agent referred to him as “it” when he went through screening following gender reassignment surgery, then — after repeatedly being told he wasn’t a man — had to argue with TSA that a male employee needed to do the pat down after being informed a woman would be more appropriate.
Another respondent was quoted as saying TSA subjected them to a longer screening as TSA searched their bag, pulled out intimate items and called friends to look and laugh. The respondent reported having “to remove my wig to prove I was the same person” and being “humiliated.”
The Screening With Dignity Act would require TSA to conduct two studies within 180 days. The first would evaluate the cost and feasibility of retrofitting advanced imaging technology screening equipment, or developing new equipment, that would operate in a gender-neutral manner. The second study would assess the impact TSA’s screening has on self-identified transgender and gender-nonconforming passengers compared to other travelers.
Further, the bill would codify vital privacy and anti-discrimination rules for travelers on the basis of numerous characteristics, including sexual orientation and gender identity.
The legislation has 15 original co-sponsors and support from groups like the American Civil Liberties Union, the Human Rights Campaign and the National Center for Transgender Equality.
Harper Jean Tobin, director of policy for the National Center for Transgender Equality, said the bill is a crucial step in alleviating the challenges transgender passengers face in TSA screenings.
“The TSA is broken, and it has been broken for all travelers for a long time,” Tobin said. “For many transgender people, every vacation or business trip begins with invasive body scans and humiliating pat-downs. No more empty promises – the TSA needs to make real changes to both the ineffective machines that cause so many false alarms and their training and procedures.”
Christine Hallquist leaned back in her swivel chair inside a private room at the Northshire bookstore and dialed up potential donors, trash-talking the plummeting approval numbers of Vermont’s incumbent Republican governor and touting her chances against her Democratic rivals. “It’s clear it’s for us to lose, which I won’t, ’cause I’m disciplined,” she assured one prospective contributor of the upcoming primary.
Beating her fellow Democrats and then defeating a sitting Vermont governor for the first time since 1962 are only the beginning. From there, Hallquist, a first-time candidate, plans to reverse the decline of rural Vermont and maybe even solve climate change.
All of this, Hallquist thinks, will be relatively easy, because she has already done the hardest thing she will ever do. In 2015, she began wearing a wig and a blouse to work, publicly coming out as a woman named Christine to her employees at the Vermont Electric Coop, the utility she had led for years as a man named Dave. It was the culmination of an eight-year gender transition that, after a lifetime of experiencing gender dysphoria, had filled her with dread at the ostracism she knew would follow.
“I was sure when I transitioned, I’d end up sleeping in a gutter somewhere,” she said.
But Vermonters greeted her transition with overwhelming acceptance, so she forgot about the gutter and began contemplating the governor’s office instead.
In April, she officially announced her candidacy for the Democratic nomination from a dive bar in her hometown, becoming the first openly transgender gubernatorial candidate in the nation’s history.
In large parts of the country, the appearance of a viable statewide transgender candidate would have caused a political earthquake, but here, her transgender status has been largely an afterthought.
“It will be irrelevant in Vermont,” former governor Howard Dean, who recently offered Hallquist campaign advice over breakfast, told POLITICO.
Rather than making her gender identity a focus of her campaign, she is running, essentially, as a wonky technocrat. Her signature issue is a plan to revitalize rural Vermont by laying high-speed, fiber optic cable statewide. It’s a platform that plays to her record turning around the fortunes of the electric utility she ran until early this year.
That her transgender status has been relegated to a non-issue — in fact, she’s starting to wield it as an asset — is in part, a testament to the state’s longstanding progressive culture. Vermont was the first state to abolish slavery, the first to grant same-sex couples civil unions with full marriage rights, and the first to legalize same-sex marriage through its legislature, rather than by court ruling.
It is also a sign of the arrival of transgender Americans as a small but burgeoning political force.
***
That was on display at a July fundraiser for Hallquist in Washington, where a small group of supporters, many of them transgender, gathered in the rooftop lounge of an upscale apartment building off Dupont Circle. A group of trans donors gathering to support a transgender candidate is not something you would have expected to see in Washington even just a few years ago.
