National
Rachel Levine in ‘rewarding’ visit speaks with trans youth at D.C. health clinic
Hospital an oasis of support amid attacks from states
It’s not unusual for Rachel Levine as assistant secretary for health to visit medical facilities on behalf of the Department of Health & Human Services. But her visit last week to the LGBTQ youth clinic at the Children’s National Hospital was special because she was able to meet with transgender youth as an openly transgender presidential appointee.
The visit on Thursday by Levine at the D.C.-based hospital comes not long after the U.S. Senate approved her appointment, making her the first openly transgender presidential appointee to win a Senate-confirmed position. As such, her visit to the LGBTQ youth clinic, where transgender kids come for transition-related care and health services, held particular significance for the patients.
Levine, speaking with the Washington Blade at the end of her visit, said having the opportunity to speak with both transgender youth and medical professionals testing them was “tremendously, tremendously rewarding”
“It’s tremendously gratifying to be able to speak to the medical professionals and the clinic personnel, but particularly to the youth and their families from my experience,” Levine added. “So I have two aspects of that. One is that I’m a pediatrician and adolescent medicine specialist. So I’ve been teaching to children and their families my entire career, but the other is coming from my lived experience as an openly transgender woman, and so I find it tremendously rewarding.”
The warm environment of the hospital for children is readily apparent upon entering the main atrium of the building. Lights dressed up as hot air balloons fill the tall ceiling while a nearby TV shows music videos consisting of squares of kids’ faces singing, followed by easy-listening country music and Asian K-pop. Children and their parents await their appointments seated in comfy plush red chairs before white blocks meant for use as tables.
Key to Levine’s visit was taking part in a discussion at the hospital auditorium with three transgender youth and their families who obtain services at the clinic. During the question-and-answer period, Levine shared her experience as a transgender person who underwent transition later in life and went on to tremendous success as a high-ranking presidential appointee.
For the transgender youth, Levine’s presence at the hospital — at a time when state legislatures are busy enacting bills to restrict their access to medical care and school activities — serves as a reminder that barriers based on gender identity are breaking down and the sky’s the limit for their future.
After the question-and-answer session, Levine told the Blade she “learned a lot” about Children’s National, which she called “a world-renowned children’s hospital and academic medical center.”
“I’ve known about it before,” Levine added. “I’m a pediatrician, adolescent medicine specialist, but I learned more about what they’re doing. And I learned specifically about their gender clinic, where they take care of transgender and gender non-conforming youth and got to meet some of the staff as well as the kids and their families.”
The Youth Pride Clinic, which opened in 2015, is one of the few clinics in the nation to provide primary care and mental health services to LGBTQ youth from ages 12 to 22. Among the services offered are hormone replacement therapy, STP/STI treatment and PrEP services as well as individual and family therapy for transgender youth.
Among the transgender youth patients at the clinic who spoke to the Washington Blade was Amir, a 15-year-old Georgia native whose last name as a minor is being withheld for confidentiality purposes.
“I started out in fifth grade coming out as lesbian,” Amir said. “I didn’t even really know, but when I came out to my grandma in Georgia, where I’m from, I still didn’t feel like myself. So then, later on, me and my friend researched, and next thing you know we came across the term transgender, and I was like, ‘This is who I am. This is me.’”
Amir said he began taking shots as part of care regimen in January. Being able to receive care from the Youth Pride Clinic, Amir said, means a lot because he has an opportunity not available to other transgender youths, who face challenges and even hostility as they make the journey to transition. The staffers at the Youth Pride Clinic, Amir said, are “like a second family” who work hard to provide the services they offer.
Sonia Murphy, Amir’s aunt who became his legal guardian, said when she began reaching out for medical help for Amir she found a two- or three-year wait list to get access to treatment, which she said makes her “saddened” such care isn’t widely available.
“There’s a population of kids and parents out there who need the services and just can’t access it because there’s not enough bandwidth, not enough manpower,” Murphy said.
Amir said he’s getting other avenues of support from his two cousins, one who is older at age 18 and one who is younger at age 12. “They’re like sisters to me, so I call them my sisters,” Amir said. Amir also identified two other male cousins as well as his uncles and his aunt.
