Opinions
Make a safer selfie during sex
Customize your strategy for staying free of HIV


If a condom appears intact after use, youāve lowered by 125,000 times your chance of contracting HIV.
These days, everything is about the selfie. We listen to our personalized music playlists on our phones, binge-watch entire seasons of our favorite program on demand and target our social media shout outs to specific people on our friends list.
So itās no surprise that you can now customize your strategy for staying safe from HIV. Hereās the new menu of choices for staying safe. Create your safer selfie.
Condoms:Ā Lots of guys use condoms when they hook up with someone who looks like he gets around, but then skip the rubbers when they meet a āqualityā guy.Ā Even quality guys may have had playful pasts, and many are telling the truth when they say they donāt think that theyāre infected ā even though they havenāt tested in years. So how well do condoms protect you?
Best case: If a condom appears intact after use, youāve lowered by 125,000 times your chance of contracting HIV. Condoms also offer this undeniable benefit: you can check to see if the other guy is really wearing one right now.
No guarantees: Condoms only work when someone is wearing them. Gay guys who claim to use condoms all the time reduced their HIV risks by 70 percent. Rule out the guys who seem to be forgetting the nights they skipped the condoms, and protection is much higher. Condoms break or slip off in as few as 0.4 to 0.6 percent of uses, and thatās because these numbers include the people who fumble with them drunk or use wildly inappropriate lubricants. Still, if you just canāt stand using condoms, there are other choices.
PrEP: Never heard of it? You will. With PrEP, an HIV-negative guy takes the anti-HIV combination medicine that people living with HIV take. The difference is that he takes it every day before a possible exposure to HIV.Ā Thatās the āpreā in PrEP.
Best case: PrEP can offer almost complete protection from an HIV exposure. In the largest studies conducted, none of the guys who took at least most of their PrEP medications became infected. PrEP does take advance planning, though. You canāt start taking PrEP the day youāre planning to have sex (it takes about a week to build up in the body).
No guarantees: Truth is, in the largest PrEP study, new HIV infections were only reduced by 44 percent, mainly because some people who said they were going to start PrEP never did, or they only took a few of their pills.Ā So just like condoms, you have to use it to get the benefits.
Treatment as Prevention: If your HIV+ partner is taking anti-HIV medications, that helps him and protects you. Less virus in his bloodstream makes him far less contagious. The first large study said that the risk of catching HIV from a treated person drops 96 percent.
Best case: taking anti-HIV treatment is something many positive guys are already doing.
No guarantees: thereās no way to see if the other guy is taking his treatment the way you could check for a condom. Once theyāre off the meds, the drugs start draining out of their system, and that means youāre not protected anymore.
Test twice, Talk, and Trust: This is not the same as only hooking up with guys you think are HIV-negative. Here, you take an HIV test with your partner, and discuss whether youāre both comfortable having a āclosedā relationship (or open only with protection).Ā If you both are, you test again to confirm neither had a new HIV infection that the first test missed, and then you may choose to take the condoms off.
Best case: Many guys have been using this strategy for years (including me), and it appears to work for those who follow all the steps.
No guarantees: If you do allow āplaying,ā remember that condoms protect better against HIV than against some other STDs that are easier to transmit.
PEP:Ā Whichever safer selfie method you choose, if something goes wrong and you realize youāve been exposed to HIV, thereās one more option. If you get on a six-week prescription of anti-HIV medicines right away (āpost-exposureā), you can often stop the virus from ālatching on.ā
Best case: Officially, you have 72 hours to start treatment, and your odds of becoming HIV+ drop by about three-quarters.
No guarantees: Donāt take the deadline too literally, and wait the whole weekend. The same studies show that the earlier you start PEP, the better the protection.
Why choose any option?Ā Maybe you just donāt consider staying HIV-free that important anymore. If and when you catch it, youāll just take a pill a day, and live forever. Well, youāre not entirely wrong, but thereās more to it than that.
Best case: If keep to your doctorās appointments and take your medicines faithfully, you can live a long life these days with HIV. Some studies predict that people can live with HIV for three or four decades, or even up to 53 years.
No guarantees: HIV treatments still cause side effects, from the unpleasant and common ones (diarrhea, fatigue, sleeplessness) to the silent bodily changes that can add up over time to cause other serious health problems in some people to trigger cardiac events, kidney failure, liver failure, and bone fractures.
Whichever safer option you choose, the best thing you can do is just to make a choice.Ā Condomless sex is up 20 percent among gay men over the past five years. HIV is still causing the equivalent of five 9-11s in U.S. deaths each year. Almost all new HIV infections are happening to guys who arenāt following any of these strategies. So pick one, stick to it, and make a safer selfie.
