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The oppression of ‘tolerance’ in Guyana

Anti-LGBT violence, attitudes pervasive in South American country

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Guyana, gay news, Washington Blade

Georgetown, Guyana (Photo by Ian Mackenzie; courtesy Flickr)

“He was burned to death in a house . . . They burned him to death. They tied him up and then burned the house . . . [The police failed to properly investigate] . . . How bad is it going to get before good comes?”

This story has haunted me since I returned from Guyana. Grace, a pseudonym, is a 44-year-old transgender woman who lost one of her best friends; he was murdered for being transgender and the police refused to investigate. While in-country, I witnessed this discrimination firsthand and bore witness to the scars and stories LGBT interviewees revealed. Another interviewee lost a friend the week we conducted interviews. Trishell, a 28-year-old transgender woman, was killed on Feb. 17, 2018, after a festival celebration in Georgetown. Her death was reported as an accident caused by a car crash — despite interviewees who reported the wounds were wholly inconsistent with this explanation.

Our research team interviewed nearly 70 stakeholders — including LGBT persons, religious leaders, human rights defenders, civil society representatives, law enforcement officials and other government officials — and uncovered a cycle of violence, discrimination and abuse that permeates all aspects of life for LGBT individuals in Guyana. The discrimination and violence start at home, continue through the education system, into the employment sector and affect their ability to access quality healthcare, safety in public spaces and justice.

The government boasted statistics demonstrating that Guyana is a tolerant country. I take issue with this: Tolerance is not acceptance. Human rights guarantee more than being “tolerated” by one’s government — human rights mean being empowered to lead a dignified life. However, at this juncture in Guyana the distinction is rather moot — stories like those above clearly indicate that Guyanese society is not even tolerant of LGBT persons. The truth is more nuanced, hidden in the same closet in Guyana where LGBT individuals seek refuge.

Guyana, a small Caribbean country located in South America, is the only country on the South American continent that still criminalizes same-sex intimacy. The country also criminalizes “cross-dressing” for an “improper purpose” — whatever that means. (Guyana’s Appeals Court upheld the law recently but refused to define the term, making it impossible to know what constitutes a violation.) These laws, which form part of the fabric of Guyanese society, perpetuate and legitimize violence and discrimination against LGBT individuals. One need not look further than the title of the article where Trishell’s murder was reported to see this connection: “Cross-dresser Killed in Vreed-en-Hoop Accident.”

While government officials preached tolerance, deep-seated discrimination was evident in their remarks. Minister of Social Protection Keith Scott — a very friendly and jovial man — proudly shared societal attitudes toward LGBT persons: “If there were two men who were kissing, there would be inward disgust at what they are seeing, but at the same time nobody [is] going to attack them.” He didn’t recognize that this was less-than-ideal. It also did not mesh with the accounts LGBT individuals provided — including being prevented from entering police stations to report crime, waiting for hours to be seen in emergency rooms while their non-LGBT counterparts were ushered ahead of them, and being verbally and physically attacked for being who they are in public.

Similarly, Crime Chief Police Officer Paul Williams affirmed that anyone “can come to my office to seek justice,” some of his other comments were less than welcoming. While Williams acknowledged that some officers are disrespectful and let their own biases interfere in their work, he underscored, nonchalantly, that LGBT persons should recognize their place: “Don’t fool yourself, you’re a minority in a large group, you have to cooperate […] conduct yourself in an appropriate manner.”

Accounts from LGBT interviewees largely comported with Williams’ assertion — they noted that they are relatively safe as long as they actively hide their true identities from most of their family, friends and government. Yet finding safety in the proverbial closet is not experiencing the full panoply of human rights — it’s oppression. Preventing persons from living a life of dignity is a violation of human rights.

Rethinking their duty to uphold human rights, some Caribbean countries have recently repealed or overturned laws criminalizing same-sex intimacy — including Belize in 2016 and, very recently, Trinidad and Tobago on April 12. It is not too late for Guyana to join them and embark on the road to changing archaic laws and dangerous attitudes. Instead of preaching tolerance, it’s time to offer acceptance.