“We can enter political space,” said attendee Raffi Freedman-Gurspan, who served as Barack Obama’s last director of LGBT outreach and was the first openly transgender White House staffer, of transgender people’s greater visibility in the electoral realm.
She observed that a transgender political community was beginning to take form more distinctly from the umbrella of the broader LGBT movement. “Just as siblings grow old together, we’ll find our different paths, but we’ll always be family,” she said.
While the LGBT rights movement has won an astounding series of victories across the Western world over the past two decades, transgender people remain among the most stigmatized and marginalized groups in Western societies, including the United States. Forty-one percent of respondents reported attempting suicide in one survey of transgender Americans, and young black transgender women in the U.S. are more than four times more likely to be murdered than their peers in the general population, according to an investigation by Mic.
For most of the 20th century, being transgender was considered a bizarre curiosity or a mental illness, when it was heard of at all, and openly transgender officeholders were unheard of. In the 1990s and early 2000s, a handful of openly transgender candidates won local elections, but it was not until 2006, with the election of Kim Coco Iwamoto to Hawaii’s board of education, that one won statewide office.
Iwamoto, who is running for Hawaii’s lieutenant governor this year, remains the only person to accomplish that feat. Hallquist appears to be only the third openly transgender candidate to even seek statewide office — the other being WikiLeaks source Chelsea Manning, who ran for Senate in Maryland earlier this year — according to former Houston Mayor Annise Parker, president of the LGBTQ Victory Fund, which supports LGBTQ candidates and recently endorsed Hallquist.
“Christine will be a historic figure if she wins the nomination, whether or not she becomes the governor,” Parker said. “If she becomes the governor, she has the potential to be a role model for every trans kid in America.”
According to LGBTQ Victory Fund communications director Elliot Imse, transgender candidates are regularly subjected to whisper campaigns and other forms of discrimination, even within Democratic primaries. “We hear of people saying to influential party people that ‘Of course, I’m not transphobic, but we can’t let the transgender candidate win because general election voters would never vote for a trans person,’” he said.
When journalist Danica Roem, a transgender woman, ran for a seat in the Virginia House of Delegates last year as a Democrat, the Republican Party of Virginia paid for campaign fliers that repeatedly referred to her with male pronouns, considered a slap in the face to someone who identifies as a woman.
But Roem went on to win her race, becoming the first openly transgender person elected to a state legislature and one of a record eight transgender candidates who won nationwide on Election Day last year (the other seven were municipal candidates).
According to Mara Kiesling, founder of the National Center for Transgender Equality and a Hallquist confidant, races like Roem’s illustrate that transgender candidates can overcome hang-ups about their identities by focusing on constituent needs. “Nobody’s looking for a transgender person to run for office,” Kiesling said. “They’re looking for somebody who will make their life better.”
In June, Roem traveled to Vermont to campaign with Hallquist, and offered similar advice. “When someone else wants to make that the narrative of the race, you acknowledge it and say, ‘Yes I’m trans and’ — in her case — ‘I happen to know a lot about our infrastructure,’” Roem said in an interview. “In my case it was, ‘Yes, I’m trans and I also know a lot about transportation.”
***
Other advice has been more tactical.
In the bookstore backroom in Manchester, Hallquist called around to potential donors with the help of commercial sales software called Phoneburner, which she called her “secret weapon” and which Roem turned her on to. Such tips are invaluable for a candidate who did not enter politics until late in life.
Born male in 1956 and raised as a boy named Dave in upstate New York, Hallquist made Vermont her home in young adulthood when her father’s job was relocated to Burlington.
She studied engineering, worked as a consultant and joined the Vermont Electric Coop in 1998, rising to become its CEO in 2005. Though her record on renewables is now being scrutinized for the compromises she made to keep rates down and the coop’s reliance on hydro- and nuclear power sources, it forms a core part of the rationale for her candidacy. It also, she argues, serves as a model for addressing climate change globally. During her time at the helm, she steered the utility from the brink of financial ruin and increased the share of its energy coming from carbon-free sources while limiting rate hikes.
That outward success masked inner turmoil.
