The Supreme Court seemed likely to uphold a key preventive-care provision of the Affordable Care Act in a case heard Monday.
Conservative justices Brett Kavanaugh and Amy Coney Barrett, along with the court’s three liberals, appeared skeptical of arguments that Obamacare’s process for deciding which services must be fully covered by private insurance is unconstitutional.
The case came before the Supreme Court after the appeals court struck down some preventive care coverage requirements. It sided with Christian employers and Texas residents who argued they can’t be forced to provide full insurance coverage for things like medication to prevent HIV and some cancer screenings.
The appeals court’s ruling took explicit aim at the H.I.V. drug regimen known as pre-exposure prophylaxis, or PrEP, saying the law’s requirement that it be fully covered violated the religious freedom of a plaintiff in the case, Braidwood Management.
The company’s owner, Dr. Steven F. Hotze, a well-known Republican donor and doctor from Houston, has previously challenged the Affordable Care Act on other grounds.
The case stems from a lawsuit filed in 2020 by Dr. Hotze and other Christian business owners and employees in Texas; they maintained that the preventive care mandate violates their constitutional right to religious freedom by requiring companies and policyholders to pay for coverage that goes against their faith.
In 2022, after living as a boy and going by a new name for several years, a 15-year-old from Madison, Wisconsin, wanted to make it official. Like most teenagers, he dreamed of getting his driver’s license, and his family wanted his government identification to reflect who he really was.
But Wisconsin law has a caveat: He would have to publish his old, feminine name and new name in the local newspaper for three weeks — essentially announcing to the world that he is transgender.
In many instances, if he had committed a crime, the law would afford him privacy as a minor. But not as a transgender teenager changing his name.
His parents worry the public notice now poses a risk as President Donald Trump has attacked transgender rights, asserted that U.S. policy recognizes only two sexes and described efforts to support transgender people as “child abuse.” The publication requirements endanger the community, lawyers working with trans people say, by creating a de facto dataset of likely transgender people that vigilantes and even the government could use for firing, harassment or violence.
Transgender people are over four times more likely to be victims of violence, research shows. Most transgender people and their families agreed to be interviewed for this story only if they weren’t named, citing safety concerns.
“Publication requirements really leave folks open and vulnerable to discrimination and to harassment more than they already are,” said Arli Christian, senior policy counsel at the American Civil Liberties Union. “It can put people at risk of violence and blatant discrimination simply because of who they are.”
Wisconsin’s legal process stems from a 167-year-old law, one of many statutes across the country that Christian said were intended to keep people from escaping debts or criminal records. Changing one’s name through marriage is a separate process that does not require publication in a paper.
Although the right to change one’s legal name exists in every state, the effort and risk required to exercise it vary. Less than half of states require people to publicize their name changes in some or all cases, according to the Movement Advancement Project, a think tank that tracks voting and LGBTQ+ rights.
Wisconsin law grants confidentiality only if a person can prove it’s more likely than not that publication “could endanger” them. But the statute does not define what that means. For years, some judges interpreted that to include psychological abuse or bullying, or they accepted statistics documenting discrimination and violence against transgender people nationwide.
In 2023, however, a state appeals court set a stricter standard after a trans teenager was denied a confidential name change in Brown County, home to Green Bay. The teen said he had endured years of bullying, in which peers called him slurs and beat him up. Court records show the Brown County judge asserted that publishing the teen’s name wouldn’t expose him to further harm because his harassers already knew he was transgender.
The teen argued that a public process would create a record available to people he met in the future. While the appeals court conceded a “reasonable judge” could agree, it found the Brown County judge had not improperly exercised her discretion in denying the request. Crucially, the appeals court determined that “endanger” meant only physical harm. The case wasn’t appealed to the Wisconsin Supreme Court.
Both of these trans girls living in Wisconsin requested the confidential name-change process after the 2024 presidential election. First image: A 14-year-old likes cuddling her cat, playing video games and practicing piano. Second image: A 12-year-old shares her artwork. Illustrations by Shoshana Gordon/ProPublica. Source images obtained by ProPublica.
The combination of Wisconsin’s public requirement, the restrictive ruling and the Trump administration’s anti-trans policies has dissuaded at least one person from going through with a name change.
J.J Koechell, a 20-year-old LGBTQ+ advocate from suburban Milwaukee, tried to change his name in November but decided against it after a judge denied his request for confidentiality, ordering him to publish his change in the local paper and create a public court record if he wanted to proceed.
“That’s already dangerous,” Koechell said of a public process, “given our political atmosphere, with an administration that’s trying to erase trans people from existence completely, or saying that they don’t exist, or that there’s something wrong with them.”
At the end of March, Wisconsin Democrats announced plans to introduce a bill that would eliminate the publication requirement for transgender people, so long as they can prove they’re not avoiding debt or a criminal record. Republicans, who control the Legislature, will decide whether it will receive a hearing or vote.
There has been a push in some states to make it easier and safer for transgender people to update their legal documents. Michigan and Illinois laws removing publication requirements took effect earlier this year. And a California lawmaker introduced a bill that would retroactively seal all transition-related court records.
Assembly Speaker Robin Vos, R-Rochester, did not respond to emails and a phone call to his office seeking comment. Wisconsin Watch and ProPublica sought comment from four other Republican leaders in the Assembly and Senate. Of the two whose offices responded, a staffer for Assembly Majority Leader Tyler August, R-Walworth, said, “It doesn’t look like something we’d consider a priority,” and a staffer for Senate Assistant Majority Leader Dan Feyen, R-Fond du Lac, said he was not available for comment.
