A federal judge on Wednesday struck down Florida rules championed by Gov. Ron DeSantis restricting Medicaid coverage for gender dysphoria treatments for potentially thousands of transgender people.
“Gender identity is real” and the state has admitted it, U.S. District Judge Robert Hinkle wrote in a 54-page ruling.
He said a Florida health code rule and a new state law violated federal laws on Medicaid, equal protection and the Affordable Care Act’s prohibition of sex discrimination.
They are “invalid to the extent they categorically ban Medicaid payment for puberty blockers and cross-sex hormones for the treatment of gender dysphoria,” Hinkle wrote.
The judge said Florida had chosen to block payment for some treatments “for political reasons” using a biased and unscientific process and that “pushing individuals away from their transgender identity is not a legitimate state interest.”
An email seeking comment from the DeSantis’ office wasn’t immediately returned.
Hinkle’s harsh language echoed that in his ruling two weeks ago over a law that bans transgender minors from receiving puberty blockers. Hinkle, who was appointed by Democratic President Bill Clinton, issued a preliminary injunction so that three children could continue receiving treatment.
The DeSantis administration and the Republican-controlled Legislature had banned gender-affirming treatments for children and a law that DeSantis signed in May made it difficult — even impossible —for many transgender adults to get treatment.
The latest ruling involved a lawsuit filed last year on behalf of two adults and two minors, but advocacy groups estimate that some 9,000 transgender people in Florida use Medicaid to fund their treatments.
Hinkle also addressed the issue of whether gender-affirming treatments were medically necessary and noted that transgender people have higher rates of anxiety, depression and suicide than the general population.
Transgender medical care for minors is increasingly under attack — Florida is among 19 states that have enacted laws restricting or banning treatment. But it has been available in the United States for more than a decade and is endorsed by major medical associations.
As an increasing proportion of Americans identify as LGBTQ, leaders in sexual and gender minority health care say that the nation’s medical schools are largely failing to adequately prepare the next generation of doctors to properly care for this population.
The need is critical, according to experts in medical education and LGBTQ care. Lesbian, gay, bisexual, transgender and queer people, as stigmatized minorities, often have difficulty accessing health care that properly addresses their health concerns, that is sensitive to their sexual and gender identities and that is not flat-out discriminatory, researchers have found.
“It’s terrible that there’s a whole population of people who aren’t getting the health care they need,” said Ann Zumwalt, an associate professor of anatomy and neurobiology at the Boston University Chobanian & Avedisian School of Medicine and a leader in the effort to improve medical school curricula pertaining to LGBTQ care.
In 2014, the Association of American Medical Colleges, or AAMC, released a call for the 158 U.S. and Canadian medical schools to provide comprehensive training in caring for LGBTQ people and those born with sex-development differences.
Since then, the need for such instruction has only ballooned, given the dramatic increase in LGBTQ identification among young people in particular.
“The current political and social climates are unfortunately leading to many, many health care-professional students and residents feeling uncertain and frightened to engage in LGBTQ+ education and training.”
DR. DUSTIN NOWASKIE, OUTCARE HEALTH
A constellation of medical schools has heeded the AAMC’s call — progress that inspires hope among queer-health advocates. But the schools’ adoption of comprehensive LGBTQ-focused curricula are the exceptions to the rule. The organization’s call, which was buttressed by a 300-page roadmap for reform but lacked the teeth of a mandate, has mostly gone unheeded nearly a decade later.
Progress at medical schools has been stymied by a myriad of factors, including the lack of LGBTQ-related content in medical licensing exams; inadequate or nonexistent knowledge and clinical experience among educators; administrators and the medical old guard’s resistance to change and concerns about competing educational priorities; and outside political pressures as conservatives seize upon transition-related care for minors and diversity policies as wedge issues and as they scrutinize higher education.
Dr. Alex S. Keuroghlian, director of education and training at the LGBTQ-focused Fenway Institute in Boston, and six other medical educators who asked to remain anonymous out of fear of the very reprisals they described told NBC News that recent state-level efforts to restrict diversity programs in education and transition-related health care for transgender minors have instilled fear in some medical schools that their LGBTQ-related medical training could draw increased scrutiny and punitive attacks from legislators.
Keuroghlian, who is also an associate professor of psychiatry at Harvard Medical School, said that the recent state gender-care bans would likely have a chilling effect “on our ability to teach in an evidence-based way that is grounded in human rights and autonomy.”
Where are the needs?
Researchers who have assessed the capacity of the nation’s health care workforce to serve the specific needs of LGBTQ Americans have found them woefully unprepared, especially to care for transgender people. And LGBTQ people remain in dire need of improved physical and mental health care, according to a trove of studies.
Despite the population skewing younger, 23% of LGBTQ people report being in poor health, compared with 14% of the non-LGBTQ population, according to the health-care analysis nonprofit KFF. And research finds that as many as 1 in 5 LGBTQ people have experienced discrimination during health care encounters, including refusals to prescribe medication and even verbal attacks.
Resulting alienation from the health care system, researchers say, is a key driver of the various health disparities that plague LGBTQ Americans. Such apparent consequences include elevated rates of heart disease, cancer, depression and anxiety, substance use disorders and risk of suicide. These disparate outcomes, according to researchers, are likely also fueled by the damage that being a member of a stigmatized minority can apparently inflict upon the mind and body. These are pervasive problems that the health care establishment would ideally mitigate, not exacerbate.