Stephen Fallon is president of Skills4, a healthcare consulting firm. Reach him via skills4.org.
Opinions
Finding the courage to flee U.S. to save my trans daughter
āMy child has begged for her safety so I must goā

Well, we did it. Two weeks ago, I climbed into our SUV with my 23-year-old trans daughter and I drove to Toronto. A foot firmly in the highly logical/practical and a foot in the conceptual/creative means I am not risk averse because I can sense a problem and comfortably decide whether I can absorb the outcome.
As a result, I donāt scare easily. Every now and then though, my more intuitive self will sound an alarm letting me know that I need to pay attention, and so I do ā especially when it comes to my children. Like many of you my internal sirens have been clanging at air raid levels for some time. Itās been clear to me that trans people are going to be both a political tool and a targeted group for the new administration. As ugly forces converged to deliver the results that Tuesday in November I have been fighting the urge to grab my family and simply leave. To get up, get out of the way of what I feel is coming. Thatās crazy talk, right? This is the United States. I mean we canāt be there? You know what I mean. THERE.
The place that created the phrase: āPessimists went to New York, optimists went to Auschwitz.ā Rounding up people and simply sending them somewhere. I think we are, and I can’t wait to be wrong.
As I listen to stunning silence from Democrats and threat-immobilized or power-driven Republicans alike, and watch companies pay fealty and capitulate in advance, I am appalled by so few rising to meet the moment. I am disgusted by the demonstrated cowardice just about everywhere we look. What luxury it is to think that as a politician youāre secure enough to wait it out, as though there will be anything left. To think that you will never be in the crosshairs or to think that itās too hard to do more than you already do. I decided I didnāt have that privilege; for my family optimism could be ruinous.
On occasion I ask my daughter how she feels about things as they evolve, the clank of each hammer on the chisel chipping away her rights, or each time the president of our country has spent five rambling minutes regularly declaring my child a villain or abomination or the result of some woke virus. Being aware, far too sharp and equally sensitive, the question would overwhelm her, āMom, I know. I know. I just canāt.ā For months that would be the end of the conversation. Sometimes she would come to me in tears to talk about how it felt to be unsafe in your own country, or to know that the administration wants to eliminate you. Itās gut wrenching.
Her circle of friends, many of whom struggle, are her lifeline. We all know how important our 20-something tribes are. But when sheād raise the topic with her loves in hopes of creating a plan they too would shut down. This is not unique. For so many of us it is overwhelming. For my daughter, any desire to leave felt like a betrayal, or like she would be abandoning her circle. Any desire to stay felt perilous. Iāve shed torrents of tears at their predicament. That this is their future. And I waited, hitting the snooze button on my internal alarm.
Then politicians started talking about camps and withholding medications. I got a text. āLetās go. Itās time. [My girlfriend] said sheād move to Canada.ā Three weeks later we left.
My family members are fighters and protesters. Ask any one of them and they’ll roll up their sleeves and argue. My parents marched on Washington in the 1960s. They demonstrated at nuclear plants in the ā70s. My daughter has always fantasized about how the only good Nazi is a dead Nazi, and embracing her free-floating desire to stay and fight. Itās only a fantasy, but I get it. I have that blood in my veins and that idealism thumping in my heart. A political science student and obsessive political hobbyist, I have gone with my peers to rage against the machine, and been an activist from time to time. I never imagined that I would be willing to walk off the field.
The optimist in me says it will all work out, that it is always worth the fight. The middle-aged woman, burdened with the tasks of modern living complains that itās too hard, too expensive. But my child, my child. My child has begged for her safety. So, I must go. Itās really just logistics, like everything else when you have to move mountains ā or countries ā for your child. Rent our house. Sell our things. Pack. Drive. Get gas. Check and check. Just like weād do for any other life change. Look for jobs. Split up the family and delegate responsibilities. Done. As I go through this I think, is it any less than Taylor Swiftās mom did when she left Pennsylvania for Tennessee? Or any family that moves and wakes way before dawn for gymnastics or hockey? Iām not going to lie, I picked the easiest place to go, and the one she was most willing to take on. We joke that if the administration is serious about invading Canada that she may choose to fight for the side where the government fights behind her. On her side and at her back.
āI want to live somewhere my own government doesnāt want me dead.ā
Staying to fight the good fight is important. But leaving to protect the vulnerable and the precarious is (while no small feat) doable. I hope. If you feel you should, do. If you feel you canāt, look again. If you have to you will.
Anonymous is the mother of a trans daughter who recently moved from the U.S. to Canada.Ā

Itās time for transgender Americans to be more scared. Donald Trump is leading a fascist administration. In his first month in office, Trump signed a flurry of executive orders that clamp down on trans people. One ordered that trans women canāt compete in womenās sports in federally funded institutions. Another banned transgender service members from the military. And yet another executive order, signed on his very first day in office, told the federal government that only two genders exist ā those that people were given at birth.
