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LGBTQIA disparities amid COVID-19

Pandemic has disproportionately impacted vulnerable groups

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COVID-19 vaccine, gay news, Washington Blade

The COVID-19 pandemic has highlighted the importance of meeting the needs of diverse communities and minorities when facing emergencies such as COVID-19. But more importantly, it highlighted their vulnerability, since they are considered much more prone populations. COVID-19 has made it even more evident the disproportionate burden vulnerable populations bear and the weakness of our health system.

Minorities who are members of racial/ethnic groups are disproportionately affected and often exposed to higher illness rates and have substantially higher mortality and morbidity rates than the general population. For example, people vulnerable to HIV infection usually belong to socially, economically disadvantaged and discriminated groups. The Human Rights Campaign presented an investigative report on how the community faces unique challenges due to their economic situations and access to healthcare. According to HRC, LGBTQIA Americans are more likely than the general population to live in poverty and lack access to adequate health care, paid sick leave and basic needs during the pandemic. The Centers for Disease Control and Prevention states in one of its reports that the LGBTQIA community experiences stigma and discrimination in their lives that “… can increase vulnerabilities to illness and limit the means to achieving optimal health and well-being…” For example, discrimination and violence against LGBTQIA persons have been associated with high rates of psychiatric disorders, substance abuse, suicide and have long-lasting effects on the individuals. Furthermore, LGBTQIA mental health and personal safety are also affected when they go through the process of personal, family and social acceptance of their sexual orientation, gender identity and gender expression.

According to the Williams Institute, the leading research center on rights based on sexual orientation and gender identity, one in 10 LGBTQIA people is unemployed and more likely to live in poverty than heterosexual people, so they cannot always pay for proper medical care or preventive health measures. Also, approximately one in five LGBTQ + adults in the United States (22 percent) lives below the poverty line, compared to an estimated 16 percent poverty rate among heterosexuals. This data is much worse when we look closely at the trans population with 29 percent and LGBTQIA Latinos with 45 percent. These disparities are even more evident when we see that 17 percent of LGBTQIA adults do not have any medical health coverage compared to the 12 percent of the heterosexual population. That 17 percent increases with the LGBTQIA Black adults with 23 percent, trans adults with 22 percent, and trans Black adults with 32 percent who do not have any health coverage, compared to 12 percent of the heterosexual population that does not possess health coverage. The Office of Disease Prevention and Health Promotion statistics reflect that the LGBTQIA community is more likely to attempt suicide, be overweight or obese, have mental health problems, and less likely to receive cancer treatment.

According to several health organizations led by the National LGBT Cancer Network, the LGBTQIA population still faces great social and economic disparities compared to the heterosexual community, so they are more likely to get infected by COVID-19. The report summarizes how COVID-19 negatively affects the lives and livelihoods of the LGBTQIA community at disproportionate levels. The older generations of LGBTQIA encounter additional health barriers in the face of COVID-19 due to isolation, discrimination in the provision of services, and the lack of competent social services. The LGBTQIA community uses tobacco at rates that are 50 percent higher than the general population, and COVID-19 is a respiratory illness that has proven particularly harmful to smokers. In addition, the LGBTQIA population has higher rates of HIV and cancer, which means a more significant number may have compromised immune systems, leaving us more vulnerable to COVID-19 infections. LGBTQIA communities also face additional risks related to conditions that are often associated with complications from COVID-19. One in five LGBTQIA adults aged 50 and above has diabetes, a factor that raises the risk of complications for individuals diagnosed with COVID-19.

A Kaiser Family Foundation research finds that a larger share of LGBTQIA adults has experienced COVID-19 era job loss than heterosexuals adults (56 percent vs. 44 percent). Furthermore, the limited anti-discrimination protections from the LGBTQIA community also make them more vulnerable to joblessness due to an economic downturn resulting from COVID-19’s spread. Since February 2020, 56 percent of LGBTQIA people report that they or another adult in their household have lost a job, been placed on furloughs, or had their income or hours reduced because of the coronavirus outbreak, compared to 44 percent of non-LGBTQIA people.