And yet a 2011 survey of 176 U.S. and Canadian medical schools found that their students received a median of just five hours of LGBT-related training. One in 3 schools devoted no such time during clinical rotations.
Dr. Dustin Nowaskie is the founder and president of OutCare Health.Courtesy Dustin Nowaskie
Dr. Dustin Nowaskie is the founder and president of OutCare Health, a nonprofit LGBTQ health-equity organization that is at the forefront of a growing movement to improve medical training on this front and has developed queer-medicine training programs for both medical students and physicians. Nowaskie, who uses gender neutral pronouns, argued in a 2020 paper that medical schools should, in fact, provide at least 35 hours of such training. This instruction, according to Nowaskie, should start with basic terminology and cultural sensitivity and expand to issues such as health conditions that occur at higher rates among LGBTQ people, including sexually transmitted infections and skin cancer.
“These skills should absolutely be required,” Nowaskie said, because of the expanding LGBTQ population and the inevitability that doctors will frequently treat such patients. Nowaskie said they consistently hear from medical students nationwide that LGBTQ-specific instruction is “often minimal,” and that it is “very outdated,” relying on language, terminology and an overall understanding of queer people that has otherwise been retired thanks to recent social progress.
A recent Gallup poll found that over the past decade, the proportion of Americans openly identifying as LGBTQ has doubled, to 7.2%, and that 1 in 5 young adults say they identify as something other than a cisgender heterosexual. The Williams Institute at UCLA Law recently estimated that 0.5% of older adults identify as transgender, compared with 1.4% of adolescents and 1.3% of young adults.
A team directed by Dr. Carl Streed, research lead for the Center for Transgender Medicine and Surgery at Boston Medical Center, is preparing to publish an update of the 2011 medical school survey. Streed was keen to highlight medical schools that have adopted comprehensive LGBTQ-related curricula — including, among many others, the University of Kentucky at Louisville, Stanford University and Boston University, where Streed is an assistant professor. But Streed tempered expectations that his team would identify much of an uptick in overall training.
“Who ends up being remotely comfortable and competent” in caring for sexual and gender minorities, Streed said, “is a matter of wherethey trained rather than whether they’ve been trained.”
Any progress over the past decade has transpired against a split-screen backdrop of sweeping advances for LGBTQ civil rights and, in response, a fierce backlash against transgender rights, in particular. At least 20 states have now passed various restrictions on transition-related care for minors — a legislative effort that even many physicians who express misgivings about the science backing such treatment say they oppose.
“The current political and social climates are unfortunately leading to many, many health care-professional students and residents feeling uncertain and frightened to engage in LGBTQ+ education and training,” Nowaskie said.
“At the same time,” Nowaskie said, “these climates are perpetuating health care stigma among biased, discriminatory providers.”
How medicine can fail LGBTQ people
Delia M. Sosa, a first-year medical student in Ohio, wants to focus on LGBTQ care. Sosa, who uses gender-neutral pronouns, said they are motivated, in part, by their own alienating encounter with the medical old guard.
After growing up in what they described as a conformist Christian community in New England, Sosa came into their trans and nonbinary identity in their early 20s. At 21, they sought to establish a relationship with a primary care physician in their hometown in hopes of eventually having a double mastectomy, or what’s known in trans medical care as top surgery. But after Sosa disclosed to the doctor their queer identity and the fact that they were dating a nonbinary person, they recalled, “she looked at me with a look of confusion” that was also “mixed with frustration.”
“Medicine is playing catch-up in a lot of ways. … I get some really seasoned, experienced physicians who come up to me and say, ‘I never had a chance to learn about this, yet I know this is something I need to learn.’”
DR. SARAH PICKLE
Sosa said they spent the bulk of the appointment providing the doctor a trans-identity 101 tutorial, including breaking down the difference between gender and sex, what it means to be nonbinary, what gender neutral pronouns are and how sexual orientation can be fluid with respect to the gender of partners. They found the experience so off-putting, they let three years pass before seeking surgery again, which they ultimately had last year.
Dr. Sarah Pickle, a family physician and medical educator in Ohio, is a leading proponent of medical schools cultivating a deft hand in up-and-coming physicians in how to care for LGBTQ people. Pickle insists that such training, which focuses, for example, on speaking with sensitivity and inclusivity regarding queer people’s differences, can be crucial in keeping LGBTQ people engaged in care.
“Medicine is playing catch-up in a lot of ways,” Pickle said. “I get some really seasoned, experienced physicians who come up to me and say, ‘I never had a chance to learn about this, yet I know this is something I need to learn.’”
Sosa discovered their own evidence of the potential perils of physicians’ lack of knowledge about treating LGBTQ patients when researching trans people’s experiences with cancer care. Some oncologists, Sosa found, were confounded over how to manage such treatment in a patient taking cross-sex hormones.
“I can’t tell you how many stories I heard of trans folks where they had delayed care because an oncologist didn’t know what to do with them,” Sosa said.
