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Barney, speaking frankly

Retiring congressman on state of LGBT movement, coming out in 1987 and his future plans

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Rep. Barney Frank

Retiring Rep. Barney Frank spoke to the Blade this week about a wide range of topics, including the state of the LGBT movement and his future plans. (Washington Blade file photo by Michael Key)

Gay U.S. Rep. Barney Frank (D-Mass.), who announced last week that he won’t run for re-election next year, said the LGBT community has seen an ā€œenormousā€ amount of progress during his more than 30 years in Congress and would achieve close to full equality in 12 years.

ā€œI think we are on the verge of a very complete victory within a dozen years or so,ā€ he told the Washington Blade in an interview in his office on Tuesday.

ā€œThat is, I think the country is supportive. It gets better generationally,ā€ he said. ā€œI don’t think people will be allowed to marry in every state, unfortunately, 10 years from now. I think people in those states where a majority of people live will be allowed to marry and will have full federal rights.ā€

Frank said he became the first member of Congress to voluntarily disclose he was gay in 1987, six years after taking office in 1981, after he determined staying in the closet was too constraining on his personal life.

ā€œI got there and I thought, OK, well I can be privately out but publicly closeted,ā€ he said. ā€œBut it didn’t work. I found it very hard to have a satisfying, healthy emotional and physical life.ā€

Frank said that during the years he withheld disclosing his sexual orientation, both as a congressman and a member of the Massachusetts State Legislature, he promised himself that he would never hold back on his strong political support for LGBT rights in an effort to conceal his status as a gay person.

ā€œI remember my thought process was, well I can’t be honest about being gay. I wouldn’t win. But it would be despicable for me as a gay man to be any less than fully supportive,ā€ he said.

In a wide-ranging discussion of his views on how the LGBT movement should push for civil rights legislation in Congress and through the states, Frank expressed in the blunt way he has been known to do that LGBT activists should use the most effective means of moving their agenda, even if that sometimes means making compromises.

He described as ā€œpolitical suicideā€ the call by some LGBT activists and bloggers for withholding support for President Barack Obama on grounds that Obama and his Democratic allies in Congress didn’t push harder for more LGBT legislative advances, including the passage of the Employment Non-Discrimination Act, or ENDA, which remains stalled in Congress.

Frank said he has seen important advances in the support for transgender rights in Congress and several states, including Massachusetts, which just passed a transgender non-discrimination bill that includes protections in employment, housing, credit and adds transgender protections to the state’s hate crimes law.

But Frank noted that the bill passed after transgender leaders and their supporters in the legislature agreed to a compromise that eliminated public accommodations protections from the bill. Lawmakers supportive of the bill said they would add public accommodations protections to the law as soon they can line up the votes in the legislature needed to do so.

Frank dismissed as ā€œridiculousā€ the attacks by some LGBT activists who called the compromise unacceptable and an outrage against the transgender community.

ā€œThat is an example of their political stupidity,ā€ he said, noting that the compromise bill provides employment and housing protections that otherwise would not have passed if advocates held out for an all-or-nothing bill.

Frank described as “reasonable” a proposalĀ by LGBT advocatesĀ that President ObamaĀ issue an executive order requiring companies that receive federal contracts in the defense and other industries to provide non-discrimination protections for their LGBT employees.

“I think that’s a reasonable thing to keep pushing for,” he said.Ā “There are limits to what you can do. You don’t want the president to overreach from what could be required in legislation. I think that’s worth pushing for if it’s carefully done.”

A transcript of the Blade’s interview with Rep. Frank follows. The interview was conducted on Dec. 6, 2011, in Frank’s Capitol Hill office.

Washington Blade: To what degree have you seen support for LGBT equality increase in the U.S. Congress since you took office as a congressman in 1981?

Rep. Barney Frank: Oh, enormously. When I first got here, the first vote we had was in 1981 when the House – as it was able to do then by a one-house vote – overturned the D.C. Council’s repeal of the [city’s] sodomy law. It was a heavy vote against us. And we’ve just made very great progress since then. It’s to the point where now — and it’s unfortunate that it’s gotten very partisan. The country has gotten much better in its view on LGBT rights. The Democrats have gotten better — equal to or ahead of the country. But the Republicans have gotten much worse. So it’s now one of the major partisan issues. It’s unfortunate how terrible the Republicans have become. You saw that in ā€˜Don’t Ask, Don’t Tell,’ for instance, in the House. But in general the expectation is the Democrats in the House will be supportive on most issues, and I think that reflects the country.

Blade: What prompted you to come out as gay in 1987?

Frank: First, my personal life. I’ve known I’ve been gay since I was 13. I lived a very repressed life until then. And then, because I had emotional and physical needs that needed an outlet, I got here and I thought, OK, well I can be privately out but publicly closeted. But it didn’t work. I just found it very hard to have a satisfying, healthy emotional and physical life. So it was primarily my personal life. But it was also the secondary factor that I thought it would be helpful in fighting prejudice. One of the things I realized about talking a lot about gay rights – and increasingly by then people knew I was gay. I wasn’t out publicly. I realized they did not understand what it was like, what we went through, what the pain was. But that’s because they didn’t know anybody. It’s hard to sympathize with people when you don’t know who they are. You don’t see what it is.

Blade: Unlike other gay public officials who were in the closet, you didn’t seem to hold back in your public support for gay rights.

