Tiffany Najberg, a Louisiana doctor who is transgender, said three insurance companies refused to reimburse her since she legally changed her name nearly two years ago.
The companies have since come to agreements with her and her Shreveport clinic, UrgentEMS, but not until after she started a petition that has garnered nearly 12,000 signatures and received news media attention about her cause, including inquiries from NBC News.
While the three insurers have agreed to update her name in their records and pay back claims, Najberg and her clinic have yet to receive any checks. In the meantime, she has spent her life savings — about $200,000 — to sustain her clinic, where she provides both primary and urgent care, including to more than 100 transgender patients, some of whom come from Alabama and Tennessee, two states that have passed restrictions on gender-affirming medical care for minors.
After Najberg changed her name in April 2021, she said, she updated it with all the necessary government offices and with databases from which most insurance companies pull information about providers.
She said Medicare, Medicaid, Blue Cross Blue Shield and United all updated the information and continued to reimburse her for the care she provided to her patients. But she said Aetna, Cigna and Humana had repeatedly denied her claims and refused to reimburse her.
“They were flagging each claim and rejecting it because of a name incompatibility with their internal database. They did not change my deadname,” she said, referring to the name she used prior to her transition.
She said all three companies told her that they don’t source information from the same database used by the government, Blue Cross and United. When she asked which database they use so that she could go through whatever steps necessary to update it, she said they wouldn’t tell her what it was. Even after her office sent the companies the court order granting her name change and copies of her updated IDs, they still wouldn’t update her name, she said.
Last March, Najberg began posting videos about the reimbursement denials on her TikTok account, where she has more than 150,000 followers. Last month, she also started a petition demanding that the three companies change her name and pay all of the back claims — something she said she did “out of sheer desperation because nothing else worked.”
“I’ve run through every dime I’ve ever had,” Najberg said. “I don’t have three to seven years for a court fight. I’ve got to make a living now. I have hundreds of patients, and most of them are in vulnerable populations. I want to keep taking care of them.”
Najberg said the situation has also had an impact on her mental health, because every time she would reach out to the three companies, their representatives would use her deadname, which at the time was still in their databases.
English Perez, who since 1998 has done medical credentialing — including helping hundreds of medical providers update their credentials following a name change after marriage or divorce, or an error in their name — said she has never encountered a problem like the one Najberg has been facing.
“That’s why I volunteered to help her,” Perez said, adding that she came across Najberg’s story on TikTok. “This needs to stop for her, for the next person that becomes their true self and lives in their authentic self — they should never have to incur this type of embarrassment.”
Perez added that Najberg’s relevant medical identification numbers and tax ID number all reflect her legal name change.
“That’s why I said it’s more about the transition, less about a name change,” Perez speculated.
By mid-January, after Najberg’s petition received more than 10,000 signatures and her story was covered by local news outlets, the three companies reached out, but they did not immediately agree to pay the back claims, she said.
As of Jan. 23, Aetna created a new contract with Najberg and agreed to process all of the back claims. Humana and Cigna had not agreed to anything at that point, she said.
NBC News reached out to all three companies on Jan. 24 for comment regarding Najberg’s reimbursement denials, their processes for updating medical provider names in their systems and Najberg’s allegations that company representatives repeatedly misgendered her. All three responded the following day, though none responded to specific questions regarding Najberg’s allegations.
A spokesperson for Aetna said, “We value our relationship with our providers and strive to resolve any issues they may experience as quickly as possible.”
Cigna’s spokesperson said name changes “have no impact on our payments to doctors or other health care providers; and we are committed to fair and prompt payment for both in- and out-of-network clinicians.”
Humana shared its first on-the-record response Jan. 27, with a spokesperson telling NBC News in an email that, “We are glad to have Dr. Tiffany Najberg as a provider in Humana’s network, and we look forward to continuing to partner with her and her office.”
The day prior, Humana had informed Najberg that the company would pay all of the back claims with interest and would create an immediately effective updated contract that puts her in their network.
On Monday, Jan. 30, Najberg said Cigna tentatively accepted her terms, and that she and her clinic now have agreements with all three insurance companies.
Perez, who noted that two of the three insurance companies did not help Najberg find a solution until they received an inquiry from NBC News, said, “We can’t relax and breathe until those checks start coming in the door.”
There is little available data on how many openly transgender medical providers there are and whether others have had issues similar to Najberg’s. Of 15,794 entering medical students surveyed by the Association of American Medical Colleges last year, 1.4% reported that their gender identity is different from their sex assigned at birth — up from 1.2% in 2021 and 0.8% in 2020.
Najberg said that she hasn’t had to stop seeing any patients as a result of the three companies denying claims for nearly two years now, but her practice has had to postpone plans to expand its telehealth services to Texas, Mississippi, Alabama and Florida, because she cannot afford the malpractice insurance in those states right now. She said she’s had more than 100 requests from residents in those states regarding telehealth care.
She said that she has been living off of Go Fund Me fundraisers for about eight months and that if she doesn’t start receiving reimbursements from the insurance companies soon, she could lose both her business and her home. She has dropped both her dental and health insurance and has eliminated all nonessential medications.
“I am literally in survival mode right now,” she said.
She said her goal isn’t to attack any of the insurance companies — but to draw attention to what has happened so that it doesn’t happen again.
“I’m not asking for anything special,” she said. “I just want to be an equal.”
When Constance Zhou got to college, they noticed that their queer friends were struggling with mental health. But they were also struggling to find providers well-versed in sexual and gender minorities or the complicated intersection of identities that often brought both discrimination and unique therapy needs.
At the same time, Zhou was working at a national suicide hotline, where many of the callers identified as LGBTQ+.
“I was getting people in Texas, in the Midwest, and in the South who really didn’t have access to resources,” Zhou said. “I began to appreciate how important it is to have access to mental health care and that it isn’t one size fits all.”
LGBTQ+ people face unique medical challenges related to sexuality and gender diversity. From experiencing higher rates of mental health stress and substance abuse to requiring gender-affirming care and treatment and prevention of HIV, needs stem from an array of factors related to how the healthcare industry and mainstream culture define identity. The criminalization of gender-affirming care in some states, as well as sports, bathroom, and book bans, contribute to the anguish faced by many in the queer community.
Medical understanding of the needs of queer people has come a long way since 1973 when activists successfully lobbied for the American Psychiatric Association to declassify homosexuality as a mental disorder. Indeed, advancements in health care have been hard fought by the community, often in the face of neglect and hostility by the medical establishment.
