Transgender Louisianians will no longer receive Medicaid reimbursement for any gender-affirming care prescriptions if their provider uses certain gender-related diagnosis codes, according to multiple LGBTQ+ organizations.
“Instead of making this change through the legislative process, the state instilled its anti-trans agenda through obscure, extralegal bureaucratic maneuvers,” the advocacy organization Trans Income Project wrote in a statement to the Illuminator. “Now, thousands of Louisianans are losing coverage for trans medicine and incurring unexpected out-of-pocket costs when attempting to pick up their regular prescriptions.”
Gender-affirming care is a catch-all term for medical treatments given to people to align their physical bodies with their identified gender. Such care is administered to transgender people, who identify as a gender different from their sex assigned at birth, as well as cisgender people, who identify as their assigned sex.
The Louisiana Department of Health did not respond to emailed questions asking why the policy has been put in place.
The Williams Institute, a think tank at UCLA School of Law that researches sexual orientation and gender identity law, estimates LGBTQ+ adults are twice as likelyas non-LGBTQ+ adults to take part in the Medicaid program.
Louisiana banned gender-affirming health care for transgender youth in 2023, but the treatments remain legal for transgender adults.
The Justice Department announced that it had sent more than 20 subpoenas to doctors and clinics involved in “performing transgender medical procedures on children.”
The department’s brief announcement Wednesday did not name any of the 20 doctors or clinics or say where they were. It also did not specify what constituted “transgender medical procedures” but said its investigations “include healthcare fraud, false statements, and more.”
“Medical professionals and organizations that mutilated children in the service of a warped ideology will be held accountable by this Department of Justice,” Attorney General Pam Bondi said in a statement.
Also Wednesday, the Federal Trade Commission hosted an all-day workshop on the “dangers of gender-affirming care.” In his opening remarks, FTC Chairman Andrew Ferguson suggested that such care is deceptive and requires greater scrutiny by the commission.
The workshop and the Justice Department’s announcement are the latest escalation of the Trump administration’s campaign to restrict transgender rights and access to transition-related medical care.
The FTC’s panel Wednesday featured more than a dozen speakers who criticized transgender health care, including people who received such care as minors and now say they regret it; doctors and psychologists who disagree with the current standards for providing such care; and political scientists and lawyers who oppose access to transition care for minors.
Claire Abernathy said she had a double mastectomy by her 15th birthday and detransitioned, or stopped identifying as trans, at 18.
“My doctors didn’t tell me that hormones would cause permanent side effects,” said Abernathy, now 20. “They hid those effects from me. They worked to silence me when I tried to complain about this abuse. We need to make sure no more kids are sold products they can’t return.”
A common refrain from many of the panelists was that it is not possible for someone to be “born in the wrong body” and that there is no evidence to support transition care as a treatment for gender dysphoria, the medical term for the distress that results from the conflict between someone’s gender identity and sex assigned at birth.
Miriam Grossman, a child psychologist who has testified in favor of state legislation to ban access to transgender care for minors, said the idea that someone can know for sure that their gender identity is more authentic to them than their birth sex “is entirely unproven and unprovable.”
“There is no objective evidence of being born in the wrong body, and saying so misleads and takes advantage of consumers, and it impacts their medical decisions,” Grossman said.
Ferguson said the FTC’s statutory mandate is to “protect people from deceptive cures and health claims. He added that the FTC would post a public request for information next week based on what was learned at the workshop.
‘Not the FTC’s lane’
The workshop faced backlash from activists and also from some employees within the FTC, Reuters reported. Nearly 150 FTC employees signed a “statement of concern” dated July 2 about Wednesday’s workshop, writing that it “would chart new territory for the Commission by prying into confidential doctor-patient consultations.”
They added, “Simply put, in our judgment, this is not the FTC’s lane.”
On Thursday, three former FTC employees also opposed the workshop at an event held by Public Knowledge, a nonprofit organization that promotes free expression and an open internet.