Furthermore, Trump took over the Kennedy Center, electing himself as the chair of the board, and immediately a Pride event was cancelled. Taking over arts and letters is a surefire sign of fascism. Fascism, as defined by Merriam Webster, is a āpopulist political philosophy or regime that exalts nation and often race above the individual, that is associated with a centralized autocratic government headed by a dictatorial leader, and that is characterized by severe economic and social regimentation and by forcible suppression of opposition.ā
America, in essence, is becoming more and more of a fascist state, and Trump is already a fascist leader. Trumpās strand of fascism is interesting, because he is an utter capitalist, with a fetish for colonizing foreign spaces. Trump has been trying to colonize Greenland for many years now, and he also shared an AI generated video of him colonizing the Gaza strip with a Trump hotel and pictures of Elon Musk spooning hummus next to the beach. Both of these are concerning, but the Trump Gaza video is especially horrifying because it shows he is in some sort of quasi break from reality where posting an AI generated future of a war-torn land seems OK. When I floated the Trump Gaza video among friends and family, they reacted with words like ācrazy,ā āinsane,ā and ādelusional.ā
When mentioning his transphobia, one relative who is politically aware theorized that Trump would unleash all of his anti-trans fury in just a few months but that he would run out of transphobic things to do. Unfortunately, the opposite seems to be true. Every passing day seems to bring a new anti-trans piece of legislation, whether itās Texasās proposed ban on being transgender in and of itself, or whether itās Utahās anti-trans bathroom ban.
Yet even more unfortunately, I am not seeing trans people get scared enough. I am not seeing enough action on our part. I am unsure whether our collective inaction is due to the fact that both houses of Congress are red, or whether some of us simply donāt have the privilege of fighting.
Regardless, I can propose one policy solution that trans people in the D.C. area can implement: Make Arlington a sanctuary city. In order to make Arlington a sanctuary city, Arlingtonians (and other Virginians for that matter) should lobby the county board to do so. However, Virginia faces stiff pushback from Gov. Youngkin when it comes to the formation of sanctuary cities. On Dec. 12, 2024, Youngkin proposed a budget that would include a āsanctuary city banā across the state. We have to make sure that we lobby the legislature to reject this proposed version of the budget.
Until then, transgender Americans need to start devising plans to move to sanctuary cities across the country and to fund underprivileged trans people who need the money to do so. Some of us also need to start thinking about moving to Canada if our futures become less bright.
Isaac Amend is a writer based in the D.C. area. He is a transgender man and was featured in National Geographicās āGender Revolutionā documentary. He serves on the board of the LGBT Democrats of Virginia. Contact him at [email protected] or on Instagram at @literatipapi. Ā
Opinions
Building LGBTQ power beyond American dependency
Unity, an international political body, and economic sovereignty are key to reclaiming our future

Two weeks ago, I mentioned āLGBTQ + sovereigntyā in this newsletter, the pursuit of self-determined, economically empowered, and politically independent queer communities that control their narratives, resources, and futures as a response to the new world order. A reader cheekily replied, āSo your next installment will discuss how to build that power?ā implying that it is easier said than done.
Itās a fair criticism. The amplitude and pace of the changes we experience make it easier to fall in love with the problem than to articulate the first steps in a response. Across the board, the people I speak with are overwhelmed and directionless. Thereās a shared sense of paralysis as if the path forward for queer liberation has vanished entirely.
Our movement had placed its bets on a single horse: American support reliant on repeated electoral victories by the Democrats. We have become quickly addicted to funding from USAID, the State Department, other U.S.-dominated international organizations, diplomatic initiatives, and leadership from American companies. Recent reports describe how the reversal of this support is debilitating for our entire movement but also illustrate in their recommendations how hard it is to imagine an LGBTQ+ future without the U.S. government and corporations.
A figure I love to quote is that, according to MAP, the number of donors giving more than $25,000 to the most significant U.S. non-profit organizations dropped from an already bafflingly low 302 in 2019 to 134 in 2023 ā a 56 percent decrease over five years, reflecting the disengagement of wealthy LGBTQ+ Americans.
One less-documented aspect of the new emerging world order is the consequences of our reliance on U.S. cultural imperialism. While the United States championed values that inspired movements for dignity and equality worldwide, LGBTQ+ people could envision a domino effect. A completely new American ethos, one that aligns with illiberal nations like Russia and China, could embolden the anti-LGBTQ+ movement everywhere.
