Opinions
The LGBTQ+ community, telehealth, and rural broadband access
Congress must act to preserve lifeline of remote healthcare
The LGBTQ+ community has come to rely more and more on remote general and specialized healthcare as the pandemic continues to limit access to in-person services. This lifeline is in danger of going away unless Congress acts, delivering a serious blow to the diverse community of people who struggle to access care in-person in their communities.
Telehealth allows doctors and other providers to provide care without an in-person visit. More specifically, telehealth refers to the health care services accessible through telecommunications services, including via audio and video (either real time or asynchronous). These services are best delivered via high-speed broadband services. Medical care appointments, consultations, prescriptions, follow-up visits, and more can be done safely and virtually.
Telehealth is a modern necessity made even more relevant due to the ongoing COVID-19 pandemic, and demand for these resources is growing. The LGBTQ+ community in particular is experiencing a significant need for improved telehealth provisions and access. Recent relaxations of telehealth regulations have expanded the reach of telehealth and positively impacted marginalized communities including the LGBTQ+ community, especially in rural and remote areas. Effective and reliable broadband access is instrumental for telehealth services and as telehealth expands, advancements to universal broadband access will be critical to reach these communities.
Telehealth and the LGBTQ+ community
More than 18 million Americans identify as lesbian, gay, bisexual, transgender, queer, questioning, or intersex (LGBTQ+), and more younger Americans than ever before are identifying as LGBTQ+. The health concerns of these individuals deserve utmost respect and care, demonstrable through high-quality health care both in person and online. Telehealth plays an important role in connecting the LGBTQ+ community with competent and affirming health care providers and services. The LGBTQ+ community has always been more heavily reliant on internet connectivity, and healthcare is no different, with 81% of LGBTQ+ youth reportedly using the internet to search for health information.
LGBTQ+ communities face many of the same healthcare concerts as non-LGBTQ+ communities, though there are differences in rates of some chronic conditions including cancer, diabetes, obesity, HIV/AIDS and other sexually transmitted infections (STIs), and tobacco-related health conditions. LGBTQ+ individuals have higher rates of mental and physical disability, and the impact of loneliness on health quality is experienced at higher rates by LGBTQ+ individuals in both urban and rural settings. Routine healthcare for these conditions improves quality of life, but LGBTQ+ individuals often report high cost as a deterrent from going to the doctor. Telehealth provides an affordable avenue to routine health care.
Many individuals in the LGBTQ+ community report a history of medical trauma as a barrier to receiving healthcare. Gender-affirming health care is one major motivator for telehealth access in the LGBTQ+ community. Nearly one-fifth of transgender individuals have been refused healthcare due to their gender identity. Online servers such as Folx Health, Plume, and QueerDoc provide gender-affirming care including hormone therapy, mental health, and documents for gender marker change. Telehealth allows users to bypass the barrier of proximity to medical care and to access providers who are informed on medical concerns and considerations that uniquely impact the LGBTQ+ community.
Regulations that previously restricted the delivery of telehealth have been eased since the onset of the COVID-19 pandemic. Specifically, rules previously limited telehealth to rural areas received in a clinical setting. The new rules allow urban and suburban patients to access telehealth from their home or other convenient setting. This makes sense as many urban areas lack convenient access to physicians and other providers. Individuals across America have benefitted from the ability to access basic health services at home, but those whose care has been most significantly enhanced are poor, elderly, members of marginalized communities such as the LGBTQ+ community, and/or those who live in remote areas of the country. For example, the total number of telehealth visits in Medicare increased from less than 1 million to more than 50 million during COVID.
There are currently hundreds of proposals pending before state and federal legislatures that address extending or expanding telehealth beyond the pandemic’s public health emergency. Current changes to telehealth regulations include loosened restrictions around telephone-based check-ins and the allowance for telehealth visits between providers and persons across state borders. Before the pandemic, patients filled a prescription after first meeting with a doctor in-person, but telehealth expansion has eliminated the required in-person appointment. Telehealth treatment for addiction is also on the rise, with addiction-specific treatments available online. General mental health resources are also increasingly accessible virtually and by phone. Now that these practices are commonplace, regulators are looking to pass legislation that will maintain this ease of service.
The expansion of telehealth has proven especially effective for the LGBTQ+ community. Easing accessibility of telehealth and prescriptions reduces the cost of care for routine medicines and check-ups for conditions that disproportionately affect the LGBTQ+ community, such as HIV. Increased availability of telehealth mental resources is critical for all youth, but especially for those in the marginalized LGBTQ+ community. Through online resources, transgender adults can safely and reliably access gender-affirming healthcare including hormone replacement therapy and counseling with specialized professionals. Additionally, telehealth access can reduce or eliminate the stigma and discrimination that LGBTQ+ individuals face daily when selecting providers, especially in remote or rural areas where there may be few providers to choose from and even fewer knowledgeable about and sympathetic to the special health care needs of LGBTQ+ individuals. Making permanent the COVID-19 exemptions currently in place that regulate telehealth services will have far-reaching, positive impacts for the LGBTQ+ community.
