In an interview Thursday with The Associated Press on the sidelines of the U.N. General Assembly’s meeting of world leaders, Foreign Minister Peter Szijjarto said his country would not cede ground on policies that have caused the European Union to impose financial penalties and start legal proceedings against it over violations of the bloc’s values.
Topping the list of contentious government policies: a controversial Hungarian law that the EU says violates the fundamental rights of LGBT people.
That led the EU’s executive commission to delay billions in economic recovery funds earmarked for Hungary — a move Szijjarto called “a purely political decision” and “blackmail.” The law, he says, is meant to protect children from pedophiles and ”homosexual propaganda.”
Japan is about to get a new prime minister – and two candidates in particular have the potential to transform LGBT+ rights, including same-sex marriage.
After the current Japanese prime minister Yoshihide Suga decided to step down a year into his term, his Liberal Democratic Party (LDP) is set to choose a successor on Wednesday (29 September).
The election is a “historic moment” for Japan – not just because two of the four candidates are women, but also because two candidates support same-sex marriage.
Alexander Dmitrenko is a co-founder and co-chair of Lawyers for LGBT & Allies Network (LLAN) and a counsel at Freshfields Bruckhaus Deringer in Tokyo. He told PinkNews that the current “frontrunners” for the election are Fumio Kishida, former foreign minister, and Taro Kono, the cabinet minister in charge of vaccinations.
Kono’s was the first voice from within the LDP in support of same-sex marriage, Dmitrenko explained, and a “fairly important” one at that.
Even before the leadership race, Kono made headlines in Japan after he said: “I will support marriage equality.”
“The LDP is not the most progressive of parties, but it has a very diverse membership,” Dmitrenko told PinkNews. “For Kono to come out during the leadership race and to express support for marriage equality is, to my mind, very leadership like.”
He said that Kono is a “very viable candidate” with “a lot of junior members of the party supporting him”, and that he is “very well-liked” within Japanese society.
Sanae Takaichi and Seiko Noda are the first women in over a decade to seek leadership of the LDP.
Noda has said that she supports same-sex marriage and in a recent campaign speech, she said that she wants to see more LGBT+ people “take centre stage” in society.
“I seek to create a society of diversity by having people who have not been given main roles in society, including children, women, the disabled and LGBTQ people, take centre stage,” Noda explained, according to ABC News.
Candidates for the presidential election of the ruling LDP pose prior to a debate on 18 September 2021 in Tokyo. The contenders (L-R) are Taro Kono, Fumio Kishida, Sanae Takaichi and Seiko Noda (AP Photo/Eugene Hoshiko/Pool/Anadolu Agency via Getty)
However, Dmitrenko told PinkNews that Noda is probably the “least favourite to win” as other candidates, like Kono, have more backing within the party.
According to Dmitrenko, Takaichi has not come out openly opposing same-sex marriage but instead reiterated that the “current status of the law of the land” is that LGBT+ can’t marry.
“And that was the answer which isn’t really an answer.”
Party members will vote for the new leader and prime minister, and polling has been favouring former foreign minister Kishida.
Dmitrenko said that Kishida “hasn’t made up his mind” on same-sex marriage, saying he would “prefer to hear various opinions on the issue”.
Currently, Japan’s constitution defines marriage as based on the “mutual consent of both sexes”.
But in a landmark ruling earlier this year, a district court in the Sapporo district said that blocking same-sex marriage is “unconstitutional”.
The judgement, however, was seen as largely symbolic.
Germany will welcome its first-ever trans MPs to the Bundestag after a federal election that saw the centre-left SDP narrowly beat the centre-right CDU.
According to preliminary results on Monday morning (27 September), the SPD and its chancellor candidate Olaf Scholz won 25.7 per cent of the vote.
Germany’s Green Party had its best-ever result in a national poll, 14.8 per cent, and Scholz believes he has a mandate to for a coalition with the Greens and liberal politicians, which would bring to an end 16 years of centre-right rule.
In another historic first, two transgender Green MPs were elected to the Bundestag – Tessa Ganserer and Nyke Slawik.
Ganserer, 44, who has been a member of parliament for Nuremberg North since 2013, came out as a trans woman in 2019. She became the the first out transgender person to sit in a regional or national parliament in Germany, and this is the first election she has run since coming out.
When she came out, Ganserer used her own experience of transition to declare the need for Germany to update the 1980 Transsexual Act, which provides a convoluted process for trans people to change their legal name and gender.