In addition, recent data show that LGBTQIA respondents were more likely than non-LGBTQIA respondents to be laid off (12.4 percent vs. 7.8 percent) or furloughed from their jobs (14.1 percent vs. 9.7 percent), report problems affording essential household goods (23.5 percent vs. 16.8 percent), and report having problems paying their rent or mortgage (19.9 percent v. 11.7 percent). The research also shows that three-fourths of LGBTQIA people (74 percent) say worry and stress from the pandemic have had a negative impact on their mental health, compared to 49 percent of those, not LGBTQIA. A recent study from the William Institute also found that LGBTQIA people of color were twice as likely as white non-LGBTQIA people to test positive for COVID-19. According to the Williams Institute, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) represented a direct benefit for the LGBTQIA community amid the pandemic. However, LGBT people have still experienced the COVID-19 pandemic differently than heterosexuals, including being harder hit in some areas. The challenges presented by COVID-19 have exacerbated the stigma and discrimination to access to healthcare, social services, and basic legal protections for the LGBTQIA community. It is not the first time the LGBTQIA confronts the stigma and discrimination amid a pandemic. Since the HIV/AIDS pandemic from the 80s until now, the LGBTQIA community has developed an extraordinary resilience over decades, and pushing back against stigma and making claims for basic human dignity and equality

The World Health Organization recognizes that “vulnerable and marginalized groups in societies often have to bear an excessive share of health problems and are less likely to enjoy the right to health…” For this reason, the WHO recognizes the need for more aggressive regulations and laws that promote equality in services for these vulnerable groups to eliminate those current statutes that aggravate marginalization and hinder gradually, and even more so, access to health services, prevention, and care. National policies and state regulations must address the needs of LGBTQIA populations, with particular attention to black LGBTQIA and the absence of standardized protections against discrimination by healthcare providers. Although there have been substantial advances for the LGBTQIA population over the last decade, legal protections remain uneven, including those jurisdictions that do not expressly prohibit discrimination based on sexual orientation, gender identity, or/and gender expression. Eliminating LGBTQIA health disparities and enhancing efforts to improve their health are necessary to reduce disparities and increase longevity. Furthermore, under the context of COVID-19, researchers have found that the intersection of race with sexual orientation and gender identity is essential to understand pandemic’s impact. For example, data collection efforts related to COVID-19 must immediately add sexual orientation and gender identity questions. Collecting sexual orientation and gender identity data will improve knowledge about disparities from sexual minorities, enhance cultural competence among health providers, help implement anti-bullying policies, and reduce suicide and homelessness among youth, among others.

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Supreme Court decision on opt outs for LGBTQ books in classrooms will likely accelerate censorship

Mahmoud v. Taylor ruling sets dangerous precedent

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U.S. Supreme Court (Washington Blade photo by Michael Key)

With its ruling Friday requiring public schools to allow parents to opt their children out of lessons with content they object to — in this case, picture books featuring LGBTQ+ characters or themes — the Supreme Court has opened up a new frontier for accelerating book-banning and censorship.

The legal case, Mahmoud v. Taylor, was brought by a group of elementary school parents in Montgomery County, Md., who objected to nine books with LGBTQ+ characters and themes. The books included stories about a girl whose uncle marries his partner, a child bullied because of his pink shoes, and a puppy that gets lost at a Pride parade. The parents, citing religious objections, sued the school district, arguing that they must be given the right to opt their children out of classroom lessons including such books. Though the district had originally offered this option, it reversed course when the policy proved unworkable.

In its opinion the court overruled the decisions of the lower courts and sided with the parents, ruling that books depicting a same-sex wedding as a happy occasion or treating a gay or transgender child as any other child were “designed to present … certain contrary values and beliefs as things to be rejected.” The court held that exposing children to lessons including these books was coercive, and undermined the parents’ religious beliefs in violation of the free exercise clause of the First Amendment.