Frank: It was quite the opposite. I decided to run for office in 1972 – to run for the state legislature in Massachusetts. And I remember my thought process was, well I can’t be honest about being gay. I wouldn’t win. But it would be despicable for me as a gay man to be any less than fully supportive … There were then two gay groups, a men’s group and a women’s group. And they wrote to everybody who was running for the state legislature in 1972. It was just a couple of years after Stonewall. And for the first time you had organized gay political activity. And they said, ā€˜Would you introduce legislation to provide legal equality for gay people, which was the term we used then. And I said yes. I was the only one who said yes. So that’s how I became the prime sponsor of the legislation. I was the only one. But I was glad to take on the role. So, yeah, I clearly decided I would not in any way retreat. And I remember the first time I testified on gay rights. I was 32, unmarried. And I thought, well, what are they going to think? And my answer was, oh, the hell with what they think. I was prepared to sacrifice enough not to come out. But I was not prepared to degrade myself by pretending to be anything less than supportive of who I was.

Blade: When you came out in Congress did you sense you were being held back from advancing because of a so-called glass ceiling due to your sexual orientation?

Frank: I think there was one at first. I think, now, yes and no. Certainly it didn’t interfere with my being the chair of a very powerful committee and being, frankly, because of the circumstances, one of the major leaders. In fact I said that on the floor. I remember saying when we were talking about the hate crimes bill, ā€˜I’m a big shot now but I used to be 15 and I remember what it was like.’ … If I were running for a leadership position it might be a problem in the House. Some of the Democrats come from the few areas left where they’re afraid. But now we have almost all the Democrats on board. We have a handful that aren’t. So no. And the other – I assumed it would have been a bar to [running for] the Senate. But in 2004, when we thought John Kerry might get elected president, we had a mock election for the Senate in Massachusetts. Five of us were running – Congressman Markey, Congressman Lynch, myself, then Congressman Meehan and Martha Coakley, now the attorney general. And we were running and I’ve had people who worked in the other camps say I would have won that race. So if Kerry had been elected president I believe I would have been elected to the Senate in 2004. So I mean other than the presidency and the vice presidency I think there’s probably not one.

Blade: Where does the LGBT movement stand now in its ability to advance legislation?

Frank: We’ve gotten better. I think there’s two good examples of great victories. They didn’t involve demonstrations, they didn’t involve marches. They involved some discretion and some compromising. Deferring to [New York Governor] Andrew Cuomo’s leadership politically in the battle for [same-sex] marriage in New York, and he told them how to do it. And then accepting the exclusion of public accommodations from the trans [non-discrimination bill, which passed in November 2011] in Massachusetts.

Blade: The trans bill in Massachusetts became an issue to some—

Frank: An issue to whom?

Blade: Some of the more outspoken trans activists, who say they are outraged because it includes employment, housing and other protections but not public accommodations protections.

Frank: No, I would say ridiculous trans activists who are outraged, who would prefer there be no rights for employment than this. That is an example of their political stupidity. They may be very bright about other things. I don’t see how anybody can see that as a rational argument right now, nor, by the way, do I think it represents five percent of our community. I don’t even think it represents a majority of the transgender people. How can it possibly be – and by the way, these people don’t know history, because I will tell you that Martin Luther King and the other civil rights leaders would not for a second have hesitated to accept that deal. They were constantly moving toward making things better but those are both examples, I think, of the political maturity of our community – of knowing how to go about it. And I think as a result we are on the verge – well, by the way, we did the same thing with ā€˜Don’t Ask, Don’t Tell.’ We didn’t abolish ā€˜Don’t Ask, Don’t Tell.’ We didn’t ban statutorily discrimination against us in the military. We banned the requirement that we discriminate. And there was some, ā€˜Oh, gee, how do you know they maybe will not do it fairly?’ I think we are on the verge of a very complete victory within a dozen years or so. That is, I think the country is supportive. It gets better generationally. I don’t think people will be allowed to marry in every state, unfortunately, 10 years from now. I think people in those states where a majority of people live will be allowed to marry and will have full federal rights.

Blade: Are you concerned about the provision of DOMA – if it’s repealed – that says the states don’t have to recognize same-sex marriages from other states –

Frank: That doesn’t mean anything. I’ve said this all along. That doesn’t mean anything at all. The court will disregard that. Quite frankly people don’t understand that. That’s a matter of interpreting the Full Faith and Credit Clause of the Constitution. The Supreme Court will tell Congress, ā€˜Mind your own business.’ It has nothing to do with you. That is totally meaningless, that section. It doesn’t mean a thing. Congress cannot affect by statute a constitutional interpretation. By the way, the Constitution always was that states did not have to recognize that. When the Supreme Court threw out the law against inter marriage racially it wasn’t based on one state having to recognize another state’s marriage. The assumption was in 1967 that Virginia, which is where the case was brought, didn’t have to recognize a marriage in Europe. So everybody agreed – an African American and a white person can get married in New York and Virginia can disregard it. It was thrown out on constitutional segregation grounds. So in the first place, that’s been the Constitution anyway. Secondly, if it was, Congress would have nothing to do with it. It’s an entirely meaningless provision.

Blade: Some, like Hillary Clinton when she ran for president in 2008, said her husband signed DOMA because it would act as a safeguard against passing a federal constitutional amendment to ban gay marriage.

Frank: That’s nonsense. Her husband signed it because he was afraid politically about what would happen if he didn’t sign it. It has nothing to do with a constitutional amendment. He signed it because it was politically necessary to sign it. And I understood that. The Republicans threw it on his lap three months before the election. [Liberal, gay-supportive Senator] Paul Wellstone [D-Minn.] voted for it. He was up for re-election that year and he was afraid of it. It had nothing to do with stopping a constitutional amendment. And the fact is it does not mean anything. And no good lawyer will tell you it has any meaning whatsoever. This is a matter of the Constitution. It would be like if Congress passed a law saying the 14th Amendment doesn’t mean this or that. No, it’s none of our business what it means or not. We can decide for ourselves what it means, and I can govern my vote. But whether the Full Faith and Credit Clause compels marriage recognition or not is entirely up to the Supreme Court. And clearly up until now they have said it doesn’t.

Blade: Do you have any predictions of what the Supreme Court might do if the Proposition 8 case gets there?

