National
Biden administration shifts monkeypox vaccine approach amid shortage
Health experts sees new guidance as mixed bag

The Biden administration, amid criticism it was slow to act on the monkeypox outbreak and still not meeting the demand for vaccines as the number of cases continues to grow, has announced a shift in guidance for implementation of the shot in an effort to enhance availability.
As the estimated number of monkeypox cases in the United States reaches 8,900, top health officials announced the new move on Tuesday as part of a decision by Secretary of Health & Human Services Xavier Becerra to issue a determination under Section 564 of the Federal Food, Drug and Cosmetic Act to justify emergency use authorization of vaccines. The announcement follows up on the Biden administration’s announcement last week declaring the monkeypox outbreak a public health emergency.
Becerra said in a conference call with reporters the 564 determination and change in approach to vaccines would “boost and strengthen” the Biden administration’s response to monkeypox, which has overwhelmingly affected gay and bisexual men, and “safely accelerates and multiplies our supply of effective vaccines by up to fivefold.”
“Today’s action also reaffirms HHS and this administration’s commitment to using all available resources and capabilities to end the monkeypox outbreak and provide the best possible care to those suffering from the virus,” Becerra added.
The new vaccine approach, which may may be considered minor to non-medical observers, would change injections of the JYNNEOS vaccine from the subcutaneous route (delivery of the vaccine under the fat layer underneath the skin) to the intradermal route (delivery of the vaccine into the layer of skin just underneath the top layer). In theory, that would allow for greater accessibility of monkeypox vaccines as it increases the number of doses from each vial of vaccine.
The change was made amid criticism the Biden administration failed to meet the demand for vaccines during the outbreak and geographic inequity as certain metropolitan areas of the country have more access to vaccines than other places.
As The New York Times reported last week, the Biden administration has faced criticism for not moving quickly enough in acquiring and distributing vaccines, including bulk stocks already owned by the U.S. government manufactured in Denmark by Bavaria Nordic now being given to other clients.
“The government is now distributing about 1.1 million doses, less than a third of the 3.5 million that health officials now estimate are needed to fight the outbreak,” the Times reported. “It does not expect the next delivery, of half a million doses, until October. Most of the other 5.5 million doses the United States has ordered are not scheduled to be delivered until next year, according to the federal health agency.”
Biden officials, nonetheless, touted the numbers of vaccines and tests in response to monkeypox as a positive, acknowledging the 1.1 million vaccines being made available as well as delivery of more than 620,000 of those doses, deployment more than 15,000 courses of the monkeypox treatment and increasing the country’s capacity to administer tests on a weekly basis to around 80,000. Meanwhile, officials also promoted the change in approach in vaccines as means to allow greater accessibility to the shots.
Rochelle Walensky, director of the Centers for Disease Control & Prevention, promoted during the conference call the use of intradermal injections and said they’re “often used for TB skin tests and have been used for other types of vaccines.”
Although Walensky conceded some health care providers “may not be as familiar with intradermal administration” as they are with subcutaneous injection, she said CDC would make additional guidance materials available, including a clinician alert message to the Association of State & Territorial Health Officials, outreach to key clinician partners and an education resource video. The change in guidance, Walensky said, is for vaccine implementation in adults, but children — where single digit monkeypox cases have been reported — would continue to receive vaccination in the traditional subcutaneous approach.
But health experts aren’t responding with overwhelming praise to the decision to change the guidance on vaccine implementation from subcutaneous injections to intradermal injections, expressing concerns the new approach may be insufficient.
Jennifer Kates, director of global health & HIV policy at the Kaiser Family Foundation, was among those saying the change in guidance on vaccine approach was a mixed bag and told the Blade more data is needed to evaluate the effectiveness.
“As we saw with COVID, using these authorities in the context of public health emergencies is an important strategy,” Kates said. “In this case, this step will significantly expand access to vaccines for those most at risk. However, there remain questions about the effectiveness of this approach — real world studies are needed — and challenges to translating vaccines into vaccinations.”
Peter Marks, director of the Center for Biologics Evaluation & Research (CBER) at the Food & Drug Administration, was asked during the conference call with reporters to respond to concerns the change in guidance was insufficient and downplayed the novelty of implementing the vaccines through the intradermal route as “not at all new.”