Since childhood, Hallquist had felt she was a girl, a feeling her mother had warned her to keep to herself or risk being committed to an asylum. But it’s a feeling she never shook. Throughout her life, she found herself buying women’s clothing and wearing it in secret. She suffered from the pain and confusion of gender dysphoria even as she married a wife, Pat, and fathered three children.
Later in life, she came out as a woman to Pat, a discreet transgender support group, the rest of her family and eventually, in 2015, to the world. She began wearing women’s clothing and accessories in public, along with a wig. She also started hormone replacement therapy, reporting that she felt angry less often and began crying more.
Hallquist, 62, said Trump’s election a year later depressed her, but also helped inspire her to enter electoral politics earlier this year.
“Thousands of people have fought for freedom before me and died for freedom,” she said. “The least I could do is give up my retirement.”
Now, Hallquist is picking up politics on the fly. In Manchester, she spoke with enthusiasm about the details of a campaign “ground game” and rued a recent faux pas that led a deep-pocketed donor to cut her off. “I did a protocol violation,” she said, but declined to elaborate, other than to say, “You’ve got to give you high-value donors special treatment.”
Despite her novice status, she exuded total confidence at the bookstore in a sleeveless white blouse and thigh-length skirt. Between calls, she chatted with her communications director, David Glidden, about plans for her primary night gathering, emphasizing the need to find a venue that serves booze.
“People party a lot as you lose or win,” Glidden remarked.
“People are going to party because we won,” she said.
During her donor calls, Hallquist noted that the Republican governor’s slide in approval ratings — an astounding 38-point net drop between the first and second quarters of this year, in Morning Consult’s polls — has coincided with her entrance into the Democratic primary.
“I’m not taking credit,” she said between calls, but added, “If there hadn’t been a strong alternative in the race, maybe the drop wouldn’t have been as precipitous.”
In fact, Gov. Phil Scott’s popularity problems appear to be mostly about guns. He ran on a promise to impose no gun control measures, but after a school shooting scare in February, he signed a sweeping law in April that has angered his base and inspired a write-in Republican primary challenge.
In response to requests for comment about Hallquist, the fall in approval rating, and the guns issue, Scott’s campaign manager, Brittney Wilson, wrote that Scott “had the most successful first term of any Governor in Vermont” and ticked off a list of fiscal accomplishments, but did not mention guns.
Vermont’s gun culture is such that gun control is thorny even in a Democratic primary. “I would prefer not talking about this issue,” Hallquist said.
But what is her position? Well, she owns five hunting rifles, which she doesn’t use because most of them she acquired a long time ago to teach her son to hunt, which she wasn’t very good at, anyway.
“I’m beating around the bush,” she said, and after some more explanation, “I’m really beating around the bush.”
Finally, she confided, “I would support regulating guns like we regulate automobiles, but I really don’t want to talk about it.”
“That’s a little bit off the record,” Glidden chimed in.
On issues of economics and inequality Halquist speaks of her desire to support marginalized communities. But she also makes it a point to take issue both with rich people who loathe the poor and with those who blame all the problems of the poor on the rich. When I suggested that the latter sounds like an oblique critique of the state’s socialist senator, Bernie Sanders, she clapped her hands and let out a laugh, before regaining herself.
“I wouldn’t ever criticize Bernie,” she said.
What she would do is say Sanders’ rhetoric is inconsistent with the concerns of managing a state budget and making a state’s economy competitive with those of its neighbors: “He’s great on the national platform,” she said. “I don’t think it works from a governor’s standpoint.”
***
After wrapping up her calls in Manchester, Hallquist drove to the small town of Ludlow for an evening candidates’ forum.
On the second floor of Ludlow’s town hall, the race’s four Democrats held forth in front of a handful of campaign staffers and an audience of actual voters that numbered about a dozen (a showing that was “big for Ludlow,” Glidden claimed). A moderator wielded a rusty old cowbell to silence anyone who exceeded their allotted answer time.
On Hallquist’s right sat environmental advocate James Ehlers, a handsome and solemn silver-haired Navy veteran who counts himself an admirer of psychedelic guru Ram Dass and is running somewhere to the left of the state’s socialist senator.
Ehlers is considered Hallquist’s chief rival for the nomination. Hallquist had raised $132,000 through mid-July to Ehlers’ $50,000, and her statewide name recognition was at 41 percent in a recent poll, more than 10 points ahead of any other Democratic candidate.