She said at the time: “Gender identity is a human right… in future it should be possible for a person to apply to change their gender recorded at birth.”
On Monday, she wrote on Twitter: “I thank you from the bottom of my heart for the trust shown by the voters.
“I’m still overwhelmed, but I’m really looking forward to my new job in Berlin!
“My congratulations too Nyke Slawik. #QueerRepresentationMatters.”
For Nyke Slawik, who is just 27 years old, this will be her first term as an MP for the Leverkusen, Cologne IV constituency.
She unsuccessfully ran for parliament in 2017, and for the European parliament in 2019.
According to Queer.de, Slawik ran in this year’s election with the hope of giving young people a voice in the Bundestag, and is determined to use her position to fight the climate crisis and increase diversity in Germany’s parliament as a trans lawmaker.
In a speech at the Green Party congress in April, she said: “Every time has its fighters. Those of the climate protectors. Those of the Greens. And those of the colorful. This is our time!”
America’s vulnerable LGBTQ+-owned restaurants and bars serving food will find a vital lifeline this fall stemming from the partnership formed by the National LGBT Chamber of Commerce (NGLCC) and Grubhub. These small business owners have been among hardest hit by Covid impact with loss of jobs and income over the past two years.
Grubhub, a leading U.S. food-ordering and delivery marketplace, and the National LGBT Chamber of Commerce (NGLCC), the business voice of the LGBTQ+ community and certifying body for LGBTQ+-owned businesses nationwide, have opened applications for their NGLCC/Grubhub Community Impact Grant Program. The grants are expected to range from $5,000 to $100,000.
“We often say at NGLCC that ‘If you can buy it, an LGBTQ+-owned business can supply it.’ That is especially true of the LGBTQ+-owned restaurants across America who kept our communities and first responders fed throughout the pandemic. We’re proud to partner with Grubhub in offering these grants to support these businesses throughout the nation. America’s 1.4 million LGBTQ+-owned business owners have shown incredible resilience during the COVID-19 pandemic, and now, in turn, we can help them recover stronger than ever,” said NGLCC Co-Founder and President Justin Nelson.
Throughout June, NGLCC was named the official partner of Grubhub’s Donate the Change program, which has raised tens of millions of dollars for organizations in need since launching in late 2018. The partnership welcomed Grubhub and Seamless diners to opt-in, round up their order total, and donate the difference, with the company matching eligible donations from Grubhub+ members. The proceeds raised will now be made available through NGLCC to support the LGBTQ+ community and LGBTQ+-owned restaurants.
“As the world starts to return to a new normal, we know many businesses are rebuilding and reopening, especially LGBTQ+-owned restaurants that are often the pillars of their communities,” said Kevin Kearns, senior vice president of restaurants at Grubhub. “We’re thrilled to partner with NGLCC and give back to the LGBTQ+ community – one that has shown incredible strength and support for those in need throughout the pandemic.”
Under the innovative grant program, the NGLCC has set a goal to allocate 30 percent of the funds to businesses owned by people of color and transgender/gender non-conforming individuals.
NGLCC and its partners will expertly evaluate applications after the October 12, 2021 closing date. Major grantees will be awarded onstage during the NGLCC Back To Business (B2B) Summit in Hollywood, Florida this November, as well as in local communities.
The NGLCC’s network of more than fifty Affiliate Chambers across America will help amplify this grant opportunity to support local restaurants. Those local chambers will also benefit from this initiative’s newly established “Affiliate Chamber Fund.” This fund will enable any establishment that receives a Community Impact Grant Program that is not currently a member of an NGLCC local affiliate chamber to have one year of membership paid. Additionally, many of NGLCC’s more than 300 corporate partners enhanced their Pride 2021 programming with food orders from Grubhub during their programming with Employee Resource Groups and community partners – a best practice expected to continue throughout future Pride celebrations.
For more information on the Community Impact Grant Program regarding restaurant eligibility requirements, timelines, how to apply, and more, please visit www.nglcc.org/ghgrant.
About NGLCC The National LGBT Chamber of Commerce (NGLCC) is the business voice of the LGBT community and is the largest global advocacy organization specifically dedicated to expanding economic opportunities and advancements for LGBT people. NGLCC is the exclusive certification body for LGBT-owned businesses, known as Certified LGBT Business Enterprise® (Certified LGBTBE®) suppliers. www.nglcc.org @nglcc
Cheers rang out, hugs were exchanged and rainbow-colored flags waved overhead across Switzerland as the Swiss resoundingly voted to allow same-sex couples to marry, final results of a nationwide referendum showed Sunday.
