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
Capitalism, patriarchy, and neocolonialism are repackaging the scramble for Africa

The old scramble for Africa was about land, minerals, and control. The new scramble is cloaked in buzz phrases such as “promoting and protecting African family values,” “natural family,” and “defending the sanctity of the African family,” but it is driven by the same trio: capitalism, patriarchy, and neocolonialism.
Across the African continent, violence against marginalized people, such as women, girls, and LGBTIQ+ people, is not just some unfortunate result of ignorance and intolerance. It is not a cultural misunderstanding. It is deliberate. It is precise. It is profitable. It is pro-hate legislation. It is ideologies. It is business and is being packaged, exported and sold under the glossy buzz phrases used by the same big global forces that have long treated Africa as an experimental lab, an extraction of resources and a playground with African lives. If we zoom out far enough to what looks like moral panic is actually a business model where patriarchy meets capitalism galvanized with extreme religious ideologies, leaving that familiar colonial aftertaste.
Can ‘Ubuntu’ counter hate?
The anti-rights and anti-gender movement is sweeping rapidly across Africa on a mission to cement hate within African communities, thus making our nations and governments their experimental lab, as mentioned earlier. But we all know that hate is inherently un-African. It does not originate from Africa. It was exported onto our African soil through colonialism, patriarchy, and capitalism.
When I say that hate is un-African, this is not to claim that our communities — pre and post colonialism — were utopias. It really is to push back against the idea that supporting and protecting marginalized groups is foreign, and that rejecting them is somehow essential to preserving African culture. Protecting and empowering groups such as women and LGBTIQ+ destabilises the pillars of patriarchy and threatens capitalism, as there would be no market to sell refurbished colonialism.
Africa is not immune to hate, but it is the result of intolerance and inequality that is being imported. Africa has long been a place of respecting diversity, and professor Sylvia Tamale describes it best in “Exploring the Contours of African Sexualities: Religion, Law and Power,” by alluding that “plurality is simultaneously the boon and the bane of Africa. The cultural diversity and richness found between and within the continent’s religious and cultural communities lend to its versatility and beauty.” Tamale reminds us that African diversity enriches and offers multiple intersectional ways of being, navigating the world, and living in community grounded in compassion and humanity — “Ubuntu!”
In their article “Understanding Ubuntu and Its Contribution to Social Work Education in Africa and Other Regions of the World”, Mugumbate et al. explore the African philosophy of “Ubuntu” and its relevance to social work education. In taking lessons from their article, “Ubuntu” emphazises interconnectedness, compassion, and communal responsibility. The authors argue that integrating “Ubuntu” can be a weapon used to counter imported hate theories and practices. In our current climate, where anti-rights and anti-gender sentiments are gaining traction across Africa, the principles of “Ubuntu” are more pertinent than ever. It serves as a reminder of the importance of community and shared humanity, advocating for inclusive practices that uphold human rights and dignity for all individuals regardless of their social status, gender identity or sexual orientation.
In all honesty, there is money in hate and exclusion. This is evident in the anti-rights and anti-gender U.S. and European religious conservative organisations’ funding of anti-rights legislation, to supporting conferences where “protecting African values” is code for keeping white supremacy, protecting patriarchy and keeping colonial control. “We see a kind of investment that pays off in political influence and dominance. But who is really in control? African leaders or global north anti-rights and anti-gender groups?”
Anti-rights and anti-gender conservative groups, such as Family Watch International, La Manif Pour Tous and Alliance Defending Freedom have been linked to supporting laws that criminalize LGBTIQ+ identities, strengthening platforms that silence women and girls and manipulate African politicians, Presidents and first ladies who are eager for power, votes and validation. It is colonialism in high definition, backed by capitalism and masked as African traditional values. It is no different from Europe’s scramble for Africa in the 19th century, but this time, they are after our minds, bodies, rights and democracy.