The federal government’s failure to respond to the HIV/AIDS crisis in the 1980s and ’90s further galvanized the queer community to take health care into its own hands. Gay Men’s Health Crisis (founded in 1982), the American Foundation for AIDS Research (1985), and ACT UP (1987) were among the early organizations to demand research, innovation, and medical access — efforts that drastically reduced HIV infections and eventually led to effective treatments and medications to prevent the spread of the virus.
Gay Men’s Health Crisis (GMHC) marchers during the annual New York City Pride March on June 30, 1985. Photo by Suzanne Poli/Getty Images
That practice of forcing the medical establishment to address the health needs of the increasingly diverse community is underscored today by efforts to improve gender-affirming care for trans and non-binary people, a movement under attack with 11 states introducing bills to restrict gender-affirming health care access.
“There’s been an enormous amount of harm done to queer people in health care environments,” said David Baker-Hargrove, co-founder and former CEO of 26Health, an LGBTQ+ health care center in Orlando, Florida. “Sometimes, it’s out of willful discrimination, but it’s also from ignorance about how our needs differ and how to interact with and provide services to members of our community.”
Many such issues are systemic, as is the lack of culturally competent care to address the needs of LGBTQ+ people. Demographic differences among queer people also play a determining role in health risks and outcomes, reflecting entrenched social inequalities.
“There are disparities in our community — notably race, ethnicity, and class — that may not be sexuality specific and that drive unequal access to care and prevention services,” Gregg Gonsalves, an early member of ACT UP and today associate professor of epidemiology at Yale School of Public Health, told LGBTQ Nation.
Sexuality and gender identity are among the many considerations included in what the World Health Organization calls social determinants of health — non-medical factors, including economic means and access to education, that impact health risks and outcomes. Such factors account for up to 50 percent of variations in health outcomes in the U.S.
“Addressing social determinants of health is as important as medical interventions,” said Gonsalves, which means addressing factors like access to care is as necessary as developing effective treatment.
That’s where advocates like Zhou come in, with hopes of changing the system for the better. They are determined to help push for care that meets the community’s complex needs by working inside and outside the system for change.
“We’re survivors,” Baker-Hargrove said. “We know how to get along outside of existing systems, and it’s made us strong.”
LGBTQ Nation spoke to a range of queer people who were inspired by their personal experiences to become healthcare advocates and providers.
Constance Zhou co-founded the Weill Cornell Medicine Wellness Qlinic. José Romero advocates for people like themselves who are living with HIV to be part of the solution to ending the epidemic. Dr. Marci Bowers is a pioneering transgender surgeon whose personal experience transitioning informs both her push for innovation and sensitivity toward patients. And Anthony Sorensen was inspired by his own sobriety journey to found Transitional Recovery in Minnesota, which provides LGBTQ+ people in recovery with a supportive living environment.
Constance Zhou: creating new spaces for mental health
Constance Zhou in New York City on December 21, 2022. Photo by Amy Mayes Photography for LGBTQ Nation
Growing up in Charlotte, North Carolina, Constance Zhou, 26, thought mental health was a storm that people weathered on their own.
That changed when Zhou got to college, where they grew comfortable identifying as queer and recognized that many queer people struggle with mental health and seek care, not only for anxiety or depression but for help developing a sense of self and to combat feelings of loneliness.
As a student, Zhou recognized the need for queer-affirming mental health care among their friends, as well as the LGBTQ+ people from around the country who called the suicide hotline where they worked. That led to Zhou’s decision to attend medical school to pursue psychiatry.
After working at a national suicide hotline, Constance Zhou realized the importance of mental health services geared toward the queer community. Photo by Amy Mayes Photography for LGBTQ Nation
Zhou witnessed firsthand the disproportionate mental health stress that young queer people face and the need for more culturally sensitive and affirming providers to meet the demand.
“The issue became very personal to me, being part of the LGBTQ+ community,” Zhou told LGBTQ Nation. “I’m Asian American, queer, and trans. I also identify as nonbinary and use they/them pronouns. And within both the Asian American community and the LGBTQ+ community, there’s a lot of stigma surrounding mental health.”
Parental pressures to succeed in academics, pressure to live up to the “model minority” stereotype, and racial and cultural discrimination are some of the stressors cited in a University of Maryland School of Public Health study. Still, the stigma Zhou mentioned is often a deterrent to seeking help.
Motivated to improve the situation, Zhou decided to specialize in mental health at medical school but said that as a student, they “see that a lot of curricula in medical school really don’t focus on LGBTQ issues.”
Zhou, an M.D./Ph.D. candidate at Weill Cornell Medical College in New York City, co-founded with a classmate the Weill Cornell Medicine Wellness Qlinic, a student-run resource that provides mental health care to queer people while serving as a training ground for the next generation of practitioners.
“I see a lot of patients who are going through feelings and experiences that I have had before,” Zhou said. “Knowing that I can use my own background in understanding and helping them has been very rewarding.”
Co-founding the Wellness Qlinic within the first week of school was transformative. “I never really thought that the work that I did would be meaningful to my queer or trans identity,” Zhou said.
The Wellness Qlinic received immediate support from faculty and administration. “A lot of people went out of their way to make sure that we felt empowered to do what we needed to do,” Zhou said. The clinic, which opened in 2019 and has expanded to include 20 students on the board, functions as a resource for the patients it serves and those who run it.
Student volunteers of Weill Cornell Medicine’s Wellness Qlinic. Photo provided by Weill Cornell Medicine
“Part of the mission of the Wellness Qlinic is to provide free and culturally competent mental health care to queer and trans folks,” Zhou said.
Those services include patient evaluations, individual and group psychotherapy, and medication management. But the clinic also serves as an essential training ground for medical students, residents, and volunteers “to give them the skills they can use later on in their own practice.”
The Wellness Qlinic follows a pattern of similar organizations around the country offering mental health care specifically to queer people. Indeed, the number of clinics offering services specially tailored to LGBTQ+ people decreased by an average of 10 percent each year from 2014 to 2018. As of 2018, about one in five mental health clinics offer services specifically geared toward queer patients.
Nonprofit organizations like Queer LifeSpace, founded in 2011 to offer mental health services to people in the Bay Area regardless of ability to pay, have sprouted up to meet the need. Queer LifeSpace also offers a 12-month clinical training program to help foster the next generation of queer therapists. There are dozens of such clinics around the country. More are necessary to increase access to services for minority populations.