Rural need for telehealth
An estimated 2.9 to 3.8 million Americans living in rural and remote parts of the country identify as LGBTQ+ and deserve high-quality and informed healthcare. Accessing a healthcare provider is, in general, more challenging in rural areas. Consider, for example, costs associated with distance. To add insult to injury, where providers are available in rural communities, the potential for discrimination against LGBTQ+ individuals and misdiagnosis of medical conditions is prevalent. Lack of access to sympathetic providers or specialized providers makes telehealth a crucial tool for the rural LGBTQ+ community.
Given the need for broadband access to ensure quality telehealth services (to access video consultations, for example), the quality of an individual’s access to broadband services will directly affect their health care experience. Rural Americans are routinely left behind in broadband deployment, contributing to the digital divide, or the gap in use of online resources. Improvements to broadband access is key for expanding the reach of telehealth services across the country, especially in rural America. The recently enacted infrastructure law includes $65 billion in new broadband funding. It must be rolled out quickly to ensure marginalized communities in rural areas gain from improvements to broadband access and the telehealth resources that come along with it.
Telehealth has become a critical tool to expand access for all patients, but especially the LGBTQ+ community. Marginalized individuals benefit the most from increased telehealth access and those living in rural areas may be the most significantly impacted. Telehealth offers a number of benefits including facilitating community health and social wellness, the delivery of gender-affirming medical care, accessible mental health care, and ease of prescription access.
Recently relaxed regulations around telehealth delivery have increased the reach of these services and provided healthcare to individuals who may have gone without care. Rural and remote marginalized communities, such as the LGBTQ+ community, will experience an especially positive impact from telehealth, and increasing rural broadband access is critical to expanding high-quality, informed healthcare to LGBTQ+ individuals across America. Crucially, Congress can permanently expand telehealth services and capitalize on the recent infrastructure law to roll out high-speed broadband that facilitates telehealth in areas with limited internet access. Without congressional action, many of the benefits marginalized communities have experienced from telehealth services will expire thereby reducing or eliminating supportive and specialized care options for these communities.
For more information visit www.LGBTQ+tech.org/telehealth.
Carlos Gutierrez is deputy director and general counsel for the LGBT Technology Partnership & Institute, which works to improve access, increase inclusion, ensure safety and empower entrepreneurship for LGBTQ+ communities around technology.
Opinions
Trump’s ‘American people derangement syndrome’
Voters must stop him before he destroys democracy
Trump, in a deranged, evil, post on X, accused Rob Reiner of suffering from “Trump derangement syndrome.” I guess that would apply to everyone who thinks Trump is an evil, dangerous, asshole who is trying to destroy our society as we know it. With that definition, I would surmise the felon himself suffers from “American people derangement syndrome,” because clearly, he thinks we are all evil, dumb, assholes, and a danger to him, and the fascists surrounding him.
His speech to the nation was called bellicose, by the New York Times. I would call it unhinged and vile. It was a plea to the populace, containing a pack of lies, to continue to believe his lies, and distortions. We all know the felon is full of shit when telling us prices have come down. We go shopping every week to feed ourselves and our families, even if he doesn’t. We have to pay heating and rent bills each month. We know since he became president nearly a year ago, all those costs have gone up. Talk to any honest person at a chamber of commerce in your area, and they will tell you small businesses are suffering. They will tell you the felon’s tariffs are hurting everyone. We know he is screwing the poor and middle class; trying to end SNAP benefits, and refusing to help with healthcare costs. All the while giving tax breaks to corporations, and the rich. People are not dumb Mr. Felon, and your lies are no longer resonating.
The evil, deranged, felon in the White House lives in a world where he can do favors for his friends in return for getting them to donate hundreds of millions for his follies. He is a grifter who hosts dinners for rich people to make money for his crypto business. He is said to have made more than $3 billon since his election. This while farmers are going broke, and losing their farms, because his tariffs screwed them. He is undermining vaccines and caused a measles epidemic in the United States. This a disease eradicated before he came into office. He ended grants to research cures for HIV/AIDS, Parkinson’s, Alzheimer’s, cancer, and an assortment of childhood diseases. He stopped research grants for mRNA vaccines. When we have the next pandemic, and it will come, that will result in millions of deaths, all on his head.