These are not random acts, they are coordinated crackdowns on humanity. From Uganda’s Anti-Homosexuality Act to Ghana’s Human Sexual Rights and Family Values Bill to Namibia’s amended Marriage Act, we are seeing regressive legislation that is cut from the same hate cloth. Across Southern Africa, from Tanzania, Namibia, Malawi to Zambia, LGBTIQ+ people are being harassed, arrested, or killed. While human rights instruments, such as the Maputo Protocol, which protects women’s rights and bodily autonomy, have come under massive scrutiny by Family Watch International, possibly leaving the rights of women and girls at the mercy of these groups. What is even more saddening is that one can see African leaders mimicking hate sentiments that are being pushed by the global north’s anti-rights and anti-gender groups. “Do our leaders know that these hate groups are controlling them?” Some African leaders have adopted rhetoric that portrays women’s autonomy and LGBTIQ+ people as a threat to national identity and traditional values. But these sentiments are not rooted in African customs but are instead borrowed and repackaged from the anti-rights and anti-gender books.
The 2025 anti-rights and anti-gender Africa tour
If you thought the colonial era was over, think again. Between May and October 2025, Africa is hosting a series of anti-rights and anti-gender convenings that are supported by US and European conservatives.
From May 9-11, the Ugandan parliament hosted the third Inter-Parliamentary Conference, which was supported by conservatives pushing the controversial African Charter on Family Values. The conference was attended by 29 African MPs, including the deputy speaker of the National Assembly of Zimbabwe. The second Pan-African Conference on Family Values, which was held in Kenya from May 12-17, convened African political leaders, policymakers, and religious leaders. The Africa Christian Professionals Forum organized the conference under the theme “Promoting and Protecting Family Values in Africa.” Attendees included representatives from the Supreme Court of Kenya.
In June 2025, Sierra Leone will host the seventh edition of the Strengthening Families Conference, an event endorsed by the first lady of Sierra Leone. Notable attendees include leaders from Cote d’Ivoire, Congo, Ghana, Gambia, Kenya, Mali, Nigeria, and Senegal. The African Advocates Conference in Rwanda, funded by the U.S.-based Alliance Defending Freedom International, will take place from Aug. 12-17. Think of them as lawyers for oppression. The conference will host delegates from 43 African countries, including government officials, judges, academics, lawyers, and students. Advocates Africa has members from Angola, Botswana, Eswatini, Lesotho, Malawi, Namibia, South Africa, Zambia, and Zimbabwe. Finally, from Oct. 19-23, 2025, Ghana will host the Africa Bar Association Conference, a platform that pushes anti-feminist, anti-rights, and anti-gender narratives, under the guise of debating foreign interference.
These are not African-led spaces, they are U.S.- and European-led laboratories for exporting hate and mayhem. A global machine fueled by capitalism, patriarchy, and neocolonialism.
This article is part of the Southern Africa Litigation’s campaign around addressing hate speech, misinformation, and disinformation. #StopTheHate #TruthMatters
Bradley Fortuin is a consultant at the Southern Africa Litigation Center and a social justice activist.
Opinions
I interviewed Biden in late 2024 and he was attentive, engaged
CNN narrative about former president’s mental state is unfair, exaggerated

In the weeks since Jake Tapper and Alex Thompson’s “Original Sin” came out, there has been so much speculation about Joe Biden’s cognitive health that feels so pointlessly retrospective to me, or conveniently certain — even though I wouldn’t say I disagree fundamentally with what seems to have emerged as the consensus view.
Writing in POLITICO, James Kirchick took the Beltway reporters to task for what he argued was their (our) failure to investigate and cover the “truth” about the president’s mental acuity, as if the truth were a simple binary (is he okay?) and as if the answer was as evident at the time as it now appears with the benefit of hindsight.
“Lack of access is no excuse,” he wrote. I happen to disagree: Not only is that an excuse but it’s also a perfectly serviceable explanation.
We can report only what we know, and we can know only what we can observe with our own eyes and ears. If you happened to catch a White House press briefing in 2023 or 2024, there’s a pretty good chance you heard difficult questions about Biden’s health. When we don’t have much time with the president, we rely on the testimony of those in his inner circle who did.