She and Ehlers are not above taking swings at each other. “I celebrate Christine for the example she’s setting,” Ehlers said before the forum, “But fundamentally we’re very, very different people and that’s reflected in my lifetime of service to people and the planet and Christine’s decision to spend her time in the corporate world.”
Hallquist scoffed at the charge, saying she could have made more money in the private sector but chose to end her career leading the local electric coop instead. “If you’re going to be negative, try to get real shit out there,” she said the next day, adding that Ehlers “keeps shooting himself in the foot.”
To Hallquist’s left in Ludlow sat activist Brenda Siegel. A single mother with purple and yellow streaks in her hair, she often gets together with Hallquist after the forums to make fun of the other candidates, and themselves, at a local bar.
On Siegel’s other side side sat rising high school freshman Ethan Sonneborn, a precocious 14-year-old who has exploited a loophole in the state constitution to make himself a legally viable candidate.
Asked to reveal a surprising personal detail in her opening statement, Hallquist spoke of the annual week she spent with a friend in the wilderness of northern New York state in the dead of winter, telemark skiing and practicing cold-weather survival techniques for 22 years straight years.
Earlier, Hallquist had said that she believes those excursions were a way of coping with her gender dysphoria — going to the extremes of masculinity to resist her feelings of identifying as a woman. It’s the same reason, she hypothesizes, that a disproportionate number of transgender women serve in the military before transitioning.
In Ludlow, Hallquist’s transgender status came up only at the end of the night, when she recounted her experience of coming out and being embraced by Vermonters in her closing statement.
The next morning, Friday, Hallquist visited the offices of her hometown newspaper, the Morrisville News & Citizen, to face an hour of questioning from a trio of bearded journalists — Tom, Andrew and Tommy — as her son, Derek, a filmmaker, taped the sitdown for a forthcoming campaign video.
Huddled over a small conference table, Hallquist described her plan to wire the rural parts of the state with a high-speed, fiber optic network as “probably one of the most bold and visionary goals we’ve seen since the electrification of Vermont.”
Her transgender status was mentioned only when she was asked whether any “assholes” were attacking her for it. Very few, she said. Still, though Hallquist said her transgender status is not a relevant factor in the race, she is finding way to make it part of the rationale for her candidacy.
When it came up at the News & Citizen, she took the opportunity to argue that a transgender governor could help cement the state’s global image as an open and welcoming place.
“Vermonters should be thrilled that we’re continuing to perpetuate our wonderful brand,” she said.
As for the political downside, Hallquist points out that any Vermonters turned off by her gender transition would probably not be voting for a liberal Democrat anyways.
From the newspaper offices, Hallquist, Derek and Glidden strolled a few blocks to a cluttered three-room office space that serves as her campaign headquarters. A smattering of colorful sticky notes stuck to the walls reminded her how she wanted to campaign (“Pay attention to details”; “low ego”; “can dish and take it”) and commingled with a framed panoramic photo from a Phish concert.
While she plowed through more call time, Derek directed me to the family residence, a modest house perched on a fairy-tale piece of land off a gravel road overlooking a lake at the southern end of Vermont’s Northeast Kingdom.
Pat had taken Derek’s two young children, 3 and 5, to visit relatives nearby. When Hallquist and Pat became grandparents, Pat decided she wanted her grandkids to call her Oma, the German word for grandmother. At the time, Hallquist was still navigating her transition and identified as “Whatever,” a term of her own making. Rather than Oma or Opa — the German word for grandfather — the grandkids called her “Owa.” They have not gotten to the point of asking about the unique term.
As Derek bobbed in the water off the dock out back, he recounted the family’s trepidation over his parent’s run (he now calls Hallquist his “parent,” occasionally reverting to habit and calling her “dad”). When Hallquist first began considering a run, she held a family conference call with Derek, her two daughters and her wife, Pat. They were concerned that entering the race, especially given the rancor in the current political climate, would expose them all to a flood of nasty transphobic attacks.
But Vermont’s political culture is notoriously genteel, and aside from some nasty remarks on social media, there have been few problems. Derek said he was worried that would change with the approach of the Aug. 14 primary and the heightened profile he expected his parent to take on if she wins it.
