Commentary
The battle ahead lies overseas
World Bank, other international groups reluctant to back LGBT efforts

Fabrice Houdart with World Bank President Jim Yong Kim and LGBT rights advocates. (Photo courtesy of Denis Largeron)
Two days before Justice Kennedy issued his landmark opinion affirming the Constitutional right of same sex couples to marry anywhere in the United States, Kyrgyzstan’s anti-gay “propaganda” bill passed its second reading in parliament by a horrifying majority of 90-2. And that’s an average week in the developing world — more than 77 countries currently criminalize homosexuality. Of those, 10 percent punish that “act” by death. In fact, recent victories here may even be causing a series of backlashes (often state-sponsored.)
The story of LGBT Americans is a story of enduring courage across generations. Last week’s victory was paved over by the sacrifice of quietly celebrated Americans. From Mattachine to Stonewall, from Act Up to the repeal of “Don’t Ask, Don’t Tell,” from Lawrence v. Texas to nationwide marriage equality, the courage and persistence of LGBT individuals and their allies has bent the arc of history closer to justice.
Like those brave Americans, LGBT leaders in the developing world now demand fair treatment in healthcare, education, housing or public policy. And like their U.S. counterparts, they dare to challenge discrimination even when it feels futile. As Igor Yasin — a Russian LGBT activist — wrote in 2013, “The time has come: we can’t expect anyone to do it for us, and nothing is going to change unless we act.”
Today we know, based on growing statistical evidence, that LGBT people are over-represented among the poorest. In fact, we believe that as much as American law and policy has embraced unprecedented recognition of LGBT rights, international development for LGBT people is in reverse gear, pushed into regression by governments and the complacency of bystanders to unprincipled and tragically harmful discrimination.
As American gays, lesbians, bisexual, and transgender people begin to enjoy more of the benefits of equality than they ever have before, the lives of our LGBT brothers and sisters abroad often are, truly solitary, poor, nasty, brutish and short. In a recent socio-economic survey we carried out in India, 80 percent of transgender respondents reported working in begging or sex work due to the lack of other options. This is an impediment to international development. One cannot eliminate poverty while ignoring such paralyzing discrimination which affects hundreds of millions.
Sadly, international organizations have been reluctant to support LGBT movements abroad because of their own entrenched cultural issues. Discrimination against LGBT people is often perceived as culturally permissible. In fact, my own organization, the World Bank Group, has spent none of its own $5 billion annual administrative budget to address LGBT discrimination in the past. A coalition of Nordic member countries have contributed from their own funds $250,000 (0.005 percent of the Bank’s own administrative funds) to the topic in the last two years.
This grant allowed my team to launch needed studies on the amplitude and impact of discrimination worldwide. It also allowed us to bring global LGBT leaders to make the case for greater protection and inclusion in development initiatives. Together we literally shamed the World Bank into creating a sexual orientation and gender identity task force just a few months ago. One single task force does not make an international Stonewall. And yet, it’s a place to start.
Perhaps more frustratingly, we LGBT people cannot rely on others to argue on our behalf. Our movement has been one supported by allies, but led from within. We must demand our fair share of development resources to benefit our brothers and sisters embattled abroad. And we must not be intimidated (back) into silence. Our movement has never succeeded — and has always suffered — in silence.
As has recently been reported by this and other LGBT outlets, my own efforts to speak up at the World Bank along with a group of LGBT organizations were the subject of a year-long $1+ million investigation and my very public demotion. Such personal costs do not compare to those paid by the LGBT activists who came before me. Perhaps that is one measure of progress. But they also pale in comparison to the price paid by LGBT activists today in Egypt, Russia or Turkey. We must not idle while discrimination is tolerated abroad. We must not be shaken, or silenced, or stymied by intimidation at home. And above all, we must, as Jamaican activist Angeline Jackson reminds us, remain hopeful: “We are not beaten; we are strong and we are resilient, and we are working for change.”
Fabrice Houdart is a country officer for the Maghreb at the World Bank. Since 2011, he is also a strong voice for greater consideration of LGBT people in international Development. In May this year, he faced disciplinary measures allegedly for having shared an official-use only document with a coalition of LGBT rights organizations pushing for greater protection for LGBT people worldwide. He lives with his twin boys in Washington, D.C.
Commentary
Protecting the trans community is not optional for elected allies and candidates
One of oldest political tactics is blaming vulnerable group for societal woes
Being an ally to the trans community is not a conditional position for me, nor should it be for any candidate. My allyship doesn’t hinge on polling, focus groups, or whether courage feels politically convenient. At a time when trans people, especially trans youth of color, are under coordinated attack, elected officials and candidates must do more than offer quiet support. We must take a public and solid stand.