To learn more about LGBT rights in Guyana related to education, employment, health, violence and safety in public spaces, and impunity for perpetrators and access to justice, keep an eye out for the Georgetown Law Human Rights Institute Fact-Finding Project report: Trapped: Cycles of Violence and Discrimination Against LGBT Persons in Guyana. It will be available online by mid-June.

 

Ashley Binetti is the Dash-Muse Teaching Fellow at Georgetown Law’s Human Rights Institute. She co-teaches HRI’s Fact-Finding Practicum, directs the Human Rights Associates Program, and leads all human rights programming at the Institute. These are the author’s reflections from HRI’s 2018 Fact-Finding Project research trip on LGBT rights in Guyana.

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Hospitals are abusing this drug discount program

Congress must step in to help low-income patients

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Hospital chains are unfairly profiting off a program meant to help low-income patients afford their medicines. If policymakers don’t reform this system soon, I worry that many of the marginalized patients I’ve devoted my career to protecting won’t be able to access the care they need.

The program, known as 340B, gives drug discounts to hospitals in underprivileged areas so that they can better serve their communities. Yet, with little oversight, the hospitals can divert the savings to their own bottom lines.

A recent report from the Drug Channels Institute exposed just how big the problem is.

The analysis found that under 340B, hospitals took discounts worth $52.3 billion in 2022 with scant evidence that those savings went to help low-income patients. The report also found that the 340B program continued its exponential growth during the pandemic, swelling by 22% between 2021 to 2022. 

In short, money intended to help marginalized communities is instead being funneled into hospital profits in ever-greater amounts. Having spent much of my career helping Black men with HIV, I find this gravely concerning. But the impact of the exploitation extends far beyond my own work, to all communities grappling with chronic disease and unaffordable health care. The solution is for Congress to bring some much-needed oversight and regulation to the 340B program. 

It all started three decades ago when lawmakers launched a seemingly benevolent plan: In order to help non-profit “safety net” hospitals in poor communities, 340B required pharmaceutical companies to sell them drugs at big discounts. The idea was that this would lower drug prices for low-income patients and also help the hospitals, so that they could reinvest in facilities, equipment, and staff to serve disadvantaged patients. 

Unfortunately, the 1992 law failed to codify any rules about what hospitals should do with the savings, so no proof of reinvestment is required. Soon enough, even hospitals serving prosperous communities realized they could use the law’s loopholes to turn 340B into a profit center. 

Many hospitals have multiple locations. Under current regulations, a hospital can use its facility in an underserved community to qualify for the 340B Program, take millions of dollars in drug discounts, then resell the drugs in more affluent neighborhoods. 

Consider the Cleveland Clinic, known as one of the best hospitals in the country. It uses satellite “rural referral centers” to qualify for discounted drugs under 340B, then sells them at full price through its Cleveland-based flagship hospital. 

The profit from such maneuvers can be substantial. For instance, 340B hospitals sell top oncology drugs at a median of 4.9 times their discounted price, according to a report from the Community Oncology Alliance.

It’s no wonder that 44% of U.S. hospitals now report that the 340B program is a substantial revenue source. It may have also contributed to industry consolidation in recent years, encouraging hospitals to merge in order to acquire qualifying facilities.  

Despite the program’s rapid expansion, there’s little evidence that it’s benefiting marginalized patients. A study in the New England Journal of Medicine found that the “financial gains for hospitals have not been associated with clear evidence of expanded care or lower mortality among low-income patients.” Another study, in the journal Health Services Research, concluded that when new hospitals join 340B, it doesn’t lead to any change in the amount of uncompensated care they provide. 

In fact, 340B may actually increase healthcare costs for low-income patients. Because hospitals benefit from the difference between the discounted drug price and the sale price, they are incentivized to prescribe more expensive drugs, which yield higher profit margins than lower-cost generic alternatives.

This appears to be happening with the PrEP drugs that prevent transmission of HIV. A report from the American Action Forum, a think tank, found that 340B likely incentivizes hospitals to prescribe more expensive brand-name PrEP over generic versions. This means some patients are paying more than they should for this lifesaving medicine. 

