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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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Washington Blade responds to concerns over White House pool duties

Inaccurate media reports create confusion but we stand with our colleagues

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A photo from inside the White House on Monday. (Washington Blade photo by Joe Reberkenny)

Last week, President Trump announced his unconstitutional ban of CNN, MSNow, and Politico from the White House. Coincidentally, on Monday, it was the Washington Blade’s turn to serve as the print pool reporter on duty covering the president’s actions that day. This important responsibility is shared and rotated among the print members with each serving roughly once per month. The Blade is the only LGBTQ outlet with a seat in the briefing room, a slot in the pool rotation, and membership in the White House Correspondents’ Association, something we fought for decades to secure after enduring years of discrimination, ridicule, and resistance to openly queer journalists working inside the White House. We take our responsibilities there seriously. 

There are two pools that cover the president: broadcast and print. The other four members of the broadcast pool — ABC, CBS, NBC, and Fox News — agreed to boycott their pool duties. There has been no boycott among the print pool, which is a separate entity. I called the president of the White House Correspondents’ Association on Monday to confirm that no outlets in the print pool were boycotting. 

A boycott by the Blade would set us back and lead to our expulsion from the pool and briefing room and our replacement by a right-wing outlet sympathetic to President Trump’s approach to attacking the media. The LGBTQ community is far better served with the Blade in the room than a far-right blogger taking our seat.

Let’s be clear: the Blade stands for diversity, equity, and inclusion and we stand for the First Amendment and freedom of the press. In solidarity with the broadcast pool, we made two important decisions on Monday — the first day anyone had to think about any of this. First, we refused to take or share any videos or still photos of the president, which would have undermined the broadcast boycott. Second, when Politico’s turn comes up for pool duty in mid-October, the Blade will not fill in and cover for them while they are banned. Politico must be readmitted and allowed to do their job. 

After a rough day navigating and reporting on all of this, the Advocate published a reckless and inaccurate story suggesting that the Blade had crossed a picket line. Not true, as there is no print pool boycott. They claimed that I wouldn’t talk to their reporter. Also not true. I called their reporter within 90 minutes of receiving his message and he didn’t take the call or call me back. Their story named me and our White House reporter, immediately exposing us to public criticism and worse. The environment in D.C. is so toxic and even violent these days that subjecting our staff to unfair and false accusations like this invites harassment, doxxing, and worse. To do that without even talking to us is next level irresponsible and the antithesis of journalism.

On Tuesday, I talked to two reporters and an editor at the Advocate but they refused to retract anything in their inaccurate story. If the reporter had returned my call, I could have explained all of this but they are more concerned with clickbait and sensational headlines, a dangerous practice in these troubled times. 

Back to the pool. The Blade was in the briefing room in the Reagan era, when Press Secretary Larry Speakes made jokes about AIDS and the reporters in the room laughed out loud. We endured all of that abuse and worse for decades, always standing in the back of the room and never being called on. The Blade’s journalists persevered. When President George W. Bush was re-elected in 2004, the Blade’s White House credentials were revoked amid an earlier press crackdown. Notably, no one boycotted or stood up for us. When Barack Obama won election in 2008, I received an email from his communications director informing me that effective midnight on Jan. 20, 2009, the Blade’s credentials would be restored. 

So we have had quite a ride navigating administrations and their changing requirements for gaining access but always playing the long game. As Barney Frank used to say, “If you’re not at the table, then you’re probably on the menu.” The Blade is at the table and we do our best to ensure the LGBTQ community’s issues are addressed by both parties. 

Thanks for reading and supporting the Blade’s work. If you have questions about our approach, you can reach me at [email protected].  


Kevin Naff is editor of the Washington Blade. Reach him at [email protected].

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Young people should know history of the fight for human rights

Trump is working to erase contributions of marginalized people

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From left, Rep. Bella Abzug (D-N.Y), Frank Kameny and Rep. Shirley Chisholm (D-N.Y.). (Photos of Abzug and Chisholm public domain; Washington Blade archive photo of Kameny)

When talking with otherwise really smart young people, I am amazed how little knowledge many of them have about the fight for human rights in the United States. Our country was founded by white men, who didn’t think about giving full rights to Black Americans, women, the LGBTQ community (what they knew of it, or called it). They wrote in the Declaration of Independence, “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” But that referred to all white men, and intentionally didn’t mention women. For 250 years, the country has been trying to make up for that, and making progress in fits and starts. We have yet to fully succeed. Today the felon, and his fascist aides, in the White House, are working daily to take us backwards. 

For that reason alone, it is important for younger generations to understand the fight for human rights, know who was fighting for those rights, and understand it is an ongoing fight. Often, when listening to some millennials speak, one would think the world began with them. They either forgot, or never learned, about all those who fought for the rights they now have. I realize this was true for previous generations as well. In 2016 I co-hosted a fundraiser for Pete Buttigieg during his run for president. He is an undeniably brilliant guy. Yet when he spoke of marriage equality, he just thanked Justice Kennedy for it. I reminded him after he spoke, while it’s nice to thank Kennedy for his vote, it shouldn’t be done without acknowledging the many activists who worked for decades, to get to the point that allowed Kennedy to cast that vote. In the same way it was clear to me during the Hillary Clinton campaign for president, many young women didn’t understand the work many of their own mothers had done, to fight for their right to control their own healthcare, and women’s rights in general. They took for granted the rights they had. Now, after losing some of them, many will realize the fight for their rights is never-ending. 