Frank: I think that’s not a good case. I think the better case is Mary Bonauto’s case [the attorney with the LGBT litigation group in Boston, Gay & Lesbian Advocates & Defenders, which is challenging the Defense of Marriage Act, or DOMA, in court on behalf of a same-sex couple.]

Blade: In your 1992 book, ā€œSpeaking Frankly: What’s Wrong with the Democrats and How to Fix It,ā€ you said some liberal Democrats unnecessarily alienated voters by being reluctant to ā€œdemonstrate that liberals are patriotic supporters of the free-enterprise system who think that hard work should be rewarded and violent criminals severely punished.ā€ Do some of these things still apply today and do they have any relevance to the gay movement?

Frank: Yes, I still believe it’s a mistake, for example, to insist that every Democrat be for gun control. That’s a great loser for us in most of the country. I’ll vote for gun control. But it’s a great loser. I also believe it has to do with – I’ll go back to marriage in New York and the non-discrimination bill in Massachusetts. Yeah, it’s very, very relevant still. You have to be smart about it, that you engage in political activity to advance your goals, not to feel morally superior.

Blade: Everybody’s talking about the presidential election. Are the Republican presidential candidates as horrible as a lot of gay activists are saying they are on LGBT issues?

Frank: Yes – they are. Romney is a total faker, having said he was going to be more pro-gay rights than Ted Kennedy and he’s moved against us on everything, not just on marriage. And Gingrich was the leader of homophobic stuff when he was here. Gingrich was the man who put the Defense of Marriage Act on the agenda in 1996 when he was the Speaker. I don’t know where Huntsman is, but he is irrelevant. It’s the whole Republican Party. On ā€˜Don’t Ask, Don’t Tell,’ you saw the overwhelming majority of Republicans vote against the defense bill in the House because it included the repeal of ā€˜Don’t Ask, Don’t Tell.’ They ordinarily all vote for the defense bill. We did get a couple of votes in the Senate. [Senator] Susan Collins’ [R-Maine] support was very important in that. But in general the Republicans have become a 90 plus percent anti-gay party. By the way, [President George W.] Bush didn’t undo stuff. He wouldn’t do anything good. But I’m not at all confident that a Republican president won’t reinstate ā€˜Don’t Ask, Don’t Tell.’

Blade: Is there a chance that the Congress would block that, even if there’s a Republican-controlled House?

Frank: Well Congress couldn’t reinstate it because they would never get it through the Senate and the president would veto it. But if the Republicans win the presidency they don’t need the Congress. The president could reinstate it by executive order.

Blade: Is it completely settled now that every gay civil rights bill will include gender identity and expression protections or it won’t be introduced, whether it would be ENDA or another bill?

Frank: I think it’s unlikely that it wouldn’t but that doesn’t necessarily mean it will pass. I think you’ll see transgender protections included. We’ve made progress on transgender. But my view is the same in that we still have the problem with the situation where people get naked together. But short of that, I think the next time we have a Democratic House, Senate and president – remember, we can only pass pro-LGBT legislation when we have a Democratic House, Senate and president. We’ve only had that twice since Jimmy Carter left office—two years under Bill Clinton and two years under Barack Obama. That’s the exception, not the norm. So the next time we get a Democratic House, Senate and president we’ll be able to pass a transgender-inclusive ENDA. But like the Massachusetts law, probably not allowing full and unrestricted access to locker and shower rooms

Blade: We get emails and calls from some activists saying the Democrats should have been held to a higher standard, that they should have done more on LGBT legislation during the period that they did have the House and Senate and the presidency under Obama.

Frank: Which was?

Blade: Among other things, ENDA.

Frank: We had a transgender inclusive hate crimes bill and a repeal of ā€˜Don’t Ask, Don’t Tell.’ I think that’s pretty good. I wish we had done ENDA. But part of the problem was the community refused to accept the kind of compromise that Massachusetts did. If we had that – one of the things the [House] leadership was worried about was … what are we going to pass the bill for if some of the people who are going to be the beneficiaries are attacking us? So what’s the point of that? People are holding us to a higher standard? Whose standard? Where did you become the standard setter? What we got, as I said, was the president coming out against DOMA and very importantly elevating the level of scrutiny that’s needed for ending discrimination. And we got hate crimes through and we got ā€˜Don’t Ask, Don’t Tell’ repealed. I think that’s pretty good.

Blade: Many in the community agree with that assessment.

Frank: In general, the people who are complaining — well, what’s their remedy? They’re complaining, what do they want, sympathy? If they’re saying they wish we had more, I do too. Are they saying that’s a reason not to be supporting Barack Obama? That’s political suicide. The next president will probably appoint another Supreme Court justice or two. I don’t see how people can say, oh, we care about the lawsuit for Prop 8, we care about the DOMA lawsuit but let’s make sure that a homophobe will appoint the next Supreme Court justice.

Blade: It’s hard to argue with that.

Frank: Well you raised it.

Blade: Some bloggers and activists have raised it.

Frank: And the answer is that it is suicidal and dumb and self-defeating. Plus, you focus much too much on this. They are a very small percentage of our community and I think that’s a tendency, whether you’re in the media or whether they blog. That is a very small percentage of the community. Do you think most transgender people – Diego would know better than you or I – What do most transgender people in Massachusetts think about the bill?

Diego Sanchez [Frank’s legislative assistant and longtime transgender advocate]: They support it.

Frank: OK.

Blade: A similar situation occurred this year in Maryland when most transgender leaders, including veteran transgender activist Dana Beyer, agreed to a compromise transgender non-discrimination bill that didn’t include public accommodations protections. Beyer was denounced by other trans activists for accepting the compromise.

Frank: Stop paying so much attention to a handful of people with terrible political judgment who are acting out emotionally. They’re only important to you, to be honest. They’re not important me. They’re not important to anyone in the Maryland Legislature.

