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Bracing for cuts after supercommittee’s failure

LGBT, HIV/AIDS programs could face reductions

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LGBT and HIV/AIDS advocates are bracing for potential cuts as a result of the congressional supercommittee’s failure this week to come up with a deficit reduction deal.

On Monday, members of the Joint Select Committee on Deficit Reduction — comprised of six Democrats and six Republicans — announced that they were unable to come up with an agreement on $1.5 trillion in budget cuts by the Wednesday deadline as established by legislation signed by President Obama in August.

As a result of the supercommittee’s failure to come up with a plan for deficit reduction, a sequester will kick in that will lower spending by $1.2 trillion beginning in fiscal year 2013 by $109.3 billion in cuts per year. Half of the cuts — $54.7 billion — will come from the Defense Department and the other half from mandatory and discretionary domestic spending — including HIV/AIDS programs and certain government programs that help LGBT people.

MORE IN THE BLADE: GAY MEN SHOULD BE SCREENED FOR HPV RELATED CANCERS

According to the Congressional Budget Office, reductions in discretionary appropriations for non-defense programs — including HIV/AIDS programs — would range from from 7.8 percent in 2013 to 5.5 percent in 2021, resulting in savings of $294 billion.

AIDS Institute Deputy Executive Director Carl Schmid (Blade file photo by Michael Key)

Carl Schmid, deputy executive director for the AIDS Institute, said the mandatory cuts that will occur in 2013 “will certainly impact funding levels” for discretionary HIV/AIDS programs such as the Ryan White Care Act, AIDS Drug Assistance Programs and research spending.

“We’re going to try to work to make sure that doesn’t happen, but if it does happen, there’ll be less money for prevention, less money for drugs to keep people healthy, less for care and treatment and less money for research,” Schmid said.

Schmid added the potential cuts are of particular concern because the number of people living with HIV/AIDS continues to grow.

“There’s more and more people living with HIV than ever before,” Schmid said. “There’s more accessing the AIDS Drug Assistance Program than ever before, so it’s at a time when there’s more and more people with HIV, and at a time that we know treatment is a way to cut transmission.”

According to a CDC report published in August, HIV in the United States continues to disproportionately impact young gay and bisexual men, although as a whole, infection rates have been relatively stable in recent years. New infections among among young men who have sex with men increased 34 percent between 2006 and 2009, while infections among young, black men who have sex with men increased 48 percent from 4,400 in 2006 to 6,500 in 2009.

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Brian Hujdich, executive director for HealthHIV, also said the failure of the supercommittee may jeopardize federal programs on which low-income Americans depend for medical coverage.

“We are disappointed but not surprised at the supercommittee’s inaction,” Hujdich said. “They had both the latitude and responsibility to make hard decisions, but once again chose to do nothing. The weight of congressional indecision now falls on the backs of the most vulnerable and medically under-served communities, whose health care coverage may be impacted in 2013.”

Other programs at risk could include some that LGBT Americans rely on in greater numbers than their straight counterparts.

Last week, Kellan Baker and Zach Britt of the Center for American Progress wrote a report that detailed how either action or inaction by the supercommittee could have significant impact on programs affecting LGBT people.

“Gay and transgender communities most at risk include families with children and gay and transgender people who are doubly marginalized in American society, such as gay and transgender people of color, those living in poverty, immigrants, homeless youth, elders, and those with disabilities,” Baker and Britt wrote.

Among the programs identified that could be cut include planned data collection by the Department of Health & Human Services on sexual orientation and gender identity; mental health services that help LGBT  youth and adults cope with depression, bullying and discrimination; and programs that support out-of-home gay and transgender youth.

Despite the failure of the committee, many were unhappy with plans the committee was proposing and thankful an agreement wasn’t made on any one of them.

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According to the CAP report, Democrats proposed cutting $400 billion from Medicare, $75 billion from Medicaid and $1.3 trillion in discretionary spending — while increasing revenue by $1.3 trillion. Republicans, on the other hand, proposed to cut $500 billion from Medicare and $185 billion from Medicaid, with $1.2 trillion more in discretionary cuts and only $40 billion in revenue increases.

Laurie Young, director of aging and economic security at the National Gay & Lesbian Task Force, said the plans the supercommittee was proposing were “really not good” and the failure to come up with a plan is better than an agreement on a bad one.

“No deal today is better than them having agreed upon a bad deal that would have cut benefits to people who are already receiving them and relying on them,” Young said.

Moreover, the two largest programs providing HIV/AIDS care to low-income people — Medicare and Medicaid — won’t see immediate cuts as a result of the supercommittee’s failure. Social Security and Medicaid are immune from cuts under the sequester. Medicare would see, at most, a 2 percent reduction in payments, but those cuts would only affect providers and would not raise co-pays or premiums on people covered under this program.

Young said the exemption of these programs is important because LGBT people are particularly dependent on Medicare, Medicaid and Social Security as they age.