History shows us how these moments begin. One of the oldest political tactics is to single out the most vulnerable and blame them for society’s anxieties — not because they are responsible, but because they are easier to blame than those with power and protection. In Nazi Germany, Jewish people were primarily targeted, but they were not the only demographic who suffered elimination. LGBTQ people, disabled people, Romani communities, political dissidents, and others were also rounded up, imprisoned, and killed. Among the earliest acts of fascistic repression was the destruction of Berlin’s Institute for Sexual Science, a pioneering center for gender-affirming care and LGBTQ research. These books and medical records were among the first to be confiscated and burned. It is not a coincidence that these same communities are now the first to suffer under this regime, they are our canaries in the coal mine signaling what’s to come.
Congress, emboldened by the rhetoric of the Donald Trump campaign, recently passed HR 3492 to criminalize healthcare workers who provide gender-affirming healthcare with fines and imprisonment. This bill, sponsored by celebrity politicians like Marjorie Taylor Greene, puts politics and headlines over people and health outcomes. Healthcare that a number of cis-gendered people also benefit from byway of hair regeneration and surgery, male and female breast augmentation, hormone replacement therapy etc. Even when these bills targeting this care do not pass, they do real damage. They create fear among patients, legal uncertainty for providers, and instability for clinics that serve the most marginalized people in our communities.
Here in D.C., organizations like Planned Parenthood and Whitman-Walker Health are lifelines for many communities. They provide gender-affirming care alongside primary care, mental health services, HIV treatment, and preventative medicine. When healthcare is politicized or criminalized, people don’t wait for court rulings — they delay care, ration medication, or disappear from the system entirely.
As a pharmacist, I know exactly what that means. These are life-saving medications. Continuity of care matters. Criminalizing and politicizing healthcare does not protect children or families — it puts lives at risk.
Instead of centering these realities, political discourse has been deliberately diverted toward a manufactured panic about trans women in sports. Let me be clear: trans women deserve to be protected and allowed to compete just like anyone else. Athletics have always included people with different bodies, strengths, and abilities. Girls and women will always encounter competitors who are stronger or faster — that is not a gender or sports crisis, it is the nature of competition.
Sports are meant to teach fairness, mutual respect, and the shared spirit of competition — not suspicion or exclusion. We should not police young people’s bodies, and we should reject attempts to single out trans youth as a political distraction. Families and doctors should be the authority on sex and gender identity.
This narrative has been cynically amplified by the right, but too often Democrats have allowed it to take hold rather than forcefully rejecting it. It is imperative to pay attention to what is happening — and to push back against every attempt to dehumanize anyone for political gain.
Trans people have always been part of our communities and our democracy. Protecting the most vulnerable is not radical — it is the foundation of a just society. My work is grounded in that commitment, and I will not waver from it. I’m proud to have hired trans political team Down Ballot to lead my campaign for DC Council At Large. We need more ally leaders of all stages to stand up for the LGBTQ+ community. We must let elected detractors know that when they come for them, then they come for all of us. We cannot allow Fox News and social media trolls to create a narrative that scares us away from protecting marginalized populations. We must stand up and do what’s right.
Anything less is not leadership.
Rep. Oye Owolewa is running for an at-large seat on the D.C. Council.
Commentary
America is going in the wrong direction for intersex children
Lawmakers are criminalizing care for trans youth, while permitting irreversible harm to intersex babies
I live with the consequences of what America is willing to condone in the name of “protecting children.”
When I was young, doctors and adults made irreversible decisions about my body without my informed consent. They weren’t responding to an emergency. They were responding to discomfort with innate physical differences and the social and medical pressure to make a child’s body conform to a rigid female-male binary. That’s the part people like to skip over when they talk about “child welfare”: the harm didn’t begin with my identity. It started with adults deciding my healthy body needed fixing.
That’s why the hypocrisy unfolding right now from statehouses to Capitol Hill feels so familiar, and so dangerous.
While harmful medical practices on intersex children, the nearly 2 percent born with differences in one or more of their physical sex characteristics, have been ongoing in the U.S. for decades, until recently, there was no law specifically condoning it.
This month, House Republicans passed one of the most extreme anti-trans bills in modern American history, advancing legislation that would criminalize gender-affirming medical care for transgender youth and threaten doctors with severe penalties for providing evidence-based treatment. The bill is framed as a measure to “protect children,” but in reality, it weaponizes the criminal legal system against families and providers who are trying to support young people in surviving adolescence.
At the same time, the administration has proposed hospital and insurance policies designed to choke off access to affirming care for trans youth nationwide by making providers fear loss of federal funding, regulatory retaliation, or prosecution. This is a familiar strategy: don’t just ban care outright; instead, make it so risky that hospitals stop providing it altogether. The result is the same everywhere. Young people lose access to care that major medical associations agree can be lifesaving.