Blade: What do you think about the possibility of an executive order by President Obama to require defense contractors or any private companies getting government contracts to have a non-discrimination policy for their LGBT employees?

Frank: I think that’s a reasonable thing to keep pushing for. There are limits to what you can do. You don’t want the president to overreach from what could be required in legislation. I think that’s worth pushing for if it’s carefully done.

Blade: To issue that executive order?

Frank: For contractors, yeah, using race as a model. The problem we do have is this. Racial discrimination is embodied in the Constitution and we’re not. So there is more power where race is concerned.

Blade: In terms of your own plans, can you say a little about what you plan to do when you leave Congress?

Frank: I’m going to teach, lecture for money, and write.

Blade: And did you say you don’t plan to become a lobbyist?

Frank: Oh, absolutely not. Now I will still be a supporter and an advocate, but I won’t lobby for money. I will continue to work on LGBT issues but not as a lobbyist for money.

Blade: Would you consider going on the board of one of the prominent national gay groups?

Frank: No, I don’t want to go to any more meetings and vote any more. I’ll do what I can do but I don’t want to go on a board. I’m just looking for freedom from that kind of responsibility. But I will continue to be an advocate and strategist.

Blade: Will you consider testifying on LGBT issues before –

Frank: Remember that for the year 2013 I will be under an ethics one-year pause. But I will be picking up again in 2014.

Blade: That’s an ethics requirement on the Hill?

Frank: One year – I can’t talk to my colleagues for a year about business.

Blade: We just saw a photo of you with your partner James Ready at a White House holiday party this week. You’ve been taking your partner to functions for quite a while. Has that caused any complications or negative political repercussions?

Frank: I read a book that was very important by a man named Charles Hamilton. It was a biography of Adam Clayton Powell. When Adam Clayton Powell got elected to Congress, while he was the third African American, he was the first to be self-respecting. The two before him had accepted segregation in the Congress. When Adam Powell got here, I think it was 1943, he was not allowed to use the House restaurant. He was told he couldn’t use either the restaurant or the swimming pool. He said ā€˜Screw you,’ and he did it. And what he then did, and this is what my view was. I should not do anything just to make a point. But I shouldn’t not do something because somebody else was trying to make a point. So I have insisted with the three partners I’ve had, but particularly with Jimmy Ready, we do everything everybody else does. He goes to the spouses’ lunches. We travel together. We do everything everybody else does. Not to make a point but because that’s what we want to do and I think we have come a long way in acceptance. I spoke earlier this year at the Bank of America in New York to a meeting of a couple of hundred LGBT people who are in the financial services industry, many of them younger. And Jimmy and I were there and Jimmy and I talked to them. And a couple of them, a number of them, said, boy, it really means a lot to us because you’re working in this financial industry, it’s somewhat conservative, can I put a picture of my girlfriend up on the desk? That’s what a woman said. I said, well, if the chairman of the House Financial Services Committee can bring his partner there, sure. And there’s also another reason. It’s a little easier for them to think of us other than this abstract embodiment of rights. I want them to think of us as flesh-and-blood people who love each other and are physical with each other.

Blade: In the course of your role as chairman of the Financial Services Committee, you were dealing with nation’s leading financial and corporate leaders. Did you sense any attempt by these people to take advantage of you because you were gay?

Frank: No, they didn’t dare. I don’t think most of them wanted to be. But early on, Jimmy and I went to in 2007 or 2008 into Manhattan. We had a series of meetings and Tim Geithner was then president of the New York Federal Reserve. And Jimmy went up to take a nap on Tim Geithner’s couch in his office while I had a meeting with him. But at the time, some guy said the Fed doesn’t yet have an affinity group for gay people. So we fixed that up that day. No, I’ve never sensed any problem.

And Hank Paulson, the then Secretary of the Treasury, to his credit, in his book, in the index, you can find Jimmy’s name. We’ve been out to dinner with him and his wife a couple of times. He and I get along very well. He said at one point the negotiations were breaking down, he was worried. And he knew that if he talked to me we could make a deal. And so he sent his two top guys to find me. He said they went looking for Congressman Frank and they found him on the third floor of the Capitol having dinner with his partner Jim Ready, which was just a gratuitous nice reference. But I’ll also tell you what I said. We had the [House Democratic] caucus [meeting] on hate crimes in 2008 when Judy Shepard [mother of Matthew Shepard, who was murdered in an anti-gay hate crime]. And they asked me about some of the African Americans who were being told by ministers that if we passed a hate crimes bill they would be criminally liable if they said homosexuality was against the Bible, which, of course, is nonsense. So I said let me address this because this has nothing to do with free speech. It’s only a crime if you hit somebody and harm somebody when you commit a crime. So I said let me put it this way. If this bill became law tomorrow it would still be entirely legal to call me a fag. I just wouldn’t recommend it if you were in the banking business. And that was my way of getting it across to my colleagues.

Blade: Is there anything else you’d like to bring up?

Frank: Well there’s one last thing. I think we’re winning. And the public opinion is on our side. But some people say if you’re winning you can take it easy. I say no. When you read military history they say sometimes military leaders make a mistake that they ease up at the point where they’re winning. That’s when you crack down. That’s when you’ve got them on the run. You have to continue to press, because I think we’re on the verge of winning this fight.

Blade: The opponents seem to be saying now, in response to the marriage fight, that society will be seriously harmed if the gay side prevails and gays are allowed to marry. How do you address that?