Asked about the safety concerns people raised, a White House spokesperson said, “President Trump has vowed to defend women from gender ideology extremism and restore biological truth to the Federal government.”
No Exceptions for Minors
Wisconsin’s law requires a transgender person to publish the details of their identity to change their name whether they are an adult or a child. The notice requirement makes no distinction based on age.
This is less privacy than the legal system typically affords young people, confirmed Cary Bloodworth, who directs a family law clinic at the University of Wisconsin Law School. Bloodworth said both child welfare and juvenile courts tend to keep records confidential for a number of reasons, including that what happens in a person’s youth will follow them for a lifetime.
“I certainly think having a higher level of privacy for kids is a good thing,” Bloodworth said, adding that she thinks the publication requirement is unnecessary for people of any age.
A mom living near the Wisconsin-Illinois border whose 11-year-old daughter recently went through the name-change process said these proceedings should automatically be private for children.
“The fact that we still have to fight to get something as simple as a confidential name change for a minor who is obviously not running away from criminal or debt charges is just so frustrating and overwhelming,” she said.
The judge deciding their case seemed reluctant to grant confidentiality at first, questioning whether her daughter was being threatened physically, she said. The judge granted the confidential change. But the family remains shaken.
“We live just in constant terror of the wrong person finding out that we have an 11-year-old trans child,” she said. “All it takes is one wrong person getting that information, and what we could end up going through, becoming a target, is horrifying.”
Right before the pandemic, a teenager told her parents she was transgender. She spent much of that first year of her transition at home, attending virtual school like the rest of her peers in the Madison school district. She came out to only a few friends and wanted to keep her gender identity private, so she kept her camera off and skipped her high school graduation.
When she decided to legally change her name, the prospect of publicizing her transition terrified her, according to her mom.
“I explained to her that it’s in tiny, tiny print, and it’s in some page of the paper that no one is going to read,” her mom said. “But it felt to her like she was just standing out there in public with a ‘TRANS’ sign on her.”
While fewer people read physical newspapers these days, much of their content gets published online and is easily searchable. The court case, too, becomes a public record that is stored online and sometimes aggregated by other websites that show up at the top of search results.
The parents of the then-15-year-old boy who changed his name before getting his driver’s license discovered that happened to their son. When anyone — say, a prospective employer — searches the young man’s name, one of the first results shows his old name and outs him as trans.
“This is what somebody would use as their first judgment of him,” his mom said. “We certainly don’t want that to be something that people would use to rule him out for a job, or whatever it is he might be doing.”
Like many other states, Wisconsin does not have laws that ban discrimination against transgender people in credit and lending practices or in public spaces like stores, restaurants, parks, doctor’s offices and hotels. However, Gov. Tony Evers, a Democrat, issued an executive order in 2019 banning transgender discrimination in state employment, contracting and public services.
After Trump took office again and began issuing executive orders attacking trans rights, the boy’s family started to investigate how they could retroactively seal the court records related to the name change. It wouldn’t change what was in the newspaper, but it could help them remove the online records. The court records also contain sensitive information like their home address that someone could use to harass them.
A friend who was a retired attorney helped their son craft an affidavit describing his experiences. His mom read from it during an interview. “‘Because of recent political events, I fear violence —’” she said before breaking off. “Oh God, I hate even reading this. ‘I fear violence, harassment, retribution because of my status as a transgender person.’”
Her son, who is now 18, shared a statement over email.
“At this moment in time I’m probably more scared about being a trans person than I ever have been before, with the public record if you have my first and last name you can easily find my deadname and therefore find out I’m trans,” he said. “I would love to say that I feel safe and valued in our society but unfortunately I can’t, at times I feel that my personhood is being stripped away under this government.”
Anne Daugherty-Leiter, who has guided transgender clients and their families through the name-change process as board president of Trans Law Help Wisconsin, said where a person lives in Wisconsin, and therefore what court they must petition, affects their likelihood of getting a confidential change.
Confidentiality is important, she said, because of how the state handles changes to birth certificates. Wisconsin birth certificates that are issued through a confidential name change show only the new name. But if a person has to announce their name change publicly, birth certificates are amended to list both the person’s old and new names. Any time the person has to use that document, at the DMV or while getting a loan, it outs them, she said.
“This Is Not Who I Am”
Koechell, a trans man and LGBTQ+ activist, was unwilling to go through with the name-change process after being denied confidentiality by a judge late last year.
Koechell lives in Waukesha County, a Republican stronghold where multiple schools have enacted policies critics have called anti-LGBTQ+.
In a letter to the judge, Koechell wrote that people had sent him multiple threats and posted his family members’ addresses online, all for “being an advocate and being transgender openly in my community.”
“I do not want to publish my deadname for people to use against me,” he said in an interview, using a term common among transgender people to refer to their birth names. “I don’t see a reason why people who are not particularly fond of me wouldn’t show up at a hearing like that and try and cause trouble.”
Court records show the judge denied Koechell’s confidentiality request and his request to reconsider. The judge’s order referred to Koechell, a trans man with a masculine voice and beard, as “she” and “her.”
Koechell decided the public process wasn’t worth the risk. But it’s hard, he said, to move through life with his old identification.