Among them was Eileen Harrington, who worked for the FTC for nearly 40 years and was its executive director from 2010 to 2012. She said that, through the workshop, the “FTC engaged in a kind of overreach that we haven’t seen for over 50 years.”
Harrington helped develop the FTC’s workshop process in 1992 when she was director of the division of marketing practices. Before a workshop, she said, the FTC would issue a public statement about the topic and then invite the public to submit comments. It would also invite stakeholders with a variety of views to speak at the workshop.
“Yesterday’s event bears little resemblance to what we intended to create back in 1992 and to what the FTC has done over the years,” Harrington said, noting that the public was barred from attending in person and that the FTC handpicked people who were allowed to speak and who represented only one point of view.
Joe Simonson, a spokesperson for the FTC, criticized the Public Knowledge event in a phone interview.
“I looked up who funds Public Knowledge, and I see it’s all big tech, and so it makes sense to me that a big tech-funded nonprofit, ostensibly devoted to copyright law, would be looking for any excuse to attack the Federal Trade Commission, even if it means standing against young men and women who say they were abused and mutilated by so-called medical professionals,” Simonson said.
He added that the workshop was not open attendance because the panelists received death threats.
Regarding criticism that the workshop included only one viewpoint, Simonson said, “Many of the panelists who appeared say they were victims of mutilation and abuse, and I don’t know who is on the other side of that.”
Asked about the majority of trans people, including youths, who say they do not regret receiving treatment, Simonson said: “We’re not talking about those people. We’re talking about people who were abused and mutilated.”
Kellan Baker, executive director of the Institute for Health Research and Policy at Whitman Walker Health, a medical clinic in Washington, D.C., said he helped create Thursday’s event to provide perspectives that were left out of the FTC’s workshop.
“We wanted to hear from the parents who are in the position of caring for their children and wanting what’s best for their children,” Baker said. “We also wanted to hear from experts in transgender health.”
Some European countries have restricted access to such care, but only one, the United Kingdom, has indefinitely banned new prescriptions of puberty blockers to treat minors for gender dysphoria.
Twenty-five states restrict access to puberty blockers and hormone therapy for trans minors, though courts have permanently blocked restrictions from taking effect in Montana and Arkansas, according to the Movement Advancement Project, an LGBTQ think tank. Arizona and New Hampshire ban operations for minors, which are recommended only in rare cases. Seventeen states and Washington, D.C., have measures that protect access to transgender health care. The care is legal in an seven more states that neither protect nor ban it.
No federal law restricts access to transition-related care. However, the Trump administration has sought to curtail it through a combination of executive orders and actions by federal agencies. In January, President Donald Trump signed a sweeping executive order aiming to prohibit federal funds from going to hospitals or medical schools that provide gender-affirming care to minors, though multiple judges have blocked that part of the order.
Then, in an April memo, Bondi directed U.S. attorneys to use laws against female genital mutilation to investigate doctors who “mutilate” children “under the guise of care” and to prosecute these “offenses to the fullest extent possible.”
“I hated my body,” the nonbinary 16-year-old said. “I hated looking at it.”
When therapy didn’t help, Pitchenik, who uses the pronoun they, started going to the Center for Transyouth Health and Development at Children’s Hospital Los Angeles, the country’s biggest public provider of gender-affirming care for children and teens. It changed their life.
But in response to the Trump administration’s threat to cut federal funds to places that offer gender-affirming care to minors, the center will be closing its doors July 22. Pitchenik has been among the scores of protesters who have demonstrated regularly outside the hospital to keep it open.
Sage Sol Pitchenik in Santa Clarita, Calif., on Monday.Jae C. Hong / AP
“Trans kids are done being quiet. Trans kids are done being polite, and trans kids are done begging for the bare minimum, begging for the chance to grow up, to have a future, to be loved by others when sometimes we can’t even love ourselves,” Pitchenik said, prompting cheers from dozens of protesters during a recent demonstration.
They went to the center for six years.
“There’s a lot of bigotry and just hate all around, and having somebody who is trained specifically to speak with you, because there’s not a lot of people that know what it’s like, it meant the world,” they told The Associated Press.