Educating providers is key to improving and expanding health care because, Baker-Hargrove noted, “most health care training programs, no matter the discipline, don’t have a lot of specific training geared towards LGBTQ+ competencies.”
Building community around HIV
José Romero in Raleigh, North Carolina, on December 12, 2022. Photo by Jessica Woodall Photography for LGBTQ Nation
José Romero has also experienced the power of community. As a public health advocate, Romero believes in building networks of mutual support in which people look out for one another. It’s a perspective rooted in personal history and informed by their experience living with HIV and pushing for greater accessibility and education around treatment and prevention.
“I’ve always been around people who have had to find ways to care for each other,” Romero, 30, said. Romero’s family emigrated from an impoverished part of Mexico to rural Washington State, where they worked as farm laborers. The nearest hospital to their small town was such a long drive that Romero’s mother nearly gave birth to them in the car. “I feel like I’ve been mobilizing for health care ever since,” Romero told LGBTQ Nation.
Romero’s first awareness he had been exposed to HIV was a phone call from a doctor.
“I had gone in feeling sick, and he asked me, ‘Do you have sex with men?’ When I said yes, he just immediately shut off to me,” recalled Romero, who identifies as non-binary. “He told me I had been diagnosed with HIV, and I should probably get a follow-up.” Romero made an appointment with another doctor, who was much more supportive.
José Romero in Raleigh, North Carolina. Photo by Jessica Woodall Photography for LGBTQ Nation
Romero didn’t share their diagnosis for another five years when they started working as an organizer. “It’s taken other advocates and people who have lived experience supporting me to get to this point in my life where I’m using my diagnosis for good,” Romero said.
Today, they serve as director of community advocacy, research, and education at Pride Foundation, which gives scholarships to students and funds community organizations serving queer people throughout the Northwest. Pride Foundation was founded in 1985 out of a desire from people dying from HIV/AIDS to leave their money and legacies to benefit the community. Pride Foundation has distributed more than $74 million in grants to queer people and organizations advocating for equity and justice in the decades since.
Since the height of the HIV/AIDS epidemic in the mid-1980s, annual infections in the United States have dropped by more than two-thirds, according to the Centers for Disease Control and Prevention. New HIV infections in the U.S. fell 8 percent from 2015 to 2019. The U.S. Department of Health and Human Services has set a goal of ending the HIV epidemic by 2030, and a number of city-based initiatives with similar aims are underway, including in former epicenters San Francisco and New York.
But men who have sex with men account for about 66 percent of new infections each year, despite being only 2 percent of the population, with Black and Latino MSM being affected disproportionately. Each group accounted for around a quarter of new HIV diagnoses among MSM in 2020.
Contributing factors to the high prevalence are intersectional and include racial discrimination, lack of access to resources, language barriers, and stigma. “It’s been really important for me to focus on this big issue by working in coalition and step-by-step,” Romero said. Since they grew up speaking Spanish, Romero recognized language as one of the biggest barriers to healthcare access. They have worked as a translator, interpreter, and advocate for hospitals to provide multilingual materials.
Though medical interventions for the treatment and prevention of HIV, such as antiretrovirals and PrEP, have extended lives and lowered infection rates, advocates are working to improve access for those who need it most, including racial minorities and trans people, who have been underserved by prevention efforts. “It wasn’t until recently that we’ve seen people who are not white or cisgender represented in media around HIV prevention and care,” Romero said.
The medications themselves aren’t enough, Romero said.“We need a social and cultural approach, and that means meaningful involvement of people living with HIV.”
Many factors put people at greater risk of negative health outcomes from HIV, including substance use, mental health, and access to stable housing. Social and political solutions that address these conditions are as important as medical innovations in the fight to end the epidemic.
“Structural interventions in the context of HIV prevention and care are going to need policy-level, community-wide solutions,” Gonsalves said. “This takes us back to the old days of LGBTQ+ advocacy — working to change the sort of environment in which we live to make it easier for us to keep ourselves healthy and safe.”
Half of all new HIV infections are located in the South, where Morris A. Singletary has been working as a peer educator to connect young men of color with care. Based in Atlanta, Singletary, 45, runs the HIV prevention and education initiative PoZitive2PoSitive, offering support and mentorship informed by his lived experience with HIV.
Singletary knows the stakes firsthand. He was near death when he received his HIV diagnosis in 2006, having not understood that he was at risk. And he struggled with the emotional fallout and with adhering to treatment for the next ten years. He also knows the shame, stigma, and lack of awareness that keep men from pursuing care.
“We have to be more intentional,” Singletary said. “We tell people to go to the doctor and get tested, but we don’t say what happens next. We need to show the cycle of care,” he added, including the patient’s role in communicating openly with providers who are trained to show support. Singletary noted that everyone involved in the healthcare process, from researchers and providers to peer educators like himself, has an integral role to play.
Morris Singletary in Atlanta, Georgia. Photo by Seven
“Storytelling is an amazing tool,” Singletary said of the connections he’s forged through sharing his lived experience and encouraging others to seek HIV treatment and prevention.
Romero agrees that people living with HIV should be integral to the path forward, and encourages outreach organizations to hire them to reach others at risk or in need of care. “We need to invest in people to be the solution to the problems that we’re facing,” Romero said. “When we are provided with the resources and opportunity to help each other, we do.”
Dr. Marci Bowers: pioneering gender-affirming healthcare
Dr. Marci Bowers has more than 32 years of experience in pelvic and gynecological surgery. Photo by Drew Bird Photography
Dr. Marci Bowers has devoted much of her history-making career as a surgeon treating transgender people, whose access to essential medical care has come under attack in recent years. Bowers, 64, has performed more than 2,000 vaginoplasties, or bottom surgeries, for trans women and is one of few surgical providers to have undergone the process herself.
“Everyone deserves access to gender-affirming care,” said Bowers, whose medical practice is based in Burlingame, California.
Growing up, Bowers knew she wasn’t comfortable with the gender identity she was assigned at birth, though it was a feeling she couldn’t describe. “I didn’t really have words for what it was to be trans,” Bowers said of the era when there were fewer role models and information. She wound up pursuing medicine, getting married, and having children, playing the role she felt was expected.
“I felt like I could displace my feminine feelings by being a woman’s health care provider,” Bowers said of her decision to become an OB-GYN. It was after Bowers transitioned, at age 37, that she considered pursuing a career in gender-affirmation surgery. “I was responding to an obvious need within the community for more providers,” Bowers said.