One expert in LGBTQ medicine, who preferred to remain anonymous because of attacks from the far right, described an often cavalier attitude among specialists toward trans patients’ hormone therapy. A cardiologist, they said, might advise a patient to simply go off hormones due to cardiovascular risk, rather than thoroughly reviewing the risks versus benefits of a therapy that is fundamental to many trans people’s sense of self and well-being.
This health care provider and medical educator expressed frustration that such doctors often remain ignorant to studies that provide insight into managing hormonal therapy in the context of certain health problems.
Who is leading the change?
Keuroghlian stands at the vanguard of the movement to train doctors in caring for trans and gay patients.
At Harvard, he and a team of colleagues led a three-year effort to design and implement a new curriculum that provides comprehensive training in such care.
The curriculum, which other schools are free to adopt, permits all professors, regardless of their own identity or experience, to weave LGBTQ themes and practices into their own instruction. So, for example, a course on endocrinology would include instruction on cross-sex hormonal treatment and an embryology course would teach about intersex variations.
Bringing a broad swath of medical educators up to speed is crucial, Keuroghlian said. A major roadblock to progress has been the fact that the professors, who are meant to pass on their own acquired knowledge, have typically never received their own training in sexual and gender minority care. So, in addition to the four-hour training he helped craft for Harvard faculty about how to teach this subject, Keuroghlian is among the educational pioneers, a group that includes Nowaskie, who are designing medical education seminars to train other health care providers nationwide.
Dr. Christopher Terndrup is an associate professor of medicine at Vanderbilt University Medical Center.Courtesy Vanderbilt University Medical Center
Dr. Christopher Terndrup, an associate professor of medicine at Vanderbilt University Medical Center in Nashville, Tennessee, noted that most demand for LGBTQ health education “is actually pushed by the medical students themselves.”
But such eagerness from the new generation can hit old bureaucratic walls, according to Dr. Nelson Sanchez, an associate professor of clinical medicine at Weill Cornell Medicine and the chair of the annual LGBT Health Workforce Conference. Sanchez said administrators often resist calls for such curriculum by insisting that a zero-sum game governs all medical-school education hours.
Dr. Lily Rolfe, who recently graduated from Rush Medical College in Chicago and is matriculating to a residency in family medicine, with a focus on caring for LGBTQ patients, at Swedish Hospital in Seattle, conducted an informal survey of students at Chicago area medical schools about the quality of their education in caring for LGBTQ people.
“It’s always, ‘The gay guy has HIV,’” Rolfe quipped regarding the typical way the respondents characterized their limited education on this front.
“HIV is important,” Rolfe said. “We should learn about it. But that shouldn’t be the entirety of LGBT health.”
Otherwise, the Chicago students said that social determinants of health pertaining to sexual and gender minorities were commonly addressed. But the survey respondents, Rolfe said, “noticed a lack of discussion about trans people, including gender dysphoria; gender euphoria; medical, social, legal and surgical transitioning; and a lack of the discussion of the over pathologization of trans people.”
Harvard’s LGBTQ curriculum, meanwhile, goes beyond just infectious disease, including basic concepts and terminology about gender and sexuality; stigma’s impacts on health inequities; major health concerns that are more common in LGBTQ people, such as anal cancer in gay men or breast cancer in lesbians; effective doctor-patient communication methods; navigating power imbalances and implicit bias; addressing microaggressions; and how to generate learning opportunities if an LGBTQ patient responds negatively to a physician’s words or actions.
Other med schools that have also established substantial training efforts on such subjects include Louisiana State University, the University of Mississippi at Jackson, the University of Wisconsin at Madison, Vanderbilt University, the University of Pennsylvania and Cedars-Sinai in Los Angeles.
The current hostile political environment notwithstanding, Keuroghlian said he remains optimistic for how well prepared the next generation of doctors will be.
“People in medical school are increasingly passionate about doing this work, because there’s more understanding for the need for skilled, culturally responsive care,” Keuroghlian said of sexual and gender minority care.
“There’s also a sense of social justice and health equity that drives young people to do this work,” he said. “They see this as one of the major health rights issues of their generation, and that’s very engaging for them.”
Large majorities of U.S. adults across different racial, ethnic, and religious identities oppose religious-based discrimination against LGBTQ+ people, according to a new Williams Institute report.
Even majorities of Republicans oppose religious-based anti-LGBTQ+ discrimination, the report found. Its findings suggest that Republican-led attacks on LGBTQ+ civil rights — many of which are couched in religious terms — are actually opposed by most American adults.
A survey of non-LGBTQ Americans show large majorities disagree with right-wing discrimination.
The data came from the Williams Institute’s September 2022 survey of a nationally representative sample of 1,003 adults.
Approximately 84% of survey respondents said they opposed religious-based denials of healthcare to LGBTQ+ people, 74% opposed religious-based anti-LGBTQ+ employment discrimination, and 71% opposed business employees denying services to LGBTQ+ people based on the employees or employer’s religious beliefs.
Over 80% of respondents in all non-white racial and ethnic groups opposed the use of religious beliefs to deny LGBTQ+ people business services, medical care, and employment. About 70% of white respondents felt the same. Female, younger, or college-educated respondents were also more likely to oppose religious-based anti-LGBTQ+ discrimination than respondents who are men, older in age, or non-college educated.