“When I go to a new doctor or new appointment or something, then that’s the name on my chart, and then I get called that in a waiting room full of people, and it’s super uncomfortable. I just want to disappear,” Koechell said. “Then eventually, I have to correct the doctors, and I’m like, ‘Hey, just to let you know, I don’t go by that name. This is not who I am.’”
Data from the latest U.S. Transgender Survey found that 22% of people who had to show an ID that did not match their identity experienced some form of negative consequence, including verbal harassment, discrimination or physical violence.
If the U.S. Senate passes the SAVE Act, which would require voters to prove citizenship with a passport or birth certificate, those consequences could include disenfranchisement. Transgender people who can’t change the name on their birth certificate or passport would be ineligible to vote, according to the liberal think tank Center for American Progress.
U.S. Rep. Chip Roy, a Texas Republican and chief sponsor of the bill, has said the legislation directs states to create a process for citizens with a “name discrepancy” to register. “No one will be unable to vote because of a name change,” he said.
Trace Schlax, a trans man in Wisconsin, has tried to change his gender marker and name on official documents. Joe Timmerman/Wisconsin Watch
After Trump won in November, Trace Schlax, a 40-year-old IT project manager, decided to expedite changing his gender marker on his passport, figuring he could update his name later in state court.
“It matters,” Schlax said. He loves to travel but has encountered extra scrutiny from airport security with outdated documents. “I get comments from TSA when I go through to travel domestically, about my hair, about how I look. I get extra pat-downs.”
He sent his application in early December and crossed his fingers. He received it back in February, rejected. By that time, Trump had issued an executive order banning trans people from changing the gender markers on their passports.
Schlax decided to continue updating what records he could, like his birth certificate and driver’s license. He worries about having conflicting documents. Will he get accused of fraud? Will he have trouble flying?
But in the end, he decided it was still important to change his name and update his license to improve his day-to-day experience.
And he decided to go about it publicly. It felt less painful, he said, to accept the risks rather than detail his personal, traumatic experiences to a judge only to have them decide he hadn’t endured sufficient danger.
“Me changing my name and my gender marker affects absolutely no one but me,” said Schlax, who has a court date to change his name in late April. “Why does this have to be so hard? Why do I have to prove myself so hard?”
The Trump administration has cleared the way for people to report doctors who provide gender-affirming care to minors — and now says they can do so without violating federal medical privacy laws.
In new guidance issued Monday, the U.S. Department of Health and Human Services announced that health care workers, clinic staff, and even third parties may file complaints against providers offering gender-affirming care and, in many cases, even disclose protected patient information under HIPAA’s whistleblower provisions. Under HIPAA, the Health Insurance Portability and Accountability Act, medical professionals must keep a patient’s health information confidential. The guidance, issued under President Donald Trump’s January 28 executive order titled “Protecting Children from Chemical and Surgical Mutilation,” establishes a new federal portal to collect these reports.
Civil rights and LGBTQ+ health advocates say the move weaponizes patient privacy law against the very people it was designed to protect — and targets providers in a sweeping campaign to scare them out of delivering medically necessary care.
“At a time when trans health is already becoming more and more difficult for patients to access, this guidance is a page out of the anti-abortion activism playbook,” said Adrian Shanker, a national LGBTQ+ health policy expert and senior HHS official under the Biden administration. “That’s the clear goal: to instill fear among providers of best-practice transgender medicine. That’s unfortunate — but it’s also dangerous for the needs of transgender patients who rely on qualified providers with specializations and training to provide that care.”
The new policy doesn’t stand alone. It follows a sweeping federal letter issued just days earlier by the Centers for Medicare and Medicaid Services advising state Medicaid agencies that they may restrict or eliminate coverage of gender-affirming care for minors. The CMS letter explicitly referenced federal sterilization regulations — originally created to protect against coerced sterilization—as justification for blocking puberty blockers and hormone therapy. Advocates called it a dangerous distortion of the law.
The online complaint form from HHS invites users to name doctors, identify hospitals or clinics, and describe the alleged “mutilation of children” — a term the administration uses to refer to evidence-based gender-affirming care. The department encourages people to cite the executive order and offers guidance on reporting providers to multiple federal agencies.
Shanker said the real consequence isn’t theoretical — it’s already happening. “It’s two sides of the same coin because it’s diminished access to care — period,” he told The Advocate. “If providers become fearful of providing the care, fewer providers will offer it.”
For those on the front lines, that fear is palpable. A pediatric gender-affirming care provider at a major children’s hospital in the Midwest told The Advocate that they’re seeing the trust that underpins medicine unravel in real time.
“It feels very chilling,” the provider said, speaking on the condition of anonymity due to security concerns. “We’ve been under the microscope for a long time, but now it feels like they’ve got a free pass to do whatever they want. It’s terrifying for our patients, and it’s terrifying for us as providers.”
The provider said colleagues were asked where their “line in the sand” was at a recent staff meeting—what it would take to stop practicing.
“All of the prescribing providers said, ‘Jail, I guess,’” they said. “That’s my line in the sand. And it feels like we’re inching closer to that every day, especially with this new hotline to report things.”
Even inside their own hospital, they no longer feel safe.
“I know there are people who work here who don’t support the gender program. I’ve heard them say things like, ‘This is over the top — why don’t these kids just get therapy?’ And now they could call this hotline and report me. What does that do to my license? To my safety as a provider?”