The center’s legacy
In operation for three decades, the facility is among the longest-running trans youth centers in the country and has served thousands of young people on public insurance.
Patients who haven’t gone through puberty yet receive counseling, which continues throughout the care process. For some patients, the next step is puberty blockers; for others, it’s also hormone replacement therapy. Surgeries are rarely offered to minors.
“I’m one of the lucky ones,” said Pitchenik, who received hormone blockers after a lengthy process. “I learned how to not only survive but how to thrive in my own body because of the lifesaving health care provided to me right here at Children’s Hospital Los Angeles.”
Many families are now scrambling to find care among a patchwork of private and public providers that are already stretched thin. It’s not just patient care, but research development that’s ending.
“It is a disappointment to see this abrupt closure disrupting the care that trans youth receive. But it’s also a stain on their legacy,” said Maria Do, community mobilization manager at the Los Angeles LGBT Center. “I think it showcases that they’re quick to abandon our most vulnerable members.”
Maria Do, community mobilization manager at the Los Angeles LGBT Center, outside Children’s Hospital Los Angeles on Thursday.Jae C. Hong / AP
The closure comes weeks after the Supreme Court upheld Tennessee’s ban on gender-affirming care for minors, amid other efforts by the federal government to regulate the lives of transgender people.
The hospital initially backed off its plans to close after it announced them in February, spurring demonstrations, but later doubled back.
The center said in a statement that “despite this deeply held commitment to supporting LA’s gender-diverse community, the hospital has been left with no viable path forward” to stay open.
“Center team members were heartbroken to learn of the decision from hospital leaders, who emphasized that it was not made lightly, but followed a thorough legal and financial assessment of the increasingly severe impacts of recent administrative actions and proposed policies,” the statement said.
California Attorney General Rob Bonta has warned that by closing the center, the hospital is violating state antidiscrimination laws, but his office hasn’t taken any further actions. Bonta and attorney generals from 22 other states sued the Trump administration over the executive order in February.
“The Trump administration’s relentless assault on transgender adolescents is nothing short of an all-out war to strip away LGBTQ+ rights,” Bonta told the AP in an email. “The Administration’s harmful attacks are hurting California’s transgender community by seeking to scare doctors and hospitals from providing nondiscriminatory healthcare. The bottom line is: This care remains legal in California.”
LGBTQ protesters and health care workers offer visibility
Still wearing scrubs, Jack Brenner, joined protesters after a long shift as a nurse in the hospital’s emergency room, addressing the crowd with a megaphone while choking back tears.
“Our visibility is so important for our youth,” Brenner said, looking out at a cluster of protesters raising signs and waving trans pride flags. “To see that there is a future, and that there is a way to grow up and to be your authentic self.”
Jack Brenner, an emergency room nurse at Children’s Hospital Los Angeles, on Thursday.Jae C. Hong / AP
Brenner, who uses the pronoun they, didn’t see people who looked like them growing up or come to understand what being trans meant until their mid-20s.
“It’s something I definitely didn’t have a language for when I was a kid, and I didn’t know what the source of my pain and suffering was, and now looking back, so many things are sliding into place,” Brenner said. “I’m realizing how much gender dysphoria was a source of my pain.”
Trans children and teens are at increased risk of death by suicide, according to a 2024 study from the Centers for Disease Control and Prevention.
Brenner described encountering young patients in the emergency room who are trans or otherwise on the gender-nonconforming spectrum and “at the peak of a mental health crisis.” Brenner wears a lanyard teeming with colorful pins emblazoned with the words “they/them” to signal their gender identity.
Jack Brenner shows their lanyard decorated with pronoun pins and buttons.Jae C. Hong / AP
“I see the change in kids’ eyes, little glints of recognition, that I am a trans adult and that there is a future,” Brenner said. “I’ve seen kids light up when they recognize something of themselves in me. And that is so meaningful that I can provide that.”
Beth Hossfeld, a marriage and family therapist, and a grandmother to an 11- and 13-year-old who received care at the center, called the closure “patient abandonment.”