Frank: And the mainstream media always lets them get away with it. They’re always making these stupid predictions. They never come through. By the way, I give credit to the commandant of the Marine Corps, General [James] Amos, who just admitted that his gloom and doom predictions of six months ago aren’t true. Remember, he’s the guy who opposed repeal of ā€˜Don’t Ask, Don’t Tell.’ He said he was wrong. It was a non-event. But I think we ought to do a better job on that, to get the stupidities that they’ve predicted and show that they weren’t true. I’ve been doing this for a long time. I’ve heard those same predictions about the Equal Rights Amendment for women, about protecting people with disabilities, about gay rights, about race. Any time you talk discrimination they say, well, I don’t dislike those people but it’s going to be chaotic. And it never is. The fact is, unfortunately, given the nature of things, anti-discrimination laws are hard to enforce. The bigots are sophisticated. It’s hard to catch them.

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Federal Government

Expert warns Trump’s drastic cuts to HHS will have far-reaching consequences

HRC’s HIV and LGBTQ health policy advocate shared his concerns with the Blade

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HHS Secretary Robert F. Kennedy Jr. (Washington Blade photo by Michael Key)

Ten years ago, as the opioid epidemic ripped through communities across the United States, the recreational use of oxymorphone with contaminated needles led to an explosion of new HIV infections in southern Indiana’s Scott County.

In places like Austin, a city with about 4,000 residents, the rate of diagnoses quickly ballooned to levels seen in some of the hardest-hit nations of sub-Saharan Africa, more than 50 times higher than the national average.

Thankfully, by 2020, NPR reported that the area was rebounding from what was the most devastating drug-fueled HIV epidemic that rural America had ever experienced, with three-quarters of patients managing the disease so well with antiretroviral therapies that their viral loads were undetectable.

Five years after officials called a public health emergency over the outbreak in Scott County, Austin had opened new addiction treatment centers, support groups, and syringe exchanges. 

Initially, Indiana’s response was sluggish. The state’s governor at the time, Mike Pence, opposed clean needle exchanges for 29 days before ultimately signing an executive order allowing for a state-supervised program. 

The administration in which he would go on to serve as vice president, however, launched an ambitious initiative designed around the objective of ending the HIV epidemic in the U.S. by the end of the decade, using proven public health strategies including syringe exchanges. 

NPR further noted ā€œthe administration’s HIV goals were championedā€ by Pence along with Trump’s U.S. Surgeon General, Jerome Adamsthe, who was Indiana’s health commissioner during the outbreak in Austin. 

Still, the news service warned, the Centers for Disease Control and Prevention determined that 220 U.S. counties were vulnerable to outbreaks of HIV and other blood borne infectious diseases like hepatitis C. 

“When you have these outbreaks, they affect other states and counties. It’s a domino effect,” Dr. Rupa Patel, an HIV prevention researcher at Washington University in St. Louis, told NPR. “We have to learn from them. Once you fall behind, you can’t catch up.”

Trump’s approach to public health, including efforts to prevent, detect, mitigate, and treat  outbreaks of infectious diseases, looks radically different in his second term.   

ā€˜I don’t know why they hate public health so much’

The Washington Blade spoke with Matthew Rose, senior public policy advocate for the Human Rights Campaign, during a recent interview about the the administration’s dramatic cuts and mass layoffs that will totally reshape the way America’s health agencies are run under Trump’s secretary of the U.S. Department of Health and Human Services, Robert F. Kennedy, Jr.  

ā€œThey’re dismantling all the things aroundā€ the first Trump administration’s Ending the HIV Epidemic in the U.S. effort, he said, eliminating key positions and offices within America’s health agencies that support this effort, including by tracking progress toward — or movement away from — the 2030 goalposts. 

Rose said there is no evidence to suggest the initiatives combatting HIV that were begun when Trump was in office the first time were ineffective,  either in terms of whether their long term cost-savings justified the investment of government resources to administer them or with respect to data showing measurable progress toward ending the epidemic within the decade. 

Therefore and in the absence of an alternative explanation,, Rose said he is left with the impression that the Trump-Vance administration does not care about Americans’ public health, especially when it comes to efforts focused on disfavored populations, such as programs supporting access to PrEP to reduce the risk of HIV transmission through sex. 

The outbreak in Scott County ā€œcan happen over and over again, if we don’t have CDC surveillance,ā€ he warned. ā€œWe’re still having a fentanyl crisis in the country that we don’t seem to really want to deal with, but you end up with outbreaks that bloom and bloom very quick and very fast.ā€ 

Rose added, ā€œThe really crazy thing is that they got rid of disease intervention and branch and response,ā€ referring  to the CDC’s National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention, specifically its Division of HIV Prevention, and the various branches within that division that are responsible for different aspects of HIV prevention, care, and research. They include HIV Research, Behavioral and Clinical Surveillance, and Detection and Response. 

ā€œThese are literally the disease detectives that chase down outbreaks,ā€ Rose added. ā€œWhen there’s a syphilis outbreak in an area, when COVID came along and we had to trace COVID outbreaks, like, those folks are the folks who do this.ā€

If (or perhaps when) communities experience an outbreak, ā€œWe wouldn’t truly know what’s going on until probably 10 years later, when those folks’ CD4 counts finally crash to an AIDS diagnosis level,ā€ he said, at which point ā€œthey’re very, very sick.ā€

ā€œThey’ll start looking like we haven’t seen people look since probably 30, 40 years ago,ā€ Rose said, a time well before the advent of highly effective medicines that from the perspective of many patients turned HIV from a death sentence to a manageable disease.Ā Ā Ā 

Additionally, ā€œevery person that we lose to follow up and care, if they don’t know their status, that’s where the majority of new diagnoses come from,ā€ he said, noting that without the CDC’s work ā€œbringing people back into care,ā€ there is ā€œno way of tracking that.ā€ HIV positive people will continue to potentially transmit the disease to others as ā€œtheir own health deteriorates at levels that it doesn’t need to deteriorate at,ā€ Rose said, ā€œso, we make it worse.ā€ 

Along with the breakthroughs in drug discovery that led to the introduction of highly efficacious and well tolerated antiretrovirals, the use of PrEP by those who are HIV-negative to drastically reduce the risk that they may contract the virus through sex has put the goal of eliminating the epidemic within reach. 