The guidance, legal experts say, is both sweeping and unlawful.
“This is blatantly unlawful for multiple reasons — because it discriminates against transgender people because it violates statutory and constitutionally protected medical privacy rights, and because it has no legal basis and is therefore arbitrary and capricious,” Shannon Minter, legal director of the National Center for Lesbian Rights, told The Advocate.
He added that the policy deliberately distorts the concept of whistleblower protection. “This is stretching the definition of a whistleblower to absurd lengths and is plainly designed to encourage the harassment of doctors and others providing needed medical care to transgender people.”
The provider said the guidance only deepens patients’ mistrust of the medical system. Many already wait a year or more to be seen.
“Our waitlist has never been shorter than a year,” they said. “By the time patients get to me, they’ve often had multiple suicide attempts. Nobody walks in and gets hormones. And I’ve never had a minor patient undergo genital surgery—ever.”
Still, the damage is done. “I don’t tell people what I do anymore. I used to say I worked in pediatrics and gender health. Now, I just say pediatrics. I’ve scrubbed all my public social media. The network of providers I refer to has gotten smaller — I only trust people I know personally. That’s what it’s come to.”
When asked what they wanted the public to understand about the care they provided, the provider didn’t hesitate.
“These medical treatments are lifesaving. I’ve seen adolescents go from depressed and suicidal to just thriving and living their best selves. If anyone saw what I see in clinic every day, they’d know this is care that works.”
The guidance claims whistleblowers are protected under several federal laws, including the False Claims Act and the Church Amendments, and outlines how HIPAA’s whistleblower provisions can shield those who report providers to oversight agencies or law enforcement.
However, medical experts and legal advocates point to a glaring omission: gender-affirming care is supported by every major medical association, including the American Academy of Pediatrics, the American Medical Association, and the Endocrine Society.
“Evidence-based policymaking would rectify this,” Shanker said. “Instead, they’re using political rhetoric around so-called mutilation rather than following the science.”
Minter is confident that if enforced, the policy would be struck down. “This is yet another example of this administration overreaching and seeking to dictate private medical decisions that belong to families and individuals — not the government.”
Planned Parenthood’s Arizona branch will resume providing gender-affirming healthcare to transgender patients. The chapter had previously paused the treatments in response to the Department of Health and Human Services (HHS) sending out a memo warning federally funded healthcare institutions against providing gender-affirming care.
The Arizona branch faced public pressure after news publications began reporting on its decision to end trans-related healthcare. Patients receiving gender treatment at the branch told news outlets they had received voicemails late on Friday, April 11, informing them that their upcoming appointments were being cancelled.
One of these patients, a 23-year-old trans woman from Mesa, Arizona, recounted receiving this call to the trans journalism website Erin in the Morning.
“We are hoping that this is a temporary pause for the next week,” a branch representative said in a voicemail to the patient. They told her the office would reach out upon being able to reschedule.
Planned Parenthood Arizona added a banner to its website explaining the situation. In the explanation, the branch said it had been sent a letter from the Center for Medicare and Medicaid Services (CMS) directing them not to provide gender-affirming care services using Medicaid funding. In response, the Arizona branch decided it would indefinitely discontinue gender treatment for trans patients.
The Arizona branch seems to be the only Planned Parenthood branch currently to pause its gender treatment as a result of this threat. The reported cancellations caused the branch to face public backlash, as many trans people, especially those in rural communities, rely on Planned Parenthood to access their healthcare.
NPR interviewed various representatives from Planned Parenthood last August after an arsonist attacked one of their facilities in Knoxville, Tennessee. In this interview, they discussed the impact that closing its facilities would have on trans patients.
Dr Bhavik Kumar, the medical director of primary and trans care at Planned Parenthood Gulf Coast, told NPR that over 35,000 patients nationwide had sought gender-affirming hormone replacement therapy in 2021.
By Tuesday, April 15, the Arizona facility rescinded its decision and updated its website to feature a new banner that reads: “Planned Parenthood Arizona deeply values and is dedicated to the LGBTQIA+ community, which includes our patients, supporters, and staff. We recognize how critical it is for our patients to have certainty to access essential services, including Gender Affirming Care.”
“After a brief pause, we are pleased to announce the continuation of our Gender Affirming Care services,” the message continued. “This pause occurred out of an abundance of caution after threats to the Medicaid services in our state.”
“The onslaught of attacks on sexual and reproductive health care services in Arizona and across the country is alarming and is a clear, continued effort to shut down Planned Parenthood,” the message added. “This will not be the last threat that aims to deny people medically sound, essential health care, needlessly putting them at risk and unnecessarily creating chaos and confusion around the accessibility of services.”
After the president signed his executive order “Protecting Children from Chemical and Surgical Mutilation,” which threatened to deny federal funding to hospitals providing gender-affirming treatment to individuals under 19 years of age, many hospitals located in sanctuary states for trans people began complying in advance by ending their trans-related healthcare offerings.
Since then, a federal judge has issued a nationwide block on the order’s enforcement, meaning that the federal government cannot withhold funding to hospitals providing gender affirming care. There is very little information to verify that the decision has since been appealed as of writing.
However, it is worth noting that the presidential administration is facing criminal contempt charges for defying a court order to cancel a deportation flight. It remains to be seen if administration officials will attempt to defy the court’s ruling against the president’s ban on gender-affirming care.