Insights gleaned by going through surgery herself have informed her sensitivity toward patients, “not just in the technical aspects of giving them what they want, but recognizing the struggle that they’d already been through being trans.”
Dr. Marci Bowers has performed more than 3,900 gender-affirming surgeries. Studies have shown that gender-affirming surgery is associated with decreased psychological distress, smoking, and suicidal ideation. Photo provided by Dr. Marci Bowers
Trans people experience disproportionately high rates of anxiety and depression and are about six times as likely as the general population to be hospitalized for a suicide attempt. Recentstudies have shown that gender-affirming care, including puberty blockers for trans adolescents, hormone therapy, and potential surgical interventions where necessary, significantly improve mental health and save lives. The latest guidelines from the World Professional Association for Transgender Health advised that hormone treatments can start from age 14.
“It’s an overwhelming, established fact that gender-affirming treatment is effective and greatly enhances psychosocial functioning and reduces suicidality,” Bowers said. “It’s about people improving their lives by assuming the identity that they feel most comfortable with.”
Even as the evidence of efficacy becomes ever more clear, gender-affirming care is being targeted across the country. As of March 2022, 15 states have restricted access to gender-affirming care or are considering laws that would do so. The consequences for people who need care are dire, cutting off access to treatment proven to improve well-being and reduce suicidality.
At the same time, the demand for gender-affirming care is growing, as is the corresponding need for more providers. “It’s growing because people are more comfortable being themselves,” said Bowers, who also helped establish the Transgender Surgical Fellowship Program at Mount Sinai Hospital in New York City to help train more doctors to care for trans people. Under the Affordable Care Act, it’s illegal for insurance providers to deny medically necessary transition-related care, and Bowers also accepts Medicaid from her patients.
“People at every socioeconomic level should have access to this care; we’ve always felt strongly about that,” Bowers said. But even for patients who have coverage, there’s a need for more doctors to provide treatment. “We need more clinicians and mental health professionals to help with the care of this population,” she said.
“Gender identity is a very deeply held value,” Bowers said, an indelible one that requires affirmative care. “It weathers any storm.”
Providing homes for recovery
Richard Fleischman Photography Anthony Sorensen at Gilbert House in Minneapolis, Minnesota, on January 11, 2023. Photo by Rich Fleischman Photography for LGBTQ Nation
When Anthony Sorensen, 52, was growing up on Long Island, New York, his father — who struggled with alcoholism — would disappear for days at a time. When Sorensen was 16, his father left for good, and Sorensen blamed himself, thinking it was because he is gay. Sorensen had started drinking the year before, blacking out the first time he tried alcohol.
“I wanted to be the bad kid who got in trouble in order to feel cool and accepted by my peers,” Sorensen recalled. “But at the same time, to save myself from the humiliation of being called out as gay, I just wanted to disappear.
“The first time I drank, all those fears and inhibitions of being humiliated went away,” Sorensen said.
Feelings of alienation like those Sorensen described are among the reasons that LGBTQ+ people are more than twice as likely to abuse drugs and alcohol than the general population, according to the National Survey on Drug Use and Health, a trend that’s been exacerbated by the coronavirus pandemic. A variety of factors contribute to the increased likelihood, including concurrent mental health conditions like anxiety, depression, and suicidality, themselves often a result of marginalization, discrimination, and trauma.
Drugs and alcohol have also occupied a historically central role in how queer people relate to each other and form social bonds. “Our community was formed in bars,” Baker-Hargrove said. “It can be hard to think about a life within the community that’s not anchored to alcohol or partying.” That’s one reason substance abuse is sometimes normalized within the community, and it may be easier to overlook when someone is struggling.
Sorensen’s heavy drinking and drug use accelerated when he moved to New York City shortly after coming out at age 19. He was 23 when he attended his first Alcoholics Anonymous meeting, but it wasn’t until he discovered AA meetings that were mainly attended by queer people that he was able to work the program and stay sober for two years.
Sorensen’s first experience with Pride Institute, a treatment and recovery center especially focused on the needs of LGBTQ+ people, was in 1999, at a facility in Belle Mead, New Jersey, that has since closed. He stayed sober for 11 years before he began drinking again, when his career as a hairstylist took precedence over his recovery, Sorensen said.
Sorensen later completed two 30-day courses of inpatient treatment at Pride Institute’s main campus in Eden Prairie, Minnesota.
Richard Fleischman Photography Anthony Sorensen at Gilbert House in Minneapolis, Minnesota. Photo by Rich Fleischman Photography for LGBTQ Nation
“Pride 100 percent saved my life,” Sorensen said. “Pride for me was the place where I knew I could authentically be myself without many of the fears that I had carried since I was a kid,” he recalled, noting that he was fortunate to have private insurance and a choice of where to seek treatment. Pride is in-network for most major insurers and works with uninsured patients on lending options to reduce financial barriers to care.
Pride Institute has pioneered a model of treatment specifically tailored to LGBTQ+ people. Since many patients like Sorensen can trace their struggles with addiction back to aspects of their queer identity, centering and affirming those aspects of their lives is essential to effective treatment. “If you can’t totally be yourself, you’re not going to move forward in your recovery,” Sorensen said.
Pride Institute’s affirming environment includes gender-neutral bathrooms and room assignments not based on gender identity assigned at birth, as well as peers and staff with lived experience who embrace and celebrate everyone for who they are. “The counselors are educated in LGBTQ+ issues and addiction and mental illness,” Sorensen said. “They made me sit with my feelings and work through them, rather than escape them” — a process Sorensen called life-changing.
Sorensen also credits the success of his recovery to transitional housing specifically designed for LGBTQ+ people, where those who have completed inpatient programs can live with others in a shared house and offer mutual support. “I saw the success that I had with transitional housing, and I want to be able to reach as many people as possible and give them that same opportunity,” said Sorensen, who ultimately decided to relocate to Minneapolis and dedicate himself to offering queer people in recovery a place to support each other.
A few years into his own recovery, in 2015, Sorensen founded Transitional Recovery in Minnesota (TRIM), which now runs two houses catering to queer people working through addiction. Sorensen works with local outpatient programs, including Pride Institute, which helps subsidize housing costs for patients so that 90 percent of TRIM’s residents have financial support to make the rent accessible.