Official results showed the measure passed with 64.1 percent of the vote while more than half of all voters approved in each of Switzerland’s 26 cantons, or states. The vote — years in the making — is set to bring the Alpine nation into line with many others in Western Europe and wraps up an often tense campaign between rival sides.
Justice Minister Karin Keller-Sutter said on Twitter that the government would implement the decision quickly and, under current plans, the new rules can take effect on July 1.
Switzerland’s parliament and the governing Federal Council — on which she sits — had supported the “Marriage for All” measure, which marks a key step for greater rights for gays and lesbians in Switzerland. The country has authorized same-sex civil partnerships since 2007.
“With this, all couples will in the future be treated equally before the law: all can enter into a civil marriage, with the same rights and obligations,” Keller-Sutter wrote.
Download the NBC News app for breaking news and politics
Passage is set to put same-sex partners on an equal legal footing with heterosexual couples by allowing them to adopt children and facilitating citizenship for same-sex spouses. It will also permit lesbian couples to utilize regulated sperm donation.
“This is a historic day for us and for Switzerland, this is a great step forward, something we have been waiting for for years,” said Laura Russo, co-president of the Geneva Federation of LGBT Associations, at a gathering of joyous supporters of the measure along a Geneva pedestrian street. “This initiative was begun in 2013; we had to wait 8 years for the vote to happen — and here, this is a big ‘Yes.’”
Opponents believe that replacing civil partnerships with full marriage rights would undermine families based on a union between a man and a woman.
Benjamin Roduit of the Christian Democratic People’s Party, which spearheaded the effort to stop same-sex marriage, claimed at least some success in raising awareness about his party’s positions despite the defeat at the ballot box.
“On our side we have tried to draw attention to the central problem, the one of children and medically assisted procreation,” he said. “On that point, I think we have succeeded in raising awareness among the Swiss people and we will still be here when other steps will be proposed.”
The campaign has been rife with allegations of unfair tactics, with the opposing sides decrying the ripping down of posters, LGBT hotlines getting flooded with complaints, hostile emails, shouted insults against campaigners and efforts to silence opposing views.
Switzerland, which has a population of 8.5 million, is traditionally conservative and only extended the right to vote to all women in the country in 1990.
Most countries in Western Europe already recognize same-sex marriage, while most of those in Central and Eastern Europe don’t permit wedlock between two men or two women.
The UK has been singled out for its “baseless and concerning” anti-trans rhetoric in a damning report on rising hate against LGBT+ people in Europe.
The extensive report was published by the Council of Europe, the continent’s leading human rights organisation, on Tuesday (21 September).
It describes “a marked increase” in anti-LGBT+ hate speech and hate crime and condemns “with particular force the extensive and often virulent attacks” on LGBT+ rights in the UK, which is named alongside Hungary, Poland, Turkey and the Russian Federation.
The council notes that these attacks “deliberately mis-characterise the fight for the equality of LGBTI people as so-called ‘gender ideology’ and seek to stifle the identities and realities of all those who challenge the social constructs that perpetuate gender inequalities and gender-based violence in our societies.
“These attacks are harmful to women as well as LGBTI people,” it adds.
The UK is specifically mentioned throughout the report, which makes particular reference to the growing problem of anti-LGBT+ hate speech on social media.
The 18-page report dedicates an entire, shameful section to the UK’s rise in anti-trans rhetoric, noting with concern how it often questions the very existence of gender as a category of protection under international human rights law.
This dangerous discourse has been “gaining baseless and concerning credibility” at the expense of trans people’s civil liberties and women’s and children’s rights, it warns.
“At the IDAHOT Forum 2021, minister for women and equalities [Liz Truss] stated, in contradiction with international human rights standards with respect to the rights of trans people: ‘We do not believe in self-identification.’
“Such rhetoric – which denies trans identities – is being used to roll back the rights of trans and non-binary people and is contributing to growing human rights problems.”
The report notes that UK hate crime statistics show a sharp increase in transphobic crimes since 2015, though though only 1 in 7 victims report them, and many trans people now fear for their safety.
“There is intense and ongoing social, political and legal debate about what constitutes harmful discourse when it comes to trans people and their rights,” it continues, “and arguments defending freedom of expression have been – and are still being – used as a tool to justify transphobic rhetoric, further penalising and harming already marginalised trans people and communities.
