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.
How do we respond to rising anti-LGBTQ rhetoric?
Pastor invokes Bible to call for death of gays
On Sunday, June 4, Pastor Dillon Awes stepped behind the pulpit at Steadfast Baptist Church in Watauga, Texas and declared, “What does God say is the answer, is the solution for the homosexual in 2022?…That they are worthy of death.” His statement was greeted by shouts of “Amen” from within his congregation. He continued preaching, saying, “they should be sentenced to death, they should be lined up against a wall and shot in the back of the head.” Again, his words were greeted by “Amens” from within his church.
This clip soon spread online, causing widespread backlash from religious and non-religious alike. But for me, an openly gay, former evangelical, Christian pastor, Pastor Awes’s words are not surprising at all. In fact, I’ve heard similar sentiments regularly. The only difference between Pastor Awes and most other conservative Christian pastors across the United States today is that Pastor Awes was willing to say the silent part out loud. After all, Pastor Awes was not wrong — the passage he was preaching on, as commonly interpreted by conservative Christians, does in fact say, “Although they know God’s righteous decree that those who do such things deserve death, they not only continue to do these very things but also approve of those who practice them.” (Romans 1:32) If you put any evangelical pastor on the spot and asked if they believed that this verse was true and was in reference to LGBTQ+ people, they would have to answer, even if reluctantly, “yes.”
In a strange way, I am glad Pastor Awes preached what he did so clearly, because he is revealing the truth that most other evangelicals don’t want to acknowledge — that their theology related to the LGBTQ+ community is a theology of death. Despite attempts in recent years by evangelicals to seem more welcoming and inclusive, their core theological claim that the lives and love of LGBTQ+ people is sinful, broken, and abomination is a claim that has resulted in the suffering, oppression, and death of millions of queer people around the world, and it is high time that they own up and are honest about the beliefs they hold and their impact on LGBTQ+ people. Because again, Pastor Awes view is not a minority view, as hard as that might be to believe. He simply said what a majority of evangelical churches teach in a horrifyingly clear way. While most evangelicals would probably disagree with Pastor Awes graphic call for the execution of LGBTQ+ people, the would still affirm the truthfulness of Romans 1:32: “They are worthy of death.”
And even if evangelicals attempted theological gymnastics to get out of this horrifying interpretation of scripture that calls for violence toward queer people, their theology, which tells LGBTQ+ people that they must suppress their sexuality or gender identity or seek to change it to be acceptable to God and welcome in the church does, in fact, cause death. A 2015 study published by the National Institutes of Health found that LGBTQ+ people who are subjected to non-affirming religious teachings have a significantly higher rate of attempted suicide. These numbers have been reaffirmed in study after study, and are certainly true in my experience as a young gay evangelical who was forced into conversion therapy by my Christian college in my early twenties. When you’re told that a fundamental aspect of your identity is evil and realize that there is nothing you can do to change it, for many, death can seem like the only viable escape from this mental and spiritual anguish.
So how are we to respond to the truth that this dangerous theology is being preached in literally every corner of our nation? How can those of us- religious or not- who are allies to the LGBTQ+ community protect our queer friends and family from violence and harm in the face of millions of people who hold to these dangerous beliefs and are feeling more empowered than ever to say them out loud and to act on them?
First, it’s important that we do our work and are informed. The truth is that while this interpretation of the biblical texts is unfortunately common among Christians around the world, it is not an accurate understanding of the biblical texts. The six verses in the Christian scriptures that reference any sort of same-sex behavior are all condemnations of a very particular practice that was common in the ancient world — sexual exploitation related to temple prostitution. Same-sex relationships and queer gender identities were well known throughout the ancient Near East and especially within the Roman Empire — instead of speaking about these realities, every condemnation of homosexuality in scripture is tied to “idolatry,” which means worshipping something other than God, and in context is clearly a condemnation of temple prostitution, a practice where people who have sex with priests or priestesses in pagan temples as a way to honor various gods and goddesses. That is what is being condemned in Scripture; there is not a single condemnation of same-sex relationships or queer gender identity anywhere, and we must challenge these teachings the same way we challenged the church’s teachings on slavery, the equality of women, and the panoply of other backwards beliefs that have been perpetuated in the name of Christianity.