ā€œOne of the things we learned from things like the PROUD study,ā€ Rose said, referring to randomized placebo-controlled HIV trials conducted in the U.K. in  2016 ā€œ is that if you can get to the highest impacted folks, the most vulnerable folks, for every one person you get on PrEP, you’re getting anywhere from 16 to 23 infections averted.ā€ 

Disparities in health outcomes are likely to worsen 

Rose noted that ā€œwe’re finally starting to stabilizeā€ the disproportionately high rate of new infections among gay and bisexual Black men who have sex with men thanks in large part to the federal government’s work by employees and divisions that were cut by Kennedy’s restructuring of HHS, initiatives like culturally competent public health messaging campaigns for vulnerable populations, addressing subjects like PrEP, other prevention methods, the importance of regular HIV/STI screenings, and the availability of treatments for HIV and other sexually transmitted infections. 

There is no way of knowing if any intervention was effective in the absence of “surveillance unitsā€ to monitor the disease’s spread through communities and track mitigation efforts, he said, adding that the gutting of these positions comes as ā€œLatin men have actually been catching [up to] Black men in terms of new diagnosesā€ while rates among Black and Latina trans women remain high. 

Along with NCHHSTP’s Prevention Communication Branch, the health secretary’s near 20 percent cut to CDC staff also eliminated the center’s  Division of Behavioral & Clinical Surveillance Branch, its Capacity Development Branch, its Quantitative Sciences Branch, and its HIV Research Branch. 

As a result, Rose said ā€œYou’re going to see these populations get hit hardest again,ā€ communities that have long suffered disproportionately from the HIV epidemic due to factors like racial or income-based disparities in access to testing and treatment. 

Broadly, the CDC is distinguished from other agencies because the Atlanta-based agency’s remit is focused to a significant extent on the population level implementation of public health interventions, endeavoring to change health outcomes, he explained. With respect to PrEP, for example, once the drug was shown safe and effective in clinical research and the evidence supported its use as a critical tool in the federal government’s effort to stop the epidemic, the CDC is responsible for work like making sure at-risk populations who are disinclined to use condoms can stick with (or are sticking with) the medication regimen.  

The administration’s cuts encompass programs on the research side as well as the implementation side, Rose said. For example, he pointed to the ā€œdecimationā€ of divisions within the National Institutes of Health’s National Institute of Allergy and Infectious Diseases, which conducts studies on HIV interventions from the preclinical basic science stage to double blind clinical trials such as those that led to the introduction of injectable PrEP, which can be administered once every other month after the first two doses. 

In fact, Rose said he worked alongside Dr. Jeanne Marrazzo, who succeeded Dr. Anthony Fauci as head of NIAID, on the Microbicide Trials Network board looking for behaviorally congruent HIV prevention products for populations that might not wish to take an oral or injectable formulation of PrEP. He added that she is a ā€œbrilliant scientistā€ who helped him better understand the vaginal microbiome as well as the ways in which ā€œwe fall short on women’s health and women’s sexual health, and what that means in the context of HIV prevention.ā€ 

Together with other top officials like Dr. Jonathan (ā€œJonoā€)  Mermin, who led the NCHHSTP, on or around April 1, Marrazzo was reportedly offered the chance to either be placed on administrative leave or relocate to Indian Health Service outposts in rural American Indian or Native Alaskan communities located in states like Montana, Oklahoma, and Alaska. 

Rose stressed the risks presented by the  administration’s decision to shutter divisions within NCHHSTP that were responsible for communications, education and behavioral studies around tuberculosis, especially provided how the disease is underdiscussed as a public health issue within U.S, borders — where rates of infection are elevated in certain communities, like unhoused and incarcerated populations, where queer folks are disproportionately represented. 

The restructuring of NCHHSTP and NIAID also raises the chances of outbreaks of viral and bacterial infections spread through sex that these public health workers could have prevented or better contained, Rose said. 

Instead, ā€œfor some reason, someone thought it was a good idea to get rid of labs at the Division of STIs,ā€ at a time when ā€œwe’ve had increases in STIs for the last, like, six years,ā€ including rising rates of congenital syphilis, ā€œthe one that kills babiesā€ and increased diagnoses of the disease among gay men.

Additionally, Rose noted disparities in health outcomes for people living with hepatitis C are likely to worsen by the cessation of federal government initiatives to slow the spread of the disease  — which co-infects one of every four patients with HIV and can be fatal if untreated because the virus can cause cirrhosis, cancer, failure of the liver — because direct acting antivirals that cure 95 percent of all cases are covered by most insurance plans only when the policyholder has already sustained severe liver damage. 

Broadly, ā€œthe fact that we’re like, getting rid of the labs to test people means that we’re literally choosing to go backwards, stick our heads in the sand, and hope that no one has the ability to want to say anything,ā€ he added. 

Even populations who are less susceptible to infection with diseases like HIV stand to benefit from basic and clinical science research into the disease, Rose said. 

He pointed to such examples as the drug discovery studies targeting a vaccine for HIV that ultimately led to the identification of combinations of antivirals that were capable of curing most cases of hepatitis C, the inclusion of participants with HIV in clinical trials that led to the introduction of Ebola vaccines, and breakthroughs in the biomedical understanding of aging that were reached through research into why patients with untreated HIV age more rapidly. 