A ruling Wednesday from the top court in the United Kingdom that says the legal definition of a woman is someone whose birth sex is female is the latest high-profile action globally involving the issue of what legal recognitions transgender people are allowed. The spectrum of protections around the world ranges widely, from none at all in a number of countries to the existence of anti-discrimination protections and legal gender identity changes in some others.
Here’s a look at actions in some countries recently:
United Kingdom
The decision from U.K. Supreme Court revolved around the U.K. Equality Act, which bars discrimination along protected categories including age, race and sex. The court’s ruling said that for the purposes of the act, the definition of a woman is someone born biologically female, which excludes transgender people. The unanimous decision means trans women can be barred from places like women-only changing rooms and homeless shelters and kept from groups like those offering medical or counseling services only to women. But the ruling also said the decision didn’t mean transgender people were without any legal protection, because the Equality Act also recognizes gender reassignment as a protected category.
Supporters of For Women Scotland, the group that brought the suit, celebrated the decision while advocates for transgender rights called it a setback.
Hungary
Rights for transgender people were restricted as part of a wider crackdown on LGBTQ communities in Hungary through an amendment to its constitution passed on April 14. The measure was proposed by the ruling coalition led by populist Prime Minister Viktor Orbán, and easily sailed through Hungary’s parliament.
Under the new amendment, the nation’s constitution says there are two sexes, male and female. A government spokesman called it “a clarification that legal norms are based on biological reality.” It lays a constitutional groundwork for denying transgender people the ability to have their gender identities protected.
Critics of the amendment said it was about humiliating and excluding people, and part of the ruling party’s moves toward authoritarianism. The amendment also banned any public events from LGBTQ communities, which Hungary’s government has strongly campaigned against in recent years.
Activists wave transgender flags in front of the Hungarian Parliament in Budapest during the Trans Pride march on May 11, 2024. Marton Monus / dpa via Getty Images file
United States
President Donald Trump has made a ban on transgender participation in sports a central focus of his administration. On Wednesday, he sued the state of Maine for not following an executive order he signed that banned transgender athletes from participating in girls’ and women’s sports.
In a February meeting with state governors, Trump called out Gov. Janet Mills for not complying with his order, and threatened to pull federal funding, to which Mills replied, “We’ll see you in court.”
The administration’s lawsuit calls for Maine to be ordered to tell its schools that it’s prohibited for males to participate in athletic competition designated for females.
Another of Trump’s executive orders insists on a rigid definition of the sexes, rather than gender, for federal government purposes. The orders are facing court challenges. For its part, Maine sued the administration after the Department of Agriculture said it was pausing some money for the state’s educational programs. A federal judge on Friday ordered the administration to unfreeze funds intended for a Maine child nutrition program.
It’s not just on the federal level; the question of legal protections for transgender people is a political issue in many American states as well. In twenty-six states, transgender girls from are banned from girls school sports. Other issues around the country include access to gender-related health care for minors and bathroom access in public spaces like schools and government buildings.
Self-defense classes geared toward LGBTQ people can be found sprinkled across the United States, and instructors and students say the skills these classes provide are giving attendees a boost of confidence and a sense of community in a fraught political environment.
“Pretend someone’s coming for you. How would you kick them if you were fighting for your life?” an instructor at Queer Fight Club in St. Louis asked attendees during a recent self-defense class.
Tori Lohmann, who is nonbinary, was among the nine students in the class. Lohmann said they never imagined joining a self-defense group but found themselves drawn to Queer Fight Club six months ago because of a lack of self-confidence stemming from the current political climate.
“I just felt so angry all the time about the state of the world,” Lohmann, 26, told NBC News.
Tori Lohmann, 26, has been taking self-defense classes at Queer Fight Club in St. Louis since January.Courtesy Anna Escoto
Lohmann’s concerns come at a time when heated rhetoric, federal policies and state legislation targeting the LGBTQ community — and particularly transgender and gender-nonconforming people — are on the rise. The American Civil Liberties Union has tracked 569 anti-LGBTQ state bills in 2025 so far, and since coming into office in January, President Donald Trump has signed several executive orders aimed at the trans and nonbinary community, including one that proclaims the U.S. government will only recognize two unchangeable sexes, male and female.
Since attending Queer Fight Club twice a month starting in January and learning skills like a two-punch combo, various kicks and how to block hits, Lohmann said they “feel so much more confident in myself.”
“Not just my ability to protect myself, but also to protect my community members,” they added.
‘You need to be prepared’
Mixed martial artist Mad Green, who founded Queer Fight Club in 2023, said they were inspired to create a self-defense group specifically tailored to LGBTQ people after observing a lack of self-defense skills in the community. They wanted to share their knowledge and prepare other queer people for potential altercations.
“A lot of people, if they haven’t been in a physical altercation, don’t necessarily think it’s going to happen,” Green said, adding that it might be more likely than many people want to believe. “You need to be prepared for it.”
According to crime data published by the FBI last year, violent crime in the U.S. decreased by an estimated 3% from 2022 to 2023, while hate crime offenses increased by about 3.7% during the same period. Sexual orientation and gender identity were the third and fourth most common bias motivations in 2023, after race/ethnicity and religion.
Queer Fight Club has a “pay what you can” policy, but Green said they ask those who can afford it to pay $15 a class to help pay for equipment and the cost of renting out a gym space.