Second, we must challenge our conservative Christian friends and family members to be honest about what they believe and the harm that it causes. The reason so many Christians shy away from saying things as clearly as Pastor Awes is because they inherently know that these beliefs are dangerous and wrong. How can one follow Jesus, whose central command was to “love your neighbor as yourself” and hold on to a belief that a group of people are abominations who are worthy of death? These are wholly inconsistent, and this inconsistency should be drawn out and turned into an invitation for our friends to change their damaging and dangerous beliefs.
Third, we must continue to uplift and celebrate LGBTQ+ people and relationships in our society. The hatred spewed by Pastor Awes is a clear reminder of why Pride is still so important — Pride celebrations began to increase visibility of queer folks, decrease stigma around our lives and loves, and to use celebration and joy as a tool for resistance in the face of fear and bigotry. Despite the broad progress the LGBTQ+ rights movement has made in the U.S., our lives and rights are consistently under attack and in the post-Trump era, there has been a reinvigoration of anti-LGBTQ+ policies and rhetoric across the nation rooted in fear being perpetuated by the alt-right. Old tropes conflating queer people with pedophilia and sexual abuse have found new life, and the demonization of LGBTQ+ people as a threat to basic morality is now commonly heard on Fox News and across social media. The way we combat such dangerous rhetoric is ensuring more people see and know LGBTQ+ people and for our allies to speak out whenever anti-LGBTQ+ rhetoric is used or policies are proposed, signaling the broad support of queer people by the American public.
During this Pride month, it’s time for a renewed commitment to the fight for LGBTQ+ dignity and equality in the United States. It’s time for queer people to stand up and let our lights shine brighter than ever before, so that LGBTQ+ youth can see our example and know that there is space for them, in all their uniqueness, in our society.
It’s time for allies to be bold in their condemnation of bigotry wherever it occurs. It’s time for our nation’s leaders to reaffirm their commitment to fight for LGBTQ+ rights in every corner of this nation and around the world. If we remain complacent, fear-based views like those of Pastor Awes will spread and will result in more abuse and violence against LGBTQ+ people. Progress is not inevitable, and the fight has not yet been won. This Pride month, may we return again to the spirit of the earliest Pride marches, standing boldly in the face of fear and bigotry and declaring that love will win in the end.
Rev. Brandan Robertson is an author, pastor, activist, and public theologian working at the intersections of spirituality, sexuality, and social renewal. He currently serves as the Lead Pastor of Metanoia Church, a digital progressive faith community.
As Israel readies for new elections, the LGBTQ community is at risk
U.S.-based groups attacking transgender Israelis
Israel’s government has collapsed — and the county is headed to new elections for the fifth time in three years. In this renewed period of uncertainty, Israel’s LGBTQ community has cause for particular concern. Any new coalition would likely welcome parties that oppose LGBTQ inclusion back into government, posing a clear and imminent threat to their human rights.
But amidst this trepidation, there is still much to celebrate: 30 LGBTQ leaders from the U.S. met with their counterparts in Israel this month. The backdrop was Tel Aviv Pride, one of the largest in the world. The leaders were there for more than celebrations. They came to learn. As with past A Wider Bridge trips, North Americans travelling to Israel and Israelis travelling to North America shared strategies for building LGBTQ inclusion, fighting conversion therapy, protecting young people needing shelter, and building vibrant pride centers. Pride celebrations got their start in the U.S. and will take place in more than 60 Israeli cities this month. Over the years, both of our countries have imported many successful approaches from one another. But one American import to Israel is less than welcome: Political transphobia. Let’s not let it become something that unites our nations.