This decision is the latest case in recent years to use religious freedom arguments to justify decisions that infringe on other fundamental rights. The court has used the Free Exercise Clause of the First Amendment to permit companies to deny their employees insurance coverage for birth control, allow state-contracted Catholic adoption agencies to refuse to work with same-sex couples, and permit other businesses to discriminate against customers on the basis of their sexual orientation.

Here, the court used the Free Exercise Clause to erode bedrock principles of the Free Speech Clause at a moment when free expression is in peril. Since 2021, PEN America has documented 16,000 instances of book bans nationwide. In addition, its tracking shows 62 state laws restricting teaching and learning on subjects from race and racism to LGBTQ+ rights and gender — censorship not seen since the Red Scare of the 1950s.

Forcing school districts to provide “opt outs” will likely accelerate book challenges and provide book banners with another tool to chill speech. School districts looking to avoid logistical burdens and controversy will simply remove these books, enacting de facto book bans that deny children the right to read. The court’s ruling, carefully couched in the language of religious freedom, did not even consider countervailing and fundamental free speech rights. And it will make even more vulnerable one of the main targets of those who have campaigned for book bans: LGBTQ+ stories.

When understood in this wider context, it is clear that this case is about more than religious liberty — it is also about ideological orthodoxy. Many of the opt-out requests in Montgomery County were not religious in nature. When the reversal of the opt-out policy was first announced, many parents voiced concerns that any references to sexual orientation and gender identity were age-inappropriate.

The decision could allow parents to suppress all kinds of ideas they might find objectionable. In her dissent, Justice Sotomayor cites examples of objections parents could have to books depicting patriotism, interfaith marriage, immodest dress, or women’s rights generally, including the achievements of women working outside the home. If parents can demand a right to opt their children out of any topic to which they hold religious objections, what is to stop them from challenging books featuring gender equality, single mothers, or even a cheeseburger, which someone could theoretically oppose for not being kosher? This case throws the door open to such possibilities.

But the decision will have an immediate and negative impact on the millions of LGBTQ+ students and teachers, and students being raised in families with same-sex parents. This decision stigmatizes LGBTQ+ stories, children, and families, undermines free expression and the right to read, and impairs the mission of our schools to prepare children to live in a diverse and pluralistic society.

Literature is a powerful tool for building empathy and understanding for everyone, and for ensuring that the rising generation is adequately prepared to thrive in a pluralistic society. When children don’t see themselves in books they are left to feel ostracized. When other children see only people like them they lose out on the opportunity to understand the world we live in and the people around them.

Advocates should not give up but instead take a page from the authors who have written books they wished they could have read when they were young — by uplifting their stories. Despite this devastating decision, we cannot allow their voices to be silenced. Rather, we should commit to upholding the right to read diverse literature.

Elly Brinkley is a staff attorney with PEN America.

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Pragmatic presidents invest in America

We need targeted, accountable investment in workforce stability

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(Photo by alptraum/Bigstock)

America may soon elect a president who identifies as LGBTQ. This possibility is no longer far-fetched, nor should it be alarming. What matters far more than who the president is, is whom the president serves.

In America, we care who the president loves because we want to know whether they love the people they represent. Not just the powerful or the visible, but those struggling to contribute more fully. The farmer in Iowa. The single mother in Ohio. The veteran in Houston who sleeps in his truck.

The moral test of any president is whether they recognize that a nation cannot call itself strong when millions of its people are locked out of participating in the economy. This is not sentiment. It is strategy.

We are heading toward a century of global competition where population, productivity, and workforce strength will decide which nations lead. The United States cannot afford to ignore the foundational truth that economic health begins with human stability. Without a well-fed, well-housed, well-prepared workforce, the American economy simply cannot compete.