Planning for the future is generally a painful exercise. It becomes even more challenging when it is not the one we worked towards. Our community has a strong preference for the present, too. This stems from a long-standing inability to envision a happy ending for our movement and personal lives. Long-term planning is not our forte.
Another obstacle is that the leaders articulating the response to the new world order are the ones who bet everything on a losing hand ā those who linked our movement to a single political party as if our fight could be outsourced to straight American politicians and corporations. They also often are personally too deep in bed with the Democrats and corporations to envision an alternative strategy. They cling to the illusion that the subsequent Democratic victory will rescue us. And, as LGBTQ+ people increasingly struggle to find dignity and economic opportunities, they continue rearranging chairs at donor galas.
I wrote about how our long-term goals diverged from those of the Democratic Party two years ago in a piece titled āThe Return of Vintage Homophobia Calls for Vintage Queer Tactics”: āProgressive politicians have a vested interest in making sure conservatives remain the villains in the fight for LGBTQ+ equality.ā
The LGBTQ+ response to a changing world cannot rely solely on the U.S. midterm elections and success in U.S. courts. Many of the changes I described are irreversible: America has lost legitimacy on LGBTQ+ issues, and international economic development is no longer a global priority. Frankly, there is also a good chance that Democrats will become wobbly on LGBTQ+ issues as the campaign to vilify LGBTQ+ people gains momentum.
If the future evolves further into a world where āmight make right,ā where economic interests override human dignity, where philanthropy and economic development are abandoned, where strict norms of masculinity and the nuclear family make a comeback, and where authoritarian regimes set the terms ā where do LGBTQ+ people stand?
In the past few weeks, I have thought about some first steps to regain control of our future:
ā Rebuilding unity. In the last year, I have had many versions of a recent conversation with a prominent investor ā someone whose track record includes backing some of the most iconic tech founders of our time ā who argued that LGBTQ+ people are not āa people,ā that we owe nothing to each other, and that we share little beyond sexual practice and loosely defined identities. It was a sobering reminder of how far weāve drifted from the fierce solidarity that once defined our movement. Larry Kramer must be spinning in his grave. Many of our community’s most economically successful members share that view ā intellectually confident yet oblivious to the sacrifices of our elders and our shared destiny. We must recreate a sense of shared destiny. We concede the foundation of collective liberation if we accept that we are just a scattered demographic and not a people bound by struggle, history, and shared hope.
ā Establish a truly representative international body. Iād argue for an organized, democratic assembly where every LGBTQ+ person ā who has paid modest dues ā has a voice and a vote. This body would unite elected representatives across geographies and identities to define a shared political and economic vision, coordinate global action, and hold institutions accountable. It would foster a sense of common purpose and ownership, moving us beyond donor-driven agendas, geopolitical games, or national silos and toward a structure rooted in accountability, solidarity, and self-determination.
āĀ Lay the foundations of economic sovereignty. Political power without economic power is always borrowed ā and today, LGBTQ+ communities remain locked out of capital flows, investment ecosystems, and financial decision-making at every level. I spent the last 15 years assessing our socio-economic outcomes, and we are systematically getting crumbs. To change that, we must architect our economic infrastructure: an interconnected system of community development financial institutions, social investment funds, queer-owned enterprises, and financial vehicles designedĀ byĀ andĀ forĀ LGBTQ+ people. We must tap into our community genius to foster employment and economic independence. TheĀ Global LGBTQ+ Inclusive Finance ForumĀ I am co-organizing this fall is a first step ā less a conference than a catalytic engine to define standards, scale innovations, and mobilize capital across borders. From Nairobi to SĆ£o Paulo to Manila, we can seed an economy that doesnāt just include us but belongs to us because economic independence is the precondition for lasting freedom.
What comes next for LGBTQ+ people is a question of imagination. For LGBTQ+ people, the challenge is to bridge our creativity with our aversion to planning for the future. If we are to reclaim the trajectory of our movement, we must be less reactionary and more strategic. The collapse of old certainties is not a tragedy ā an American-driven queer liberation movement was also inexorably tied to the doomed U.S. brand of capitalism, but an opening. We are being called to imagine more than a world where generous straight allies toss us the scraps of their power and goodwill. Our sovereignty ā political, cultural, economic ā is not something to be granted by the Democratic party or won in U.S. courtrooms. It is something we must build with intention, with vision, and with each other. This is the work of a generation. Letās begin.
Fabrice Houdart is a human rights and corporate social responsibility specialist with 20 years of experience at the World Bank and the United Nations. In 2022, he founded the Association of LGBTQ + Corporate Directors, and in 2023, he co-founded Koppa, a nonprofit focused on LGBTQ+ economic empowerment. He originally published this article on “Fabrice Houdart | A Weekly Newsletter on LGBTQ+ Equality” on March 23.
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