“They’re all very supportive of me,” Amir said. “My auntie Tonya, for example, Pride month came up, first day, she sent me a paragraph, saying, ‘I’m glad you’re yourself and you’re open to who you are and things like that,” and that I’m not afraid to be who I am around anybody. It’s just things like that. And for my birthday, I had tons of Pride shirts, and I got a rainbow shirt with the fist in the middle for Black Lives Matter, and it was a ton of different things.”
Lawrence D’Angelo, director of the Youth Pride Clinic and an occupational health adolescent medicine specialist, told the Blade being able to start the facility in 2015 in and of itself was one of the key victories for the initiative, although he said the Children’s National has been providing transition-related care since 1998.
“When we started it…we thought that we were going to be running a PrEP clinic, that we were going to be providing preventive services to LGBTQ kids,” D’Angelo said. “The first day, the first patient actually came in and asked for PrEP, and the other six patients that were scheduled that day all wanted transgender services. So, suddenly, it became obvious what we were going to be spending 90 percent of our time doing, which is exactly what we think we should be doing, because that’s where the need is the greatest.”
Despite the advantages of having access to the Youth Pride Clinic, transgender youth have clear challenges and face hostility based simply on their gender identity, especially in a year when state legislatures have in an unprecedented manner enacted legislation against them. The Youth Pride Clinic, in many ways, is an oasis of support.
Arkansas, for example, enacted a measure that would make criminal the kind of services provided at the clinic. Other states have enacted measures prohibiting “biological boys” from participating in sports, which essentially bars transgender girls from participating in sporting events.
While anti-trans measures aren’t being enacted in D.C. or any nearby states, the advancement of anti-trans legislation in states has had a negative effect on transgender patients at the Youth Pride Clinic.
D’Angelo, based on conversations he’s had with the patients, said they’re aware of the wave of legislation, which he said has led to fear, anger and being “unable to understand what is happening and why it’s happening.”
Amir said watching states enact legislation against transgender youth “makes me feel some type of weight,” pointing specifically to the anti-trans sports measures because he said he’d welcome the opportunity to participate in athletics.
“I’m athletic,” Amir said. “I do all types of sports. I play basketball, soccer, I’m going to do boxing…With sports and stuff, I just feel like I want to be able to do everything, just as a regular cisgender person will be able to do,”
Amir, despite the enactment of anti-trans laws, has an optimistic outlook and said the enactment of state measures against transgender youth demonstrates they’re now “on the radar” of the social conservative movement.
“I feel like if everybody who’s a part of LGBTQ and trans together, we can stand up and we can overcome this because the thing is, there are so many people out there who don’t understand what we do, and the thing is that they’re noticing us, so that’s a start to something big.”
With many states hostile to transgender youth, others are looking to the federal government for support under the Biden administration. On his first day in office, Biden signed an executive order directing federal agencies to implement the U.S. Supreme Court’s decision against anti-LGBTQ discrimination to the fullest extent possible.
Levine cited an announcement from HHS that resulted from this order on implementing regulations prohibiting anti-LGBTQ discrimination in medical care, reversing a policy under the Trump administration that green lighted discrimination, as one of the ways it has answered that call and helped families like the Youth Pride Clinic.
“So the Affordable Care Act says that you cannot discriminate based upon sex,” Levine said. “The Department Health & Human Services and the Office of Civil Rights has interpreted sex to include sexual and gender minorities, to include sexual orientation and gender identity, which means LGBTQ individuals under that. So we need to look at all aspects of the Affordable Care Act, and to work to implement that interpretation of the statute. That was only done a month or so ago, so we’re going to be working on that now.”
Is there anything more the federal government can do to support the clinic? D’Angelo cited a number of key things already secured, including the hospital being able to offer insurance to patients and the affirmation from HHS against anti-LGBTQ discrimination. More research dollars and greater focus from the National Institutes of Health on gender diverse and sexual minority individuals, D’Angelo said, would also be welcome.
“There are things out there that the federal government can do, but I think…there are limitations of what they can do,” D’Angelo said. “They can’t, unfortunately, effect what’s going on in individual states, which is, in some cases draconian. That’s an awful thought if we were practicing medicine in Arkansas, we could be in jail.”