Today, millions of Americans remain outside the labor force. According to the Bureau of Labor Statistics, roughly six million working-age Americans are not working or actively looking for work. Another 36.5 million live below the poverty line. Many of them lack the basic conditions required to contribute to our modern economy: shelter, nutrition, healthcare, or safety.

The result is predictable. A smaller workforce. Greater dependencies. Stagnant productivity. In 2024, the Congressional Budget Office projected a long-term decline in labor force participation unless structural barriers are addressed. This is not only an economic issue. It is a national security issue.

China and India are investing heavily in their own labor capacity. Meanwhile, we risk squandering ours. This is the backdrop against which the next president, whoever they are, must lead.

The role of government is not to provide individual comfort or cradle-to-grave care; that responsibility rightly belongs to families, communities, and civil society. Its role is to maintain the conditions necessary for every willing individual to contribute productively and invest with confidence. This means access to a safe home. It means access to basic nutrition. It means access to the building blocks of a productive life. Securing for our work forces what the Apostle Paul called diatrophas and skepasmata; or food and a place to sleep. These are not luxuries or favors. They are investments that yield growth in national capacity.

Too often these issues are framed in moral or ideological terms rather than pragmatic business interests. This rhetoric can mask poor planning, inefficiencies, and broken promises that leave communities worse off. Meanwhile these concerns go beyond common sense. They make business sense.

Consider housing. The National Low Income Housing Coalition reports a shortage of more than seven million affordable rental homes for extremely low-income households. This gap affects workforce mobility, job retention, and family stability. In cities with severe housing stress, employers cannot fill jobs because workers cannot live nearby.

Or take hunger. The USDA estimates that more than 47 million Americans live in food-insecure households. Children who are malnourished underperform in school. Adults who skip meals cannot stay focused on work. These are not abstract concerns. They are immediate threats to productivity and growth.

A president who understands this will not be swayed by ideology. They will ask: What strengthens our democracy? What builds a workforce that can out-innovate, out-produce, and out-lead our rivals?

The answer is not more bureaucracy. It is a targeted, accountable investment in workforce stability. Presidents should promote responsible public-private partnerships and remove barriers to full engagement. Communities need to strengthen local support and work with businesses on food, housing, and job training. Businesses recognize the returns on investments in workforce development and inclusive workplaces. Individuals should engage locally, build skills, and participate in practical solutions for community prosperity.

There is precedent. Conservative leaders have long understood that a stable society is a prerequisite for economic freedom. Abraham Lincoln supported land grants and public education. Dwight Eisenhower built the interstate system to connect markets and communities. Ronald Reagan expanded the Earned Income Tax Credit.

The next president should recognize these approaches. It is time to revive a governing vision that puts dignity at the heart of national strategy. That includes all Americans, from skilled professionals to warehouse workers, nurse’s aides, and long-haul truck drivers. Everyone has a responsibility to do their part to keep the economy moving.

This is where leadership matters. Not in posing as a cultural warrior, but in protecting our investments in the people who keep the nation running. A president who cares about this country will not ask what’s needed to make things easier. They will ask what’s needed to help us thrive together. They will help us choose the right way, the hard way, and maybe even the long way because building a competitive economy and a secure nation requires investing in the realities that make that happen.

If the next president can rise to that standard, then identity will matter far less than results. And maybe that is the clearest sign of progress yet.


Will Fries is a Maryland communications strategist with experience in multiple major presidential campaigns.

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We can’t afford Medicaid cuts in fight against HIV

A dangerous message about whose lives are deemed worth protecting

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(Photo by mothy20/Bigstock)

Right now, members of Congress are considering a budget proposal that would rip away life-saving health care coverage, particularly Medicaid from millions of people in the United States. This isn’t just unjust—it’s dangerous.