“In fact, the reason why the Bavaria part of this equation comes from the fact that in Germany, this vaccine was given intradermally originally, in an effort to replicate the original version of the smallpox vaccine,” Marks said. “It’s been given to thousands of people intradermally, so this isn’t the first time it’s been done.”
Walkensky said the intradermal vaccine approach has been implemented amid policies among localities to implement a one-dose approach to the JYNNEOS vaccine through the subcutaneous route. (The D.C. government is one of the jurisdictions that had enacted a one-dose approach amid a vaccine shortage.) There is not data, Walkensky said, to support that approach and “in fact, if anything, there are data saying that that is not protective enough.”
“So by using this alternative strategy of intradermal dosing, not only do we have more doses, but we actually allow people to get two doses in a way that shows immunologic response that’s superimposable from the subcutaneous dosing,” Walkensky said. “So we have more doses, and in fact, we have the ability to doubly vaccinate people so that they get the protection that they need.”
Federal Government
Treasury Department has a gay secretary but LGBTQ staff are under siege
Agency reverses course on LGBTQ inclusion under out Secretary Scott Bessent

A former Treasury Department employee who led the agency’s LGBTQ employee resource group says the removal of sexual orientation and gender identity (SOGI) from its discrimination complaint forms was merely a formalization of existing policy shifts that had already taken hold following the second inauguration of President Donald Trump and his appointment of Scott Bessent — who is gay — to lead the agency.
Christen Boas Hayes, who served on the policy team at Treasury’s Financial Crimes Enforcement Network (FinCEN) from 2020 until March of this year, told the Washington Blade during a phone interview last week that the agency had already stopped processing internal Equal Employment Opportunity (EEO) complaints on the basis of anti-LGBTQ discrimination.
“So the way that the forms are changing is a procedural recognition of something that’s already happening,” said Hayes. “Internally, from speaking to two EEO staff members, the changes are already taking place from an EEO perspective on what kind of cases will be found to have the basis for a complaint.”
The move, they said, comes amid the deterioration of support structures for LGBTQ workers at the agency since the administration’s early rollout of anti-LGBTQ executive orders, which led to “a trickle down effect of how each agency implements those and on what timeline,” decisions “typically made by the assistant secretary of management’s office and then implemented by the appropriate offices.”
At the end of June, a group of U.S. House Democrats including several out LGBTQ members raised alarms after a Federal Register notice disclosed Treasury’s plans to revise its complaint procedures. Through the agency’s Office of Civil Rights and EEO, the agency would eliminate SOGI as protected categories on the forms used by employees to initiate claims of workplace discrimination.
But Hayes’s account reveals that the paperwork change followed months of internal practice, pursuant to a wave of layoffs targeting DEI personnel and a chilling effect on LGBTQ organizing, including through ERGs.
Hayes joined Treasury’s FinCEN in 2020 as the agency transitioned into the Biden-Harris administration, working primarily on cryptocurrency regulation and emerging technologies until they accepted a “deferred resignation” offer, which was extended to civil servants this year amid drastic staffing cuts.
“It was two things,” Hayes said. “One was the fact that the policy work that I was very excited about doing was going to change in nature significantly. The second part was that the environment for LGBTQ staff members was increasingly negative after the release of the executive orders,” especially for trans and nonbinary or gender diverse employees.
“At the same time,” Hayes added, “having been on the job for four years, I also knew this year was the year that I would leave Treasury. I was a good candidate for [deferred resignation], because I was already planning on leaving, but the pressures that emerged following the change in administration really pushed me to accelerate that timeline.”
Some ERGs die by formal edict, others by a thousand cuts
Hayes became involved with the Treasury LGBTQ ERG shortly after joining the agency in 2020, when they reached out to the group’s then-president — “who also recently took the deferred resignation.”
“She said that because of the pressure that ERGs had faced under the first Trump administration, the group was rebuilding, and I became the president of the group pretty quickly,” Hayes said. “Those pressures have increased in the second Trump administration.”
One of the previous ERG board members had left the agency after encountering what Hayes described as “explicitly transphobic” treatment from supervisors during his gender transition. “His supervisors denied him a promotion,” and, “importantly, he did not have faith in the EEO complaint process” to see the issues with discrimination resolved, Hayes said. “And so he decided to just leave, which was, of course, such a loss for Treasury and our Employee Resource Group and all of our employees at Treasury.”