As it happened, Hallquist arrived home in the mid-afternoon, excited to announce that a teaser video for an upcoming news segment about her had been released on social media by the UK’s Channel 4 and that it was quickly racking up tens of thousands of views. She also revealed that the video was unleashing a torrent of online vitriol directed at her from men around the world.
During a swing through Washington at the beginning of the week, she had been advised to contact a specific FBI agent for help with the threats she would be expected to face if she wins the primary and gains widespread attention. Now that the wrong kind of attention had arrived early, she resolved to call the FBI agent that day.
But she did not seem scared, and she said she viewed the call to the FBI as a “precaution.”
Soon, Pat returned home with the grandkids, who greeted their father and their owa enthusiastically.
The threats became an afterthought as Hallquist talked about the possibility that Elizabeth Warren and Joe Biden could stump for her if she wins her primary. Then she wandered off to push her granddaughter on a swing set out back.
U.S. Immigration and Customs Enforcement has released from its custody 14 transgender women who are seeking asylum in the U.S.The American Civil Liberties Union of Massachusetts in a July 31 press release that announced the trans women’s release said they had been detained at the Cibola County Correctional Center in Milan, N.M.
The press release notes the ACLU of Massachusetts’ Immigrant Protection Project, 18 lawyers and two law students in June petitioned ICE through a New Mexico organization to release 20 trans women who were seeking asylum in the U.S.
The ACLU of Massachusetts says the trans women left El Salvador, Honduras and Guatemala and arrived at the U.S.-Mexico border in May. The press release notes ICE detained them once they entered California.
“The women suffered harm because of their gender identity in their home country, and were found by federal immigration officials to be at serious risk of persecution if they were returned to their home country,” reads the press release.
“We kept fighting and we won,” said ACLU of Massachusetts’ Immigrant Protection Project Coordinator Javier Luengo-Garrido in the press release. “This victory has changed the lives of 14 women, and has energized us to continue fighting for people’s basic human rights.”
Violence and persecution based on gender identity remains pervasive in El Salvador, Honduras and Guatemala.
An activist in San Pedro Sula, Honduras, who has previously received death threats told the Washington Blade last month during an interview at her office that insecurity and a lack of economic opportunity are among the reasons that prompt trans Hondurans to migrate from the country. Advocates in El Salvador with whom the Blade spoke last month also said violence and poverty prompt LGBTI Salvadorans to seek refuge in the U.S.
“People are not going to the U.S. because it’s cold,” said Andrea Ayala, executive director of Espacio de Mujeres Lesbianas por la Diversidad, an advocacy group known by the acronym ESMULES, during a July 13 interview in the Salvadoran capital of San Salvador.
President Trump’s “zero tolerance” immigration policy that includes the separation of migrant children from their parents continues to spark outrage in the U.S. and around the world.
Roxana Hernández — a trans Honduran woman with HIV who U.S. Customs and Border Protection took into custody on May 9 when she asked for asylum at the San Ysidro Port of Entry south of San Diego — was at the Cibola County Correctional Center before she died at a hospital on May 25. U.S. Rep. David Cicilline (D-R.I.) in June said after he traveled to South Texas there are no policies in place that specifically address the needs of trans, gay, lesbian, bisexual and intersex migrant children who the Trump administration has separated from their parents.
According to the Mexican news site ContraMuro.com and Forbes Mexico, a 248-room LGBT resort featuring five bars and three restaurants will open next year on or near (this is unclear) Cuba’s resort island Cayo Guillermo.
The “luxurious five-star” hotel is reportedly the project of MGM Mutha Hotels, which currently operates about two dozen resorts in Europe and India, and already has two locations in Cuba, including one on Cayo Guillermo.
According to the first report linked above, further details on the project will be revealed once Cuba’s National Assembly votes to reform the country’s constitution, which would include the legalization of same-sex marriage. The first draft of the reform was approved last week.
Since she transitioned in 1998, at the age of 16, all of Danni Askini’s identity documents have read “female.” But last month, when Askini went to renew her passport, her request was denied. Askini says the U.S. Passport Office told her she had “failed to disclose” that she was transgender and needed to provide proof of gender transition — after 20 years of having a passport that says she’s female.