Since the late 1970s, there has been a strong push to advance the rights and well-being of LGBTQ+ elders, including the growing number of people aging with HIV. This community faces unique and often complex quality of life issues that require consistent, comprehensive care. Medicaid provides essential coverage for these services, including access to HIV medications, primary and specialist care, long-term care, and behavioral health support. Proposed cuts to Medicaid would destabilize this vital lifeline, threatening the health and dignity of one of the most medically vulnerable and historically marginalized communities in our country.

Congress is deciding just how deeply Medicaid could be cut. What’s at stake amounts to one of the most significant threats to public health in recent memory—one that would have a devastating impact on people aging with HIV.

The facts are clear: Medicaid is the single largest source of health care coverage for people living with HIV in the United States, covering roughly 4 in 10 people living with the disease. Many of those individuals are older people who rely on Medicaid not just for access to HIV treatments, but for managing other conditions that often accompany aging with HIV—such as cardiovascular disease, cognitive issues, and diabetes.

We have made remarkable progress in responding to HIV. Today, with effective treatment, people living with HIV can lead long, healthy lives. When HIV is suppressed to undetectable levels, it cannot be transmitted sexually. But this progress depends on consistent access to care. Without Medicaid, many people risk losing access to the medications that keep them healthy and alive—and that help prevent the transmission of HIV.

Moreover, Medicaid expansion has been directly associated with increased access to PrEP, a medication that is up to 99% effective at preventing HIV acquisition. Scaling back Medicaid would not only affect people already living and aging with HIV, but it would also limit preventive care that is essential to reducing new cases of HIV. In a world that too often dismisses older people as non-sexual and overlooks their need for HIV prevention services, the last thing we need is to further restrict access to sexual health services.

Older people with HIV often experience higher levels of isolation, stigma, and economic insecurity. They are more likely to be housing insecure and to have little to no family support. Medicaid helps older people maintain independence and age with dignity. Cutting Medicaid isn’t just a policy decision—it would create real hardship and suffering in the community.

Across the country, advocates and service providers see this reality every day. Countless LGBTQ+ elders and people aging with HIV rely on Medicaid for basic care and services. But that security can disappear quickly. That’s why taking action—right now—to help protect Medicaid is critical.

Here’s what you can do:

Call your members of Congress at 866-426-2631 and tell them “No cuts to Medicaid.” 

Write your members of Congress and tell them that Medicaid must be protected for people aging with HIV. Our colleagues at AIDS United have created a simple and effective tool to help you reach your representatives directly.

Join the SAGE Action Squad. When you sign up, you’ll receive alerts and updates on urgent advocacy issues affecting LGBTQ+ elders and people aging with HIV. It’s a powerful way to stay informed and engaged—and to ensure your voice is part of this movement.

We understand that budget decisions are complex. But we also believe that protecting health care for the most vulnerable members in our community should never be negotiable. Cutting Medicaid doesn’t just reduce spending—it puts lives at risk. It creates new barriers for people aging with HIV to access care, manage their health, and live with dignity. It also limits critical prevention services for those vulnerable to acquiring HIV, undermining efforts to end the HIV epidemic.

If enough of us act, we can help stop these Medicaid cuts from happening. We can ensure that Medicaid continues to serve the people who need it most.

SAGE has been at the forefront of this fight for decades. We’ve helped secure victories in access, equity, and representation. But we can’t do it alone. We must come together to defend the programs that safeguard the health, dignity, and future of our community. Cutting Medicaid would not only roll back progress—it would deepen disparities, put lives at risk, and send a dangerous message about whose lives are deemed worth protecting. We must speak out and demand that our elected leaders prioritize care over cuts. Let’s protect Medicaid. Let’s protect people aging with, and vulnerable to, HIV. Let’s protect our community—and build a future where every older person with HIV can age with health, respect, and pride.


Terri L Wilder, MSW is the HIV/Aging Policy Advocate at SAGE where she implements the organization’s federal and state HIV/aging policy priorities. 

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