“It is also becoming increasingly difficult for individuals and organisations to publicly affirm young trans people without being subject to hostility and disproportionate questioning from wider society.
“The ‘gender-critical’ movement, which wrongly portrays trans rights as posing a particular threat to cisgender women and girls, has played a significant role in this process.”
The council also identifies several “vitriolic media campaigns” in which trans women have been “vilified and misrepresented” and says that trans healthcare is also being “erroneously portrayed” as a form of LGB conversion therapy.
Despite this concerning track record, the UK government plans to encourage other countries to tackle LGBT+ inequality at its first global LGBT conference, ‘Safe to Be Me,’ next year.
The event promises to bring together elected officials, policy makers, and the international LGBT+ community to “protect and promote” the rights of LGBT+ people around the world.
PinkNews has reached out to Liz Truss’ office for comment.
Hundreds of students marched out of school in protest after a lesbian teacher was allegedly escorted off campus amid a row over “safe space” stickers on classroom doors.
Crowds of students were seen pouring out of MacArthur High School in Irving, Texas on Wednesday (22 September) in response to the school’s alleged “targeted discrimination” against LGBT+ children and teachers.
Many wore heart-shaped rainbow stickers on their faces and clothes, the symbol teachers used to show their classes were a safe space for LGBT+ students – until several weeks ago, when those stickers suddenly disappeared.
“I was freaked. The kids were freaked out,” said Rachel Stonecipher, an English teacher and sponsor of the campus’ Gay Straight Alliance, speaking to DFW News. “I was a little scared too because I’m the only openly, very obviously gay teacher, lesbian teacher.”
Stonecipher was among teachers who emailed asking for an explanation. A staff memo from the new principal said the school wanted “to set a different tone this year,” explaining: “The district’s position is that our responsibility is to make campuses a safe zone for all students, not just in our classrooms, but on every inch of our campus.”
Tensions grew as the school administration began “randomly” questioning students who attended the Gay Straight Alliance club.
Sophomore Alyssa Harbin described a “long, drawn out interrogation” that lasted 45 minutes – and although she was assured she hadn’t done anything wrong, the students who were questioned appeared to have one thing in common.
“All of these randomly selected people have been to at least one Gay Straight Alliance meeting making it feel extremely targeted,” she said at a meeting with school board members, as reported by DFW News.
Stonecipher told WFAA: “There’s a lot of hurt, confusion, and fear from students who feel like the administration has a problem with them for being LGBTQ+. It was emotionally terrible for them.”
They became even more alarmed when they saw Stonecipher being escorted off campus last week, and they say they haven’t seen her since. As the students marched out of class on Wednesday many carried signs with the teacher’s name, expressing their support for her.
“It’s not fair that, one, I have to fight for this, two, we had to go to this level, and it’s not even the first six weeks [of term],” one told WFAA.
So many students walked out of school that Irving Police were called to the campus. The school told Iriving Weekly that it was aware of the walkout and ensured that “all students are safe”.
“We value each student and strive to provide a welcoming and inclusive environment for every student, employee and family,” the Irving School district added in a statement.
“To ensure that all students feel safe regardless of background or identity, the district has developed guidelines to ensure that posters, banners and stickers placed in classrooms, hallways or offices are curriculum driven and neutral in viewpoint.”
When questioned by local media, neither Stonecipher nor the district could answer questions about the teacher’s removal or employment status. In a statement to CBS11, a spokesperson said it is policy that “teachers shall not use the classroom to transmit personal beliefs regarding political or sectarian issues.”
Students are taking a stand against anti-LGBT+ school policies
The walkout at MacArthur High School is the latest in a series of protests against anti-LGBT+ policies in schools. All across the US, queer students and allies have been taking a stand against alleged discrimination against LGBT+ students and teachers.
Many centre on religious schools, like the Catholic Bishop Amat Memorial High School in California, where around 200 students walked out of class after teachers threatened to out a gay classmate to her parents if she didn’t attend counselling.
Another walkout happened in Valor Christian High School in Denver when a gay volleyball coach was allegedly forced to resign after school officials learned of his sexuality.
In June students, parents and alumni of Niles New Tech in Michigan staged a protest outside their school to draw attention to homophobic bullying that had gone largely unchallenged by officials.
And earlier this month more than a hundred students of Winterset High School in Iowa walked out of class to protest the suspension of a teacher who revealed he was bisexual. They also launched a Change.org petition in his defence, which gained over 4,000 signatures.