He is embarrassing the United States around the world. They watch him give unhinged speeches, raise and lower tariffs irrationally, screw our allies, and now trying to interfere in their elections. He is bombing fishing boats, claiming they are carrying drugs, with no proof at all. Then he releases from prison the man who brought more cocaine into the country than anyone else ever did. All this is what the lying, cheating, grifting, evil, heartless, felon in the White House, is doing to you, the good people of the United States, and the world. He sounds more unhinged every day while trying to blame everything on former President Biden and Democrats, who haven’t controlled the levers of government in nearly a year.
I know the results of the 2025 elections must scare him. They show him the majority no longer accept his BS. We will go into 2026, and the midterm elections, with our eyes wide open. He wants to be King and we don’t want kings in our country. He has what his chief of staff calls, “an alcoholic’s personality” “because he believes there’s nothing he can’t do.” She is right about that, but we will call him on it in the next election. We will say clearly, with our voices, and our votes, “no more, enough is enough.” We are taking back the country and will throw out anyone in office who still supports him.
We try and forgive those who voted for him, as long as they now recognize he lied to them, and is screwing them. Young people must understand they will suffer their whole lives because he is a climate denier. Latino and Hispanic voters, who believed he was going to support them, now see he wants to deport them. Farmers who once thought he supported them, until he screwed them. We must now all join together, and show the evil SOB in the White House, who is building his grand ballroom, taking planes, and other gifts, and pardoning the guilty; his time is coming to an end. Again, we will go into the voting booth, eyes wide open, and vote to stop him before he completely destroys our lives, our families, our democracy, and brings fascism to our country.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
Opinions
Using movement to boost your mental health during holidays
Sometimes the goal is simply steadiness
We’re told this is the season of Ho Ho Ho. Joy. Family. Home.
But let’s be honest. The holidays are stressful for almost everyone. Even in the best situations, this time of year comes with pressure. Expectations. Family dynamics. Financial stress. Comparison. The emotional labor of trying to make everything feel warm and magical while quietly holding a lot inside.
For some people, home is comfort. For others, it’s complicated. A place where old roles come back fast. Where you’re expected to be a version of yourself that no longer fits. Where love exists, but understanding feels incomplete.
And for many of us in the LGBTQ community, that stress can carry extra weight. Sitting at tables where parts of who you are feel debated instead of celebrated. Navigating politics and beliefs that don’t feel abstract, but personal. Deciding when to speak up, when to stay quiet, and when to just go refill your drink. Grief changes how the holidays land.
For me, the holidays have often been quiet. I’m deeply grateful for the family I still have and the support they’ve given me, and I also need to be real. I’ve been jealous. Jealous AF. Jealous that I can’t go home and hug my mother. Jealous that my dad isn’t there. Jealous when I see the cozy movie version of the holidays play out in other people’s lives. Not because they don’t deserve it, but because I wish I had it too.
Long before fitness became my career, the gym was my sanctuary. Without movement, these seasons would have been much harder. My body changed as a byproduct, sure, but what movement gave me first was something more important. Stability. A place to put grief. A way to move stress out of my body when words weren’t enough. Stress doesn’t just live in the mind.
We like to think stress is something we can talk through or think our way out of. But stress and anxiety live in the body. Chronic stress has been shown to disrupt sleep, weaken the immune system, and show up physically as tension, fatigue, and pain. When it’s left unaddressed, it doesn’t just affect how we feel emotionally. It affects how we function.
Most people don’t come into fitness because they’re thriving. After 20 years of coaching, almost everyone I’ve met started with physical goals. Lose weight. Build muscle. Look different. What they don’t always see is how stress, burnout, emotional eating, and putting everyone else first got them there. Most people aren’t failing. They’re exhausted.
When we talk about mental health, we think about therapy, medication, boundaries, vacations, or staying away from that one family member who always finds a way to press your buttons. All of those things matter. They save lives. But movement is rarely treated as part of the mental health plan, even though every single person who moves consistently feels better mentally. Not perfect. Just better. As my business partner Chase likes to say, sexy is the side effect. This isn’t just empathy. It’s a strategy.
The holidays don’t sneak up on us. We know which dinners will be hard. We know which brunches will test our patience. We know which days we’ll feel alone. So instead of raw-dogging our way through it, we can prep for it.
First, plan your movement the same way you plan the hard stuff. If you know a dinner is going to be stressful, don’t show up already hot. Schedule your workout that day, the day before, or in the days leading up so your nervous system is already in a better place. You’re not trying to win the day. You’re trying to lower the starting line.