“It’s a political decision, not a medical one, and that’s disturbing to me,” she said.
The results are in for the world’s most sexually liberated cities in 2025, and a surprising UK city has made the top 10.
Global research by escort consultancy group Erobella analysed cities around the world and ranked them based on the number of gay bars they have, the frequency of LGBTQ+ events there, access to contraception, transgender rights, the legality of sex work, and laws protecting against homophobic and transphobic behaviour.
This year, eight European cities have made the top 10 most sexually liberated cities, whilst only one US city has made the list. This marks a clear shift from last year’s rankings, when seven US cities dominated the top 20 (New York, Los Angeles and Chicago have all dropped out of the rankings this year).
Amsterdam, known for its Red Light District, is the most sexually liberal city in 2025. (Getty Images)
Amsterdam, which is known for its Red Light District, unsurprisingly claimed the top spot. The capital city of the Netherlands was praised for its “comprehensive legal protections, abundant sexual health resources, and vibrant LGBTQIA+ scene”.
Sex work was legalised in the city in 2000, with the Dutch government aiming to give sex workers “more autonomy over their profession, reduce criminal activity, and improve their labour conditions”, as per Humanity In Action. The city is widely considered to be “the birthplace of LGBTQ+ rights” after homosexuality was decriminalised in 1811.
Coming in at number two is this year’s only US city on the list, San Francisco. The city is home to one of the first gay neighbourhoods in the US, The Castro, while San Francisco Pride has continued to stand strong in the face of DEI rollbacks in the US.
San Francisco, California, is the only US city on the list this year. (Getty Images)
Cologne, Germany; Vancouver, Canada; Lisbon, Portugal; and Berlin, Germany, claim the top three, four, five and six spots, respectively.
Meanwhile, the UK has thrown a curveball in the form of Manchester, a city in northwest England, which sits at number 7. The city has a thriving LGBTQ+ scene, particularly in the Gay Village near Canal Street, which hosts over 30 gay bars and clubs, as per Wanderlog.
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Hamburg, Germany; Vienna, Austria; and Barcelona, Spain round off the top 10 most sexually liberated cities.
As the Trump administration escalates its attacks on transgender people’s rights, revoking “X” gender markers on passports (something a federal court has halted), instructing consular officials to deny visas based on gender presentation, and enforcing a binary-only framework, one LGBTQ+ travelcompany is charting a course toward inclusivity for marginalized travelers.
VACAYA, a queer-focused cruise and resort company founded in 2017, has become a sanctuary for those too often sidelined, even within LGBTQ+ spaces: transgender, nonbinary, BIPOC, body-diverse, bisexual, and pansexual travelers.
“In our industry, trans travelers are often trapped, by their passports, by government systems, by legal names that don’t reflect who they are,” Randle Roper, VACAYA’s cofounder and chief experience officer, told The Advocate in an interview. “We can’t overturn federal policy. But we can create joy and freedom onboard, and that’s what we do.”
Patrick Gunn and Randle Roper cofounded VACAYA in 2017.
Unlike successful decades-old legacy brands such as Atlantis Events, which caters primarily to cisgender gay men with circuit-party-style itineraries, or Olivia Travel, which targets lesbians, VACAYA’s leadership said the company intentionally created something different. “Atlantis caters to maybe 3 to 5 percent of our community,” Roper said. “We’re building something for everyone else.”
“We have a really keen eye on the balance of an experience,” Roper said. “There’s no way to push guests seven nights in a row, all night long until noon the next day, and expect people to do that without some kind of enhancement, right? We don’t do that.”
VACAYA’s parties typically wrap around 3 a.m., Roper explained, so guests can sleep, explore ports of call, and recharge.
Co-founding partner Patrick Gunn said that during a recent cruise where the host cruise line, without consulting VACAYA, brought an independent medical care team onboard. “We kind of chuckled,” Gunn said. “We were like, ’wow, you’re going to have a really quiet week.’ And that’s exactly what happened.”