“Make no mistake, this was an intentional action by the State Department to withhold recognizing my gender,” says Askini, who was eventually granted a temporary two-year passport that allowed her to travel from her Seattle home to Sweden. The activist and executive director of Gender Justice League needed to leave Seattle, she says, after a series of death threats posted on the anti-trans website Kiwi Farms, as well as threats from local alt-right groups in the Pacific Northwest. She’d had her most recent passport for 10 years, but it was up for renewal.
Askini’s battle with the U.S. Department of State — which oversees the Passport Office — began last month, and a June 29 tweet she posted about the ordeal went viral.
Just this week, another trans woman encountered the same problem.
New York-based technology researcher Janus Rose says she’s had her passport, with a female gender marker, since November. But recently she finalized a legal name change, and sent in paperwork along with her current passport to renew the document with the new legal name. It seemed like a simple formality, until she received a phone call from a passport processing center in South Carolina.
“She basically told me that even though the government had changed my gender marker in the last year, that was a mistake,” says Rose. The passport official told Rose that the State Department should not have allowed her to change her gender on the document — and that the medical documentation she’d supplied at the time was invalid.
“This letter is something my clinic has been using as a boilerplate for years for so many people,” Rose says. “The clinic says I’m the first person to get a rejection.”
Rose had successfully changed the gender marker on her passport in 2017 using a letter signed by the nurse practitioner at her clinic. The clinic, she says, told her they’ve never encountered a person being told that that letter is invalid or that they need to have it written by an M.D. instead.
“It seems pretty clear that even if the policy hasn’t changed, something has changed in terms of guidance on how to enforce this — because it’s being enforced differently now,” says Rose.
According to the State Department’s policy, a person seeking a gender change on a passport must submit an ID “that resembles your current appearance,” a recent passport photo, proof of legal name change if applicable, and a “medical certification that indicates you are in the process of or have had appropriate clinical treatment for gender transition.”
In response to an emailed request for comment, a State Department official said the department doesn’t comment on individual applications — but provided more context on the gender change policy in general.
“Every applicant who applies for a U.S. passport undergoes extensive vetting of their identity, claim to U.S. citizenship and entitlement to a passport,” said the State Department official. “When a passport applicant presents a certification from a medical physician stating that the applicant has undergone or is receiving appropriate clinical treatment for gender transition, a new passport will be issued with an updated gender marker. Sexual reassignment surgery is not a prerequisite for updating the gender marker in a passport and documents proving sexual reassignment surgery are not required.”
The State Department did not respond directly to a question about why someone’s gender marker would be “revoked” after already being changed years ago.
Rose says she’s frustrated that a simple name change turned into a reevaluation of the validity of her gender.
“I spoke to someone the other day, a cis person, who had their legal name changed and it was fine,” says Rose. “There was no asking for additional documentation or proof. She literally did the same thing just the other day. That’s what this is about. A cis person can go in and make this simple change, and a trans person cannot.”
Askini, in contrast, was disturbed by the fact that the State Department even knew she was transgender. In her specific case, her legal gender transition was granted by a judge when she was still a minor — and in relation to a sex trafficking case and a safety effort to conceal her identity, all of the child welfare records were sealed at the time.
“None of my documentation would disclose my trans status,” says Askini. “No databases that are local, state, or federal should note my gender as anything other than female.”
Askini believes the only reason she was eventually granted a temporary passport is because Seattle-based congresswoman Rep. Pramila Jayapal’s office put direct pressure on the passport agency on the well-known activist’s behalf.
“I believe that the Trump Administration or someone in the Seattle Passport Office has targeted me politically and politicized the process for obtaining passports,” says Askini. “Their actions and statements are NOT consistent with the actual letter of the code related to trans people.”
Rose has similar suspicions. Though she’s careful to steer clear of “the temptation to blame everything on Trump,” and notes that trans people have faced bureaucratic discrimination for years, she says it feels like a very sudden change has occurred at the State Department.
“It seems like they’re applying a different standard of enforcement to these cases now. I’ve never heard of a person having a problem changing their name on a passport until now,” says Rose.