Many schools remain committed to their anti-LGBT+ policies and continue to fight their cases in long and bitter lawsuits. But the increasing pushback from student bodies and the media attention that accompanies it means they’re unable to keep these battles out of the public eye as they once could.
Alejandra Caraballo, 30, spent three years and countless hours after work — which “felt like a second part-time job” at times — putting together hundreds of documents to get her health insurance to cover her facial feminization surgery.
She even planned to sue her nonprofit employer, the New York Legal Assistance Group, or NYLAG, and the insurance company it used, UnitedHealthcare, in the spring of 2019 for denying the coverage.
Alejandra CaraballoAlejandra Caraballo
“My own clients at NYLAG were getting it covered under Medicaid, no issue,” she said. “And I, having private insurance, was having it consistently denied and, not to mention, working at a place that prides itself on inclusion and diversity and being social justice-oriented in terms of providing direct legal services to low-income New Yorkers.”
She said that she had lobbied for policy change but that when she met with NYLAG’s general counsel, she was told that the organization didn’t view the explicit exclusions for certain gender-affirming operations and voice therapy for transgender people as discrimination.
“It felt really invalidating and just like I wasn’t being heard,” she said, adding that she is a lawyer who knows the case law that affects the issue.
She started preparing her lawsuit, but then, in May 2019, her employer told her that it would be switching insurance plans to Cigna, and she had to start all over again.
After the switch, in July 2019, Cigna approved the first part of her surgery, which took place in October 2019, but when she tried to get the second part covered in June 2020, it denied the claim, she said. The New York Department of Financial Services overturned the decision in August and forced Cigna to cover the surgery, which she had in October.
“I did quite an ordeal in terms of getting this covered, and I say this with the tremendous privilege that I’m an attorney who’s connected in the trans rights movement,” said Caraballo, who is now a clinical instructor at Harvard Law’s Cyber Law Clinic.
NYLAG said that Caraballo was “a valued member of our team” and that it advocates alongside its team members “as they may experience and navigate life’s systematic inequalities and inequities.”
“At NYLAG we aim to create an environment that supports all NYLAG employees during their employment, which includes making available the best options for insurance, qualified by the state of New York,” Jay Brandon, NYLAG’s director of external affairs, said in a statement. “We wish all our former employees the best in their personal endeavors and support Alejandra’s continued fight for equitable coverage from her insurance provider.”
A spokesperson for UnitedHealthcare said the company can’t comment on specific cases. The spokesperson said coverage for the treatment of gender dysphoria may include physicians’ office visits, mental health services, prescription drugs and surgical procedures.
“Our mission is to help people live healthier lives regardless of age, race, ethnicity, sexual orientation or gender identity,” the spokesperson said in a statement. “Our customer service advocates are trained to help people navigate the health care system by matching them with experts who guide them when they have questions, and we have a special gender identity team to support members through their transition.”
A spokesperson for Cigna said gender-affirming treatments “are covered in all of our standard commercial health plans when medically necessary.”
“As this field evolves, we’re seeing more of our clients opt to expressly include additional procedures like facial feminization surgery and voice therapy,” the spokesperson said. “We also regularly evaluate and update our gender dysphoria coverage policies, informed by the latest clinical guidance and expert consensus, including leading organizations like” the World Professional Association for Transgender Health, or WPATH, a nonprofit organization devoted to treating and understanding gender dysphoria.
Caraballo’s experience echoes that of many transgender people who have tried to get gender-affirming care, particularly operations, covered by their insurance — whether it’s publicly or privately funded. Trans people describe months and sometimes years of effort to get their insurance companies to cover care recommended by their doctors.
Majority report being denied care
Although many insurance companies and some politicians describe gender-affirming surgery as cosmetic, major medical organizations say it is medically necessary.
Surgical intervention is one of many treatments for gender dysphoria, which refers to the psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity, according to the American Psychiatric Association.
WPATH, which is considered the governing body on the issue, wrote in a “medical necessity statement” in 2016 that “medical procedures attendant to gender affirming/confirming surgeries are not ‘cosmetic’ or ‘elective’ or ‘for the mere convenience of the patient.’”
“These reconstructive procedures are not optional in any meaningful sense, but are understood to be medically necessary for the treatment of the diagnosed condition,” WPATH wrote. “In some cases, such surgery is the only effective treatment for the condition,” and for some people, genital surgery, in particular, is “essential and life-saving.”