Richard Fleischman Photography Anthony Sorensen at Gilbert House in Minneapolis, Minnesota. Photo by Rich Fleischman Photography for LGBTQ Nation
“When someone comes into the house, they are 100 percent made to feel like they’re at home,” Sorensen said of TRIM, a model of affirmative support that Sorensen experienced at Pride Institute. “Whether a gay man or a transgender woman who walks through those doors, we all have a very unique set of experiences, but we go through similar things being a minority within our society.”
Though LGBTQ+ people face a variety of challenges based on other aspects of identity and social determinants of health, a sense of solidarity continues to be important in pushing for better health outcomes across the board. “We want everybody to survive, thrive, and prosper,” Gonsalves said, “and LGBTQ+ people need to think of activism as a component of fighting for their health and safety.”
Early activism during the AIDS epidemic continues to be the prime example. Gonsalves pointed to the recent Mpox outbreak and the queer community’s response as proof of how effective collective action continues to be, often in the face of a flawed institutional response.
“LGBTQ+ communities were essential over the past year in slowing down and putting the brakes on the epidemic,” Gonsalves said, noting the pressure placed on government leaders for accelerated vaccine access and the spontaneous reduction of sexual activity that slowed the spread. Unequal risk and access, based on factors like race and class, persisted, and policy-level change is necessary to protect the well-being of the queer community.
In the meantime, LGBTQ+ people continue to lead the charge, taking on disparities the community faces in the medical system and revolutionizing how we care for ourselves and each other.
On Black HIV/AIDS Awareness Day, we must remember the myriad ways the work to end the HIV epidemic overlaps with the work for LGBTQ justice and overlaps with the work to dismantle white supremacy. One of these overlaps is laws that criminalize HIV.
HIV criminalization is when a state criminalizes otherwise legal conduct or increases the penalties for illegal conduct based on a person’s HIV status. As of 2022, there are at least 35 states with HIV criminalization laws.
Each state’s laws vary. Some require the prosecution to prove the person intended to expose others to HIV, but in most states, simply not disclosing your HIV status is enough to convict. Apart from several state reforms over the last few years, no states require evidence of actual transmission or an intent to do harm.
Following a bad breakup, Suttle’s former partner reported him to the police, stating he was unaware of Suttle’s HIV status. Under Louisiana law, it is illegal to engage in sexual activity if you know your HIV status and do not disclose it. Suttle says he disclosed his status, but it was a case of he said, he said. At court, he took a plea deal to avoid trial and the possibility of the maximum sentence. As a result, he was charged with a felony and spent six months in prison.
After his release, Suttle was placed on the state’s sex offender registry, which places a mark on his driver’s license, and he was forced to publish a photo of himself in the newspaper.
Suttle’s story is a typical example of how HIV criminalization laws are used, and how they further criminalize marginalized and BIPOC communities.
States like Louisiana have laws that are outdated, based on obsolete science and misconceptions of HIV. Many of the HIV criminalization laws were drafted in the late 1980’s at the onset of the HIV epidemic and were driven by public fear when very little was known. In some states, spitting or biting — which has little possibility of transmission — are criminalized. In other states, safe sex practices (such as condom use) are irrelevant and cannot be used as defenses.
Most laws also do not take into account the fact that undetectable equals untransmittable. Once someone reaches a point in their treatment where the amount of the virus in their body is so low that it doesn’t show up on blood tests, they are said to have reached an undetectable viral load. A person with an undetectable viral load cannot pass the virus along to anyone.
Science has progressed by leaps and bounds, making treatment of STIs more manageable and HIV no longer a death sentence. The science has moved forward, it’s time for the law to follow suit.
What’s more, these laws are a barrier to preventing the spread of HIV. HIV criminal laws stigmatize HIV, discourage individuals from knowing their status and accessing medical treatment. That’s why almost all major public health organizations — including the American Medical Association, the Centers for Disease Control and Prevention, and the Presidential Advisory Council on HIV/AIDS — all urge a public health approach over criminalization.
New York is one state poised to update its archaic HIV laws, a law that was first written in 1909 to prevent the spread of “venereal diseases” among members of the military.
With the onslaught of World War II, combatting sexually transmitted infections (STIs) became a national priority as their treatment took soldiers out of commission for months. In 1943, the New York legislature increased the penalty to a felony. In 1946 the law was rewritten again making it applicable to the general public and a misdemeanor. It remains unchanged 76 years later.
The New York state law does not make sense in the age of modern medicine.
Pending before the New York state legislature is the REPEAL STI Discrimination Act. The act will repeal the state law that criminalizes STIs and provides for the expungement of past convictions. It also creates a defense so that having an STI does not mean potential criminal charges when engaging in consensual sex.
The New York legislature should pass the REPEAL STI Discrimination Act, and other states should quickly follow suit, because we are all only as safe as the members of our community most at risk and for HIV.
Public health advocates have long known that the best way to promote everyone’s health is an approach that treats people as individuals who need care rather than vectors for disease or criminals to be punished. Decreasing stigma and increasing access to testing, treatment and support are the best ways to combat disease.
On this Black HIV/AIDS Awareness Day, let us stand in solidarity and work to repeal all HIV criminalization laws.
Jose Abrigo is Lambda Legal’s HIV Project Director and Carl Baloney Jr. is AIDS United’s vice president and chief advocacy officer.
Being a transgender woman in South America is not easy when her average life expectancy in the continent is 35 years. It is even more difficult for those who are of indigenous descent.
Claudia Ancapán Quilape, an indigenous trans woman with a Huilliche father and a Mapuche mother, has turned her fate around.
Ancapán is 46-years-old and lives in Recoleta in the Chilean capital of Santiago. She is a midwife who works in a private clinic and recently earned a master’s degree in health. Ancapán is working on another master’s degree in gender and will soon begin a doctorate in public policy.
She is also a spokesperson for Salud Trans para Chile, a trans rights group, and participates in Santiago’s “LGBTQA+ Roundtable.”
Ancapán for six years fought to have her identity legally recognized, long before Chile passed its Gender Identity Law. She won that battle on May 20, 2014, and Ancapán later lobbied lawmakers to approve the statute.
Claudia Ancapán Quilape in 2014 won her 6-year legal fight for Chile to legally recognize her gender identity. (Photo courtesy of Claudia Ancapán Quilape)
The road on which Ancapán traveled in order to become a woman has been difficult.
“I am a person who has had to struggle with being a woman, trans and indigenous,” she told the Washington Blade.