Meanwhile, Levine said the Biden administration, including Secretary of Health & Human Services Xavier Becerra, is working on both internal and external policies to facilities like the Youth Pride Clinic to help them secure their place in the health system and reach transgender youth.
“The secretary and I will be doing everything we can to advocate for the LGBTQ community,” Levine said. “So I think we’re going to be working externally, in terms of advocacy, and then we’re going to be working internally in terms of policy.”
Federal Government
Holiday week brings setbacks for Trump-Vance trans agenda
Federal courts begin to deliver end-of-year responses to lawsuits involving federal transgender healthcare policy.
While many Americans took the week of Christmas to rest and relax, LGBTQ politics in the U.S. continued to shift. This week’s short recap of federal updates highlights two major blows to the Trump-Vance administration’s efforts to restrict gender-affirming care for minors.
19 states sue RFK Jr. to end gender-affirming care ban
New York Attorney General Letitia James announced on Tuesday that the NYAG’s office, along with 18 other states (and the District of Columbia), filed a lawsuit to stop U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. from restricting gender-affirming care for minors.
In the press release, Attorney General James stressed that the push by the Trump-Vance administration’s crusade against the transgender community — specifically transgender youth — is a “clear overreach by the federal government” and relies on conservative and medically unvalidated practices to “punish providers who adhere to well-established, evidence-based care” that support gender-affirming care.
“At the core of this so-called declaration are real people: young people who need care, parents trying to support their children, and doctors who are simply following the best medical evidence available,” said Attorney General James. “Secretary Kennedy cannot unilaterally change medical standards by posting a document online, and no one should lose access to medically necessary health care because their federal government tried to interfere in decisions that belong in doctors’ offices. My office will always stand up for New Yorkers’ health, dignity, and right to make medical decisions free from intimidation.”
The lawsuit is a direct response to HHS’ Dec. 18 announcement that it will pursue regulatory changes that would make gender-affirming health care for transgender children more difficult, if not impossible, to access. It would also restrict federal funding for any hospital that does not comply with the directive. KFF, an independent source for health policy research, polling, and journalism, found that in 2023 federal funding covered nearly 45% of total spending on hospital care in the U.S.
The HHS directive stems directly from President Donald Trump’s Jan. 28 Executive Order, Protecting Children From Chemical and Surgical Mutilation, which formally establishes U.S. opposition to gender-affirming care and pledges to end federal funding for such treatments.
The American Medical Association, the nation’s largest and most influential physician organization, has repeatedly opposed measures like the one pushed by President Trump’s administration that restrict access to trans health care.
“The AMA supports public and private health insurance coverage for treatment of gender dysphoria and opposes the denial of health insurance based on sexual orientation or gender identity,” a statement on the AMA’s website reads. “Improving access to gender-affirming care is an important means of improving health outcomes for the transgender population.”
The lawsuit also names Oregon, Washington, California, Colorado, Connecticut, Delaware, the District of Columbia, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Mexico, Pennsylvania, Rhode Island, Vermont, and Wisconsin as having joined New York in the push against restricting gender-affirming care.
At the HHS news conference last Thursday, Jim O’Neill, deputy secretary of the department, asserted, “Men are men. Men can never become women. Women are women. Women can never become men.”
DOJ stopped from gaining health care records of trans youth
U.S. District Judge Cathy Bissoon blocked an attempt by the Department of Justice (DOJ) to gain “personally identifiable information about those minor transgender patients” from the University of Pittsburgh Medical Center (UPMC), saying the DOJ’s efforts “fly in the face of the Supreme Court.”
Journalist Chris Geidner originally reported the news on Dec. 25, highlighting that the Western District of Pennsylvania judge’s decision is a major blow to the Trump-Vance administration’s agenda to curtail transgender rights.
“[T]his Court joins the others in finding that the government’s demand for deeply private and personal patient information carries more than a whiff of ill intent,” Bissoon wrote in her ruling. “This is apparent from its rhetoric.”
