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The LGBTQ+ community, telehealth, and rural broadband access

Congress must act to preserve lifeline of remote healthcare

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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.

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Ghana

Intersex lives, constitutional freedom, and the dangerous future of Ghana’s Human Sexual Rights and Family Values Bill

Lawmakers continue to consider draconian measure

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(Bigstock photo)

There is a dangerous silence surrounding intersex lives in Ghana — a silence shaped by fear, misinformation, cultural misunderstanding, and institutional neglect. Today, amid discussions around the possible passage of the Human Sexual Rights and Family Values Bill, 2025, that silence risks becoming law, reinforcing exclusion and deepening the marginalization of already invisible lives. 

Much of the national debate surrounding the bill has focused on LGBTQ+ identities. Yet buried within it are implications for intersex persons that many Ghanaians do not fully understand because intersex realities remain largely invisible. 

Intersex persons are born with natural variations in chromosomes, hormones, reproductive anatomy, and/or genital characteristics that do not fit typical definitions of male or female bodies. Intersex is not a sexual orientation or gender identity. It is a biological reality. Ghana’s Commission on Human Rights and Administrative Justice (CHRAJ) has clearly acknowledged this distinction. 

Despite this distinction, the bill mistakenly collapses intersex realities into a legal framework linked to LGBTQ+ criminalization. 

Although the bill contains only limited references to intersex persons, under certain medical exceptions, these references do not amount to recognition or protection. Instead, they frame intersex bodies as abnormalities requiring regulation, correction, and institutional management. This approach is inconsistent not only with Ghana’s constitutional guarantees of dignity, equality, privacy, and liberty, but also with emerging African and international human rights standards. The African Commission on Human and Peoples’ Rights Resolution on the Promotion and Protection of the Rights of Intersex Persons in Africa – ACHPR/Res.552 (LXXIV) 2023 affirms protections relating to bodily integrity, dignity, freedom from discrimination, and against harmful medical practices. Additionally, the United Nations has repeatedly condemned medically unnecessary and non-consensual interventions on intersex children. Rather than affirming the humanity and autonomy of intersex persons, the bill risks legitimizing systems of surveillance, coercion, violence, and institutional erasure. 

This is not protection.

It is managed erasure.

A child born intersex in Ghana already enters a society shaped by secrecy and stigma. Families are often pressured to hide intersex children or seek “correction” to make their bodies conform to social expectations. 

The bill risks intensifying this pressure.

Clause 17 creates space for “approved service providers” to support interventions relating to intersex persons, yet offers little protection around informed consent, bodily autonomy, confidentiality, or coercive treatment. Under the language of “correction” or “support,” harmful interventions may become normalized. 

The intersex community has documented painful lived experiences of intersex Ghanaians that reveal the devastating consequences of stigma and invisibility. 

One heartbreaking case involved intersex twins born in Ghana’s Eastern Region in 1993, who were repeatedly forced to move from village to village because of rejection and ridicule. After losing their father, their main source of protection and support, they became even more vulnerable and reportedly experienced severe emotional distress, including suicidal thoughts linked to years of stigma and exclusion. This is what invisibility looks like in practice. 

Another painful example is the story of Ativor Holali, whose lived experience exposed the cruel realities intersex persons face in sports and public life. Ativor Holali endured invasive scrutiny, public humiliation, and social suspicion because her body did not conform to rigid expectations of femininity. Rather than being protected as a Ghanaian athlete deserving dignity and privacy, she became the subject of speculation, gossip, and institutional discomfort.

Her experience reflects a broader social crisis: when society insists that every body must fit a narrow binary definition, intersex people are forced to defend their humanity in spaces where dignity should already be guaranteed.

Intersex Persons Society Of Ghana (IPSOG)’s Ŋusẽdodo research further revealed that approximately 70 percent of intersex respondents reported depression, anxiety, trauma, or severe emotional distress linked to medical mistreatment, family rejection, bullying, and social exclusion.

The bill risks transforming these existing prejudices into institutional policy. Several provisions risk deepening surveillance, restricting advocacy, weakening confidentiality, and discouraging public education around intersex realities. Intersex-led organizations providing healthcare guidance, legal referrals, psychosocial support, and community services may face serious challenges.

This places IPSOG and other intersex-led organizations in Ghana at serious risk.

For many intersex Ghanaians, these spaces are not political luxuries.

They are survival mechanisms.

Governments derive legitimacy by protecting the natural rights of all persons, including dignity, liberty, bodily autonomy, and freedom from arbitrary interference. The bill raises concerns because it risks weakening these protections for intersex persons through surveillance, coercive interventions, and restrictions on advocacy.

Ghana’s Constitution declares that “the dignity of all persons shall be inviolable.” Articles 15, 17, 18, and 21 specifically protect dignity, equality, privacy, expression, and freedom of association. These protections should apply equally to intersex persons. 