Despite the medical necessity of gender-affirming care as stated by physicians, many trans people who have insurance — about one-fifth have reported that they don’t — say they have struggled to get coverage.
A report last year from the Center for American Progress found that 40 percent of transgender respondents — and 56 percent of trans respondents of color — said their health insurance companies denied coverage for gender-affirming care, which includes treatments like hormones and surgery. It also found that 48 percent of trans respondents, including 54 percent of trans respondents of color, said their health insurance companies covered only some gender-affirming care or had no providers in network.
Dallas Ducar, CEO and a co-founder of Transhealth Northampton in Massachusetts, said she was shocked by the “endless barriers that exist for patients seeking to transition.”
“For cisgender individuals, hormonal replacement, puberty blockers are really easily accessible, and they’ve been used in the past to treat precocious puberty,” she said. “Hormone replacement therapy has been beneficial for endocrine, cardiovascular conditions, and trans people are burdened with paperwork, psychiatric assessments, insurance pre-authorizations.”
She said that most of the people in power — clinicians, politicians and people who work for insurance companies — are cisgender, meaning they identify with the genders they were assigned at birth, and that they have created systems that have reduced access to quality gender-affirming care.
“Those barriers that exist and that numerous amount of paperwork or assessments that you have to go through are really, really harmful, and they add to the layers of discrimination that exists within the trans community,” she said.
Yearslong battles and hefty loans
Alex Petrovnia, 24, and his partner, who are both transgender men living in central Pennsylvania, faced barriers similar to Caraballo’s when they tried to get UnitedHealthcare to cover their hysterectomies. Petrovnia said that twice — in February and in April — United called them less than 24 hours before their operations and said their claims had been denied. The first time, Petrovnia said, the company said it was because Petrovnia and his partner hadn’t sent the required paperwork, even though Petrovnia said he had faxed it three separate times months in advance.
Alex PetrovniaAlex Petrovnia
Petrovnia had received two letters — one from a doctor and one from a therapist — confirming that a hysterectomy was necessary for his gender dysphoria, but he said the UnitedHealthcare representative told him that he needed a letter from another therapist.
He said that the second time their operations were denied, UnitedHealthcare called them when they were on their way to the hospital — just hours before their scheduled procedures — and said they were required to have been on hormone replacement therapy for one year before they could get hysterectomies. Petrovnia said the policy he had at the time said the requirement was only six months. He wrote about the experiences on Twitter.https://iframe.nbcnews.com/MgfYrb6?app=1
He and his partner have been on hormone replacement therapy for a year as of last month, so he said they plan to try to reschedule the procedures for December.
“If they’re willing to just make up the rules and contradict their own rules, it’s very difficult to have hope that it’ll work out, especially since it’s been canceled less than 24 hours in advance twice now,” he said.
UnitedHealthcare said it couldn’t comment on Petrovnia’s case.
Some government-funded insurance bans gender-affirming surgery outright in certain circumstances. For example, TRICARE, the military’s self-funded health insurance for service members, “generally doesn’t cover surgery for gender dysphoria,” according to its website. Active-duty service members can request waivers if their providers deem the surgery “medically necessary,” but waivers aren’t available for dependents — spouses and other family members.
That meant that when Jamie Traeger, whose spouse is an officer in the Army, filed a claim to get a double mastectomy in early 2019, TRICARE denied it outright even though three doctors had said the procedure was medically necessary.
Traeger, who uses gender neutral pronouns, said that they considered getting a job at Starbucks so they could have insurance that would cover the procedure but that they and their spouse decided to take out a $10,000 personal loan, instead.
“I just remember thinking this is crazy — that Starbucks has better trans health care than military family members,” they said.
Traeger, 32, said they were able to get a hysterectomy covered in 2016 because they emphasized that it would treat their uterine fibroids and avoided any mention of gender dysphoria.
“I remember the doctor saying, ‘I’m going to write this [claim] up in a very specific way, because if I indicate that this is because of gender dysphoria, TRICARE might give us a problem,’” Traeger said.
Traeger said they were happy when they saw the news in July that the Department of Veterans Affairs was changing its policy to cover all gender-confirmation procedures for trans veterans.
It’s “fabulous and long overdue,” they said. “But I just remember having this sinking feeling of … we’re getting left behind — the spouses and children of active-duty service members are getting left behind. We don’t have access to this care, and I feel like no one really knows that.”
The Military Health System, which oversees TRICARE, hasn’t responded to a request for comment.