Bissoon cited the DOJ’s “incendiary characterization” of trans youth care on the DOJ website as proof, which calls the practice politically motivated rather than medically sound and seeks to “…mutilate children in the service of a warped ideology.” This is despite the fact that a majority of gender-affirming care has nothing to do with surgery.
In United States v. Skrmetti, the Supreme Court ruled along party lines that states — namely Tennessee — have the right to pass legislation that can prohibit certain medical treatments for transgender minors, saying the law is not subject to heightened scrutiny under the Equal Protection Clause of the Fourteenth Amendment because it does not involve suspect categories like race, national origin, alienage, and religion, which would require the government to show the law serves a compelling interest and is narrowly tailored, sending decision-making power back to the states.
“The government cannot pick and choose the aspects of Skrmetti to honor, and which to ignore,” Judge Bissoon added.
The government argued unsuccessfully that the parents of the children whose records would have been made available to the DOJ “lacked standing” because the subpoena was directed at UPMC and that they did not respond in a timely manner. Bissoon rejected the timeliness argument in particular as “disingenuous.”
Bissoon, who was nominated to the bench by then-President Obama, is at least the fourth judge to reject the DOJ’s attempted intrusion into the health care of trans youth according to Geidner.
A Wider Bridge on Friday announced it will shut down at the end of the month.
The group that “mobilizes the LGBTQ community to fight antisemitism and support Israel and its LGBTQ community” in a letter to supporters said financial challenges prompted the decision.
“After 15 years of building bridges between LGBTQ communities in North America and Israel, A Wider Bridge has made the difficult decision to wind down operations as of Dec. 31, 2025,” it reads.
“This decision comes after challenging financial realities despite our best efforts to secure sustainable funding. We deeply appreciate our supporters and partners who made this work possible.”
Arthur Slepian founded A Wider Bridge in 2010.
The organization in 2016 organized a reception at the National LGBTQ Task Force’s Creating Change Conference in Chicago that was to have featured to Israeli activists. More than 200 people who protested against A Wider Bridge forced the event’s cancellation.
A Wider Bridge in 2024 urged the Capital Pride Alliance and other Pride organizers to ensure Jewish people can safely participate in their events in response to an increase in antisemitic attacks after Hamas militants attacked Israel on Oct. 7, 2023.
The Jewish Telegraphic Agency reported authorities in Vermont late last year charged Ethan Felson, who was A Wider Bridge’s then-executive director, with lewd and lascivious conduct after alleged sexual misconduct against a museum employee. Rabbi Denise Eger succeeded Felson as A Wider Bridge’s interim executive director.
A Wider Bridge in June honored U.S. Rep. Debbie Wasserman Schultz (D-Fla.) at its Pride event that took place at the Capital Jewish Museum in D.C. The event took place 15 days after a gunman killed two Israeli Embassy employees — Yaron Lischinsky and Sarah Milgrim — as they were leaving an event at the museum.
“Though we are winding down, this is not a time to back down. We recognize the deep importance of our mission and work amid attacks on Jewish people and LGBTQ people – and LGBTQ Jews at the intersection,” said A Wider Bridge in its letter. “Our board members remain committed to showing up in their individual capacities to represent queer Jews across diverse spaces — and we know our partners and supporters will continue to do the same.”
Editor’s note: Washington Blade International News Editor Michael K. Lavers traveled to Israel and Palestine with A Wider Bridge in 2016.
The White House
‘Trump Rx’ plan includes sharp cuts to HIV drug prices
President made announcement on Friday
President Donald Trump met with leaders from some of the world’s largest pharmaceutical companies at the White House on Friday to announce his new “Trump Rx” plan and outline efforts to reduce medication costs for Americans.
During the roughly 47-minute meeting in the Roosevelt Room, Trump detailed his administration’s efforts to cut prescription drug prices and make medications more affordable for U.S. patients.
“Starting next year, American drug prices will come down fast, furious, and will soon be among the lowest in the developed world,” Trump said during the meeting. “For decades, Americans have been forced to pay the highest prices in the world for prescription drugs by far … We will get the lowest price of anyone in the world.”
Trump signed an executive order in May directing his administration “to do everything in its power to slash prescription drug prices for Americans while getting other countries to pay more.”