While Democrats unsurprisingly opposed these various types of religious-based anti-LGBTQ+ discrimination by about 90%, the report surprisingly found that Republican majorities also opposed such discrimination: 52% opposed religious-based refusal of business services to LGBTQ+ people, 54% opposed religious-based anti-LGBTQ+ employment discrimination, and 71% opposed religious-based anti-LGBTQ+ healthcare discrimination.
Respondents who personally know LGBTQ+ people were more likely to oppose such religious-based discrimination, the report found. However, even respondents who don’t personally know LGBTQ+ people were also opposed to religious-based anti-LGBTQ+ discrimination by margins of 65% to 80%.
Even majorities of Protestant/Christian, Catholic, and non-Christian faiths opposed such religious-based anti-LGBTQ+ discrimination.
When asked about their support for allowing religious-based anti-LGBTQ+ discrimination, less than 30% of respondents in almost every different demographic supported allowing such discrimination.
These findings matter specifically because Republicans have introduced over 400 anti-LGBTQ+ bills in state legislatures nationwide. Many have been couched in religious justifications.
Florida, for example, passed a law in May that allows any medical worker or insurer to deny care to anyone based on “ethical, moral, or religious beliefs.” The U.S. Supreme Court is also about to issue a ruling on whether religious beliefs should permit public-facing businesses to violate LGBTQ+ anti-discrimination laws.
“Recent efforts by some state legislatures to expand religious exemptions from LGBTQ-inclusive non-discrimination laws are largely out of alignment with the views of most Americans,” wrote Christy Mallory, Legal Director at the Williams Institute and author of the study. “More than three in four Americans now favor civil rights laws protecting LGBTQ people against religiously motivated discrimination.”
It’s Pride Month and as more and more businesses have climbed on board the rainbow train, Republicans are running out of places to dine out.
“Rainbow washing” and “rainbow capitalism” have become common refrains from some in the community who are weary of corporations slapping a rainbow on their logo without supporting the community during the other 11 months of the year. But with over 600 anti-LGBTQ+ laws proposed at the federal and national levels by Republicans and the religious right, this is the year to overlook that in favor of just making them squirm.
But as the far-right boycotts Disney, Target, Budweiser, and any other company they can, the perpetually angry are quickly running out of options. Even Chick-fil-A, the right’s bastion of fast food righteousness, has been deemed too “woke” for waffle fries after they hired a vice president of diversity, equity, and inclusion.
So where is a Republican supposed to go on Sundays after church like God intended? Not these restaurants. They’re not offering a side of hatefulness to their menus.
Click through to see some of the brands celebrating online
With hundreds of anti-LGBTQ+ bills filed over the past year, both at the federal level and in state legislatures across the country, it’s a difficult time for the queer community. Republican politicians, far-right online personalities, neo-Nazis, and white supremacists have launched vicious attacks against the community, especially drag queens and transgender people.
June is usually a celebration for the LGBTQ+ community, but this year many have found it challenging to enjoy Pride like in previous years. They’ve been traumatized by the nonstop vitriol and threats of violence.
So how can you take care of yourself this year? The onslaught of negativity can quickly take its toll, so LGBTQ Nation spoke with a therapist and psychologist to get tips on how to recognize your trauma, protect your mental health, and show yourself some compassion at the same time.
“These relentless attacks against LGBTQ folks, at minimum, leave us afraid, anxious, and insecure. When we leave our homes, are we safe? Will I be faced with attacks ranging from disgust to outright physical harm?” clinical psychologist Roxy Manning, Ph.D. pointed out. “Someone might call themselves an ally, but will they publicly intervene when horrendous comments are directed at me, or is their allyship restricted to privately commiserating with me and telling me that what happened was so wrong? We begin to doubt ourselves.”
“So many of us walk the world in this state of perpetual anxiety and uncertainty – am I safe, do I truly belong, am I truly welcome, am I appreciated and valued? And these attacks make it impossible for us to fully trust a ‘yes’ to any of those questions, no matter how often we are told otherwise. At our most elemental level, we know that it will only take another slur yelled as we walk down the street or another bullet ripping through our community to let us know how shaky that welcome truly is.”
The Human Rights Campaign recently declared a state of emergency for queer people in the United States, particularly in states politically dominated by Republicans. Pride festivals have been canceled due to threats of violence or legal ramifications. And social media has become an even more giant cesspool, if possible. For a community that already suffers disproportionately from depression and suicide risks, Talkspace therapist Cynthia Catchings, LCSW-S, warns that it is essential to be aware of your mental health risks.
“Fear of the unknown and knowing that there is an emergency can create stress and anxiety. That can result in other negative thoughts and actions, including panic attacks, depression, or PTSD,” she said. “Look out for negative emotions; drastic mood changes; fear, anxiety, or panic attacks; a lack of interest in things that you enjoyed doing before; irritability; not feeling like socializing or talking to others; crying spells, poor hygiene, lack of or excessive sleep; and changes in eating habits.”
“Staying informed but moderating the information intake is essential to avoid more severe mental health issues. You can take some time to observe and reflect on how you feel. It also helps to be open to listening to what those who care about you tell you. A person that loves you will share their concern. Being open to listening to them. Speaking with a mental health professional or joining a support group can help too.”