For the first year, Green said, there were about 20 people taking their biweekly self-defense classes. Since the November election, however, there’s been increased interest in self-defense from the local queer community due to a “refreshed fear” around personal safety, and they’ve had about 300 new people join at least one of their classes, Green said.
“My favorite thing about fight club is seeing someone come in for the first time, and then they throw a punch, and they’re like, ‘I didn’t know I could do that,’” Green said. “Just letting people know that they can is really empowering by itself.”
‘Space for everyone to feel welcomed’
Andrew Degar and his wife, Sarah, founded the nonprofit Third Ward Jiu-Jitsu in Houston in 2019 after noticing a need for a more inclusive mixed martial arts space.
“We were both coaching at an MMA gym and just hated the toxicity of the culture, and we wanted to open a space for everyone to feel welcomed and included,” Degar said.
The couple has been providing free self-defense classes to those in the Houston area since they first started their organization. They added classes specifically geared toward the LGBTQ community in August 2023, and Degar said they now have queer people from around the state who travel to take them.
Third Ward Jiu-Jitsu founders Andrew and Sarah Degar started a self-defense class for the LGBTQ community in August 2023.Courtesy Andrew Degar
“People are looking for a safe space,” Degar said. “They’re looking for trustworthy people, and we are recognized as a resource in the queer community in Texas.”
Degar said Third Ward Jiu-Jitsu incorporates various scenarios during self-defense classes that focus on de-escalating conflicts while ensuring readiness in a variety of situations.
“We go into how you may be feeling unsafe from someone you don’t know, then we will even go as far as someone who’s trying to harm you. Here’s how we can attack back,” he said.
‘Protecting ourselves and each other’
Even in a state like New York, which is known to be among the most progressive when it comes to LGBTQ rights, reported hate crimes have surged in recent years. A report published by the Office of the New York State Comptroller last year found reported hate crimes increased nearly 70% from 2019 to 2023, with anti-LGBTQ crimes among the most common.
Groups like Fearless Queers, which has been organizing self-defense pop-up classes throughout New York City since 2022, want LGBTQ people — and particularly trans people, who are more likely to be victims of violent crime — to feel less vulnerable in this environment.
Co-founder Chrissy Rose said she also wants those who attend a Fearless Queers session “to see capable queer and trans fighters leading their class.”
“I want them to see the possibility that they can defend themselves and above all that they are worth that fight,” she said.
Rose and her co-founder, Tara Bankoff, who are both experienced in martial arts, said they’ve seen demand for their classes rise this year, and they now serve hundreds of New Yorkers every month.
Their main priorities, Rose said, are to ensure their classes are accessible and free, and to encourage attendees to trust themselves.
While the group hosts various pop-ups for self-defense fundamentals and open-mat sessions for drills and solo practice, Rose said classes focus heavily on verbal techniques to avoid both victimization and criminalization.
“Trans women are stereotyped as being aggressive, meaning that if they defend themselves, they have a much higher risk of being criminalized or just socially punished for doing so than, say, a cisgender woman does,” Rose explained. “We deprioritize striking and emphasize grappling and verbal self-defense in our curriculum for that reason.”
New York City resident Alexis Gee, who is nonbinary, said she reached out to Fearless Queers in November after feeling afraid and unprotected.
“In communities like ours, we have to be vigilant about protecting ourselves and each other, and I didn’t feel like that was something I was equipped to do,” Gee, 32, said.
In January, Gee had the courage to attend her first Fearless Queers class and has been going consistently since then.
“We don’t have to be alone in our fear, and we don’t have to be aggressive and angry in order to feel protected,” Gee said. “We just need to know who our allies are and how to reach them.”
Last Monday, the U.S. Supreme Court will hear Kennedy v. Braidwood Management, a case which The Advocatefirst broke news of in 2022, that could dismantle one of the most widely used and life-saving provisions of the Affordable Care Act: the guarantee that insurers must cover preventive services—like HIV prevention medication, cancer screenings, and maternal health care—at no cost to patients.
While the case began as a religious objection to PrEP coverage by a group of conservative Christianbusiness owners in Texas, it’s evolved into a full-blown challenge to the ACA’s preventive care mandate. A ruling against the government could jeopardize no-cost access to cancer screenings, STI testing, contraception, diabetes care, and more.
What exactly is the Supreme Court being asked to decide?
At the center of the case is whether the U.S. Preventive Services Task Force—a nonpartisan body of health experts that recommends what services insurers must cover under the ACA—was constitutionally established. The plaintiffs argue that because the Senate doesn’t confirm its members, its authority is invalid.
José Abrigo, HIV project director and senior attorney at Lambda Legal said the case is “about whether science or politics will guide our nation’s public health policy.”
“The plaintiffs in this case are not challenging the medical effectiveness of PrEP or other preventive services—they are attacking the legitimacy of the U.S. Preventive Services Task Force, an expert, nonpartisan body created by Congress to make evidence-based recommendations about what kinds of care should be covered,” Abrigo told The Advocate. “Allowing ideological or religious objections to override scientific consensus would set a dangerous precedent.”
He noted that similar tactics are being used to try to dismantle access to gender-affirming care and warned, “We cannot afford to repeat those mistakes.”
Who is behind the Braidwood case?
