Opinions
The state of HIV in Washington: 29 years later
From fear and despair to promising new treatments and hope
On April 4, 1983, AIDS entered the public arena of the District of Columbia.
On a Monday evening 29 years ago, Whitman-Walker held the first public forum on AIDS in D.C. At that time, Cabbage Patch dolls were a hit, people were watching M*A*S*H, and AIDS was destroying the gay male community. A panel of public health experts and advocates spoke to a full house at Lisner Auditorium of The George Washington University. The audience of predominantly gay men was driven to the forum after watching friends, lovers and colleagues die quickly and horribly from AIDS. And they were in a state of fear bordering on panic.
The forum that night probably did little to calm that fear. Think about what was happening in 1983. AIDS had only been recently named. The HIV virus had not been discovered yet. There was no test to see if someone was infected and there was no treatment. In fact, people were unsure if you could catch AIDS from a simple kiss. In short, there was almost no good news that night; only fear and despair for the future.
Today, on the eve of the 2012 International AIDS Conference, there is far more good news in the world of HIV/AIDS.
Since that forum in 1983, HIV testing has become standard operating procedure for many Americans, particularly those in groups at high risk for HIV, like gay or bisexual men. Successful treatments are keeping people with HIV healthy and alive for many years. And people are more knowledgeable about condom use and other safer sex practices.
Over the last few years, even more developments have brought new hope and optimism in the fight against HIV/AIDS, including the idea of using HIV medications to prevent HIV transmission, also known as “Treatment as Prevention.”
One of the best ways to reduce new HIV transmissions is by diagnosing people with HIV, getting them into care and on medications. These HIV medications can suppress the amount of virus in the person’s blood to very low levels, which make it much less likely for that person to transmit the virus. In fact, studies have shown successful treatment to reduce the risk of transmission by up to 96 percent. This same strategy is used to prevent the mother’s HIV from transmitting to the baby.
Another way HIV medications are used to reduce transmission is through HIV “post-exposure prophylaxis” or “PEP.” If a person has a needle stick at work or an unsafe sexual encounter they can take HIV medications for a month to prevent infection. This method is at least 80 percent effective if used within 72 hours of the potential exposure.
Recently, studies have shown HIV medications can be taken by individuals at high risk for HIV before they are exposed to the virus to protect them from infection. “Pre-exposure prophylaxis” or “PREP” is still undergoing clinical trials but seems to be very effective for certain populations at high risk for HIV, such as men who have sex with men and serodiscordant couples (where one partner has HIV and the other is HIV-negative).
All of these new “Treatment as Prevention” tools add to weapons in the fight against new HIV transmissions, but none are a magic bullet. Currently, in the District of Columbia, 70 percent of people diagnosed with HIV do not have a suppressed viral load. Why is this number so high? A large number of people in D.C. have HIV and do not know it. Others have been diagnosed with HIV but have not seen a doctor yet (often due to denial, stigma, etc.). And lastly, a good percentage of HIV-positive people on medication do not have a suppressed HIV viral load due to poor adherence to their medication regimen (often due to depression, addiction issues or competing priorities). We are lucky at Whitman-Walker to have comprehensive health care on site, including care teams, mental health practitioners, a pharmacy, and nurses that focus on patients’ barriers to care. Through this team model, 85 percent of our HIV patients on medications have a suppressed viral load.
Now that the health care community has more options in our fight against HIV, we have to figure out a comprehensive way to prevent new HIV transmissions from occurring. But the good news is that we are more knowledgeable about HIV transmission and there are more prevention options with known effectiveness.
So come join us in a Return to Lisner Auditorium on Tuesday, July 24, at 7 p.m. You will hear from leaders in the field that reducing the number of new HIV infections in Washington, D.C. is possible. You will learn about “Treatment as Prevention.” And we will all reflect on how far we have come in the past 29 years.
Dr. Ray Martins is chief medical officer of Whitman-Walker Health.