As leaders of groups in Israel and the U.S., we’ve watched with sadness as trans kids in America have been put in harm’s way through legislation making their medical care less available and prohibiting their teachers and school counselors from providing the lifesaving support they need. And it turns out that the same retrograde forces fighting trans inclusion in the U.S. are backing similar efforts in Israel. There have always been opposition to LGBTQ rights, including trans inclusion in both countries and around the globe. What’s new is a vastly well-funded campaign — with plenty of American backing — directed at attacking the Israeli trans community. While the fight for LGBTQ equality in Israel hasn’t been easy, historically the community hasn’t been used as a political cudgel. That’s changing, and we’re ringing the alarm bell.
Groups like the Kohelet Forum, which is largely American-funded, are trying to take their American brand of anti-trans hate to Israel. While think tanks and policy shops aren’t a new phenomenon in Israel, Kohelet has adopted the broader American model of political change-making. They’ve launched a constellation of organizations working informally together to usher in transformational policy change. With the support of Kohelet and others, the anti-trans movement has exploded in Israel.
Their orchestrated effort comes at a very unfortunate moment. Ma’avarim, Israel’s most prominent trans organization, and the entire Israeli trans community have worked tirelessly for years, building careful relationships, educating important allies — and is making tremendous advances due to an Israeli government that was willing to embrace many key goals. There are historic opportunities to implement new life-saving policies including access to healthcare, legal recognition of gender identity, and diversity in the education system. All of this is now in jeopardy. Just as these successes are coming to fruition, the anti-trans movement is using social media and other tactics to spread disinformation and false accusations such as “men in dresses raping women in bathrooms.” These fabrications are felt by many in the trans community to be like anti-Semitic blood libels — made-up stories that lead to fear, hatred, and even violence. They help fuel anti-trans advocacy and lobbying to advance exclusionary policies and legislation to deny Israeli transgender persons their dignity and rights.
The new anti-trans movement has several distinctive features that require new responses. Firstly, unlike the traditional opposition for LGBTQ rights that springs from religious and social conservatives, anti-trans advocacy is now often fronted by self-styled “progressive” women. They bring with them established connections within liberal circles. Secondly, the central arena of the “progressive” anti-trans campaign is both traditional and social media — drawing on existing networks with hundreds of thousands of followers, while trans community organizations have minimal presence in social media beyond the trans community. Thirdly, the funding being poured into anti-trans campaigns eclipses the budgets of LGBTQ organizations. In Israel alone, the groups waging battle against the trans community have budgets in the tens of millions with hundreds of paid staff, many of whom work on anti-trans campaigns.
None of us should sit idly by while these attacks on the trans community take place. As in other countries, this anti-trans hate movement poses an immediate threat to the safety and wellbeing of transgender and gender non-conforming persons. We cannot allow them to have their very existence denied.
But it doesn’t stop there. While transgender persons are the immediate targets of hate and violence, anti-trans campaigns have far-reaching political aims: dividing the liberal bloc of women’s, LGBTQ and minority rights, instilling hate, and turning liberal democratic societies against a newly created enemy from within. Anti-trans propaganda has proved instrumental in spreading disinformation and conspiracy theories that further undermine democratic values in society.
The eyes of the world often look to Israel on LGBTQ rights. Dana International, a trans woman from Tel Aviv, won the Eurovision music contest, became an international hero, and played a role in ushering greater acceptance of the trans community.
The world will be watching after Israel’s new elections: Will they continue to make progress in affording rights and protections to LGBTQ people? Or will they turn back the clock? Now more than ever, fighting the anti-trans movement must be a top priority not only for the transgender community but for LGBTQ people, feminists, and the wider progressive community in Israel- and in the United States.
Ethan Felson is the executive director of A Wider Bridge, an organization that fights for LGBTQ inclusion, counters anti-Semitism, and strengthens relationships between the LGBTQ community in Israel and North America. Elisha Alexander is the founding director of Ma’avarim, Israel’s leading NGO advocating for the transgender community.
Celebrating Pride within the military
Advancing equality and inclusivity
Discrimination weakens us and when it exists within a community like the military, where its members constantly rely on each other to survive, it is particularly destructive. As a Black man and veteran, I have first-hand experience of the very real and prevalent discrimination that exists within our military. But racism is just one type of prejudice the military community is grappling with; LGBTQ+ discrimination is another.