Intersex persons are not threats to Ghanaian culture.

Intersex children are not moral dangers.

Intersex bodies are not political weapons.

They are human beings deserving dignity, healthcare, safety, and constitutional protection. 

The true measure of a democracy is how it protects those most vulnerable to exclusion. At this moment, Ghana faces a choice: deepen fear and silence, or uphold dignity, bodily autonomy, and constitutional freedom for intersex persons. 

History will remember the choice we make.

Fafali Delight Akortsu is the founder and president of the Intersex Persons Society of Ghana (IPSOG).

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Opinions

A case of retaliation, not stalking

Disbelief in how Capital Pride Alliance continues to portray me

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Darren Pasha (Photo courtesy of Pasha)

You don’t know me, but you have heard of me. What you’ve heard are rumors, stories, and narratives repeated by others. People often prefer labels and gossip over facts because it is easier than asking questions. But truth does not stay buried forever; it eventually comes forward.

I am grateful to the Washington Blade and Lou Chibbaro Jr., who has written multiple articles about this case. But I want to be clear: This matter is about retaliation, not stalking. Since I raised concerns during World Pride month, several individuals connected to Capital Pride Alliance have resigned or stepped away. One of them was Ashley Smith. Whether he resigned or left under pressure, there has been no clear explanation provided.

What matters to me is that I chose to speak up when I believed I was treated unfairly. Many people stay silent out of fear of backlash or social consequences. I chose not to remain silent. I am reserving many details for trial, where facts will be examined properly. I am confident in representing myself.

Under D.C. law, an Anti-Stalking Order requires two or more qualifying incidents, with at least one within 90 days before filing. That timing requirement is important. CPA intends to present numerous individuals, but I will address how those claims fit the legal standard in court. I recognize only a few of the individuals mentioned, and there are inconsistencies I will respond to in the proper setting.

I do not accept the label often used online to describe me. From the beginning, my position has been consistent: The truth will be established through the legal process.

My concerns began during World Pride when I confided in someone I trusted, June Crenshaw. I believed I was speaking to someone supportive. My experience since then has been one of feeling misled, which I consider a betrayal.

This case is retaliation, not stalking.

Crenshaw wrote an opinion piece published by the Blade that reflected advocacy more than neutral reporting. It suggested broader social implications and directly referenced me. It also framed court rulings in a way that implied risk, even though the order was limited and modified.

Opinion writing can influence public perception while legal matters are ongoing.

The article also questioned my visibility and framed it in a negative way, which feels discouraging to my ability to respond publicly.

The article suggested the court failed by modifying the order and allowing access to community spaces, implying danger simply because the outcome was not fully aligned with CPA’s position. I believe the court acted within its authority.

At this point, it feels as though CPA would prefer my exclusion from their spaces. That is difficult, given that CPA promotes pride, inclusion, and visibility in Washington, D.C.

I continue to believe that accountability and clarification will come.

Truth is established through evidence, not repetition. I will continue addressing these matters through the legal process rather than public speculation. I also want to emphasize that my intention has never been to escalate conflict outside of proper legal channels, but rather to ensure that my concerns are documented and addressed in a structured setting. I understand that public discussion can often blur important distinctions, which is why I am focusing on the court process itself. I am prepared to respond to all claims with evidence and clarity when the time comes, and I expect that process to provide a full and fair opportunity for the record to be examined. My position remains consistent throughout, and I will continue to rely on facts rather than speculation as this matter proceeds forward. I also recognize that misunderstandings can arise when information is shared in fragments, as the legal proceedings move forward in a careful and orderly manner based on evidence in court. I will let the facts speak for themselves in court proceedings. 


Darren Pasha is a D.C.-based LGBTQ advocate. 

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IDAHOBiT a reminder we all must stand up against transphobia

Trans rights remain under attack in U.S., around the world

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Máxima Mauricio Rodas, a transgender Latina activist and sex worker, participates in the Gender Liberation March that took place in D.C. on Sept. 14, 2024. The International Day Against Homophobia, Transphobia, and Biphobia is a reminder that we all must challenge transphobia. (Washington Blade photo by Erkki Forster)

May 17 is the International Day Against Homophobia, Transphobia, and Biphobia. 

In 2026, transphobia is the biggest issue out there: all the stereotypes that were used against the LGBTQ community in general in the past are now used to attack the rights of transgender people and to create a moral panic against them. As a person who understood that they were not a girl — despite being assigned female at birth — since they were four, and who in their 30s had to wait in line for a gender clinic, I am obviously worried about this situation. Trans people continue to be seen less as people and more as part of an “agenda,” and there is a greater risk that the international trend of attacks on trans rights is just a first step in a broader attack on the LGBTQ community, and that soon bi, gay, and lesbian people will lose part of their hard-won rights to have the same protections and opportunities as heterosexual people.