Hospitals chains’ continued abuse of 340B also takes critical resources away from the healthcare facilities the program is meant to help. For instance, Ryan White HIV/AIDS providers help low-income people living with HIV access medications and support services. But letting hospitals exploit loopholes in 340B could leave fewer discounted drugs for Ryan White and similar safety net programs.

Congress needs to reform the bloated and unaccountable 340B program as soon as possible. Democrats and Republicans should be able to agree that eligibility standards must be tightened and reporting requirements improved. Hospitals must use 340B profits to help our most vulnerable patients.

Guy Anthony is president and CEO of Black, Gifted & Whole.

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Key West doesn’t need more, or bigger, cruise ships

Seeking a balance of ‘environmental protection and sustainable tourism’

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(Photo by Miami2you/Bigstock)

There is a fight today about whether they should let more, and bigger, cruise ships dock in Key West. The New York Times recently wrote about it. As someone who has spent many memorable vacations in Key West, I side with those who say “no” to more cruise ships. The organization Safer, Cleaner, Ships, is fighting to keep more, and larger, ships, out of Key West. They have the right idea. 

The question that should be asked is: “What kind of an island do the people living on Key West want?” And the answer should drive the decision of the Florida Legislature, and Governor DeSanctimonious. Unfortunately, it may be decided based on political donations the governor received. One resident of Key West, Christopher Massicotte, co-founder of Duval Street Media, said, “Key West voters overwhelmingly supported reducing cruise ship size, and the number of daily disembarkations. Then greedy Mark Walsh, who owns the dock, went straight to the governor and the legislature asking them to overturn the will of the people for his own financial gain, greased with a $1 million contribution to DeSantis’s campaign for president. The citizens of Key West aren’t trying to stop all cruise ship traffic, or bring the city back to ‘The good old days.’ We are trying to create a balance of environmental protection and sustainable tourism.”  

I cruise regularly and love it and have traveled to Alaska on a cruise and woke up one morning on the ship in Ketchikan, to step out on the balcony and see six massive ships, and hundreds of busses on the pier, ready to take passengers on tours. In Key West, that won’t happen. Instead, the thousands of passengers will not get on busses, rather throng the main street (Duval), from one end of town to the other, making it look more like Times Square, instead of a sleepy little island, which is what always attracted people to the idea of Key West. It is what attracted Hemmingway. It attracted President Truman to set up his winter White House. Everyone going to visit Key West heads to the Southernmost Point in the U.S. to snap their photo. One doesn’t need thousands more people heading there all at once. Just the thought of this would have Hemmingway and Truman turning over in their graves.

I always thought Key West did fine with an airport, and people coming to visit by car, then staying in a hotel, or guesthouse. I often stayed at one of the great little guesthouses, or some of the smaller hotels, on the island. I remember the larger ones being on both ends of Duval Street. There were great bars and restaurants, and you could amble down Duval slowly, enjoying the sound of the music coming out of the bars — think Jimmy Buffett.

I loved Key West when it was a gay Mecca, having the first openly gay mayor of a city. At the time there were lots of gay guesthouses and clubs. I remember dancing at the Copa, and there was the dock on the southern side of the island, next to the one tiny beach, which locals called ‘dick dock.’ It was a great spot for nude sunbathing, as was the pool at the Southernmost Motel. That period ended when the gay community moved to South Beach in Miami. Key West is still welcoming to the LGBTQ community. There is the iconic La Te Da hotel, on Duval Street, with its tea dance. Performing there is another Key West icon, Christopher Peterson, a female impersonator extraordinaire. Christopher said, “Unfortunately I don’t think we need to dredge again the beautiful coral reef we live on, just to have 10,000 more people here for six hours, adding nothing to the economy because they eat and drink on the ship for free.” He added, “Bigger is not always better unless it’s in the bedroom…. king-size bed…. dirty minds!”

Numbers can always be used in many ways, but the Times column reported “Before the pandemic, nearly a million people a year were visiting Key West aboard cruise ships. But when Covid-19 brought that to a halt, the city’s $2.4 billion tourism industry, responsible for 44 percent of its jobs, did not collapse. Instead, hotel tax revenue rose 15 percent, and with 1.4 million arrivals, the airport set a record in 2021.”