And at this point I become agnostic on the question of whether there was a coverup by those closest to him or an effort to obfuscate the truth. Because even now the reality looks murky to me, and I was fortunate enough to spend more time with Biden than many of my colleagues near the end of his tenure in the White House.
As many of our readers will know, in September 2024 I had the great privilege of interviewing the president one on one across the Resolute Desk in the Oval Office.
Biden was as attentive and engaged as anyone I’ve spoken with. When I reflect on the experience, I remember how blue his eyes looked and how electrifying it felt to have his gaze and focus fixed on me.
Part of that is charm and charisma, but I also think he took very seriously the opportunity to talk about his legacy of helping to advance the equality of queer people in America. He wanted to be there. He spoke clearly and from the heart.
The president came with a binder of talking points prepared by the press secretary and the communications director, but he barely glanced at the notes and needed assistance from his top aides only very briefly — on two moments when he stumbled over the name of the Heritage Foundation’s Project 2025 (specifically the “2025” part) and Karine Jean-Pierre spoke up to help him.
On the one hand, Project 2025 was a critical part of the messaging strategy of his and then his vice president’s 2024 campaign, and our conversation came at the tail end of the election cycle last year. On the other hand, considering the totality of my experience talking with Biden, looking back it doesn’t seem like those lapses were that big of a deal.
I guess what I am ultimately trying to say is this: I think we should extend some grace to the former president and those closest to him, and we should also have some humility because a lot of these questions about Biden’s cognitive health are unclear, unsettled, and even to some extent unknowable.
And another thing. I am grateful for the opportunity to interview him, for his years of public service, and for his unwavering defense of my community and commitment to making our lives better, safer, richer, healthier, happier. I pray for his recovery such that these words might come to describe not only his legacy in public life, but also his years beyond it.
Christopher Kane is the Blade’s White House correspondent. Reach him at [email protected].
Opinions
LGBTQ health equity must not be abandoned
Beneath the glitter of Pride there is a simmering fear

Pride month feels different this year. There is a simmering fear beneath all the glitter. Of course, Pride has always been a festivity interwoven with a certain amount of unease. Our rainbow parades were forged from protest marches, demonstrations that erupted from a community under the searing fire of violence and humiliation. Accordingly, our rhinestone costumes and glimmering disco balls have always held an element of precarity, though that edge may have felt less present recently. Nevertheless, Pride is a holiday in active conversation with our communities’ place in society. At once, it is a moment of radical celebration while also an act of resolute defiance.
However, Pride month feels different this year because that conversation has shifted. The discourse around our communities carries a renewed threat of violence: systemic, political, and physical. In just six months since the inauguration, the Trump administration has worked swiftly to strip protections from LGBTQ+ communities, erase our histories, and demonize us in the public imagination. The vitriol that Trump and his lackeys have spewed against the trans community specifically is completely baseless and profoundly dangerous. Although our communities have long weathered such abuse, the return of such bigoted ideology at the highest levels of power is alarming, to say the least.
One of the key ways Trump has attacked LGBTQ+ communities is by targeting our access to healthcare. While healthcare is essential for anyone, for LGBTQ+ people, it can mean life or death. Our medical needs are unique and complex, often compounded by intersecting identities of race, ethnicity, gender, and sexual orientation. Denying us affirming, equitable care is not just negligent, it’s dangerous. By enacting barriers to gender affirming care, slashing tens of millions of dollars in grants for LGBTQ+ medical research, and stripping away essential protections, the current federal administration is carrying out a calculated assault with catastrophic consequences.
As a queer, nonbinary person and practicing psychiatrist, I have an intimate, visceral understanding of these issues. Even before Trump ever set foot in the Oval Office, the medical disparities affecting my LGBTQ+ friends, colleagues, and patients were obvious to me. As a young medical student in Indiana, I quickly became aware of the substantial gaps in access to healthcare for LGBTQ+ communities. At a base level, there is already significant distrust between LGBTQ+ patients and their providers, stemming from a long history of mistreatment and, in many cases, outright gaslighting, abuse, and trauma. This distrust can prevent patients from seeking care, and even when they do, providers often lack the training to deliver the affirming care they need.
