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.”
Two anti-LGBTQ bills die in Va. Senate
Democrats maintain 21-19 majority in chamber
Two anti-LGBTQ bills died in the Virginia Senate on Thursday.
A Senate Education subcommittee voted against state Sen. Travis Hackworth (R-Tazewell County)’s Senate Bill 20, which would have eliminated the requirement that school districts must implement the Virginia Department of Education’s transgender and non-binary student guidelines.
The Senate General Laws and Technology Committee in an 8-7 vote tabled state Sen. Mark Peake (R-Lynchburg)’s Senate Bill 177, a religious freedom measure that critics contend would have allowed anti-LGBTQ discrimination in housing.
Virginia’s statewide nondiscrimination law includes sexual orientation and gender identity. Peake’s bill would have removed “the provision of the exemption for religious organizations under the Virginia Fair Housing Law that denies such exemption where the membership in such religion is restricted on account of race, color, national origin, sex, elderliness, familial status, sexual orientation, gender identity, military status, or disability.”
The General Assembly’s 2022 legislative session began on Jan. 12 with Republicans in control of the House of Delegates. Republican Gov. Glenn Youngkin took office three days later.
Democrats, who maintain a 21-19 majority in the state Senate, have vowed to block any anti-LGBTQ bill.
Department of Education investigating BYU LGBTQ+ discipline policy
“They’ve wronged marginalized communities at BYU and they need to be held accountable for it” ~ former gay student at BYU
PROVO, Ut. – The U.S. Department of Education has opened an investigation into policies at Brigham Young University (BYU) that discipline LGBTQ students, aiming to determine whether or not the private religious school, owned by the Church of Jesus Christ of Latter-day Saints (LDS), is violating their civil rights.
The Education Department is investigating a complaint that came after BYU removed rules banning “homosexual activity” from its honor code in 2020, only to clarify weeks later that same-sex partnerships were still prohibited.
The probe, which opened in October of last year, will focus on Title IX, a law prohibiting universities from discriminating against students and others based on gender.
Last year, President Joe Biden signed an executive order mandating every federal agency, including the Education Department, clarify that civil rights laws protect LGBTQ people from discrimination. However, religious schools have Title IX exemptions, making federal scrutiny rare.
“It’s really significant that investigators are stepping in now,” Michael Austin, a BYU alumnus and vice president at the University of Evansville, told the Salt Lake Tribune. “It means there’s some reason to think the university has gone beyond the religious exemptions it has and is discriminating even beyond those.”
The investigation, headed by the Office of Civil Rights within the department, seems to be about whether faith-based exemptions apply even if the behavior is not directly related to education or expressly written in the honor code. BYU also bans alcohol, beards and piercings, among other things.
BYU did not respond to the Blade’s request for comment. But a spokesperson told the Associated Press that the school does not anticipate any further action because “BYU is exempt from application of Title IX rules that conflict with the religious tenets” of the LDS.
Though the LDS has softened some of its rules around LGBTQ issues, the church remains opposed to same-sex marriage and sex outside of marriage.
In a November 2021 letter to the Education Department, Kevin Worthen, president of BYU, argued that religious exemptions do apply to the school. The letter adds that all BYU students, faculty, administrators and staff “‘voluntarily commit to conduct their lives in accordance with the principles of the gospel of Jesus Christ.’”
The Department of Education responded to the letter, affirming that the university has some religious exemptions, but the department had to investigate if the complaint falls under those exemptions.
An Education Department spokesperson confirmed the investigation to the Blade but declined further comment.
Queer students at BYU celebrated the school’s removal of the anti-LGBTQ language in the honor code. Yet, the university announced weeks later that there was “some miscommunication” as to what the changes meant, clarifying that “the principles of the Honor Code remain the same.”
Bradley Talbot, a former gay student at BYU, was on campus during the apparent reversal, saying it “instilled a lot of fear and a lot of students.”
“There are still a lot of feelings of betrayal and apprehension around it,” he told the Blade.
At BYU, students who hold hands or kiss someone of the same sex can face punishment, including expulsion. LGBTQ+ students face harsher discipline than heterosexual couples at the school.
Talbot said he knew of “quite a few people” who lost their degrees and were kicked out during his time at BYU because of the gay dating ban. “People were turned in by roommates. Some people were turned in by their own parents,” he added.
The university’s clarification frustrated LGBTQ students, according to Talbot. In response, he organized a demonstration in March of 2021, lighting the “Y” that sits above BYU’s campus – one of the school’s oldest traditions – in rainbow Pride colors on the one year anniversary of the university’s letter sent to students that clarified the LGBTQ dating policy.
“We did it to reclaim that traumatic day and spin in a positive light of support, love and unity to create more visibility and awareness,” said Talbot. “And also to take a stand that we weren’t going to put up with just being tossed around by BYU. We deserve to be a part of the BYU community and a part of the LGBTQ community.”
The school has since updated its policies, banning protests and other demonstrations on Y Mountain, where Talbot staged his demonstration, in December of last year.
“Demonstrations should be consistent with BYU’s faith-based mission, intellectual environment and requirements described in the policy,” a statement added.
Still, Talbot, who is now graduated, has hope that the Education Department’s investigation will “finally change” things at BYU. “This has been something that’s been going on for decades,” he said. “They’ve wronged marginalized communities at BYU and they need to be held accountable for it.”
LGBTQ advocates fight on for trans athletes, but they may be losing the battle
Transgender women competing in women’s sports remains unpopular in polls
In the wake of the NCAA changing its policies regarding transgender athletes and state legislatures advancing new legislation against trans inclusion in school sports, LGBTQ advocates continue the fight to ensure athletes can compete consistent with their gender identity, although they may be losing the battle.