Last Pride month, I called upon fellow Americans to consider each individual’s role in helping champion and support long-awaited change for LGBTQ+ servicemembers and veterans. Now, almost exactly a year later, the progress we’ve seen is minimal at best.
Out of a veteran population of 19 million, an estimated 1 million U.S. veterans identify as LGBTQ+. Yet, in spite of their significant presence, LGBTQ+ veterans continue to face unequal treatment, blatant discrimination, and a far greater number of obstacles than their non-LGBTQ+ counterparts.
Throughout the history of the military, an estimated 100,000 LGBTQ+ servicemembers have been discharged from service simply because of their gender identity or sexual orientation. At least 14,000 of them were discharged under the “Don’t Ask, Don’t Tell” law. These other-than-honorable discharges have caused countless servicemembers to confront unprecedented and life-altering losses, many of them are still dealing with the ramifications today.
An other-than-honorable discharge is more than just a job loss. Its effects can compound further into a series of negative consequences far beyond the discharge itself. Those who are forced to leave the military under such circumstances are not likely to be allowed to re-enlist in the Armed Forces or reserves. Bad paper discharges also hamper future employment opportunities for LGBTQ+ veterans, particularly in the government. This significantly affects the financial security and the overall career trajectory of many.
The direct impacts of these discharges, as well as the constant burden placed on LGBTQ+ veterans to avoid them, have led to horrible health consequences for too many. Ex-servicemembers who were forced out of the military under DADT have reported debilitating mental health issues, including depression and trauma disorders. Thus, it is no surprise, that DADT has left a legacy of high suicide attempt rates (15 times higher than veterans overall) among LGBTQ+ veterans.
Other than honorable discharges under DADT also led to housing instability among LGBTQ+ veterans. Often ineligible for housing vouchers afforded to other veterans, coupled with financial insecurity, many LGBTQ+ veterans have experienced homelessness. Long after the DADT repeal, LGBTQ+ veterans are still struggling with homelessness.
LGBTQ+ servicemembers today have inherited major burdens from the era of DADT and even earlier. They are still less likely than non-LGBTQ+ active-duty servicemembers to report that they are currently covered by any form of health insurance, less likely to report owning a home, and are four times more likely to report an overall financial difficulty getting by.
COVID-19 has only amplified the dangers faced by at-risk veterans over the past two years. My organization,
Iraq and Afghanistan Veterans of America’s comprehensive care program, the Quick Reaction Force (QRF), has seen a nearly 500% increase in veterans reaching out for help since the start of the pandemic. 72% of the outreach included veterans seeking support for mental health needs, economic insecurity, homelessness, or a combination of those issues.
Our nation has failed to protect those who dedicated their lives to protect others. So how do we push for change? Passing the Equality Act into law is certainly a start. The bill aims to expand federal civil rights protections and prohibits discrimination based on sex, sexual orientation, and gender identity. The bill passed the House with bipartisan support, and advocates are pushing for a vote in the Senate in the coming months.
In addition to the Equality Act, Congress must work to include the proposed “Truman Amendment” to the FY 2023 National Defense Authorization Act (NDAA). The amendment aims to ensure that eligibility for service in the military is not influenced by race, color, national origin, religion, or sex (including gender identity, sex characteristics, or sexual orientation) of an individual. Such non-discrimination policies, while significant on their own, are limited in their application and enforcement as executive orders. Through inclusion in NDAA, the Truman Amendment would codify these protections into law.
Policymakers saying they are “encouraged” by the advancement of legislation like the Equality Act and Truman Amendment in Congress without working to actively pass them, is not enough. We must call on our Senators to pass the Equality Act and to include the Truman Amendment in the NDAA.
While we cannot undo the harm suffered by LGBTQ+ servicemembers and veterans, it is our responsibility to ensure that their sacrifices are recognized and they are given the acceptance and protection they are owed. Together, we can achieve this.
Jeremy Butler is a Navy veteran and the CEO of the HYPERLINK “https://iava.org/” \t “_blank” Iraq and Afghanistan Veterans of America.
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