“We don’t have the same ability to access economic security and retirement that our heterosexual counterparts do,” Young said. “And so, we’re twice as likely to age alone and four times less likely to have children who would take care of us.”

But Schmid said the protection of Medicare and Medicaid from the sequester “doesn’t mean all the problems are solved” and those programs could be affected as Congress makes the decisions for cuts.

“There’s still going to be pressure to cut Medicare and Medicaid in the future, so we have to remain vigilant,” Schmid said.

Since the cuts won’t begin until Jan. 2, 2013, Congress has the opportunity to come up with an alternative for deficit reduction rather than the sequestration imposed the supercommittee’s failure to come up with a plan.

Young predicted Congress would work to come up with an alternative because Republicans won’t want to see drastic cuts to defense and Democrats won’t want to see drastic cuts to domestic programs.

“We’re going to have to work over the next year to make sure that we get a balanced plan that doesn’t depend on just slashing benefits or slashing cuts in federal agencies, but also really looks to raising revenues,” Young said. “The chore for next year is making sure that we can get a balanced plan, which was never really considered by the supercommittee.”

Schmid said advocates are going to fight to include HIV/AIDS among the programs that won’t receive cuts, but acknowledged they’re facing an uphill battle.

“These are supposed to be across the board cuts, but there are some other low-income programs that are exempt by the law to sequestration and, I think, we will fight to be included in them as well,” Schmid said. “That will be our job over the next year before these cuts take place in 2013.”

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Puerto Rico

The ‘X’ returns to court

1st Circuit hears case over legal recognition of nonbinary Puerto Ricans

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(Photo by Sergei Gnatuk via Bigstock)

Eight months ago, I wrote about this issue at a time when it had not yet reached the judicial level it faces today. Back then, the conversation moved through administrative decisions, public debate, and political resistance. It was unresolved, but it had not yet reached this point.

That has now changed.

Lambda Legal appeared before the 1st U.S. Court of Appeals in Boston, urging the court to uphold a lower court ruling that requires the government of Puerto Rico to issue birth certificates that accurately reflect the identities of nonbinary individuals. The appeal follows a district court decision that found the denial of such recognition to be a violation of the U.S. Constitution.

This marks a turning point. The issue is no longer theoretical. A court has already determined that unequal treatment exists.

The argument presented by the plaintiffs is grounded in Puerto Rico’s own legal framework. Identity birth certificates are not static historical records. They are functional documents used in everyday life. They are required to access employment, education, and essential services. Their purpose is practical, not symbolic.

Within that framework, the exclusion of nonbinary individuals does not stem from a legal limitation. Puerto Rico already allows gender marker corrections on birth certificates for transgender individuals under the precedent established in Arroyo Gonzalez v. Rosselló Nevares. In addition, the current Civil Code recognizes the existence of identity documents that reflect a person’s lived identity beyond the original birth record.

The issue lies in how the law is applied.

Recognition is granted within specific categories, while those who do not identify within that binary structure remain excluded. That exclusion is now at the center of this case.

Lambda Legal’s position is straightforward. Requiring individuals to carry documents that do not reflect who they are forces them into misrepresentation in essential aspects of daily life. This creates practical barriers, exposes them to scrutiny, and places them in a constant state of vulnerability.

The plaintiffs, who were born in Puerto Rico, have made clear that access to accurate identification is not symbolic. It is a basic condition for moving through the world without contradiction imposed by the state.

The fact that this case is now being addressed in the federal court system adds another layer of significance. This is not a pending policy discussion or a legislative proposal. It is a constitutional question. The analysis is not about political preference, but about rights and equal protection under the law.

This case does not exist in isolation.

It unfolds within a broader context in which debates over identity and rights have increasingly been shaped by the growing influence of conservative perspectives in public policy, both in the United States and in Puerto Rico. At the local level, this influence has been reflected in legislative discussions where religious arguments have begun to intersect with decisions that should be grounded in constitutional principles. That intersection creates tension around the separation of church and state and has direct consequences for access to rights.

Recognizing this context is not an attack on faith or religious practice. It is an acknowledgment that when certain perspectives move into the realm of public authority, they can shape outcomes that affect specific communities.

From within Puerto Rico, this is not a distant debate. It is a lived reality. It is present in the difficulty of presenting identification that does not match one’s identity, and in the consequences that follow in workplaces, schools, and government spaces.

The progression of this case introduces the possibility of change within the applicable legal framework. Not because it resolves every tension surrounding the issue, but because it establishes a legal examination of a practice that has long operated under exclusion.

Eight months ago, the conversation centered on ongoing developments. Today, there is already a judicial finding that identifies a violation of rights. What remains is whether that finding will be upheld on appeal.

That process does not guarantee an immediate outcome, but it shifts the ground.

The debate is no longer theoretical.

It is now before the courts.