All of this is happening under the banner of preventing “irreversible harm.”
But if America were genuinely concerned about irreversible harm to minors, the first thing lawmakers would address is the medically unnecessary, nonconsensual surgeries still performed on intersex infants and young children, procedures that permanently alter healthy tissue, often without urgent medical need, and long before a child can meaningfully participate in the decision. Human rights organizations have documented for years how these interventions are justified not by medical necessity, but by social pressure to make bodies appear more typically “female” or “male.”
Here is the uncomfortable truth: all of the state laws now banning gender-affirming care for transgender youth explicitly include exceptions that allow nonconsensual and harmful intersex surgeries to continue.
A recent JAMA Health Forum analysis found that 28 states have enacted bans on gender-affirming care for minors that carve out intersex exceptions, preserving doctors’ ability to perform irreversible “normalizing” procedures on intersex children even while prohibiting affirming care for trans adolescents.
This contradiction is not accidental. It reveals the real priority behind these laws.
If the goal were truly to protect children from irreversible medical interventions, intersex kids would be protected first. Instead, these policies target one group of children, transgender youth, while continuing to permit permanent interventions on another group whose bodies challenge the same rigid sex and gender binary that lawmakers are trying to enforce.
Intersex people are routinely erased from American policy debates, except when our bodies are invoked to justify harmful laws, warning that intersex children are being used as legal loopholes rather than protected as human beings. This “protect the children” rhetoric is routinely deployed to justify state control over bodies, while preserving medical practices that stripped intersex children like me of autonomy, good health, and choice. Those harms are not theoretical. They are lifelong.
What makes this moment even more jarring is that the federal government had finally begun to recognize intersex people and attempt to address the harms suffered.
In 2024, at the very end of his term, the Biden administration released the first-ever intersex health equity report — a landmark admission that intersex people have been harmed by the U.S. health care system. Issued by the Department of Health and Human Services, the report documents medically unnecessary interventions, lack of informed consent, and systemic erasure and recommends delaying irreversible procedures until individuals can meaningfully participate in decisions about their own bodies.
This should have been a turning point. Instead, America is moving in the opposite direction.
On day one, President Trump issued an executive order defining “sex” in a way attempting to delegitimize the existence of transgender Americans that also erased the existence of many intersex people.
When medicine is used to erase difference, it is called protection, while care that supports self-understanding is treated as a threat. This is not about medicine. It is about control.
You cannot claim to oppose irreversible harm to children while legally permitting surgeries that intersex adults and human rights experts have condemned for decades. You cannot claim to respect bodily autonomy while denying it selectively, based on whose bodies make lawmakers uncomfortable.
Protecting children means protecting all children, transgender, intersex, and cisgender alike. It means delaying irreversible interventions when they are not medically necessary. It means trusting and supporting young people and families over politicians chasing culture-war victories.
America can continue down the path of criminalizing care for some children while sanctioning harm to others, or it can finally listen to the people who have lived the consequences.
Intersex children deserve laws that protect their bodies, not politics that hurt and erase them.
Kimberly Zieselman is a human rights advocate and the author of “XOXY: A Memoir”. The author is a co-author of the JAMA Health Forum article cited, which examined state laws restricting gender-affirming care.
Today, on World AIDS Day, we honor the resilience, courage, and dignity of people living with HIV everywhere especially refugees, asylum seekers, and queer displaced communities across East Africa and the world.
For many, living with HIV is not just a health journey it is a journey of navigating stigma, borders, laws, discrimination, and survival.
Yet even in the face of displacement, uncertainty, and exclusion, queer people living with HIV continue to rise, thrive, advocate, and build community against all odds.
To every displaced person living with HIV:
• Your strength inspires us.
• Your story matters.
• You are worthy of safety, compassion, and the full right to health.
• You deserve a world where borders do not determine access to treatment, where identity does not determine dignity, and where your existence is celebrated not criminalized.
Let today be a reminder that:
• HIV is not a crime.
• Queer identity is not a crime.
• Seeking safety is not a crime.
• Stigma has no place in our communities.
• Access to treatment, care, and protection is a human right.
As we reflect, we must recommit ourselves to building systems that protect not punish displaced queer people living with HIV. We must amplify their voices, invest in inclusive healthcare, and fight the inequalities that fuel vulnerability.
Hope is stronger when we build it together.
Let’s continue to uplift, empower, and walk alongside those whose journeys are too often unheard.
Today we remember.
Today we stand together.
Today we renew hope.
Abraham Junior lives in the Gorom Refugee Settlement in South Sudan.