Although the State Department did not directly respond to a question asking whether there had been a recent change in policy or internal guidance mandating new enforcement rules, a change would hardly be surprising. Since Trump took office, his administration has altered existing transgender-inclusive guidelines at the Department of Education, the Department of Justice and Bureau of Prisons, the Department of Defense, the U.S. Census, the Department of Health and Human Services, and the Department of Housing and Urban Development. Even the Centers for Disease Control was instructed in an internal memo not to use the word transgender — along with terms like “diversity” and “evidence-based.” It’s not unfair to say the Trump administration has stopped just short of outlawing transgender people entirely.
“I think there’s an internal policy change to make it as difficult as possible for trans people,” says Rose. “The goal is to create friction. They can’t change all these laws right away, but they can make it really hard.”
A former employee at Tesla’s Fremont factory filed a wrongful termination lawsuit against the electric carmaker, alleging he was fired in retaliation after seeking protection from anti-gay harassment, TheGuardian reported today.
The defendant, an assembly line worker named Jorge Ferro, claims he was taunted for being gay and threatened with violence. “Watch your back,” one supervisor told him after mocking his “gay tight” clothing, the paper said. After complaining to an HR representative, Ferro was repeatedly moved to different assembly lines, but the harassment didn’t stop.
Ultimately, HR told him there was “no place for handicapped people at Tesla” after noticing an old scar on his wrist, according to TheGuardian. He was sent home, and eventually terminated.
In a strongly worded statement to the paper, Tesla denied the allegations and defended itself against the charges. “There is no company on earth with a better track record than Tesla,” a spokesperson said.
The lawsuit is the latest to paint an unflattering picture of life at the popular carmaker. Earlier this week, three former African-American employees sued Tesla, claiming they’d suffered constant, often daily racial discrimination and harassment, and that the company did little to nothing to stop the behavior.
In both cases, Tesla argued the defendants were actually employed by third-party contractors. To be sure, Tesla’s full-time employees have to sign arbitration agreements that force them to settle harassment claims privately. Even so, the company says it attempted to separate Ferro from his alleged harasser. Ferro’s lawyer told TheGuardian Tesla erred by moving the defendant after he complained. “It’s perceived by many to be retaliatory,” said Chris Dolan, Ferro’s attorney. “It sends a message to other employees that if you complain, you’re the one who’s going to have your job changed. In essence, you’re penalizing the party who’s making the complaint.”
In a statement, Tesla’s spokesperson also attacked the media for reporting on lawsuits against the company, as well as the lawyers for filing the complaints:
“Media reporting on claims of discrimination at Tesla should bear a few things in mind: First, as one of the most highly reported-on companies in the world, anyone who brings claims against Tesla is all but assured that they will garner significant media coverage. Second, in the history of Tesla, there has never been a single proven case of discrimination against the company. Not one. This fact is conveniently never mentioned in any reporting. Third, as we have said repeatedly, even though we are a company of 33,000 employees, including more than 10,000 in the Fremont factory alone, and it is not humanly possible to stop all bad conduct, we care deeply about these issues and take them extremely seriously. If there is ever a case where Tesla is at fault, we will take responsibility. On the other hand, Tesla will always fight back against unmeritorious claims. In this case, neither of the two people at the center of the claim, Mr. Ferro and the person who he alleges to have mistreated him, actually worked for Tesla. Both worked for a third-party. Nevertheless, Tesla still stepped in to try to keep these individuals apart from one another and to ensure a good working environment. Regardless of these facts, every lawyer knows that if they name Tesla as a defendant in their lawsuit, it maximizes the chances of generating publicity for their case. They abuse our name, because they know it is catnip for journalists. Tesla takes any and every form of discrimination or harassment extremely seriously. There is no company on Earth with a better track record than Tesla, as they would have to have fewer than zero cases where an independent judge or jury has found a genuine case of discrimination. This is physically impossible.”
Tesla is still in the middle of lawsuit from a former employee who alleged that women experienced “unwanted and pervasive harassment.” And just last week, the company fired hundreds of workers during a time CEO Elon Musk has described as “production hell” as it attempts to ramp up production of the Model 3.