By the conclusion of the trip, the care team, Roper said, reported just one intervention: a Dungeons & Dragons player experiencing an anxiety attack during a fantasy quest. “That was their most tense moment,” Roper said. “I love that story.”
That mindset of balance and care underlies VACAYA’s programming, from DJs spinning “anthem moments of pure joy” to D&D sessions hosted by Magic Academy, Gunn explained.
“You can enjoy this without overdrinking or adding other stimulants,” Gunn said. “The joy is real. And it’s shared.”
Of course, he added, “Vacayans” (that’s what they call their loyal guests) can expect to enjoy world-class entertainment, dining, and unforgettable excursions.
Each trip also features gender-neutral bathrooms, “including for people who sit to pee,” Roper said. Everybody is invited to wear pronoun pins, and for a retreat away from the bustle, a “Transcend Lounge,” a dedicated onboard space for trans, nonbinary, bisexual, pansexual, and female-identifying guests to gather, decompress, or exist.
For Gabrielle “Gabby” Dorsey, a Black trans woman and VACAYA team member, the lounge isn’t a novelty. “It’s a space where you get to be 100 percent yourself,” she said. “No questions, no judgment. If you’ve spent your life hiding or suppressing your identity and you need to connect, that room means everything.” On recent trips, the lounge overlooked a pool deck, allowing those enjoying the lounge to be away without being excluded.
Mason Fitzpatrick, a 34-year-old transgender man who works on VACAYA’s media and guest support teams, echoed that sentiment. “It’s rare to be in a place where no one questions who you are,” he said. “I live in a conservative Trump town. I’m stealthy most of the time for safety. But on that ship, the walls come down. You get to breathe.”
Those opportunities also allow guests to take emotional risks, he said. “You watch people walk differently by the end of the week,” Fitzpatrick said. “Their shoulders drop. Their voices get louder. Something shifts.”
Jamie Hartman, a 42-year-old transgender woman, parent of two kids, and software engineering manager from Portland, Oregon, described a similar experience. “I didn’t have to shield myself or explain myself,” she said.
Hartman now regularly travels with the company, often with her partner of seven years. She’s even been invited to help guide consent-forward programming in the Red Light District, VACAYA’s adult play space.
She said organizers, impressed by her feedback and engagement in spaces like the ship’s red light district and Tantra workshops, asked her to help make the red light district more inclusive. “If you don’t know about the red light district, it’s really kind of like a bathhouse out there at sea,” she said. “I’ll have these opportunities to facilitate organic encounters. Somebody, I’ll just kind of smile on the pool deck, and we’ll strike up a conversation. I’m a hugger. You want a hug? Okay, cool. Maybe the conversation goes in a space where you can practice some enthusiastic consent. You’re in a space where all of the people around you are also feeling liberated and open to, hey, experience some of those yellow zones.”
VACAYA charters entire cruise ships.
For Hartman, those “zones” serve as a way to gauge comfort and safety: green signifies ease and familiarity, yellow signals a stretch into new or slightly uncomfortable territory that can spark growth, while red indicates overwhelming distress or panic to be avoided. At VACAYA, she said, people are encouraged to explore the yellow zone if they wish — pushing boundaries in ways that feel consensual and safe — without fear of crossing into the red.
That goes for conversations, too. Hartman, who appreciates a bit of gender ambiguity, recalled one guest who assumed she was transitioning “in the opposite direction, from female to male.” She said, “It was validating on multiple levels. I got to just be and not perform.”
That affirmation, Hartman said, matters more than most travelers realize. “At the welcome table, there are pins with your pronouns. Mine says ‘she/they,’ and I don’t feel like I have to choose. I can show up fully.”
Alysse Dalessandro, a plus-size queer woman and content creator, as well as a former inclusivity consultant for the company, helped design the pronoun system after raising concerns on an early cruise.
“It wasn’t just, ‘here’s a rainbow bowl of pins,’” she said. “We had detailed conversations about design, placement, wording, and guest education, because VACAYA wanted to get it right.”