The umbrella LGBTQ ERG that Hayes led included hundreds of members across the agency, they said, and was complemented by smaller ERGs at sub-agencies like the IRS and FinCEN — several of which, Hayes said, were explicitly told to cease operations under the new administration.
Hayes did not receive any formal directive to shutter Treasury’s ERG, but described an “implicit” messaging campaign meant to shut down the group’s activities without issuing anything in writing.
“The suggestion was to stop emailing about anything related to the employee resource group, to have meetings outside of work hours, to meet off of Treasury’s campus, and things like that,” they said. “So obviously that contributes to essentially not existing functionally. Because whereas we could have previously emailed our members comfortably to announce a happy hour or a training or something like that, now they have to text each other personally to gather, which essentially makes it a defunct group.”
Internal directories scrubbed, gender-neutral restrooms removed
Hayes said the dismantling of DEI staff began almost immediately after the executive orders. Employees whose position descriptions included the terms “diversity, equity, and inclusion” were “on the chopping block,” they said. “That may differ from more statutorily mandated positions in the OMWI office or the EEO office.”
With those staff gone, so went the infrastructure that enabled ERG programming and community-building. “The people that made our employee resource group events possible were DEI staff that were fired. And so, it created an immediate chilling effect on our employee resource group, and it also, of course, put fear into a lot of our members’ hearts over whether or not we would be able to continue gathering as a community or supporting employees in a more practical way going forward. And it was just, really — it was really sad.”
Hayes described efforts to erase the ERGs from internal communication channels and databases. “They also took our information off internal websites so nobody could find us as lawyers went through the agency’s internal systems to scrub DEI language and programs,” they said.
Within a week, Hayes said, the administration had removed gender-neutral restrooms from Main Treasury, removed third-gender markers from internal databases and forms, and made it more difficult for employees with nonbinary IDs to access government buildings.
“[They] made it challenging for people with X gender markers on identification documents to access Treasury or the White House by not recognizing their gender marker on the TWAVES and WAVES forms.”
LGBTQ staff lack support and work amid a climate of isolation
The changes have left many LGBTQ staff feeling vulnerable — not only because of diminished workplace inclusion, but due to concerns about job security amid the administration’s reductions in force (RIFs).
“Plenty of people are feeling very stressed, not only about retaining their jobs because of the layoffs and pending questions around RIFs, but then also wondering if they will be included in RIF lists because they’re being penalized somehow for being out at work,” Hayes said. “People wonder if their name will be given, not because they’re in a tranche of billets being laid off, but because of their gender identity or sexual orientation.”
In the absence of functional ERGs, Hayes said, LGBTQ employees have been cut off from even informal networks of support.
“Employees [are] feeling like it’s harder to find members of their own community because there’s no email anymore to ask when the next event is or to ask about navigating healthcare or other questions,” they said. “If there is no ERG to go to to ask for support for their specific issue, that contributes to isolation, which contributes to a worse work environment.”
Hayes said they had not interacted directly with Secretary Bessent, but they and others observed a shift from the previous administration. “It is stark to see that our first ‘out’ secretary did not host a Pride event this year,” they said. “For the last three years we’ve flown the rainbow Pride flag above Treasury during Pride. And it was such a celebration among staff and Secretary Yellen and the executive secretary’s office were super supportive.”
“Employees notice changes like that,” they added. “Things like the fact that the Secretary’s official bio says ‘spouse’ instead of ‘husband.’ It makes employees wonder if they too should be fearful of being their full selves at work.”
The Blade contacted the Treasury Department with a request for comment outlining Hayes’s allegations, including the removal of inclusive infrastructure, the discouragement of ERG activity, the pre-formalization of EEO policy changes, and the targeting of DEI personnel. As of publication, the agency has not responded.
U.S. Supreme Court
Supreme Court to consider bans on trans athletes in school sports
27 states have passed laws limiting participation in athletics programs

The U.S. Supreme Court on Thursday agreed to hear two cases involving transgender youth challenging bans prohibiting them from participating in school sports.
In Little v. Hecox, plaintiffs represented by the ACLU, Legal Voice, and the law firm Cooley are challenging Idaho’s 2020 ban, which requires sex testing to adjudicate questions of an athlete’s eligibility.