Dr. Manning agrees. “As we work on expanding our capacity for self-compassion, we can find support in not doing this alone. It can seem counter-intuitive. People used to tell me, ‘You just need to learn to accept yourself.’ But it’s hard to accept yourself when all around you, people are putting you down, making fun of you, and demonstrating that they think you have little value. We can more easily access self-compassion when we experience compassion, when we see reflected in other people’s behavior that we are worthy of care, consideration, and acceptance.”
“Other people can show us the path to self-compassion when it’s new to us, and can keep reminding us that this is possible. For a long time, when I judged myself harshly, I would remember the voice of a dear friend who always received me with total compassion. I couldn’t always find the words to be compassionate to myself, but recalling his words would be a needed jumpstart.”
But what if our emotions keep us from celebrating Pride? That’s okay, they say. Pride started as a protest against authorities abusing their power to persecute the LGBTQ+ community, after all. Give yourself time to process everything from an inside point-of-view instead of solely external, and see if that helps you feel better.
“Not wanting to celebrate is okay,” Catchings says. “Any feeling we are experiencing that makes us avoid participating during the celebrations has a valid reason. However, it is important to take some time to reflect on the reasons why you feel that way. Ask yourself if that attitude is creating more issues or if you will be more resentful in the future for not celebrating this year.”
Mindfulness activities, journaling, yoga, breathing exercises, practicing a hobby or sport, or participating in a support group can help to soothe your emotions. Still, Dr. Manning warns that some techniques may seem helpful at the time but aren’t.
“As a Black psychologist, so many people have shared messages of anti-compassion they’ve learned from their family, often with the best intentions. Instead of giving ourselves permission to feel, to self-empathize, we’re told just to get back out there, pretend,” she said. “For many of us, without the capacity for the healing effect of self-compassion, we seek strategies to distract ourselves or numb ourselves.”
“We use food, alcohol, drugs, and increasingly, the internet and social media. We want to feel cared for and nurtured, so we turn to meaningless sexual encounters. We rely on accessing and expressing anger and judgment at ourselves or others. We even have behaviors that seem prosocial but still serve to distract us from our feelings.”
“Many of us have some emotions we think it’s okay to experience, and others we demonize. I might allow myself to feel anger and rage but not allow myself to feel grief and despair. We think we have to ‘chin up’ and soldier on, be professional, don’t let them see it hurts,” Dr. Manning added. “We can welcome and hold all our reactions and emotions with compassion.”
“One way we can access that compassion for our reactions is to recognize that each emotion is fueled by an underlying need, something that is deeply important to us. If we feel anger, it might be fueled by our deep longing for justice, for relief from pain. We can even feel compassion for our numbness – our inability to feel may be our body’s best strategy to relieve the intense pain.”
“Remember that you are the change that you want to see in the world, and not celebrating or participating in some way may sabotage progress and your own happiness,” Catchings pointed out. “If you feel like it after reflecting on your reasons not to celebrate, pick up those colors and wear them proudly wherever you go!”
A $100,000 donation from HBO was announced on Wednesday for regional, national, and local LGBTQ+ organizations in conjunction with the Emmy, Peabody, and GLAAD-award-winning unscripted series We’re Here. The donations will benefit LGBTQ+ non-profits in the locations where the show recorded its third season.
PFLAG Fort Worth, MS Capital City Pride, Pride of Southern Utah, TriVersity Pride Center, Equality Florida, and Lambda Legal are among the organizations receiving the donations, according to HBO.
During season three, Bob the Drag Queen, Eureka O’Hara, and Shangela toured Texas, Utah, Florida, Mississippi, and New Jersey, bringing together a range of residents to promote acceptance and raise awareness. In each town, the queens support their “drag daughters” by empowering them to express their true selves and to encourage acceptance and tolerance in their communities, despite increased opposition from state governments in Republican-controlled states nationwide.
The season was shot during the beginning of a fraught period for LGBTQ+ people as right-wing extremists and conservative Republican politicians targeted the community with a particular disdain for transgender people and drag queens.
Queer people, especially those who are trans, have been falsely accused of grooming children by the far-right.
In the show, local groups protested the production happening in their towns due to these conspiracies.
https://www.youtube.com/embed/9ghvJYFxt-0?rel=0&start=85We’re Here Season 3 | Official Trailer | HBOwww.youtube.com
This donation will benefit organizations supporting or advocating for the LGBTQ+ community in their state.
Dedicated to improving the lives of LGBTQ+ people and people living with HIV and AIDS, Lambda Legal focuses on impact litigation, societal education, and public policy nationwide.
Using lobbying, grass-roots organizing, education, and coalition building, Equality Florida protects the LGBTQ+ community from harassment and discrimination, particularly in the face of an all-out assault by the state’s Republican governor and 2024 GOP presidential hopeful Ron DeSantis.
As a community-based organization in Mississippi, MS Capital City Pride provides safe spaces for LGBTQ+ communities and mentors emerging leaders. Among the many services the TriVersity Pride Center offers to the LGBTQ+ community in New York, New Jersey, and Pennsylvania are events, educational programming, a media center, and support groups.
PFLAG Fort Worth provides confidential peer support, support for families, education, and advocacy for LGBTQ+ people in that part of Texas. As a community-based organization in Mississippi, MS Capital City Pride provides safe spaces for LGBTQ+ communities and mentors emerging leaders.