This lack of equitable and affirming healthcare led me to found OutCare Health. OutCare started with a carefully curated list of medical professionals with the knowledge, training, and experience to provide LGBTQ+ people with the care they desperately need and deserve. That list has since blossomed to more than 6,000 providers and has become a vital resource for LGBTQ+ communities, their families, and allies. Over the last decade, our grassroots efforts have grown into a national force, and our programming has expanded to include health equity training, care navigation, and public education. That early momentum gave me hope that we were making headway in the fight to ensure that LGBTQ+ communities have access to the care they deserve.
However, with the return of Trump to the White House, it feels like everything has changed. We endured his first administration, bolstered by what felt like a nationwide resistance to his presidency, but this time, something is different. Instead of resistance, the air feels thick with despair, lulling the country into a doleful acceptance of our fate. Moreover, there is a pervasive sense of fear. Some providers have asked to have their names removed from our OutList of affirming providers, not out of a desire to stop helping our community, but out of a legitimate fear of retribution, professional retaliation, and even their own safety. This is a request I completely understand. There is nothing wrong with protecting yourself, your livelihood, and your family, but the need to do so speaks volumes about the political climate in which we find ourselves.
What has been truly demoralizing has been the behavior of the healthcare field at large. The willingness to grovel to the unscientific, harmful, and ignorant policies of the Trump administration is not just disappointing, it’s disgraceful. Even more disturbing is the speed and enthusiasm with which some health systems and organizations have preemptively distanced themselves from LGBTQ+ equity work, as if racing to prove their compliance with regressive ideology. Many of our past partners have vanished, most without a last goodbye. To those outside our communities, this quiet retreat from providing life-saving care to those of us who are being vilified may seem unfortunate yet pragmatic. But let me be clear: if you abandon your values in moments of inconvenience, you never really held them in the first place.
Nevertheless, I do not believe we can resign ourselves to walking despondently into the future being laid out for us. Although we are seeing an attempt to systematically dismantle many of the structures that we have put in place to help ensure health equity for LGBTQ+ communities, it is worth remembering that it was we who built those structures. Fifty or even 25 years ago, we had so much less than we do now, even after these attacks. Today, we have life-saving medications and therapies that we used to only dream of. We have networks and coalitions with deep knowledge and formidable strength. They may force us to take a step backward, but they cannot and will not make us turn around.
Most importantly, we have each other, and we have the wisdom of those who came before to guide us. From the Stonewall Riots to seizing control of the FDA, the LGBTQ+ community has shown a staunch resilience and strength of spirit that has always been one of our greatest assets. Although we are a broad and diverse banner and may not always agree, we must remember that our sense of community and our ability to organize are what have gotten us where we are today. We must stand shoulder to shoulder, hand in hand. The echoes of our footsteps drumming the streets can cause even the most unyielding enemy to cower. These are lessons we cannot afford to forget. Our survival depends on it.
So yes, Pride month does feel different this year. There is indeed a simmering fear beneath the glitter, but deeper than that fear, more enduring and infinitely stronger, there is grit—grit forged in fire and defiance. We are vibrant, colorful, and unapologetically queer, but do not mistake our joy for weakness. We’re loud, we’re resilient, and we’re holding the damn line.
In this spirit, let me make one thing abundantly clear: OutCare Health is not going anywhere. When I founded this organization 10 years ago, I knew it wouldn’t be easy, but I didn’t do it because it would be easy. I did it because it was necessary. Because it was right. Because it was my life. Your life. Our lives. We will not back down, and we will not be erased. We will continue to uplift our communities and fight for truth, equity, and democracy—no matter what the bigots throw at us.
To my OutCare family and all LGBTQ+ families, know that we are here for you, and we will not stop. To our allies, now is the time to show up—loudly, proudly, and relentlessly. To those who fear our freedom, despise our joy, and resent our very existence: our glitter may catch your eye, but don’t underestimate the strength burning beneath it. We will not break. We will not be silent. We’re not going anywhere.
Happy Pride!
Dustin Nowaskie, MD is founder and chief medical officer of OutCare Health.
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