If that is enough revenue to keep Key West being the wonderful place it is to live and visit, it seems adding thousands of more day trippers out of cruise ships isn’t going to make the place better. Rather, it will hurt the environment, and make things worse.

Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist. He writes regularly for the Blade.

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Most of America opposes Speaker Johnson’s anti-LGBTQ hate

No one should have their identity politicized so GOP can score points with its base

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House Speaker Mike Johnson (R-La.) (Washington Blade file photo by Michael Key)

When I was a kid, I was afraid to come out to my religious family – at the time, gay marriage was still illegal. Fortunately, times have changed: My family is supportive of me for who I am and I now plan to marry my partner one day. But the newest speaker of the House jeopardizes that dream, making me fear the life I have planned with the person I love will soon fall out of reach.

Recently, after three weeks of chaos, the House of Representatives elected Mike Johnson (R-La.) as speaker. His extremist rhetoric and horrific record of discrimination toward the LGBTQ community doesn’t represent where most of America is – but it does clue us into the priorities of today’s Republicans.

The love that I and my partner have built over our three years together is the same as straight couples. Yet Johnson’s legislative record flies in the face of that as he’s argued to uphold bans on same-sex marriage, sought to ban inclusion of gay couples in employment benefits, and compared gay marriage to bestiality. It’s impossible to feel optimistic that, with a background like that, Johnson will protect my rights during his tenure.

The entirety of my community feels the same apprehension. My coworker, Mads Stirling, who came out as a nonbinary trans person in 2021, has the same fears that I do. They found that being empowered to live as their authentic self through hormone replacement therapy (HRT) and changing their driver’s license gender marker improved their mental health. 

“But even as I was transitioning with the crucial support of family, friends, coworkers, and the local government, I felt terrified as I watched Republican-led states roll back rights for trans people,” Mads said.

Johnson contributed to the dangerous climate that spurred these attacks, speaking in favor of banning gender-affirming care for transgender youth and joining a contingent of politicians who proposed more than 500 anti-LGBTQ bills in the U.S. in 2023. In his new role as speaker, Johnson could even help unravel important protections like federal nondiscrimination laws. 

It feels like our country is moving backward and that nowhere is safe for people with identities like mine. Having been there myself, my heart breaks for LGBTQ children who will hear the new speaker’s horrible homophobia and transphobia and feel unsafe being their authentic selves. No person, least of all children, should have their identity politicized so the Republican Party can score points with its members. 

It is appalling that while 70% of Americans support gay marriage, we have a speaker who opposes it. It is appalling that while gender-affirming care reduces suicidality in trans adults and children, we have a speaker that wants to deny life-saving care to them. It is appalling that, in 2023, a person in power can spread such hatred toward a group of people for simply existing.

The Speaker of the House should be a voice for all Americans, representing our interests and embodying the role of a leader. But as a gay Black man, it is impossible for me to feel that Johnson — and the Republican Party he answers to — can ever represent us when they work so actively against us.

The Republican Party and Mike Johnson have demonstrated over and over again that protecting and uplifting LGBTQ+ people is not a priority. We expect Johnson intends to serve only his own party’s extremist agenda by further isolating and oppressing LGBTQ people — after all, they maneuvered him into power. We fear the erasure of LGBTQ identities entirely by disappearing us from public life and making our private lives intolerable by criminalizing our families and our healthcare.

America deserves better than Mike Johnson. We can never tolerate nor normalize Johnson’s hateful rhetoric toward LGBTQ people, and now that he has a national platform, it’s more important than ever to speak out and vote against the GOP’s extremist policies. We must continue our work to elect representatives that will champion LGBTQ people and fearlessly defend their rights so that in the future, no one with views like these can assume a place in Congress. 

We deserve leadership reflective of the American people and that’s not Mike Johnson or the GOP’s anti-LGBTQ agenda.

Mike Griffin is senior electoral organizer for D.C.-based Community Change.

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