All major social media platforms do poorly at protecting LGBTQ users from hate speech and harassment — especially those who are transgender, non-binary or gender non-conforming, the advocacy group GLAAD said Thursday. But Twitter is the worst.
In its annual Social Media Safety Index, GLAAD gave Facebook, Instagram, TikTok, YouTube and Twitter low or failing scores, saying the platforms don’t do enough to keep their users safe. That said, most improved from a year ago.
Twitter, which was acquired by Tesla CEO Elon Musk last October, was the only exception. GLAAD’s scorecard called it “the most dangerous platform for LGBTQ people” and the only one that saw its scores decline from last year.
Twitter’s communications staff was eradicated after Musk took over the company and for months inquiries to the press office have been answered only an automated reply of a poop emoji, as was the case when The Associated Press reached out to the company for comment.
LGBTQ advocates have long warned that online hate and harassment can lead to violence offline. But even when it does not, online abuse can take a toll on a person’s mental health.
“There isn’t a week that goes by that we don’t have a doxxing situation for somebody in our community that we have to come in and help them stop it and stop the hate, stop the vitriol and stop the attacks,” said GLAAD CEO and President Sarah Kate Ellis referring to the malicious practice that involves gathering private or identifying information and releasing it online without the person’s permission, usually in an attempt to harass, threaten, shame or exact revenge. “It’s really been amped up to a level that we’ve never seen before.”
On Twitter, attacks on LGBTQ users have increased substantially since Elon Musk took over the company last fall, according to multiple advocacy groups.
A big part of the reason is the drastic staffing cuts Musk has enacted since his takeover — there are simply not enough content moderators to handle the flood of problematic tweets that range from hate speech to graphic material and harassment. Musk has also described himself as a “free-speech absolutist” who believes Twitter’s previous policies were too restricting.
In April, for instance, Twitter quietly removed a policy against the “targeted misgendering or deadnaming of transgender individuals,” raising concerns that the platform is becoming less safe for marginalized groups. Musk has also repeatedly engaged with far-right figures and pushed misinformation to his 143 million followers.
Twitter, as part of the same retooling of its site policies, also changed how it responds to tweets that violate its rules. While in the past, offending tweets were removed, the company now says it will sometimes restrict a tweet instead of removing it from the platform altogether.
“Twitter is is largely a cesspool now. You can’t post without getting attacked. There’s no room for conversation. It is just about hand-to-hand combat,” Ellis said. “And that’s what it is. It’s like backyard dogfights.”
Ellis lamented that before the takeover, Twitter was a “leader” among major social media platforms when it comes to protecting LGBTQ users.
Meta, which owns Facebook and Instagram, saw a 15 percentage point score increase for both its platforms, to 61% and 63%, respectively. GLAAD’s index measures 12 LGBTQ-specific indicators, such as explicit protections from hate and harassment for LGBTQ users, offering gender pronoun options on profiles, and prohibiting advertising that could be harmful or discriminatory to LGBTQ people.
While Meta has improved and has strong policies in place, GLAAD says the company does not consistently enforce them. For instance, the group says for many abusive posts that it reports, Meta will send an automated response stating that due to the high volume of reports it receives, it is not able to review the post.
Meta said in a prepared statement that it works with “civil society organizations around the world in our work to design policies and create tools that foster a safe online environment,” including getting input from LGBTQ safety and advocacy organizations.
TikTok, which saw its score increase from 14 points to 57%, said it is “proud to have strong policies aimed at protecting LGBTQ+ individuals from harassment and hate speech, including misgendering and deadnaming, and we’re always looking to strengthen our approach, informed both by our community and the advice of experts, such as GLAAD.”
Google’s YouTube, meanwhile, scored 54%, up nine points from 2022.
“Our policies prohibit content that promotes violence or hatred against members of the LGBTQ+ community. Over the last few years, we’ve made significant progress in our ability to quickly remove this content from our platform and prominently surface authoritative sources in search results and recommendations,” said spokesperson Jack Malon.
Musk, in tweets and public statements, has repeatedly said he supports freedom of speech and calls himself a “free speech absolutist” who wants to turn Twitter into a “digital town square” where people with differing views can debate freely. The company’s newly installed CEO, Linda Yaccarino, also tweeted recently that “you should have the freedom to speak your mind. We all should.”
But GLAAD and other organizations advocating for marginalized groups note that unfettered freedom for one group can infringe on the free speech of others.
“Freedom of speech does not mean I get to, you know, bully and harass people relentlessly,” said Jenni Olson, GLAAD’s director of social media safety. “And that is why companies have hate speech policies, because … if someone is bullying and harassing me that actually means that I don’t have freedom of speech because I’m afraid to say anything.”
The American Medical Association has strengthened its position supporting the care for all transgender and gender-diverse people.
The AMA’s House of Delegates, holding its annual meeting in Chicago, voted Monday to pass the Endocrine Society’s resolution on protecting access to gender-affirming care, according to an Endocrine Society press release.
In the resolution, the AMA committed to opposing any criminal and legal penalties against patients seeking gender-affirming care, family members or guardians who support them in seeking medical care, and health care facilities and clinicians providing it.