ā€œWe continuously find new scientific endeavors that are able to help the general population, but also able to help the LGBTQ population,ā€ Rose said, as ā€œthe things that happen in the HIV space spill over to other places.ā€

ā€œFrom the LGBTQ health perspective, and especially from the research side,ā€ he said, ā€œwe have just, in the last decade, started to really think about what interventions those populations need — not just [with respect to] HIV, but [other health issues like] smoking, alcohol and substance use and abuse,ā€ including ā€œcrystal meth, which is always the number two drug in most major cities.ā€ 

Likewise, as large swaths of America’s public health infrastructure are unraveled under the direction of the president and his health secretary, the dissolution of each position or each division should not be considered in isolation given (1) the interdisciplinary nature of the work in which these individuals and entities are engaged and (2) the administration’s efforts elsewhere to restrict access to healthcare, especially for disfavored populations like trans and gender-diverse communities. 

ā€œThere’s first the attack on the research pipeline,ā€ Rose said, such as the HIV Vaccine Trials Network’s identification of an urgent or unmet need (behaviorally congruent methods of HIV prevention for women) and its discovery of a new intervention through research and clinical trials (a ring worn inside the vagina that releases an antiretroviral drug to stop the virus from entering the body during sex). 

ā€œThen there’s the destruction of key health interventions,ā€ he said. For example, ā€œSTI testing is a public health intervention. It keeps people healthy, and we’re able to reduce the amount of STI floating in populationsā€ through regular testing and monitoring of new diagnoses. ā€œGetting rid of programs that look at and support these [efforts] is really, really bad,ā€ Rose said. 

He noted that the administration has endeavored to restrict healthcare access along a variety of fronts, especially when it comes to transgender medicine for youth, Rose said, from working to pass regulations circumscribing the scope of the ACA’s coverage mandate to gutting the HHS Office of Civil Rights such that vulnerable populations have less recourse when they are denied access to care or experience unlawful discrimination in healthcare settings, and conditioning the government’s federal funding for providers and hospital systems on their agreement not to administer guideline directed, evidence based interventions for the treatment of gender dysphoria in youth. 

ā€œLast year, CDC documented that we had reduced new HIV infections by 6% and by 23% and 26% in counties that were in the Ending the Epidemic jurisdictions,ā€ Rose said.  

In the face of these challenges shortly into the president’s second term, he said, ā€œwe will stand up to a scientific rigorous process every time, because we’ve done it every time, and every time we’ve done it, the world has been better for it.ā€

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National

National resources for trans and gender diverse communities

Amid attacks, help is available from wide range of organizations

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Activists have been protesting against the Trump administration’s anti-trans policies. If you need help, there are resources out there to assist. (Washington Blade file photo by Michael Key)

The Trump administration has launched a series of executive orders and other initiatives restricting the rights of the transgender community since taking power in January, targeting military service, affirming healthcare, and participation in sports. 

Though many executive orders are being challenged in court, it’s an uncertain time for a community that feels threatened. Despite the uncertainty, there are resources out there to help.

From legal assistance to mental health support, here’s a list of nonprofits and organizations dedicated to improving the everyday livelihood of trans and gender diverse people. These are mostly national organizations; there are many additional groups that work in local communities across the country. Some of these national groups will connect those in need of help to a local organization.

President Trump issued an executive order declaring there are only two genders –– male and female –– which applies to legal documents and passports. The order doesn’t recognize the idea that one can transition their gender at birth to another gender.

Ash Lazarus Orr filed to renew his passport with a gender marker reflecting his identity. That was in January, and he still hasn’t received it. He refused to accept a passport without an accurate identification of who he is, so he filed a lawsuit with the ACLU in what is now known as Orr v. Trump.

Orr told the Washington Blade that not receiving his passport back has taken away his freedom of visiting family in Canada and receiving gender-affirming care from a trusted provider in Ireland.

The one thing getting him through this uncertain time is knowing who he’s fighting for –– the trans community, his loved ones, and himself.

ā€œI’m trying to be that person that those younger parts of me needed growing up,ā€ Orr said. Check out a couple of legal support organizations below:

Transgender Law Center

The Transgender Law Center (TLC) provides legal resources and assistance. TLC has a list –– called the Attorney Solidarity Network –– of attorneys that can provide advice or representation for trans people.

The organization also has a legal information help desk that answers questions regarding laws or policies impacting trans people.

Website: transgenderlawcenter.org

Phone: 510-587-9696

Email: [email protected]

Advocates For Trans Equality

With a variety of different programs tailored toward legal assistance and advocacy work, Advocates For Trans Equality’s reach is wide.

The non-profit offers the Name Change Project, which provides pro bono legal name change services to low-income trans, gender-non-conforming and nonbinary people by utilizing its partnerships with law firms and corporate law departments.

Advocates For Trans Equality also has departments and programs dedicated to increasing voter engagement, educating lawmakers on trans issues and offering litigation assistance to a small number of cases.

Website: transequality.org

Phone: 202-642-4542

General email: [email protected]Ā 

To contact a specific department or program, visit its website above.

ADVOCACY

Looking to take action and get involved? Act now.

American Civil Liberties Union

The ACLU is a national nonprofit organization that mobilizes local communities and advocates for national causes.

Getting involved is as easy as filling out letters to representatives or signing petitions. One live petition is to ā€œdefend trans freedom.ā€

You can also join its People Power platform, where you serve as a volunteer in your community to ā€œadvance civil liberties and civil rights for all.ā€ ACLU has different chapters across the country, so visit its website for more information.

Website: aclu.org

Phone: 212-549-2500

MILITARY AND VETERANS

Trump signed an executive order in January banning transgender service members from serving, stating their identity ā€œconflicts with a soldier’s commitment to an honorable, truthful and disciplined lifestyle, even in one’s personal life.ā€ 

Though the order has been legally challenged and struck down by a judge, U.S. Navy Lieutenant Rae Timberlake said it’s created an uncertain atmosphere for themself and other troops.

