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Opinion | LGBTQ youth face mental health challenges amid pandemic

We must assist with legislative remedies, resources

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The mental health of many has suffered amid the coronavirus pandemic, with rates of depression, anxiety, and other mental illnesses steadily rising since March 2020. Youth, especially those who identify as LGBTQ, are being hit especially hard by these manifestations. 

The Trevor Project’s 2021 Youth Mental Health National Survey found that 72 percent of LGBTQ+ people between the ages of 13 and 24 experienced symptoms of generalized anxiety disorder and 62 percent experience symptoms of major depressive disorder — a steep increase since the 2020 survey. This uptick can be attributed to the lack of support that two out of every three respondents to the 2021 survey experience in their homes. 

Due to the pandemic and resulting restrictions placed on social gatherings, LGBTQ youth are unable to participate in in-person activities where their identities are affirmed, and forced to endure misgendering and other discriminatory situations within their homes that are confirmed to increase feelings of loneliness, depression, and anxiety. Online crisis lines, LGBTQ organizations that offer online events for youth, and other resources that support young LGBTQ people are especially vital to their mental health during this time when school-wide Gender and Sexuality Alliances and counseling aren’t as widely accessible. 

Before the pandemic, LGBTQ youth were already suffering from mental illness at extremely high rates. The Trevor Project’s 2019 Youth Mental Health National Survey reported that 39 percent of respondents had seriously considered suicide, more than double the national statistic encompassing both LGBTQ and cisgender, heterosexual youth found in a CDC study the same year. 

The culture surrounding many LGBTQ students in their homes and schools contributes to their alarming rates of mental illness. 

The lack of positive representation of LGBTQ identities in books, on screen, and in classrooms leads youth to believe that there is no hope to ever have successful lives as openly LGBTQ people. 

The LGBTQ characters that young people do have to look up to are often unnecessarily killed off when the “bury your gays” trope is employed, or their storylines center around their LGBTQ identity and disregard any other part of their humanity; tricking them into thinking that they’re nothing beyond their sexual orientation or gender identity and can’t be functioning and productive members of their communities because of it. 

According to the Human Rights Campaign’s 2020 State Equality Index, only two U.S states have laws addressing discrimination against students based on sexual orientation, and only one state has legislated protections for transgender and gender-nonconforming students. Six states specifically restrict the inclusion of LGBTQ topics in curricula. 

The institutionalized exclusion of LGBTQ students from school curriculum further alienates them in spaces where they should feel comfortable and accepted for who they are and helps to facilitate a breeding ground for further discrimination. 

Students internalize the stereotypes, tropes, and other ways in which homophobia and transphobia permeate society and are poisoned with beliefs that they’re abnormal, perverted, and disgusting. Over time, this brainwashing eats away at the psyche of youth as they grow and leads to the high rates of mental health issues in LGBTQ youth. 

Straight and cisgender students are also affected by these failings and in turn, affect the mental health of their LGBTQ counterparts. They absorb the same falsehoods about LGBTQ people and their identities, and lash out at those who they’ve been taught are lesser than them, including their friends and classmates. The internal struggle that manifests in LGBTQ youth as well as external attacks from their peers results in the unique mental health crisis they face. 

LGBTQ youth have also been affected by the pandemic at a higher capacity than other groups. A 2017 study by Chapin Hall at the University of Chicago found that LGBTQ youth are over 100 percent more likely to report homelessness than straight and cisgender youth. 

Many LGBTQ people, especially members of the transgender community, avoid seeing doctors or mental health professionals due to the absence of protections for LGBTQ people and hostile experiences with medical personnel. 

Without access to spaces where they can interact with other LGBTQ youth, shelters in which they feel safe, LGBTQ affirming doctors, and policies in place that protect LGBTQ workers and patients, LGBTQ youth are struggling mentally in high volume that increased during the pandemic. 

The lives and futures of LGBTQ youth are not expendable, and it’s time that they stop being treated as such. Legislated protections for LGBTQ students and resources that are available to youth are necessary to combat the daunting rates of mental illness within the young LGBTQ community.

Maeve Korengold is a freelance journalist and student ambassador for Safe Space NOVA.

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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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Opinions

This World AIDS Day, we must protect access to HIV medicines

We stand on the precipice of ending the epidemic

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As a physician who has worked with patients living with HIV since the AIDS crisis in the 1980s, I’ve seen the darkness and the light.

Back then, it was a scary, anxious time—not only for patients, but also for clinicians. We lacked effective medical treatments. Patients swallowed handfuls of pills. These complex regimens often worked only for short periods of time and brought difficult side effects. Contracting HIV seemed like a painful death sentence—and one that too often lacked dignity, as many morticians then refused to embalm those who had succumbed to the disease. 

Today, the reality is much brighter. I now regularly counsel my patients who contract the virus to plan on living a full life into their golden years. With longer lives, more people now access prescription HIV drugs from Medicare than ever before. While we still lack a cure, we stand on the precipice of ending the epidemic because we know people cannot transmit the virus through sex when they have undetectable levels of HIV. This incredible step forward—a concept known as U=U, or undetectable equals untransmittable—is due in large part to the steady supply of a wide variety of antiretroviral medications. So long as patients have access to quality care and the right medicine, HIV is now a manageable disease.

One important but unsung hero in this progress? An obscure federal law with long, bipartisan support, known as the “six protected classes” policy. It mandates that Part D prescription drug plans cover “all or substantially all” medications in six protected classes. It helps Medicare beneficiaries with some of the most serious health conditions: not only HIV, but also cancer, epilepsy, and those at risk of organ transplant rejection. Now that policy is under threat because pharmacy benefit managers—or the drug middlemen who decide which drugs your plans include and your pharmacy carries—are pressing the federal government to weaken the policy to pad their bottom lines.

For those living with HIV, the stakes could not be higher. Until we have a cure, patients must take drugs regularly and diligently for the rest of their lives. Thanks to decades of incredible innovation, there are now 23 different antiretrovirals in nine different drug classes available to those living with HIV. I have prescribed every single one. Sometimes, I’ll prescribe from nine different two- or three-drug single tablet co-formulated combinations to find the most effective option for a patient. 

While patients have more options, they still face challenges adhering to their regimen. Some experience a gap in coverage due to loss of insurance or a switch in plans. Copayments can become a financial barrier. Others might experience side effects or have conditions making a particular medication unsuitable. 

These antiretroviral medications are not interchangeable. If a patient doesn’t take the exact medicine they need, they risk side effects, problematic medication interactions, and possibly developing resistance to HIV. If the virus comes back, it is genetically unforgiving. Now resistant to an entire class, the virus steals precious options for the patient, particularly those who have been living with HIV for decades. To overcome this, I need—my patients need—every single option at their disposal. The only way I can keep my patients maximally suppressed, living well, feeling good, and able to live a full, healthy life is if they have access to the full range of drugs. 

We have come a long way. Over the past decade, we have driven new deaths down by 70 percent and new infections down by 40 percent worldwide. But this progress is not guaranteed. If we eliminate the number of antiretrovirals available to patients, the danger of a backslide into resistant strains of the virus is real. 

As we recognize World AIDS Day, let us not only remember the millions this disease has taken, but let us also recommit ourselves to the 40 million people worldwide living with HIV and many more who are at risk of contracting it. 

Let’s protect this critical federally protected drug class policy that has delivered so much progress. We can’t slide back into darkness. We must keep pushing forward into the light.

Dr. James A. Sosman is a recognized leader in the field of HIV/AIDS medicine and serves as medical director for the Midwest AIDS Training and Education Center.

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