The AMA promised to work with federal and state legislators and regulators to oppose policies restricting access to the care and collaborate with other organizations to educate the Federation of State Medical Boards about the importance of gender-affirming care.
The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Urological Association, the American Society for Reproductive Medicine, the American College of Physicians, the American Association of Clinical Endocrinology, GLMA: Health Professionals Advancing LGBTQ+ Equality, and AMA’s Medical Student Section cosponsored the resolution.
The AMA already has a long history of supporting gender-affirming care, including support for insurance coverage of the procedures, which include puberty blockers for young people, hormone treatment, and surgery. Medical associations agree that genital surgery should be delayed until patients reach age 18.
But right-wing politicians are increasingly attacking such care, calling it experimental and unproven, when in fact more than 2,000 scientific studies have examined aspects of gender-affirming care since 1975, including more than 260 studies cited in the Endocrine Society’s Clinical Practice Guideline, the society notes in its press release.
Twenty states have passed laws banning most or all gender-affirming care for minors, and some states restrict the care for certain adults as well, such as those who receive insurance coverage through Medicaid. Five of the states make it a crime to provide the care. At the federal level, far-right Republican Congresswoman Marjorie Taylor Greene last year introduced a bill that would have made it a felony to deliver the care to minors. It went nowhere, but Green reintroduced it this year.
The United Kingdom’s National Health Service recently decided to limit the use of puberty blockersto clinical trials, a move that received criticism from LGBTQ+ activists.
In the U.S., 11 states and several cities, including New York City, Kansas City, Mo., and Washington, D.C., have taken steps to protect access to gender-affirming treatment.
Several studies have made clear that gender-affirming care saves lives. A 2020 study, for instance, found that trans adults who had received puberty blockers in their youth had lower likelihood of lifetime suicidal ideation than those who wanted the treatment but did not receive it. A recently released study found that receiving hormone treatment as teens significantly reduced the risk of ever attempting suicide.
The American College of Pediatricians, a small, right-wing extremist group of physicians who for two decades has struggled to gain traction finds itself for the first time with more power than it has ever had as the far-right takes greater hold on America.
But along with their new-found power comes a deep dive into at least 15 years worth of their internal documents, the result of the group reportedly publishing a link to its own unsecured Google drive in April, which WIRED uncovered and reported on back in May.
The Washington Post combed through 10,000 of the group’s documents, and on Thursday publishing its exposé on the American College of Pediatricians, which the Southern Poverty Law Center lists as an anti-LGBTQ hate group.
“The American College of Pediatricians (ACPeds) is a fringe anti-LGBTQ hate group that masquerades as the premier U.S. association of pediatricians to push anti-LGBTQ junk science, primarily via far-right conservative media and filing amicus briefs in cases related to gay adoption and marriage equality,” SPLC writes in its extensive report.
According to The Washington Post, the American College of Pediatricians is a “small group of conservative doctors” that “has sought to shape the nation’s most contentious policies on abortion and transgender rights by promoting views rejected by the medical establishment as scientific fact.”
The American College of Pediatricians promotes the discredited practice of “conversion therapy,” which has been called “torture” by some who have been subjected to it. Conversion therapy, which purports to change a human being’s sexual orientation or gender identity, is outlawed in several states, while most credible medical organizations have denounced it.
The group’s success comes at the expense of transgender youth.
“The organization’s quest to ban the use of puberty blockers and hormone therapy for transgender minors has culminated in a string of recent legislative wins following lobbying in at least eight states, internal documents show,” The Post reports. “Arkansas first enacted such a law in 2021, after Michelle Cretella, then executive director of the American College of Pediatricians, described such care as ‘experimental and dangerous‘ to legislators. A federal appeals court temporarily blocked it.”
“Versions of the law have since passed at least 20 other state legislatures, including Florida, Idaho, Indiana, West Virginia, Oklahoma, Missouri, Montana, Texas, North Dakota and Louisiana this spring alone; some face court challenges and one was vetoed by a governor. Similar bills are making their way through legislatures in North Carolina and Ohio.”
In other words, lawmakers in about half the country are working to harm transgender children, with the help of the American College of Pediatricians.
Also among the American College of Pediatricians’ more dangerous efforts over the years have been its attacks on homosexuality.
“Internal records from 2010 show how the group tied homosexuality to health risks — even death — in a letter campaignto educators, citing a 1991 study to demonstrate that for each year adolescents delay ‘self-labeling as ‘gay’,’ the risk of suicide decreases by 20 percent.”
That claim we know today is false.
“According to more recent research, suicide risk rises with therapy directed at changing sexual orientation. Lesbian, gay and bisexual people who experienced conversion therapy were almost twice as likely to think about suicide and to attempt suicide compared with peers who had not experienced conversion therapy, according to the Williams Institute at the UCLA School of Law,” The Post adds.
2010 may seem like light years ago, but LGBTQ rights were very much a large part of the national conversation back then.
In 2010, President Barack Obama directed the federal government to extend spousal benefits to same-sex couples. A critical portion of the anti-LGBTQ federal law, the Defense of Marriage Act, was ruled unconstitutional by a federal court. President Obama also signed into law the repeal of “Don’t Ask, Don’t Tell” that year. And a federal judge ruled California’s infamous Prop 8 was unconstitutional.