A public policy ‘marble cake’
No one policy governs how insurers cover gender-affirming procedures.
Lindsey Dawson, an associate director at KFF (formerly the Kaiser Family Foundation), a nonprofit organization focused on health policy, described state laws as a “patchwork.”
Twenty-four states and Washington, D.C., prohibit transgender exclusions in health insurance coverage, according to the Movement Advancement Project, a nonprofit think tank. Twenty-three states, one territory and Washington, D.C., have Medicaid policies that explicitly cover transition care for transgender people. The remaining states have a mix of policies: Some don’t have any Medicaid policy that explicitly covers transgender care, 10 states have Medicaid policies that explicitly exclude trans health coverage and care, and one state — Arkansas — allows all insurers in the state to refuse to cover gender-affirming care.
“A clear federal protection for gender identity and sexual orientation would eliminate this sort of patchwork issue that we’re facing in the states right now,” Dawson said. “But right now that environment is in flux.”
The Obama administration interpreted Section 1557 of the Affordable Care Act, which prohibits discrimination based on sex in federally funded health care facilities, to include discrimination based on sexual orientation and gender identity, but “the Trump administration essentially erased those protections,” she said.
The Biden administration has yet to issue a new rule regarding its interpretation of Section 1557. In the meantime, the Office of Civil Rights at the Department of Health and Human Services said it would enforce Section 1557 to prohibit discrimination based on LGBTQ status. That, however, requires people to file legal complaints, which Dawson said is “kind of a patchwork approach to equity.”
Some cases regarding state health plans are still ongoing: The 4th U.S. Circuit Court of Appeals ruled this month that trans people who are enrolled in the North Carolina State Health Plan can sue over the state’s 2018 policy that excludes all coverage for gender dysphoria counseling, hormone therapy, surgical care or other treatment.
Blue Cross and Blue Shield of North Carolina also changed its policies in July to include coverage for gender-affirming facial surgery and voice therapy as medically necessary care.
Forcing insurance companies to cover all gender-affirming care, including operations, would be difficult, said Caraballo, the former NYLAG lawyer, because the issue is a “classic public policy marble cake,” meaning it’s governed by state, federal and sometimes local laws.
She said the Department of Health and Human Services’ Office of Civil Rights could address the issue in a few ways. One of the easiest would be for it to use its enforcement authority to crack down on insurance companies that exclude coverage for gender-affirming care, she said.
States could also pass their own legislation. She cited Washington, which passed legislation in May that requires all insurers in the state to cover gender-affirming care, including operations.
She said that, in the end, she got her surgery covered but that her case is an outlier.
“There’s so many people that are going through the same thing,” she said. “I’ve spoken with so many people who, they see those exclusions, they don’t even try.”
On an overcast day in late August, a line of homeless people gathered eagerly outside Sara D. Roosevelt Park in New York City’s Lower East Side.
Four volunteers were rapidly pulling backpacks out of a U-Haul and handing them to those in line. In just 45 minutes, the volunteers from Backpacks for the Street, a mobile nonprofit group that provides vital supplies to those without homes, handed off 165 backpacks — a new daily record.
“I think the need is growing more and more,” said Jeffrey Newman, 53, who, along with his husband, Jayson Conner, 44, started the volunteer group in 2018. “People are getting kicked out of the hotel shelters,” he added, referring to an emergency hotel shelter program that ended over the summer.
Newman, a retired businessman, said he runs Backpacks for the Street around the clock, while Conner, who works at a local restaurant, joins him on his days off. The couple decided to start the group after volunteering at a soup kitchen for several years.
Since then, the group has grown to at least 80 volunteers and has given out 32,000 backpacks stuffed with 50 items, including hand sanitizer, masks, toiletries and socks. The backpacks also contain a slip of paper with instructions on how to get vaccinated and a card with Newman’s personal cellphone number, so clients can reach him directly for help. The group also connects people with free programs available to the homeless.
Jeffrey Newman hands out a backpack.Backpacks for the Street
“If we get out there and we show the people how to get to these organizations, these programs, show them what is out there, that is part of the solution to get them off the street,” Newman said.
Demand for help is surging, according to him. Since Covid-19 arrived in the city in March 2020, the group has given out 25,000 backpacks. But while the homeless are eager to grab up backpacks, some are less enthusiastic about getting a vaccine.
“There’s a lot of misinformation out there, a lot of confusion about vaccines, and trying to conquer that is a task unto itself,” Newman said.