In addition to the discrimination she suffered, a group of neo-Nazis in 2005 attacked her in Valdivia, a city in southern Chile where she was studying. The attack, which could have cost her her life, motivated her to become a queer rights activist.
Ancapán told the Blade her family’s indigenous culture allowed her to be herself in private since she was a child. Outside of her home, however, she had to pretend to be a man.
“My family allowed me to develop myself and that changed my life,” she told the Blade. “I was always a woman to my father, mother and siblings because my parents were not prejudiced against it. However, they protected me from society and I acted like a man once I walked out the door of my house because people outside our culture would not understand.”
Most indigenous groups in South America did not view LGBTQ people negatively before European colonization. They included them in their respective communities and respected them.
European colonizers exterminated many of them and buried their culture.
“Christopher Columbus arrived on his ship with religious cultural impositions that were imposed and everything was turned into sin,” Ancapán told the Blade. “If you review the history of our native peoples in Chile, they stand out because they had no conflict with homosexuality or gender identity.”
Since ancestral times there were “machis” called “weyes,” who had an important social and spiritual role within a Mapuche community. They were known for their ambiguous gender roles that could vary from feminine to masculine. “Weyes” could also incorporate feminine elements that had a sacred connotation and were allowed to have same-sex relations with younger men.
The “machi weyes” until the 18th century had a lot of authority and influence because they were recognized as a person with “two souls.”
“Pre-Columbian cultures saw the integrality of the human being linked to nature, so sexuality was an integral part of a whole (person),” explained Ancapán. “So it was not so sinful to fall in love or love a person of the same sex or for a person to present themselves with an identity different from the one they should have biologically.”
“That makes me respect my indigenous background,” she emphasized. “That’s why I am so proud of who I am and of my native belonging.”
According to Elisa Loncón, the former president of Chile’s Constitutional Constitution and a leading expert in Mapudungun, the Mapuche people’s native language, the Mapuche always recognized LGBTQ and intersex people through their language. Gay men were categorized as “weyes” and lesbian women were known as “alka zomos.” “Zomo wenxu” meant “woman man,” while “wenxu zomo” translated to “man woman.”
There is currently no indigenous LGBTQ or intersex organization in Chile, but Ancapán noted there are queer people who are indigenous.
“I know Diaguita people. I am also aware that there are trans Easter Islanders. I have Mapuche friends who are trans. And lately I made a friendship with an indigenous person who lives with two spirits,” she said.
Claudia Ancapán Quilape participates in a protest for the rights of queer indigenous people. (Photo courtesy of Claudia Ancapán Quilape)
Ancapán said two-spirit is “a category of gender identity that is not well known in Chile, but it is linked to native people.”
“In fact, they have always been there, but very little is known about it. This is related to the native peoples of pre-Columbian America, where they saw identity and gender as a way of life where they saw identity and the expression of sexuality as distinct,” she explained to the Blade.
Many people who claim to be two-spirit say they feel neither male nor female, escaping from the traditional gender binary.
“These manifestations are also in the indigenous peoples of Canada and Mexico,” said Ancapán. “They are known more in the north of North America. Two-spirit is basically spiritually associated, where two identities, two spirits, coexist in you. And that speaks of breaking down the binary system.”
“So these manifestations come from the integral vision of different sexuality and from the acceptance that existed in some cultures about sexual and gender dissidence,” she further stressed.
“I believe in nature and the power of the elements,” added Ancapán. “I am very close to my culture that talks about the connection with the spiritual of nature and the respect for nature. And from that point of view it linked me to my original people, to my native peoples.”
A trans woman is facing an upcoming trial in which she has been charged with five felony counts of indecent exposure for an incident that occurred at a Los Angeles spa.
A judge recently ruled that the trial of Darren Merager can move forward after multiple witnesses testified in a pre-trial hearing that in the summer of 2021 Merager made them uncomfortable while naked in the spa’s women’s locker room due to her exposed penis.
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Witnesses cannot agree on whether or not Merager’s penis was erect, but the possibility that an erection took place was enough for the judge to move the case forward, according toLos Angeles Magazine (LAMag). The judge, Lana S. Kim, also said that the spa’s antidiscrimination policy protecting trans customers “was not an affirmative defense.”
At the time of the alleged incident, a video of a woman complaining to spa staff about a “man” in the women’s locker room went viral and the dispute quickly became a right-wing conspiracy. The spa in question at first denied a trans woman was using the facilities at the time and no evidence had publicly been made available showing otherwise.
But weeks later, the Los Angeles Police Department (LAPD) charged Merager with indecent exposure and said she was already a registered sex offender due to indecent exposure incidents in 2002 and 2003.
The woman, going by the online moniker Cubana Angel, was complaining in the video that a man was allegedly posing as a woman to use women’s facilities at the spa, and that he tried to expose himself to women in the room. Customers at the family-friendly facilities are frequently undressed while bathing and soaking in the hot water.
In the video, the woman shouts, “There is no such thing as transgender. He has a dick.”
With the spa maintaining that there was no trans woman or cisgender man pretending to be a trans woman knowingly sharing the facilities with cis women at the time, several media outlets deemed the entire controversy likely to be a conspiracy or hoax based on misinformation. Yet the LAPD and right-wing media remained fixated on the incident.
QAnon believers quickly seized on the video as “evidence” for the conspiracy theory that Democratic politicians and celebrities belong to a pedophilic cannibal cult run by aliens. Adherents spread similar false rumors about a D.C. pizza parlor, claiming the restaurant’s basement was a nexus for pedophiles.
In 2018, the LAPD printed public information posters saying Merager often “claims to be female in order to gain access to women’s locker rooms and showers.”
In an interview at the time, Merager claimed the witnesses at the spa were spewing “a bunch of garbage and lies.”
“She never saw me naked,” Merager reportedly told a right-wing journalist at the time. “I was underwater with water all the way up to my chest.”
“If you go into an area where you’re expected to be nude, there has to be an indecent exposure exemption,” Merager also said.
At the pre-trial hearing, a witness named Claudia, who was present at the spa with her two daughters, reportedly stated that Merager “was relaxed, like it was normal.”
“He was walking, like in a beauty contest, completely naked, like it was normal for a guy to walk around naked there.” (Merager has previously told LAMag that she uses both she/her and he/him pronouns. Her driver’s license has reportedly identified her as female since 2019).