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National

LGBTQ community explores arming up during heated political times

Interest in gun ownership has increased since Donald Trump returned to office

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Gun rights organizations and advocates say interest in gun ownership seems to have increased in the LGBTQIA+ community since President Donald Trump returned to the White House last year. (Photo by Kaitlin Newman for the Baltimore Banner)

By JOHN-JOHN WILLIAMS IV | As the child of a father who hunted, Vera Snively shied away from firearms, influenced by her mother’s aversion to guns.

Now, the 18-year-old Westminster electrician goes to the shooting range at least once a month. She owns a rifle and a shotgun, and plans to get a handgun when she turns 21.

“I want to be able to defend my community, especially being in political spaces and queer spaces,” said Snively, a trans woman. “It’s just having that extra line of safety, having that extra peace of mind would be important to me.”

Snively is among what some say is a growing number of LGBTQ gun owners across the United States. Gun rights organizations and advocates say interest in gun ownership appears to have increased in that community since President Donald Trump returned to the White House last year.

The rest of this article can be read on the Baltimore Banner’s website.

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Tennessee

Tenn. lawmakers pass transgender “watch list” bill

State Senate to consider measure on Wednesday

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Tennessee, gay news, Washington Blade
Image of the transgender flag with the Tennessee flag in the shape of the state over it. (Image public domain)

The Tennessee House of Representatives passed a bill last week to create a transgender “watch list” that also pushes detransition medical treatment. The state Senate will consider it on Wednesday.

House Bill 754/State Bill 676 has been deemed “ugly” by LGBTQ advocates and criticized by healthcare information litigators as a major privacy concern.

The bill would require “gender clinics accepting funds from this state to perform gender transition procedures to also perform detransition procedures; requires insurance entities providing coverage of gender transition procedures to also cover detransition procedures; requires certain gender clinics and insurance entities to report information regarding detransition procedures to the department of health.”

It would require that any gender-affirming care-providing clinics share the date, age, and sex of patients; any drugs prescribed (dosage, frequency, duration, and method administered); the state and county; the name, contact information, and medical specialty of the healthcare professional who prescribed the treatment; and any past medical history related to “neurological, behavioral, or mental health conditions.” It would also mandate additional information if surgical intervention is prescribed, including details on which healthcare professional made a referral and when.

HB 0754 would also require the state to produce a “comprehensive annual statistical report,” with all collected data shared with the heads of the legislature and the legislative librarian, and eventually published online for public access.

The bill also reframes detransitioning as a major focus of gender-affirming healthcare — despite studies showing that the number of trans people who detransition is statistically quite low, around 13 percent, and is often the result of external pressures (such as discrimination or family) rather than an issue with their gender identity.

This legislation stands in sharp contrast to federal protections restricting what healthcare information can be shared. In 1996, Congress passed the Health Insurance Portability and Accountability Act, or HIPAA, requiring protections for all “individually identifiable health information,” including medical records, conversations, billing information, and other patient data.

Margaret Riley, professor of law, public health sciences, and public policy at the University of Virginia, has written about similar efforts at the federal level, noting the Trump-Vance administration’s push to subpoena multiple hospitals’ records of gender-affirming care for trans patients despite no claims — or proof — that a crime was committed.

It has “sown fear and concern, both among people whose information is sought and among the doctors and other providers who offer such care. Some health providers have reportedly decided to no longer provide gender-affirming care to minors as a result of the inquiries, even in states where that care is legal.” She wrote in an article on the Conversation, where she goes further, pointing out that the push, mostly from conservative members of the government, are pushing extracting this private information “while giving no inkling of any alleged crimes that may have been committed.”

State Rep. Jeremy Faison (R-Cosby), the bill’s sponsor, said in a press conference two weeks ago that he has met dozens of individuals who sought to transition genders and ultimately detransitioned. In committee, an individual testified in support of the bill, claiming that while insurance paid for gender-affirming care, detransition care was not covered.

“I believe that we as a society are going to look back on this time that really burst out in 2014 and think, ‘Dear God, What were we thinking? This was as dumb as frontal lobotomies,’” Faison said of gender-affirming care. “I think we’re going to look back on society one day and think that.”

Jennifer Levi, GLAD Law’s senior director of Transgender and Queer Rights, shared with PBS last year that legislation like this changes the entire concept of HIPAA rights for trans Americans in ways that are invasive and unnecessary.

“It turns doctor-patient confidentiality into government surveillance,” Levi said, later emphasizing this will cause fewer people to seek out the care that they need. “It’s chilling.”

The Washington Blade reached out to the American Civil Liberties Union of Tennessee, which shared this statement from Executive Director Miriam Nemeth:

“HB 754/SB 676 continues the ugly legacy of Tennessee legislators’ attacks on the lives of transgender Tennesseans. Most Tennesseans, regardless of political views, oppose government databases tracking medical decisions made between patients and their doctors. The same should be true here. The state does not threaten to end the livelihood of doctors and fine them $150,000 for safeguarding the sensitive information of people with diabetes, depression, cancer, or other conditions. Trans people and intersex people deserve the same safety, privacy, and equal treatment under the law as everyone else.”

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