Dalessandro also helped rebrand what had been called “Women of VACAYA” into a more inclusive program for women, trans, and nonbinary guests. “We had a trans man who said, ‘This isn’t for me.’ I said, ‘No, but it should be.’ And we changed it.”
In one memorable moment, she recalled hosting a hot tub night during an underwear party attended mainly by the cisgender gay men onboard. “One guest presented as female on the cruise but male back home for safety. At that moment, they were in a bikini for the first time, in public, with their partner.”
The company offers a diverse range of experiences, from entertainment and cuisine to alluring shore excursions, quiet reading spaces, Dungeons & Dragons nights, book clubs, and wellness workshops.
“They know not everyone wants a fetish party,” Dalessandro said. “So we also played [the sapphic card game] Les Convo over wine one night. It was spicy, but it was our kind of spicy.”
Roper said VACAYA offers roommate matching and no-interest payment plans, with trips ranging from $1,100 resort weeks to $30,000 luxury expeditions. It runs a “Reach Out” program that delivers supplies to local communities and raises funds for LGBTQ+ nonprofits. VACAYA also spent $90,000 in 2025 for WorldPride in Washington, D.C., the company said.
And in February, when guests spotted Cuban refugees adrift in the Gulf of Mexico, and officials brought them aboard, VACAYA staff and travelers sprang into action, providing food, clothing, and medical care until the U.S. Coast Guard arrived. President Donald Trump had recently dictated that the Gulf of Mexico be called the “Gulf of America.”
“It was the Republican nightmare: refugees, gays, and the Gulf,” Roper said. “But it was also a metaphor. This community knows what it means to be adrift, and to be rescued.”
VACAYA travelers
For Hartman, that metaphor holds. “This isn’t a space where you’ll never encounter a misgendering,” she said. “But you’ll never face it alone. You’ll be affirmed and supported. You’ll be reminded you belong.”
Dorsey put it more simply: “No matter where you are on that journey, if you’re just starting into your gender journey, you’re welcome. If you’re 15, 20, or 30 years into that gender journey, you’re welcome. If you’re someone who’s looking for a space to be your authentic self because nowhere else you’re able to do so, you are more than welcome.”
There are more LGBTQ+ new business owners than ever recorded — and they’re treating their employees better than others.
Ten percent of all new business owners in 2024 identified as LGBTQ+, according to a new report from Gusto, marking a 50 percent increase from 2023. This is in line with demographic shifts, the study notes, as about 9.3 percent of U.S. adultssaid in a Gallup survey last year that they identify as something other than heterosexual, up from 7.6 percent from the previous year.
This suggests that “more LGBTQ people are seeing fewer barriers to entrepreneurship and are choosing it as an accessible and viable path to make a living,” the Gusto study states.
The new business owners were also more likely to be younger, as Gen Z and Millennials accounted for 70 percent of all new LGBTQ+ entrepreneurs in 2024. This is also in line with data that shows younger generations are much more likely to be LGBTQ+ than the generations before them — 28 percent of Gen Z adults identify as LGBTQ+, compared to 16 percent of millennials, seven percent of Gen X, and four percent of baby boomers, according to the Public Religion Research Institute.
New LGBTQ+ entrepreneurs were 56 percent more likely than their non-LGBTQ+ peers to start a business in order to make a positive impact on their community. Over one-third of businesses started by LGBTQ+ people in 2024 were in the professional services industry, and more than half were in community or personal services, including health care, accommodation, and retail.
New LGBTQ employers were also 30 percent more likely to offer benefits than their non-LGBTQ+ peers, with 95 percent offering benefits compared to 74 percent. Among those that offer benefits, new LGBTQ+ business owners were 79 percent more likely to offer health insurance and 30 percent more likely to offer retirement benefits.
“LGBTQ entrepreneurs are starting businesses with a clear sense of purpose,” the report concludes. “Their decisions around industry, motivation, and employee support reflect commitments to autonomy, equity, and community. Their growing presence in entrepreneurship is a sign that more people see business ownership as a viable and inclusive path.”
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.”