When, in U.S. states such as Kansas, trans people face escalating legal and political restrictions on recognition that affect their everyday lives — for example, requiring their driving licenses to match the gender assigned at birth even after transition — while trans people in the U.S. are banned from military service and federal funding is stopped for gender-affirming care for trans youth, it is obvious to everyone that the problem is real. It is also global.

For example, there have been significant attacks on trans rights in the UK in recent years, especially against trans youth, many of whom have been denied gender-affirming care. The day when I finally found the energy to write this story was the day of the local British elections, when surprisingly many seats in city and town councils were won by the queerphobic populist Reform Party, creating some new Reform-dominated councils. Reform Party leader Nigel Farage has praised U.S. President Donald Trump and expressed admiration for Russian dictator Vladimir Putin — both of whom are known for endangering the lives of their trans citizens and rejecting trans identity as something that should be accepted.

So, who can challenge it? The general public often takes cues from public figures. Celebrities play a significant role in shaping public opinion and framing how different social issues are understood.

We need trans celebrities to speak up against transphobia when “anti-trans” celebrities like JK Rowling oppose our rights. It seemed that when conservatives around the globe stood up together to support each other, the trans community should unite, and trans celebrities should protect their trans siblings, while the broader LGB community should recognize the threat and unite around trans rights.

But not everything is so simple. Surprisingly, at a time of the greatest attack on trans rights in this century, many lesbian, gay, bi and even trans celebrities and influencers openly support transphobic policies and ideologies.

One of the clearest examples is Caitlyn Marie Jenner, a retired Olympic gold medal–winning decathlete and public figure known for her participation in the reality show “Keeping Up with the Kardashians.” She is one of the most famous trans people in the world.

From 2015 to 2016, she starred in the reality television series “I Am Cait”on E!, which focused on her gender transition and on telling a story to inspire the younger generation of trans people. In the first episode, Jenner also visited the mother of Kyler Prescott, a 14-year-old trans child who died by suicide earlier that year, and spoke openly about using her privilege to fight for awareness, equality, and dignity for trans people. The idea of supporting trans youth was one of the core themes of her TV series. 

That was then.

Jenner’s perspective on trans rights became more and more transphobic. For example, in 2021 she opposed trans girls participating in girls’ school sports. In 2023, she launched a PAC campaign attacking trans youth rights. She also expressed support for Donald Trump and said about herself that she would never be a “real woman.”

Another famous example is transmasculine sex educator and activist Buck Angel, a former adult film actor. He was seen as a modern and progressive person in the 2000s and early 2010s, praised for increasing visibility for trans men through sex education, documentaries, public speaking, and media work. But later he started calling himself “transsexual” rather than “transgender,” following a more transphobic and rigid view of trans identity, and openly showed support for Trump and MAGA.

Of course, there are plenty of trans celebrities who continue to fight for trans rights — the most obvious example is Lana and Lilly Wachowski, notable film directors who gave us “The Matrix” films and the “Sense8” TV series. But the Wachowski sisters were known for being politically left-wing and progressive even before their transition. They are part of a progressive movement, not just a “famous trans person” like Jenner was.

So, why is this happening? Why have more mainstream and conservative trans celebrities, as well as some LGBTQ groups, turned away from trans rights? And what do we need to do?

One of the reasons is fear. 

Popular and privileged people — whether they are socialites, actors or leaders of big organizations — are not used to being outcasts, and so they follow dominant trends. For them, the fear of not fitting in, being rejected by the audience and losing their position in society became bigger than their sense of justice. This is probably one of the reasons why some LGBTQ groups, such as the Log Cabin Republicans in the U.S., became more transphobic, or why the LGB Alliance in the UK became more popular.

Another reason is the polarization of society. 

Some LGBTQ activists may hate me for saying this, but it is partly our fault. Mainstream trans communities sometimes make trans identity look like a “trend” or part of an ideology. The media — especially tabloids — are even more to blame for this stereotype than the trans community itself. When uninformed people hear about trans people today, many of them imagine left-wing, maybe even socialist, non-religious young supporters of Palestine who are good at understanding ecological issues and worried about global warming. Of course, many trans people are like that. But many are not. And those who are not often feel excluded and become more prone to public self-hatred.

It created a cycle in which people who did not feel part of the community started searching for an alternative that rejected them for being trans and encouraged them to accept transphobic rhetoric, betraying themselves and their trans siblings. This led to greater polarization and hatred against conservative trans people, pushing them even further away.

The International Day Against Homophobia, Transphobia, and Biphobia needs to be a day when we stand up against all transphobia, including the kind expressed by trans people, while at the same time supporting all trans people, no matter how uncomfortable their views may be for us.

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