According to both Claudia and her daughters, Merager was sitting on the edge of the jacuzzi with her legs opened 45 degrees. They said she did not try to get their attention but that it made them uncomfortable nonetheless.
Claudia said she was worried about her 14-year-old daughter. “I was afraid for her – here’s this guy with an erect penis.”
Another witness named Christina had previously told a detective that Merager’s penis was “partially erect.” Meanwhile, Claudia’s 14-year-old testified that the penis was “soft” but that she felt “unsafe” and “uncomfortable” anyway because she had never seen anyone’s penis before. Claudia’s other daughter claimed Merager’s penis was erect.
But in the original viral videos, there was reportedly no mention of an erect penis, and Merager is claiming the witnesses have changed their stories.
“Every single one of these witnesses that get up on the stand decided it’s an erection a month later. Where are my witnesses?” Merager told LAMag during the pre-trial hearing. “Why weren’t the two dozen women in the spa indecently exposed? Only men can be indecently exposed, but women can’t? Only the penis is indecent.”
Arraignment for the case will take place on February 21st.
The American Bar Association (ABA), a membership organization for attorneys in the United States that develops professional ethics codes, has issued a resolution supporting the rights of children with intersex traits to consent to surgeries.
The ABA’s resolution follows years of legal and policy progress recognizing that “normalizing” surgeries on people with variations in their sex characteristics should be chosen by the individual, not their parents or doctors.
Around the world, since the 1950s, people born with variations in their sex characteristics, sometimes called “intersex,” have been subjected to harmful medically unnecessary “normalizing” surgeries. Surgeons popularized these cosmetic surgeries on infants to remove gonads, reduce the size of the clitoris, or increase the size of the vagina.
But these procedures are not designed to treat a medical problem, and there is no evidence they help children “fit in,” which some surgeons say is their aim. The operations carry high risks of scarring, loss of sexual sensation, incontinence, and psychological trauma. Despite growing consensus that these surgeries should end, along with progress globally banning medically unnecessary intersex surgeries, some parents continue to face pressure from surgeons to choose these operations – even though their children are too young to participate in the decision.
Pushback on the default-to-surgery paradigm, which was popularized in the US, has gained pace in recent years, with the American Academy of Family Physicians and two pediatrics bodies endorsing a delay of surgery until kids themselves can consent. Three former US surgeon -general reviewed the evidence and called for an end to the nonconsensual procedures. Children’s hospitals in Chicago and Boston have banned the operations.
Now the ABA has made it clear that it opposes “medical or surgical intervention on minors with intersex traits (also known as variations in sex characteristics) without the minor’s informed consent or assent.” The ABA, “urges licensed professionals not to conduct or propose medical or surgical intervention on minors with intersex traits until the minor requests the proposed care, understands the impact of the proposed care as well as alternatives, is provided with affirming psychosocial supports, and gives informed consent or assent, except when immediate life-threatening circumstances require emergency intervention.”
Medical professional bodies and legislatures should follow the ABA and develop their own policies to protect intersex children from harm.
Many in the transgender community are mourning the death of British teenager Brianna Ghey, a trans girl who was stabbed to death Sunday.
Ghey, 16, was found dead in a park in Warrington, England — roughly 16 miles west of Manchester, England — with visible stab wounds, British authorities said. Police said they have arrested two teenagers, both 15 years old, on suspicion of the murder.
Ghey’s family released a statement through local authorities, saying Ghey was “a much loved” and “larger than life character who would leave a lasting impression on all that met her.”
“The loss of her young life has left a massive hole in our family, and we know that the teachers and her friends who were involved in her life will feel the same,” Ghey’s family wrote.
According to authorities, at this time there is no evidence to suggest Ghey’s murder was “hate-related.” This did little to quell discontent among trans activists regarding larger transphobic sentiments they say permeate throughout the U.K.
In a tweet that has accrued over 872,000 views as of Monday afternoon, a user slammed trans-exclusionary radical feminists, or TERFs, in the name of Ghey’s death.
The climate in the U.K. has grown increasingly hostile for trans people over the last few years. For example, J.K. Rowling, the author and creator of the Harry Potter saga, has become an outspoken critic of trans rights. In a nearly 4,000-word blog post in 2020, the bestselling author said that allowing trans women to use women’s bathrooms and changing rooms would make cisgender women “less safe” — an anti-trans talking point that has been debunked by research.
Simultaneously, in recent years trans activists have accused the British press of stoking or abating anti-trans sentiments.
Notably, the BBC was slammed by LGBTQ activists last year after publishing an article that many critics said painted all transgender women as sexual predators. The British broadcaster defended its piece — titled “We’re being pressured into sex by some trans women” — arguing that it went through a “rigorous editorial process.”
The outcry against the media grew louder among trans activists on Monday, after British newspaper The Times “deadnamed” Ghey, that is, it published the name Ghey went by prior to her transition.
“I will be writing to @thetimes and @IpsoNews regarding this,” British MP Charlotte Nichols wrote on Twitter on Monday, referring to The Times and British media regulator Independent Press Standards Organisation.
The Times did not immediately respond to NBC News’ request for comment. A spokesperson for IPSO declined to comment.
Following Ghey’s death on Sunday, some trans activists also chided the government for a lack of a nationwide law that would allow trans people in the U.K. to change their gender without a medical diagnosis of gender dysphoria, which is the distress caused by a sense of conflict between an individual’s sex assigned at birth and their gender identity. Last month, the British government blocked a similar “self-identify” law from being implemented in Scotland.
In the UK tech industry, 75 per cent of LGBTQ+ founders and 80 per cent of investors do not feel safe sharing their gender and sexual identity with their peers, new research has found.
The LGBTQ+ Founder Report was carried out by Proud Ventures (PV), a UK collective of LGBTQ+ investors, founders and venture capitalists, and surveyed 61 investors and 130 founders.
The first-of-its kind research sought to address the fact that “any attempt to engage with or support the LGBTQ+ community in tech or VC has been held back by the repeated question of whether there is actually any problem to solve”.
Data in the report revealed that many people in the LGBTQ+ community, be it founders or investors, “do not feel comfortable to share their identities with investors and other stakeholders”.
The result of this concealment can potentially have an impact on LGBTQ+ people’s health and wellbeing, as they feel forced to separate part of their identity.
Only 25 per cent of founders explained they were comfortable to share their identity with every investor they met, a significant majority (75 per cent) of LGBTQ+ founders were not.