To date, about 62 percent of adults in New York City are fully vaccinated, with an additional 7 percent receiving at least one dose, according to data provided by the city. But relatively few of the city’s estimated 60,000 homeless are fully inoculated despite free vaccines available at walk-in clinics and mobile vaccine centers throughout the city: At least 11,300 homeless New Yorkers (about 19 percent) have been fully vaccinated through the Department of Social Services’ vaccination efforts and the city’s mobile vaccination program through the end of August, according to spokespersons for the Department of Social Services and NYC Test & Trace Corps.
With so few homeless people fully vaccinated, Newman fears the worst.
“I think that we’re going to see a tremendous amount of homeless getting sick, if not worse,” he said, “more so because they don’t even know much about the delta [variant].”
New York City was already in the midst of a homelessness crisis before becoming ground zero for the coronavirus last year. To date, over 34,000 New York City residents have lost their lives to Covid, the majority of deaths occurring prior to the rollout of free vaccines in the spring.
The true number of homeless New Yorkers who have died from Covid is unknown. As of the end of February, the New York City Department of Homeless Services documented 113 deaths of homeless people from Covid, 101 of whom died in shelters. Newman said he suspects the actual number is probably much higher, with deaths among the unsheltered likely attributed to other factors, such as extreme cold. At least a dozen of his nonprofit’s regular clients died from the coronavirus, he said, including a few who were personal friends.
As the highly contagious delta variant spreads, now making up at least 97 percent of cases in the city as of last month, Newman is desperately working to educate the homeless about vaccines and get them to vaccination centers. But he said vaccine misinformation is running rampant on the streets, with many homeless believing vaccines are “some evil thing.”
So far, he and his husband have helped more than 160 individuals receive shots, driving them to nearby walk-in centers. But fighting vaccine hesitancy is tough, he said. To incentivize them, the group offers $25 McDonald’s gift cards, and volunteers share their own stories about getting the vaccine.
Newman, who is HIV-positive and vaccinated, said that sitting with clients and talking to them one-on-one about getting inoculated — showing them “I walk the walk, I talk the talk” — often persuades those who are fearful. And since the couple have developed a bond with their homeless clients over the years, many trust them.
The city is also working on getting more homeless vaccinated. According to Adam Shrier, press secretary for the NYC Test & Trace Corp, the mobile vaccination program began sending six vans to “canvas streets, subway stations and parks” at the beginning of September.
Newman fears it won’t be enough.
“It breaks my heart more than anything else,” he said, though he vowed to continue doing what he can to help.
“We request your attention to these matters and periodic updates on your progress as you continue to implement the COVID-19 Hate Crimes Act and work to reduce the violence from xenophobia and hate in our country,” the letter stated.
A DOJ spokeswoman confirmed receipt of the letter.
Co-sponsored by Hirono and Meng, the legislation was signed May 20 by President Joe Biden after winning bipartisan support in Congress and directed the DOJ to expedite the review of Covid-19-related hate crimes that were reported to law enforcement agencies, to help them create ways to report such incidents online and to execute public outreach.
Though the Democratic lawmakers’ letter commended Garland’s efforts to combat hate crimes, it asked the DOJ to look further into establishing online reporting for both hate crimes and incidents. The letter referenced a recent analysis from reporting forum Stop AAPI Hate that revealed over 9,000 anti-Asian bias incidents over the course of roughly 15 months during the pandemic. Verbal harassment made up nearly two-thirds of the total incidents reported, while shunning made up almost 17 percent.
The lawmakers explained that though not all acts of discrimination would equate to a hate crime, “the impetus for these actions are the same—fear and xenophobia.”
“In order to meaningfully address the root causes of this bias and hostility, we need a clear and full picture of the scope of the problem,” the letter stated. “Data on hate crimes alone is insufficient.”
The letter also requested “the expansion of public education campaigns aimed at raising awareness of hate crimes” in different languages to encourage victims to come forward.
Hirono and Meng additionally called for the law to be applied to all hate crimes occurring during the coronavirus pandemic, citing antisemitic attacks in May following “an outbreak in violence between Israel and Hamas” and the deaths of at least 44 transgender or gender-nonconforming people in 2020, “some as the result of anti-transgender bias.”
The letter ended by sharing fears that as the pandemic continues, frustration over the virus “will undoubtedly resurface.”
“We fear the impact this could have on perpetuating hate-based violence against people,” the letter stated. “Full implementation of the COVID-19 Hate Crimes Act will help stem the tide against further violence.”