Opinions
Rollback of health IT standards will harm LGBTQ patients
Trump proposal would remove most data fields in medical records
For most Americans, the ability to change healthcare providers and easily have their health records transfer feels like a given. But it was not until the 21st century Cures Act was signed in 2020 that regulations on health technology mandated that electronic health records had to be able to collect, receive, and transfer specific data fields in a uniform way (known as the U.S. Core Data for Interoperability). Before that, if your new doctor and your prior doctor subscribed to different electronic health records systems, there was a very good chance that the data fields didn’t match up and some patient information would literally be lost in translation.
Through the Office of the National Coordinator for Health IT, created through executive order by President George W. Bush, the Biden administration advanced health IT policy specifically to ensure that LGBTQI+ patients records would transfer to new providers with unique information that patients need their providers to have access to. This includes data fields for chosen names, pronouns, and sex parameters for clinical usage – or in other words, what sex should be listed for lab work, regardless of the patient’s gender identity. There were also fields added for sexual orientation and gender identity. To be clear, the requirement was for the electronic health record systems to be able to collect, transfer, and receive these data points. There was never a requirement for providers to ask all these questions or for patients to be required to answer them. But if the IT systems aren’t mandated to have these fields in a uniform way, the impact of a provider asking the questions is limited only to the care that the specific provider offers to the patient. The Trump administration has proposed removing 34 of the 60 required data fields in electronic health records, including the fields for chosen names, pronouns, sexual orientation, gender identity, and sex parameters for clinical usage.
There has been widespread support for these regulations on health IT companies. Having a lowest common denominator for health IT systems is good for patients and for healthcare providers. It also isn’t particularly controversial. Not surprisingly, the only folks cheering on deregulation are those ideologically opposed to any government regulations, and the specific companies who are subject to these health IT regulations.
The deregulators in the Trump administration would have us believe the myth that these regulations somehow hinder innovation and make it harder for tech startups to enter the health IT field. They gaslight us by calling this clear disservice to patients “prosperity.” But imagine what it would be like to go back to a time before these critical health IT regulations. When the new doctor you see doesn’t have very much if any information about the patient and the transfer of patient records was manual and cumbersome, often requiring someone to pay for their records to be printed, mailed, and then scanned into a different electronic health record system. This won’t lead to innovation, but it will lead to harm for the patient-provider relationship, and worsened health outcomes for the American people.
HHS Secretary Robert F. Kennedy Jr. has been deliberate and unrelenting in his rollbacks of health equity measures for LGBTQI+ Americans. He has proposed rules that would ban hospitals from receiving federal funds if they offer gender affirming care for youth; he has gutted the Office of Infectious Disease and HIV/AIDS; he has rolled back civil rights protections in health care for LGBTQI+ Americans; and he has eliminated most federal health agency data collection of sexual orientation and gender identity. And this is just a small slice of his crusade at HHS to erase LGBTQI+ people.
There are currently many proposed rules and administrative changes that would harm access to equitable, high quality healthcare for LGBTQI+ people. So it makes sense that LGBTQI+ Americans may not be aware of such a wonky area of policy as federal health IT regulations. But we want to stress that deregulating health IT, with a specific goal of removing the minimum requirements for electronic health record systems to collect, transfer, and receive basic data fields of importance to LGBTQI+ people’s clinical care, will worsen both access to as well as quality of even basic healthcare for LGBTQI+ Americans. And for healthcare providers it is uniquely scary. They rely on the data in patient’s electronic records. And they need the IT systems they use to be able to talk to each other. Deregulating health IT is akin to trying to charge an iPhone with an Android charger, but as if your life depended on it.
There is an opportunity for public comment until Feb. 27, and anyone can make a comment. As a person who receives healthcare and/or a person who provides healthcare, speaking up is imperative. These health IT regulations are described by some as “woke” but really it’s very simple: when you go to the doctor, any doctor, you want them to have some basic information about who you are. Without that information, a healthcare provider could easily make an assumption about the patient that is inaccurate and that leads the provider to make different recommendations than what the patient needs.