As public polling has demonstrated, transgender athletes competing in sports — especially trans women in women’s sports — remains unpopular even among pro-transgender people. Key figures have emerged in recent days opposing transgender inclusion amid the focus on Lia Thomas, a recently transitioned swimmer at the University of Pennsylvania who has been smashing records in women’s aquatics.
Nonetheless, LGBTQ advocates charged with fighting for transgender rights are continuing the efforts. After a coalition of LGBTQ advocates sent a letter to the NCAA urging the organization to include a non-discrimination provision in its updated constitution, the Human Rights Campaign condemned the organization for refusing to keep the language, which appears to have the effect of allowing the sports division to decline to allow transgender athletes to compete consistent with their gender identity, and sent an action alert to supporters.
Joni Madison, interim president of the Human Rights Campaign, said in a statement the NCAA “needs to show us their playbook for protecting LGBTQ+ and specifically transgender athletes from discrimination” as state legislatures advance legislation against transgender kids in sports.
“The NCAA has so far proven to be an unreliable ally to LGBTQ+ athletes across the country who depend upon the organization to protect them from discrimination and now they owe these athletes answers,” Madison said.
Instead of reaffirming non-discrimination protections, the NCAA announced a change in policy that goes in different directions but appears aimed at limiting participation of transgender women without taking full responsibility for it. On one hand, the NCAA delegates to the bodies governing individual sports the policies for transgender participation, but on the other hand requires transgender women to document having limited testosterone levels over a certain period of time.
The fight now continues in state legislatures as sports bills are among the latest crop of measures seeking to limit access for transgender people. After South Dakota Gov. Kristi Noem made a push for legislation against transgender kids in sports at the start of the year, the state legislature responded by advancing such a measure. On Wednesday, a South Dakota House committee favorably reported out legislation already approved by wide margins in the Senate that would make biological sex the standard for sports in an attempt to limit transgender participation.
Sam Ames, director of advocacy and government affairs at The Trevor Project, said in a statement upon the committee vote the legislation “has nothing to do with fairness — and everything to do with South Dakota politicians using transgender youth as pawns on a political chessboard.
“Proponents of this blanket ban are hard-pressed to find examples of transgender students making South Dakota sports less fair or safe,” Ames said. “Research from The Trevor Project makes clear that many already opt out of sports due to fear of bullying and discrimination.”
Although the issue of transgender women in sports has emerged in recent years as conservative activists found a way to challenge LGBTQ rights in a way that was palatable to the public, the fervor peaked as Thomas made headlines for breaking records in the pool.
After having previously competed in men’s aquatics, Thomas — after she transitioned — began competing in women’s events and was beating her competitors by wide margins. In one event in December, Thomas came in first in the 1,650-yard freestyle and 38 seconds ahead of her closest competitor. The NCAA rules would appear to have the effect of barring Thomas from further competition.
Public polling, which has shown strong support for LGBTQ rights in general, continues to show the sentiment is against transgender women competing in sports, although the outcome of the poll can change considerably depending on the wording of the question. One Gallup poll last year found only 34 percent of those surveyed supported transgender athletes participating on teams consistent with their gender identity, while 62 percent said transgender people should have to compete with other athletes of their gender designated at birth.
One LGBTQ strategist, who agreed to speak on condition of anonymity, said the time may have come for LGBTQ advocates to admit a fait accompli if they want to seek broader civil rights protections in employment, housing and public accommodations with the Equality Act or other federal legislation.
“Advocates should just admit this is a very different issue than a trans person applying for a job or finding an apartment,” the strategist said. “Equality principles differ by situation — that’s why we have separate men’s and women’s sports in the first place. The same public opinion overwhelmingly supportive of the Equality Act is also clearly skeptical of a one size fits all federalization of all sports everywhere.”
Adding fuel to the fire are recent comments from key figures in athletics.
Caitlyn Jenner, who before she transitioned was an Olympic champion in the 1970s, has been among the more prominent voices to speak out against transgender women in sports and said on a recent appearance on Fox News it represents “a woke world gone wild.”
Jenner, who came out against transgender participation in sports during her unsuccessful gubernatorial campaign last year in the California recall election, said the NCAA “just kicked the can down the road” on the transgender sports issue and had choice words for Thomas.
“When you do transition and you do go through this, you have to take responsibility and you have to have integrity,” Jenner said. “I don’t know why she’s doing this.”
Michael Phelps, the decorated Olympic swimmer, also declined to support transgender athletes fully when asked about the issue during an interview on CNN, bringing up doping in sports in comparison.
“I don’t know what it looks like in the future,” Phelps said. “It’s hard. It’s very complicated and this is my sport, this has been my sport my whole entire career, and honestly the one thing I would love is everybody being able to compete on an even playing field.”
To be sure, advocates for allowing transgender people to compete in sports consistent with their gender identity also have their supporters in the sports world, including tennis legend Billie Jean King. On Monday, Dorian Rhea Debussy, who’s non-binary and one of 54 facilitators in the NCAA Division III LGBTQ OneTeam program, resigned in protest over recent NCAA actions.
“I’m deeply troubled by what appears to be a devolving level of active, effective, committed, and equitable support for gender diverse student-athletes within the NCAA’s leadership,” Debussy said. “As a non-binary, trans-feminine person, I can no longer, in good conscience, maintain my affiliation with the NCAA.”
Arguably, schools complying with the new NCAA policy and states enacting anti-transgender laws would be violating Title IX of the Education Amendment of 1972, which prohibits discrimination on the basis of sex in education, especially after the U.S. Supreme Court’s ruling in Bostock v. Clayton County finding anti-transgender discrimination is a form of sex discrimination.
One federal court last year blocked a West Virginia state law against transgender participation in sports on that legal basis. No litigation, however, appears to be in the works at this time challenging colleges or the NCAA policy.
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