ā€œAll of the transgender service members I know have served with honor and integrity for many years…[and we’re] targeted for removal and not subject to any kind of review based on merit,ā€ Timberlake, who joined the Navy at age 17, said. ā€œThere’s kind of just this cloud looming over our organizations and our units, because we know any day our transgender shipmates could no longer be on the team.ā€

But Timberlake’s message to any service member struggling because of the executive order was one of compassion and truth: ā€œThere’s no policy that can take away what you’ve accomplished and what you’ve done.ā€

Here are some organizations that support service members and veterans:

SPARTA Pride

SPARTA is a peer-support group composed of active duty, veteran and ā€œfuture warriorā€ service members.

The group also engages in advocacy work and has helped change policies on gender neutral uniforms and reducing the time a trans service member would have to wait to return to their duties during their transition.

Contact SPARTA to learn more about joining its support network.

Website: spartapride.org

Email: [email protected]Ā 

Modern Military Association

Modern Military supports service members and veterans through advocacy, legal assistance and mental health support.

It tracks LGBTQ+ and HIV discrimination through reports made on its website, and offers guidance and advice to whoever submitted the report.

It also supports the mental health of LGBTQ+ veterans and their families through its Resilient Heroes Program. By signing up, you’ll receive virtual peer support and case management services with a mental health coordinator.

Website: modernmilitary.org

Phone: 202-328-3244 

Email: [email protected]Ā 

CRISIS & MENTAL HEALTH SUPPORT

If you have a more urgent matter, or just need someone to listen, here are some organizations you can reach out to:

The Trevor Project

The Trevor Project offers 24/7 counseling services. Calling, texting or chatting is free and confidential, and you’ll get to speak with someone specialized in supporting LGBTQ youth.

The organization also focuses on public education by hosting online LGBTQ suicide prevention trainings. It advocates for policies and laws that contribute to supporting queer youth.

Website: thetrevorproject.org

Crisis hotline: 1-866-488-7386

General inquiry phone number: 212-695-8650

Trans Lifeline

Trans Lifeline is a hotline run and operated by trans people. Whether you’re questioning if you’re trans or are a trans person just wanting to talk, someone will be there to help. It’s free and confidential, and there won’t be any non-consensual active rescue, such as calling the emergency services.

The line is not 24/7, however. Check out its website for hours within your time zone.

Website: translifeline.org

Phone: 877-565-8860

Here are other organizations that offer support to the trans community:

TransFamilies (support): Support for families with a gender diverse child.

TransLatina Coalition (advocacy): Advocates for the specific needs of the transgender, gender expansive and intersex communities in the U.S.

TransAthlete (information): Provides informative resources about trans athletes.

Campaign for Southern Equality’s Trans Youth Emergency Project (healthcare support): A fund to help trans youth access lifesaving healthcare.

TransTech Social (economic empowerment): Dedicated to discovering and empowering the career-ready skills of LGBTQ+ people.

World Professional Association For Transgender Health (health): Resources, symposiums and research dedicated to improving transgender health.

Sylvia Rivera Law Project (legal): Legal programs and services for marginalized communities.

Gender Spectrum (support): Resources and support groups for trans youth and families.

The Okra Project (support): Creates and supports initiatives that provide resources for the Black Trans community.

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The White House

White House does not ‘respond’ to reporters’ requests with pronouns included

Government workers were ordered not to self-identify their gender in emails

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White House Press Secretary Karoline Leavitt and a senior advisor in the Department of Government Efficiency rejected requests from reporters who included their pronouns in the signature box of their emails, each telling different reporters at the New York Times that “as a matter of policy,” the Trump-Vance administration will decline to engage with members of the press on these grounds.

News of the correspondence between the journalists and the two senior officials was reported Tuesday by the Times, which also specified that when reached for comment, the White House declined to “directly say if their responses to the journalists represented a new formal policy of the White House press office, or when the practice had started.”

ā€œAny reporter who chooses to put their preferred pronouns in their bio clearly does not care about biological reality or truth and therefore cannot be trusted to write an honest story,ā€ Leavitt told the Times.

Department of Government Efficiency Senior Advisor Katie Miller responded, ā€œI don’t respond to people who use pronouns in their signatures as it shows they ignore scientific realities and therefore ignore facts.ā€

Steven Cheung, the White House communications director, wrote in an email to the paper: ā€œIf The New York Times spent the same amount of time actually reporting the truth as they do being obsessed with pronouns, maybe they would be a half-decent publication.ā€

A reporter from Crooked media who got an email similar to those received by the Times reporters said, ā€œI find it baffling that they care more about pronouns than giving journalists accurate information, but here we are.”

The practice of adding pronouns to asocial media bios or the signature box of outgoing emails has been a major sticking point for President Donald Trump’s second administration since Inauguration Day.

On day one, the White House issued an executive order stipulating that the federal government recognizes gender as a binary that is immutably linked to one’s birth sex, a definition excludes the existence of intersex and transgender individuals, notwithstanding the biological realities that natal sex characteristics do not always cleave neatly into male or female, nor do they always align with one’s gender identity .

On these grounds, the president issued another order that included a directive to the entire federal government workforce through the Office of Personnel Management: No pronouns in their emails.

As it became more commonplace in recent years to see emails with “she/her” or “he/him” next to the sender’s name, title, and organization, conservatives politicians and media figures often decried the trend as an effort to shoehorn woke ideas about gender (ideas they believe to be unscientific), or a workplace accommodation made only for the benefit of transgender people, or virtue-signaling on behalf of the LGBTQ left.

There are, however, any number of alternative explanations for why the practice caught on. For example, a cisgender woman may have a gender neutral name like Jordan and want to include “she/her” to avoid confusion.

A spokesman for the Times said: ā€œEvading tough questions certainly runs counter to transparent engagement with free and independent press reporting. But refusing to answer a straightforward request to explain the administration’s policies because of the formatting of an email signature is both a concerning and baffling choice, especially from the highest press office in the U.S. government.ā€

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