This is not radical, this is the very premise of healthcare delivery. And LGBTQI+ patients stand to be left behind, deliberately and systematically, if these deregulations of health IT are put into effect. Without accurate, timely data, providers are unable to live up to the promise of precision medicine and will fail to ensure everyone receives the care that matches their unique needs.
Adrian Shanker is senior fellow at Lehigh University College of Health. He served as deputy assistant secretary for health policy and senior adviser on LGBTQI+ health equity at the U.S. Department of Health and Human Services in the Biden-Harris administration. Dr. Carl G. Streed, Jr. is Associate Professor of Medicine at Boston University Chobanian and Avedisian School of Medicine and Research Director at the GenderCare Center at Boston Medical Center.
Commentary
Honoring 50 queer, trans women with inaugural ‘Carrying Change’ awards
Naming the people who carry our movements forward
Dear friends, partners, and community:
We write to you as two proud Black and Brown queer women who have dedicated our lives to building safer, bolder, and more just communities as leaders, organizers, policy advocates, and storytellers.
We are June Crenshaw and Heidi Ellis.
June has spent almost 10 years guiding the Wanda Alston Foundation with deep compassion and unwavering purpose, ensuring LGBTQ+ youth experiencing homelessness have access to stability, safety, and a path forward. Her leadership has expanded housing and support services, strengthened community partnerships, and helped shift how Washington, D.C. understands and responds to the needs of queer and trans young people. In her current role with Capital Pride Alliance, June advances this work at a broader scale by strengthening community infrastructure, refining organizational policies, and expanding inclusive community representation.
Heidi is the founder of HME Consulting & Advocacy, a D.C.–based firm that builds coalitions and advances policy and strategy at the intersection of LGBTQ+ justice and racial equity. Her work spans public service, nonprofit leadership, and strategic consulting to strengthen community-driven solutions.
We’re writing because we believe in intentional recognition — naming the people who carry our movements forward, who make room for those who come next, and who remind us that change is both generational and generative. Too often, these leaders do this work quietly and consistently, without adequate public acknowledgment or what one might call “fanfare,” often in the face of resistance and imposed solitude — whether within their respective spaces or industries.
Today, we are proud to introduce the Torchbearers: “Carrying Change” Awards, an annual celebration honoring 50 unstoppable Queer and Trans Women, and Non-Binary People whose leadership has shaped, and continues to shape, our communities.
This inaugural list will recognize:
- 25 Legends — long-standing leaders whose decades of care, advocacy, and institution-building created the foundations we now stand upon; and
- 25 Illuminators — rising and emerging leaders whose courage, creativity, and innovation are lighting new paths forward.
Why these names matter: Movement memory keeps us honest. Strategy keeps us effective. Recognition keeps us connected. By celebrating both Legends and Illuminators side by side, we are intentionally bridging histories and futures — honoring elders, uplifting survivors, and spotlighting those whose work and brilliance deserve broader support, protection and visibility.
Who will be included: The Torchbearers will represent leaders across a diverse range of sectors, including community organizing, public service, sports, government, entertainment, business, education, legal industry, health, and the arts — reflecting the breadth and depth of queer leadership today. They include organizers providing direct service late into the night; policy experts shaping budgets and laws; artists and culture workers changing hearts and language; healers and mutual-aid leaders; and those doing the quiet, essential work that sustains us all.
Intersectionality is our core commitment: identity in its fullness matters, and honorees must reflect the depth, diversity, and nuance of queer leadership today.
How you can engage: Nominate, amplify, sponsor, and attend. Use your platforms to uplift these leaders, bring your organization’s resources to sustain their work, and help ensure that recognition translates into real support — funding, capacity, visibility, and protection.
We are excited, humbled, and energized to stand alongside the women and non-binary leaders who have carried us, and those who will carry this work forward. If history teaches us anything, it’s that the boldest change happens when we shine light on one another, and then pass the flame.
YOU CAN MAKE A NOMINATION HERE
June Crenshaw serves as deputy director of the Capital Pride Alliance. Heidi Ellis is founder of HME Consulting & Advocacy.