The lawsuit is being spearheaded by Jonathan Mitchell, a former Texas solicitor general and architect of some of the most extreme legal strategies targeting marginalized communities in recent memory. Mitchell is perhaps best known for writing Texas’s Senate Bill 8, the 2021 law that effectively banned abortion and deputized private citizens to enforce it with lawsuits.
In the Braidwood case, Mitchell represents a group of Christian employers who argue that covering PrEP encourages “homosexual behavior” and thus violates their religious freedom. He has made clear that his goal is not only to challenge individual mandates but to dismantle the federal government’s ability to enforce health care protections more broadly.
LGBTQ+ legal experts say this case fits a pattern. Mitchell has openly stated his goal is to unwind decades of civil rights and privacy protections rooted in Supreme Court precedents, many of which form the legal basis for LGBTQ+ equality.
Isn’t this just about PrEP?
No—and that misunderstanding is precisely what advocates say is most dangerous. Although the case started as a challenge to HIV prevention drugs, its outcome could affect everyone.
“It would be a serious mistake to think this only affects LGBTQ people,” Abrigo said. “The real target is one of the pillars of the Affordable Care Act: the preventive services protections. That includes cancer screenings, heart disease prevention, diabetes testing, and more. If the plaintiffs succeed, the consequences will be felt across every community in this country by anyone who relies on preventive care to stay healthy.”
“This case exemplifies the other side’s tactic of using marginalized communities as wedge issues to attack all of our rights,” he added. “We as a country are only as healthy as our neighbors, and an attack on one group’s rights is an attack on all.”
What would happen if the Court rules against the government?
A ruling favoring the plaintiffs could strip insurance coverage mandates for a wide range of preventive services recommended by the USPSTF, leaving insurers to decide whether they’ll cover services and at what cost to the patient.
“Losing these protections for full coverage of PrEP and other preventive services would have an enormous impact on all Americans, including LGBTQ+ individuals,” said Jeremiah Johnson, executive director of PrEP4All.
“Over 150 million people could suddenly find themselves having to dig deep into already strained household budgets to pay for care that they had previously received for free,” he said. “Even small amounts of cost-sharing lead to drops in access to preventive services. For PrEP, just a $10 increase in the cost of medication doubled PrEP abandonment rates in a 2024 modeling study.”
The ruling could also come at a particularly pivotal time. “Loss of PrEP access would be devastating with so much recent progress in reining in new HIV infections in the U.S. This would also be a particularly disappointing time to lose comprehensive coverage for PrEP with a once-every-six-month injectable version set to be approved this summer,” Johnson said.
Why hasn’t this case gotten more attention?
Johnson said the lack of widespread coverage may be because of how the case was initially framed.
“It’s possible this case hasn’t received more widespread coverage because it started as an attack on LGBTQ+ communities,” he said. “But Braidwood has been a bit of a Trojan horse scenario: an attack on a subset of the population has morphed into something much broader that threatens preventive health care access for over 150 million Americans.”
“If mainstream media outlets treat this case as primarily an LGBTQ+ issue and fail to alert more Americans to the threat this case poses to them, the general public may end up paying a very steep price.”
What do PrEP users say is at stake?
The ruling is personal for Michael Chancley, communications and mobilization manager at PrEP4All. He’s been on PrEP for over a decade and has helped others access it, too.
“A big part of what PrEP4All has done is fight for the access to PrEP for uninsured individuals,” Chancley said in a video released by the group. “If the ruling is upheld by the Supreme Court… now we’ll have to also fight for people who actually are paying into insurance because their insurance companies may revoke the right for them to be able to access these preventive care services.”
Chancley said he’s often heard people say, “I wish I had access to PrEP. I wish somebody had taught me about PrEP. I wish I knew how to get PrEP,” only after receiving a positive HIV test result.
Jason Watler, an HIV activist and Medicaid recipient, said PrEP “has changed and revolutionized my life in a way where I am able to have less anxiety.”
“I’m also taking back the narrative that society has placed onto Black and brown queer and trans folks,” he said. “This would have a really, really negative effect if this actually backfires.”
Edric Figueroa, a program director at the Latino Commission on AIDS, said the financial impact would be immediate and devastating. “What’s at stake is the cost for my preventive medication would go up,” he said. “And I would have to make the decision between staying on PrEP and paying for it myself, or not using it and using that money for my savings, for my rent.”
He noted that the outcome of the case reaches beyond HIV prevention. “This isn’t just an LGBTQ issue. Preventive care saves lives, period, and we need to value public health over any ideology and protect the ACA.”
The Supreme Court is expected to issue a ruling by the end of June. The Biden administration initially defended the ACA’s preventive care mandate in court, but the case has continued under the Trump administration, which supports the legal challenge.
The U.S. Department of Health and Human Services will remove gender dysphoria from disabilities protected under federal law, but it’s still unclear whether 17 Republican state attorneys general will continue a related lawsuit that could dismantle federal protections for all people with disabilities.
Last fall, Texas GOP Attorney General Ken Paxton sued the federal government over the Biden administration’s addition of a gender identity-related disorder to the disabilities protected under a portion of federal law known as Section 504.
Republican attorneys general from 16 other states joined the lawsuit: Alaska, Alabama, Arkansas, Florida, Georgia, Indiana, Iowa, Kansas, Louisiana, Missouri, Montana, Nebraska, South Carolina, South Dakota, Utah and West Virginia.