The 9th U.S. Circuit Court of Appeals described the process in a 2023 decision halting the policy’s enforcement pending an outcome in the litigation. The “sex dispute verification process, whereby any individual can ‘dispute’ the sex of any female student athlete in the state of Idaho,” the court wrote, would “require her to undergo intrusive medical procedures to verify her sex, including gynecological exams.”
In West Virginia v. B.P.J., Lambda Legal, the ACLU, the ACLU of West Virginia, and Cooley are representing a trans middle school student challenging the Mountain State’s 2021 ban on trans athletes.
The plaintiff was participating in cross country when the law was passed, taking puberty blockers that would have significantly reduced the chances that she could have a physiological advantage over cisgender peers.
“Like any other educational program, school athletic programs should be accessible for everyone regardless of their sex or transgender status,” said Joshua Block, senior counsel for the ACLU’s LGBTQ and HIV Project. “Trans kids play sports for the same reasons their peers do — to learn perseverance, dedication, teamwork, and to simply have fun with their friends,” Block said.
He added, “Categorically excluding kids from school sports just because they are transgender will only make our schools less safe and more hurtful places for all youth. We believe the lower courts were right to block these discriminatory laws, and we will continue to defend the freedom of all kids to play.”
“Our client just wants to play sports with her friends and peers,” said Lambda Legal Senior Counsel Tara Borelli. “Everyone understands the value of participating in team athletics, for fitness, leadership, socialization, and myriad other benefits.”
Borelli continued, “The U.S. Court of Appeals for the Fourth Circuit last April issued a thoughtful and thorough ruling allowing B.P.J. to continue participating in track events. That well-reasoned decision should stand the test of time, and we stand ready to defend it.”
Shortly after taking control of both legislative chambers, Republican members of Congress tried — unsuccessfully — to pass a national ban like those now enforced in 27 states since 2020.
Federal Government
UPenn erases Lia Thomas’s records as part of settlement with White House
University agreed to ban trans women from women’s sports teams

In a settlement with the Trump-Vance administration announced on Tuesday, the University of Pennsylvania will ban transgender athletes from competing and erase swimming records set by transgender former student Lia Thomas.
The U.S. Department of Education’s Office for Civil Rights found the university in violation of Title IX, the federal rights law barring sex based discrimination in educational institutions, by “permitting males to compete in women’s intercollegiate athletics and to occupy women-only intimate facilities.”
The statement issued by University of Pennsylvania President J. Larry Jameson highlighted how the law’s interpretation was changed substantially under President Donald Trump’s second term.
“The Department of Education OCR investigated the participation of one transgender athlete on the women’s swimming team three years ago, during the 2021-2022 swim season,” he wrote. “At that time, Penn was in compliance with NCAA eligibility rules and Title IX as then interpreted.”
Jameson continued, “Penn has always followed — and continues to follow — Title IX and the applicable policy of the NCAA regarding transgender athletes. NCAA eligibility rules changed in February 2025 with Executive Orders 14168 and 14201 and Penn will continue to adhere to these new rules.”
Writing that “we acknowledge that some student-athletes were disadvantaged by these rules” in place while Thomas was allowed to compete, the university president added, “We recognize this and will apologize to those who experienced a competitive disadvantage or experienced anxiety because of the policies in effect at the time.”
“Today’s resolution agreement with UPenn is yet another example of the Trump effect in action,” Education Secretary Linda McMahon said in a statement. “Thanks to the leadership of President Trump, UPenn has agreed both to apologize for its past Title IX violations and to ensure that women’s sports are protected at the university for future generations of female athletes.”
Under former President Joe Biden, the department’s Office of Civil Rights sought to protect against anti-LGBTQ discrimination in education, bringing investigations and enforcement actions in cases where school officials might, for example, require trans students to use restrooms and facilities consistent with their birth sex or fail to respond to peer harassment over their gender identity.
Much of the legal reasoning behind the Biden-Harris administration’s positions extended from the 2020 U.S. Supreme Court case Bostock v. Clayton County, which found that sex-based discrimination includes that which is based on sexual orientation or gender identity under Title VII rules covering employment practices.
The Trump-Vance administration last week put the state of California on notice that its trans athlete policies were, or once were, in violation of Title IX, which comes amid the ongoing battle with Maine over the same issue.