“This represents the greatest victory for patient affordability in the history of American health care, by far, and every single American will benefit,” he added.
Several pharmaceutical executives stood behind the president during the announcement, including Sanofi CEO Paul Hudson, Novartis CEO Vas Narasimhan, Genentech CEO Ashley Magargee, Boehringer Ingelheim (USA) CEO Jean-Michel Boers, Gilead Sciences CEO Dan O’Day, Bristol Myers Squibb General Counsel Cari Gallman, GSK CEO Emma Walmsley, Merck CEO Robert Davis, and Amgen Executive Vice President Peter Griffith.
Also in attendance were Health and Human Services Secretary Robert F. Kennedy Jr., Commerce Secretary Howard Lutnick, Centers for Medicare and Medicaid Services Administrator Mehmet Oz, and Food and Drug Administration Commissioner Marty Makary.
Under the Trump Rx plan, the administration outlined a series of proposed drug price changes across multiple companies and therapeutic areas. Among them were reductions for Amgen’s cholesterol-lowering drug repatha from $573 to $239; Bristol Myers Squibb’s HIV medication reyataz from $1,449 to $217; Boehringer Ingelheim’s type 2 diabetes medication jentadueto from $525 to $55; Genentech’s flu medication xofluza from $168 to $50; and Gilead Sciences’ hepatitis C medication epclusa from $24,920 to $2,425.
Additional reductions included several GSK inhalers — such as the asthma inhaler advair diskus 500/50, from $265 to $89 — Merck’s diabetes medication januvia from $330 to $100, Novartis’ multiple sclerosis medication mayzent from $9,987 to $1,137, and Sanofi’s blood thinner plavix from $756 to $16. Sanofi insulin products would also be capped at $35 per month’s supply.
These prices, however, would only be available to patients who purchase medications directly through TrumpRx. According to the program’s website, TrumpRx “connects patients directly with the best prices, increasing transparency, and cutting out costly third-party markups.”
Kennedy spoke after Trump, thanking the president for efforts to lower pharmaceutical costs in the U.S., where evidence has shown that drug prices — including both brand-name and generic medications — are nearly 2.78 times higher than prices in comparable countries. According to the Pharmaceutical Research and Manufacturers of America, roughly half of every dollar spent on brand-name drugs goes to entities that play no role in their research, development, or manufacturing.
“This is affordability in action,” Kennedy said. “We are reversing that trend and making sure that Americans can afford to get the life-saving solutions.”
Gilead CEO Dan O’Day also spoke about how the restructuring of drug costs under TrumpRx, combined with emerging technologies, could help reduce HIV transmission — a virus that, if untreated, can progress to AIDS. The LGBTQ community remains disproportionately affected by HIV.
“Thank you, Mr. President — you and the administration,” O’Day said. “I think this objective of achieving the commitment to affordability and future innovation is extraordinary … We just recently launched a new medicine that’s only given twice a year to prevent HIV, and we’re working with Secretary Kennedy and his entire team, as well as the State Department, as a part of your strategy to support ending the epidemic during your term.
“I’ve never been more optimistic about the innovation that exists across these companies and the impact this could have on America’s health and economy,” he added.
Trump interjected, asking, “And that’s working well with HIV?”
“Yes,” O’Day replied.
“It’s a big event,” Trump said.
“It literally prevents HIV almost 100 percent given twice a year,” O’Day responded.
A similar anti-HIV medication is currently prescribed more than injectable form mentioned by O’Day. PrEP, is a medication regimen proven to significantly reduce HIV infection rates for people at high risk. Without insurance, brand-name Truvada can cost roughly $2,000 per month, while a generic version costs about $60 per month.
Even when medication prices are reduced, PrEP access carries additional costs, including clinic and laboratory fees, office visits, required HIV and sexually transmitted infection testing, adherence services and counseling, and outreach to potentially eligible patients and providers.
According to a 2022 study, the annual total cost per person for PrEP — including medication and required clinical and laboratory monitoring — is approximately $12,000 to $13,000 per year.
The TrumpRx federal platform website is now live at TrumpRx.gov, but the program is not slated to begin offering reduced drug prices until January.
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