Of these founders, 34 per cent stated they didn’t feel comfortable sharing their LGBTQ+ identity with any investor at all, 25 per cent said they only felt comfortable to share with a few investors, 11 per cent noted they only feel comfortable sharing with an investor after a few calls and five per cent said they would only feel comfortable with those investors already on their cap table.
Of the 80 per cent of investors who hide their LGBTQ+ identity, half said they would only share their identity with another investor after meeting a few times, 17 per cent stated they never would share their identity with another investor and 11 per cent revealed they would only share the information with investors they are closest to or who are on their team.
Of those surveyed, 45 per cent said they thought their identity was not relevant to the situation, 27 per cent) revealed they did not feel comfortable enough to share it, 18 per cent noted they felt sharing could harm their efforts at fundraising and 10 per cent said they didn’t think it could help them.
The report outlined the negative impacts such concealment can have on LGBTQ+ people’s health and wellbeing, including memory and cognition.
“Clear data has drawn a causational link between LGBTQ+ people practising increasing concealment and worse health outcomes,” the document reads.
Funds raised are not equal in the LGBTQ+ community
The survey found gay founders raised 2.25 times more than bisexual founders and 22 times more than lesbian founders. Cis men founders raised 2.5 times more than cis women founders and 10 times more than trans founders.
Interestingly, the research revealed a correlation between LGB people who were more open about their identity and greater capital raised.
However, this was not the same for people who are open about their gender identity, with research suggesting that founders who were more open about their gender identity raised less and generated less revenue.
Several recommendations were put forth by the report, including investors publicly showing support for LGBTQ+ founders, having teams share their pronouns publicly and hiring more diverse investment teams.
South Dakota has joined five other states that have restricted transition-related care for transgender minors in just the past two years.
On Monday, Gov. Kristi Noem, a Republican, signed the “Help Not Harm” bill, which bans health care professionals from providing puberty blockers, hormone therapy and surgery to minors as treatment for gender dysphoria, which is the distress caused by a sense of conflict between the assigned sex at birth and the person’s gender identity.
Providers who are already treating trans minors with puberty blockers, which temporarily pause puberty, or hormone therapy will be required to taper the minors off the medications by Dec. 31.
The measure makes exceptions for intersex infants and for the treatment of conditions unrelated to gender dysphoria.
“South Dakota’s kids are our future,” Noem said in a statement. “With this legislation, we are protecting kids from harmful, permanent medical procedures. I will always stand up for the next generation of South Dakotans.”
Health care providers who violate the law could have their medical license revoked. Until they turn 25, minors who receive care in violation of the law can also sue providers.
People protest a bill that would bar transgender girls from playing on sports teams that match their gender identity outside the state Capitol in Pierre, S.D., on Jan. 15, 2022.Toby Brusseau / AP for Human Rights Campaign
Elliot Morehead, a trans teen who uses they/them pronouns and had planned to access gender-affirming care within the next year, said the measure has “affected my future deeply.”
“I was hoping to maybe start any kind of treatment for myself and now our legislators, who are supposed to support us, have taken away that opportunity for me and I’m bummed,” they told CBS affiliate KELO-TV in Sioux Falls on Thursday after the bill passed the Senate.
Morehead, 16, told House committee members last month that they had to receive six months of therapy and a letter from their therapist before they could begin hormone therapy.
“People think you can just like walk in and then get like testosterone or estrogen or puberty blocking — it doesn’t work like that,” they said, according to The Associated Press.
Over the years, South Dakota has been what advocates have described as a testing ground for legislation targeting trans people.
In 2016, the state was the first to pass a school “bathroom bill,” which would’ve required students to use the school facilities that correspond with their assigned sex at birth. The measure was ultimately vetoed by then-Gov. Dennis Daugaard, a Republican, who said at the time that it did not “address any pressing issue concerning the school districts of South Dakota,” according to the Argus Leader, a local newspaper.Three states — Alabama, Oklahoma and Tennessee — bar transgender students from using the school facilities consistent with their gender identity, according to the Movement Advancement Project, an LGBTQ think tank.
On Saturday, more than 400 South Dakotans, including trans youths, their families and allies, protested the bill’s passage in the Senate, according to Transformation Project Advocacy Network, a local trans rights group.
Following Noem’s signing of the bill Monday, the American Civil Liberties Union and the ACLU of South Dakota said in a joint statement that the measure “won’t stop South Dakotans from being trans, but it will deny them critical support that helps struggling transgender youth grow up to become thriving transgender adults.”
“But make no mistake–this fight is not over,” the groups said. “We will never stop fighting for the right of trans youth to get the love, support, and care that every young person deserves. As much as Governor Noem wants to force these young people to live a lie, we know they are strong enough to live their truth, and we will always fight for communities and policies that protect their freedom to do so.”
So far this year, lawmakers in at least 24 states, including South Dakota, have introduced legislation that would restrict transition-related care for minors, according to an NBC News analysis. Governors in six states — Alabama, Arkansas, Arizona, South Dakota, Tennessee and Utah — have signed such restrictions. Federal judges have blocked bans in Alabama and Arkansas from taking effect pending the outcome of lawsuits.
A transgender man won a $20,000 settlement in a lawsuit against the fast food chain Shake Shack after he faced a month of transphobic harassment on the job with no support from his employer.
The man, who has not been identified in the media, worked at Shake Shack in 2020 in Oakland, California. He said that he was harassed daily and referred to as female.
He told his supervisors about the harassment and instead of helping him they told him to “explain his gender to co-workers rather than rely on management to correct discriminatory behavior,” according to the California Civil Rights Department, which helped him with his lawsuit. The supervisors said it was his responsibility to convince his coworkers to stop harassing him.
His lawsuit says that after a month he grew “frustrated by management’s failure to address his concerns” and quit.
“California law prohibits intentional misgendering in the workplace,” California Civil Rights Department director Kevin Kish said. “Intentional misgendering and other forms of discrimination based on gender identity and gender expression can be stressful and traumatic.”
After mediated talks, the agency said that Shake Shack agreed to improve their discrimination training for managers and employees and adopt more strict policies about discrimination and harassment. Shake Shack also agreed to report anti-LGBTQ+ discrimination and harassment complaints directly to the state for the next year and pay the former employee $20,000.
“Creating a welcoming and fulfilling environment for all our employees and guests is critical,” reads a statement from Shake Shack. “We are constantly taking steps to ensure our policies and culture reflect our commitment to diversity and inclusion in the workplace.”