Opinions
In favor of healthcare for trans youth
Denying teenagers puberty blockers is a human rights offense
One of the hottest issues in America right now is that of gender affirming care for trans youth. Even people close to me — as close as parents and siblings and dear friends — voice their disapproval of letting trans or nonbinary adolescents (and those who are younger) receive appropriate healthcare in the form of puberty blockers and other medicines to prevent their original gender from onset, and instead establish a new gender that they feel comfortable in. This is a topic that I believe is highly contested among Democrats themselves, so I have taken extra time, patience, and detail to write this article. Out of all of the op-eds I have penned for the Blade, this is the one I have most prepared for.
Trans youth should be able to access quality gender affirming care. Denying these children and teenagers puberty blockers is a human rights offense.
Many older trans people in the current day report feeling “off” about their gender from a young age. The majority of us, myself included, didn’t have a vocabulary to describe our feelings, so we instead lived teenage years under this strange angst — this strange anxiety about our bodies that we couldn’t put a name to. Maybe a lucky few of us grew up in Manhattan, or some other elite coastal city, and were, for instance, raised by lesbian moms or gay fathers or were put into some scenario in which we had access to vocabulary such as “gender dysphoria,” “cisgender,” and “transgender.” I’ve only known one person who had this vocabulary handed to them, but they were intersex, so questions about their genitalia were asked from a young age. Other than that, the point is this: Many transgender people feel like something was wrong during childhood. And here is the other point to be made: Many youth in the current day feel that something is wrong. The difference now is that modern day youth have access to more puberty blockers, more hormones, and more grown ups who want the best for them, in addition to more evil and cruel grown ups who don’t.
Youth who are genuinely transgender — who will likely live the rest of their life as a new gender — are in so much pain that they often want to kill themselves. These kids, be they seven, eight, 11, or 13 years old, engage in extremely unhealthy thoughts about their bodies and lives. Doctors will see signs of suicidality from the get go: the kid might exhibit parasuicidal behavior, such as scratching their arm with a razor, they might think of jumping off of a building, and they generally will not want to wake up the next day to confront the bullies who will tease them about their hair, clothes, and identity. Opponents of gender affirming care for youth often don’t understand the wrath that gender dysphoria places on its beholder: they don’t understand how depressed, anxious, and overall terrorized these kids feel. They perhaps just think that these kids can live a normal adolescence, maybe cross dress on occasion, and wait to fix their bodies until they are of “sane” and “healthy” mind. But I want to ask parents out there if they really feel as if children and teenagers who are suicidal is healthy: Do you think that a boy who wants to be a girl but can’t is going to bed feeling happy? The answer is no.
It is totally unhealthy for trans youth not to be able to delay their puberty. It is unhealthy for them to have to sit and stew in this wretched, cruel, and twisted universe that scorns their label of a new gender. It is unhealthy for them to turn on CNN and watch as Marjorie Taylor Greene or the president of the United States calls them monsters, or says that they are somehow sick.
Don’t get me wrong — it is appropriate and necessary for these gender nonconforming youth to be screened by doctors. They should be vetted by psychiatrists, psychologists, primary care physicians, endocrinologists, and licensed social workers. A rigorous and intelligent process for evaluating their dysphoria and alleviating their symptoms should be in place. What they are experiencing, after all, is not healthy.
What is healthy is giving these youth access to a new channel of freedom — healthcare that makes their bodies more aligned with their minds and healthcare that will cause them to be less suicidal, and more in touch with their surroundings and school environment. These youth deserve a chance at life–a shot at success. They deserve to learn in schools where their teachers don’t get punished for asking for preferred pronouns. Boys deserve to wear dresses and girls deserve to cut their hair short. The world needs to relax about gender. We are the ones suffering, not you. We are the ones bearing the brunt of cruelty. Let us have healthcare when healthcare is appropriate.
Isaac Amend is a writer based in the D.C. area. He is a transgender man and was featured in National Geographic’s ‘Gender Revolution’ documentary. He serves on the board of the LGBT Democrats of Virginia. Contact him on Instagram at @isaacamend