Second, give yourself time limits. You don’t have to do the full four hours. There’s a lot of space between not showing up at all and staying until you’re emotionally fried. Do an hour. Schedule a fake work meeting if you have to. Show up in a way that lets you stay in character and protect your peace. That still counts.
Third, move how you can move. If you’re traveling, alone, out of routine, or your gym is closed, it doesn’t have to be perfect. Twenty minutes works. A walk works. A jog works. A short breathing or meditation session works. Even a quick bodyweight circuit in your childhood bedroom works. And if you need ideas, we share our monthly programming and workouts on the SWEAT DC Instagram so anyone can follow along and move, wherever they are.
Fitness doesn’t have to look good to be effective. It just has to be intentional. Especially this time of year.
As the year comes to a close, my hope isn’t that this season suddenly feels easy. It’s that you feel supported. That you remember movement isn’t about punishment or perfection. It’s about care.
Sometimes the goal isn’t happiness. Sometimes the goal is steadiness. And honestly, some years, that’s a win. We can do that. And we don’t have to do it alone.
Gerard Burley, also known as Coach G, is founder and CEO of Sweat DC.
Commentary
Protecting the trans community is not optional for elected allies and candidates
One of oldest political tactics is blaming vulnerable group for societal woes
Being an ally to the trans community is not a conditional position for me, nor should it be for any candidate. My allyship doesn’t hinge on polling, focus groups, or whether courage feels politically convenient. At a time when trans people, especially trans youth of color, are under coordinated attack, elected officials and candidates must do more than offer quiet support. We must take a public and solid stand.
History shows us how these moments begin. One of the oldest political tactics is to single out the most vulnerable and blame them for society’s anxieties — not because they are responsible, but because they are easier to blame than those with power and protection. In Nazi Germany, Jewish people were primarily targeted, but they were not the only demographic who suffered elimination. LGBTQ people, disabled people, Romani communities, political dissidents, and others were also rounded up, imprisoned, and killed. Among the earliest acts of fascistic repression was the destruction of Berlin’s Institute for Sexual Science, a pioneering center for gender-affirming care and LGBTQ research. These books and medical records were among the first to be confiscated and burned. It is not a coincidence that these same communities are now the first to suffer under this regime, they are our canaries in the coal mine signaling what’s to come.
Congress, emboldened by the rhetoric of the Donald Trump campaign, recently passed HR 3492 to criminalize healthcare workers who provide gender-affirming healthcare with fines and imprisonment. This bill, sponsored by celebrity politicians like Marjorie Taylor Greene, puts politics and headlines over people and health outcomes. Healthcare that a number of cis-gendered people also benefit from byway of hair regeneration and surgery, male and female breast augmentation, hormone replacement therapy etc. Even when these bills targeting this care do not pass, they do real damage. They create fear among patients, legal uncertainty for providers, and instability for clinics that serve the most marginalized people in our communities.
Here in D.C., organizations like Planned Parenthood and Whitman-Walker Health are lifelines for many communities. They provide gender-affirming care alongside primary care, mental health services, HIV treatment, and preventative medicine. When healthcare is politicized or criminalized, people don’t wait for court rulings — they delay care, ration medication, or disappear from the system entirely.
As a pharmacist, I know exactly what that means. These are life-saving medications. Continuity of care matters. Criminalizing and politicizing healthcare does not protect children or families — it puts lives at risk.
Instead of centering these realities, political discourse has been deliberately diverted toward a manufactured panic about trans women in sports. Let me be clear: trans women deserve to be protected and allowed to compete just like anyone else. Athletics have always included people with different bodies, strengths, and abilities. Girls and women will always encounter competitors who are stronger or faster — that is not a gender or sports crisis, it is the nature of competition.
Sports are meant to teach fairness, mutual respect, and the shared spirit of competition — not suspicion or exclusion. We should not police young people’s bodies, and we should reject attempts to single out trans youth as a political distraction. Families and doctors should be the authority on sex and gender identity.
This narrative has been cynically amplified by the right, but too often Democrats have allowed it to take hold rather than forcefully rejecting it. It is imperative to pay attention to what is happening — and to push back against every attempt to dehumanize anyone for political gain.
Trans people have always been part of our communities and our democracy. Protecting the most vulnerable is not radical — it is the foundation of a just society. My work is grounded in that commitment, and I will not waver from it. I’m proud to have hired trans political team Down Ballot to lead my campaign for DC Council At Large. We need more ally leaders of all stages to stand up for the LGBTQ+ community. We must let elected detractors know that when they come for them, then they come for all of us. We cannot allow Fox News and social media trolls to create a narrative that scares us away from protecting marginalized populations. We must stand up and do what’s right.
Anything less is not leadership.
Rep. Oye Owolewa is running for an at-large seat on the D.C. Council.