But also in 2010, just as LGBTQ people were starting to be able to access the rights and recognition they had always been denied, the American College of Pediatricians sent a letter, The Post reports, “to 14,800 public school superintendents [that] urged school officials not to affirm any student expressing homosexuality. It directed them to a website operated by the group that pushed ‘sexual reorientation therapy’ for those with ‘unwanted homosexual attractions.’”
The Heritage Foundation, a once-vaunted right-wing think tank that has succumbed to pro-Trump MAGA far-right extremism, is a big fan of the American College of Pediatricians.
“They have had the courage to take stands in court and to speak as medical professionals in relating their experience when it comes to questions of human dignity in unborn life, freedom of conscience, and the protection of children,” Roger Severino, Heritage’s vice president of domestic policy, told The Post.
Severino, a far-right religious extremist, served in the Trumpadministration as the head of the Department of Health and Human Services’ Office of Civil Rights.
In its report on Thursday, The Washington Post adds that Severino “said [he] relies on the American College of Pediatricians for scientific expertise.”
Amplifying far-right wing anger that the LGBTQ Pride flag was hanging from the White House during President Joe Biden’s historic Pride celebration over the weekend, the Heritage Foundation lashed out, attacking the entire LGBTQ community and the Biden administration.
On Wednesday the Heritage Foundation declared that the LGBTQ Pride flag “does not represent anything good and it certainly does not represent America.”
IGLTA, the world’s leading LGBTQ+ travel association, is proud to announce the global launch of a groundbreaking initiative to support full equality within the travel industry: IGLTA Accredited™. Following a soft launch within IGLTA’s network, IGLTA Accredited™ has opened applications to hotels and accommodations worldwide, with anticipation of rapidly building momentum as travel organizations globally seek to champion LGBTQ+ inclusivity.
IGLTA Accredited™ sets the standard as an independent quality assurance process, providing concrete evidence that participating hotels genuinely welcome LGBTQ+ guests through their actions, not just empty words. To obtain accreditation, hotels must successfully document fulfillment of eight criteria, showcasing their dedication to creating a safe and welcoming environment for their staff and LGBTQ+ travelers.
The eight criteria of IGLTA Accredited™ are built upon the pillars of diversity, equity, inclusivity, policy, community, advocacy, transparency, and sensitivity. They encompass the implementation of non-discriminatory policies protecting both LGBTQ+ travelers and hotel staff, comprehensive sensitivity training, a proven commitment to inclusive marketing practices, and tangible evidence of genuine support for the LGBTQ+ community.
“We believe allyship should be year-round, not just for pride,” said IGLTA President/CEO John Tanzella. “LGBTQ+ travelers are looking for real accountability in their travel experiences, and travel advisors want to know they are directing LGBTQ+ clients to hotels/accommodations that truly welcome them. We invite properties around the world to join us in championing integrity within the travel industry and elevating the standard of travel for all. IGLTA Accredited™ strives to provide peace of mind for all LGBTQ+ travelers, wherever their adventures might take them.”
W Costa Navarino was the first hotel globally to become IGLTA Accredited™. The resort opened last year in Costa Navarino, a sustainably driven destination in the Greek region of Messinia, southwest Peloponnese. They have implemented several practices to ensure a welcoming experience, such as role-play inclusivity seminars for associates, establishing an LGBTQ+ associates ambassador, and the creation of gender-neutral room amenities, spa treatments, and restrooms.
“The foundation of Costa Navarino is built upon a deep respect for our guests. Our commitment is not only to meet but to exceed their expectations,” said Stephanos Theodorides, Managing Director of TEMES, the developers of Costa Navarino. “Recognizing that everyone has a unique personality, we strive to anticipate diverse needs, ensuring that everyone feels as comfortable as they would in their own home. The fact that W Costa Navarino is the first hotel in the world to be IGLTA Accredited™ is a true honor.”
In today’s cultural climate, trust has become a rare commodity. The 2022 Edelman Trust Barometer, which surveyed 28 countries, showed that nearly 6 in 10 people currently say their default emotion is distrust. It is no longer enough for brands to claim authenticity, it must be proven. This is especially true for the LGBTQ+ community.
Discover how IGLTA Accredited™ is transforming the landscape of trust and authenticity during our virtual event on 22 June at 10am ET. Click here to RSVP and to learn more about the program.
About IGLTA & the IGLTA Foundation
The International LGBTQ+ Travel Association is the global leader in advancing LGBTQ+ travel and a proud Affiliate Member of the United Nations World Tourism Organization. IGLTA’s mission is to provide information and resources for LGBTQ+ travelers and expand LGBTQ+ tourism globally by demonstrating its significant social and economic impact. IGLTA global network includes 12,500+ LGBTQ+ welcoming accommodations, destinations, service providers, travel agents, tour operators, events, and travel media in 80+ countries. The philanthropic IGLTA Foundation empowers LGBTQ+ welcoming travel businesses globally through leadership, research, and education. For more information: iglta.org, igltaconvention.org or iglta.org/foundation and follow us on Facebook @IGLTA, @IGLTABusiness or @IGLTAFoundation, Twitter, LinkedIn, and Instagram @iglta.