When I speak to younger members of the LGBTQ community, I am amazed how many don’t know the history of the AIDS epidemic, many thinking it was always a disease you could deal with by taking medication. They don’t understand the work so many activists did to bring attention to this devastating disease, and get the healthcare so many needed. Those like Cleve Jones, Larry Kramer, Dr. Anthony Fauci, and so many others. Recently, I realized how many young women don’t know the names of Gloria Steinem, Betty Friedan, Shirley Chisholm, Bella Abzug — women who fought for their rights. And this is just recent history, no less knowing about the Suffragettes, the strong women who fought for their right to vote. I’ve met young women who don’t know what the ERA is, and others who think it passed. Many don’t know the nation couldn’t get 38 states to approve an amendment to include them in the Constitution. The same for young members of the LGBTQ community who don’t know what the Equality Act is. Others think it passed, and are shocked when told it didn’t and in 27 states, they can be married on Sunday, and kicked out of their home, and fired from their job, on Monday. They don’t know names like Frank Kameny, Harvey Milk, Barney Frank, or the history of the Mattachine Society, or the Stonewall Riots.

Our current president is trying to wipe out all this history, and reverse any progress that has been made. Knowing this, it makes it even more important for school systems across the nation to fight to educate our children. We should ensure no child can graduate high school, without taking a course called “The 250-year fight for human rights in the United States.” They need to understand the history, and learn about the people who fought for their rights. They need to know how far we have come in 250 years, and understand, as we begin the next 250, how far we still have to go, to ensure real, full equality, for all.


Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.

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What LGBTQ veterans are building after ‘Don’t Ask, Don’t Tell’

DADT repeal took effect on Sept. 20, 2011. Trans servicemember ban reinstated

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The Pentagon (Photo by icholakov/Bigstock)

Fifteen years ago this month, the repeal of “Don’t Ask, Don’t Tell” took effect. At the time, the importance of the change was obvious: gay, lesbian, and bisexual Americans would no longer have to hide who they were to wear the uniform. What was harder to see was what would follow: a generation of LGBTQ veterans able to carry their service openly into American civic life.

Earlier this month, Alaska state Rep. Andrew Gray, an Army veteran, stood before the Anchorage Assembly and asked the city to recognize Sept. 20 as LGBTQ Veterans Day.

His former command sergeant major, Mike Grunst, followed him to the microphone. A 35-year veteran who had served in combat, Grunst called troops who had served while hiding who they were “the bravest I have ever served with.”

Then Denise Sudbeck stepped forward. A Vietnam-era Navy veteran, she thanked the country for the privilege of serving and asked that the next generation have the same chance.

The Assembly approved the recognition.

Nothing about the scene required a new vocabulary. A veteran made a request of his community. A commander vouched for those who served beside him. Another veteran asked that younger Americans inherit the opportunity she valued. They entered the civic record simply as veterans.

That identity can do more than win recognition.

When federal policy abruptly ended the careers of transgender servicemembers this year, veterans and servicemembers in California began asking a practical question: What happens when those Americans come home?

Republican Assemblyman Jeff Gonzalez, a Marine combat veteran, began one hearing with questions about transgender military service. He listened as veterans explained how the military handles medical care and deployment case by case.

Then the discussion turned to separation.

“I don’t wanna see any veteran homeless,” Gonzalez said. Before the hearing ended, he was asking: “How can I help? How can I understand? How can I be a good advocate?”

The legislation that followed would provide housing, employment and transition assistance to discharged servicemembers. Republican state Sen. Shannon Grove spoke for it. The Senate passed it 32 to 0.

Americans have plainly not settled their disagreements over transgender people. Nor should military service be a prerequisite for rights that belong to every citizen.

But military service creates relationships that are difficult to reduce to the abstractions of the culture war. Before a legislature, “the transgender issue” can become a veteran who deployed, an officer who led troops, or the person who once stood beside you.

The political question changes because the human relationship has already changed.

The pattern is beginning to appear across the country. Kansas is among the states recognizing LGBTQ Veterans Day for the first time this year. New York and Virginia are pursuing broader state-level programs for LGBTQ veterans.

Sept. 20 is deliberate. On that day in 2011, “Don’t Ask, Don’t Tell” ended.

We usually remember repeal for what LGBTQ Americans gained: the ability to serve openly. Fifteen years later, we can also see what the country gained.

A gay veteran can stand before his local government beside the commander who once led him. A transgender servicemember can sit before a legislator who begins with doubts and ends by asking how he can help. A veteran from an older generation can ask her neighbors to give those who follow her the same chance to serve.

This is citizenship in practice.

The enduring legacy of “Don’t Ask, Don’t Tell” repeal is not only that Americans were finally allowed to serve openly. It is also what they can now build after coming home.

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