But they faced a swift backlash earlier this year. Disability advocates pointed to parts of their lawsuit that asked the court to find all of Section 504 unconstitutional, not just the update that included gender dysphoria.
If the court agrees, advocates fear that schools, workplaces, hospitals and other entities could refuse to provide disability accommodations they’ve been required to provide for the past 50 years.
AGs hurried to distance themselves. Arkansas Republican Attorney General Tim Griffin, Georgia Republican Attorney General Chris Carr and others adamantly denied that interpretation and said their only goal was to remove protections for people with gender dysphoria.
The new HHS ruling seems to achieve what the AGs said they wanted. It essentially declares that the Biden update adding gender dysphoria to disability law can’t be enforced.
But the broad language of the lawsuit leaves open the possibility, some experts say, for the court to strike down the entirety of Section 504 protections.
The state AGs’ position should become clearer in a few days. They’re scheduled to file an update with the court on April 21.
Cincinnati Pride announced that it will no longer accept corporate sponsors who have retreated from diversity, equity, and inclusion (DEI) efforts and will move to a community-funding model.
Pride event organizers state that companies fear being targeted by the White House after the president signed an executive order entitled “Ending Radical And Wasteful Government DEI Programs And Preferencing,” which aimed to end DEI programs in government offices.
Though only applying to federal agencies, this move has put political pressure on corporations as well, resulting in many of them slashing their DEI programs.
Last month, for example, Anheuser-Busch declined to sponsor Pride St. Louis’s upcoming annual PrideFest, leaving the organizers $480,000 short, they told NBC News.
Pride organizations rely on sponsorship money for security, as anti-LGBTQ+ groups are known to show up to these events.
“We’re trying not to sound a huge alarm or to make this the only focus, but when we are down money, we’re down safety and security and accessibility as well,” said Eve Keller, co-president of USA Prides. Keller added that Pride organizations are now holding fewer and smaller events to avoid making cuts to security measures.
Cincinnati Pride, the LGBTQ+ nonprofit responsible for organizing the annual Pride Month Festival and Parade in Ohio’s state capital, is actively cutting ties with companies canceling their DEI programs. The organization hopes to raise $50,000 in community donations for this year’s Pride festival in June.
On the group’s website, the homepage shows a progress bar for the amount they have raised so far and a statement: “2025 is already proving to be one of the most important moments in time for our community. That’s why we at Cincinnati Pride have made the decision to reset our expectations around organizations that we partner with this year. While our organization relies heavily on achieving financial goals to help achieve our mission, we cannot in good conscience continue to collaborate with organizations that work against our mission of providing the greater Cincinnati LGBTQ+ community with resources to positively impact the lives of all individuals… This decision puts a significant amount of funding at risk.”
As of writing, the group has raised 77% of their funding goal at a total of $38,518.
The sponsors that remain with Cincinnati Pride are the grocery store chain Kroger, Fifth Third Bank, Delta Airlines, Procter & Gamble, and Hilton through its subsidiary franchise HardRock Hotel & Casino. Their sponsors include local businesses as well, such as Cincinnati-based Pure Romance.
The list of previous sponsors that have stuck with Cincinnati Pride have made statements that they will not be rolling back DEI initiatives in response to the administration’s crackdown.
“We are steadfast in our commitments because we think that they are actually critical to our business,” Delta’s chief external affairs officer, Peter Carter, told Fox5 when asked about the future of the company’s DEI initiatives. “Sustainability is about being more efficient in our operations, and really DEI is about talent, and that’s been our focus.”
Trans Canadian singer Bells Larsen has been forced to cancel his US tour over the administration’s anti-trans visa rules.
Larsen cancelled his tour following the Trump administration signing legislationthat required IDs, including passports and visas, to show a person’s sex as “either male or female”. The requirement has already been implemented by US citizenship and Immigration Services.
Taking to Instagram, Larsen confirmed that his tour will be cancelled following the American Federation of Musicians stating that he can no longer apply for a visa that aligns with his gender.
The post added: “To put it super plainly, because I’m trans (and have an M on my passport), I can’t tour in the States.
“I hesitate to include a ‘right now’ or an ‘anymore’ at the end of my previous sentence, because – in this sociopolitical climate – I truly don’t know which phrasing holds more truth.”
Larsen added that the “irony” of the cancellation is that it comes exactly two weeks before the release of his album, which is about his transition.
The singer had intended to tour this spring in Boston, New York, Los Angeles and San Francisco, among other areas, but refunds will now be available to those who purchased tickets for his US shows.
His Instagram announcement added that he had contemplated going ahead with the tour by travelling with a cisgender man, performing in “exclusively blue states” and handing border agents a visa and passport with “M” markers on. However, “distressing stories, texts and updates kept multiplying,” leading him to think “through a trans lens,” which he said “made everything all the more complicated”.
He concluded that there is “no way to move forward here”.
Comments under Larsen’s post have sent support his way, with many sharing that the update is “devastating”.
“I’m so very sorry. And as an American so truly embarrassed… I look forward to the day when America is safe for you again,” a comment that has been liked more than 670 times reads.
Another reads: “Reading this breaks my heart! You are amazing. Thank you for sharing your story!”
The Williams Institute at UCLA’s School of Law estimated that around 16,700 non-binary people requested a passport using an X gender marker each year. This represents 1.4 per cent of the non-binary population in the US, which the institute estimates is around 1.2 million adults in the country.
