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Racial disparities persist in monkeypox outbreak despite equity efforts

Percentage of cases for Black men grows amid overall decline

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Demetre Daskalakis, the face of LGBTQ outreach for the Biden Administration in monkeypox efforts, speaks as new cases are on the decline.

Racial disparities persist in response to the monkeypox outbreak as the numbers of Black and Latino men contracting the disease are now disproportionately high, but that inequity is getting new attention as overall cases drop.

Although overall new cases in the monkeypox outbreak are steadily on the decline after numbers peaked in the summer, a growing share of the continuing numbers belong to men who have sex with men who are racial minorities.

The latest numbers show the racial disparity dramatically. In the week of Sept. 4, Black people consisted of 41 percent of the cases and Latinos consisted of 27 percent, while 26 percent were white and three percent were Asian, according to data from the Centers for Disease Control.

Black people among the new cases of monkeypox were much smaller when numbers were first reported earlier in the summer. For example, the percentage was 18 on June 22 and as low as 8 percent June 8. The percentage of Latinos, as with white people, has been on the decline, although they’re still overrepresented in new cases in the context of their demographics in the U.S. population at large.

The disproportionate impact of new monkeypox cases on racial minorities hasn’t gone unnoticed. As a result, health officials are attempting to shift the focus of the monkeypox outbreak away from gay and bisexual men and other men who have sex with men more broadly and more toward men of color who are sexual minorities.

Sean Cahill, director of health policy research at the Boston-based Fenway Institute, said in an interview with the Washington Blade the racial disparities in the monkeypox outbreak are largely the result of Black and Latino men being “less likely to get vaccinated than their proportion of the population.”

“So they’re more vulnerable to monkeypox, and they’re less likely to get the vaccine,” Cahill said. “So that’s a real problem, and it’s really critical that you know, federal, state and local partners come together and really center equity in the response and try to reduce the burden on Black and Latino gay men, but also increase access to the vaccine to ensure that people can protect themselves.”

The Fenway Institute last week issued a blueprint calling for a more effective federal response to monkeypox, accusing the U.S. government of failing to effectively mobilize existing public health infrastructure to aid communities affected by the virus. The document outlines a range of possible actions, but also concludes marginalized communities are having difficulty accessing vaccines and treatments, which are concentrated at well-resourced institutions less accessible to communities of color.

Cahill, asked to characterize whether the numbers demonstrating racial disparity have changed over time or have remained stagnant, said any trends are difficult to determine because the data on racial demographics has been available only recently and “it’s very imperfect data.”

“I don’t know if it’s getting worse or better, the disproportionate racial ethnic impact,” Cahill said. “But it’s definitely there, and it doesn’t seem to be going away.”

The Biden administration, while touting the 20 percent decline in overall cases in the monkeypox outbreak, has also started to recognize the continued disproportionate impact of monkeypox on Black and Latino men who have sex with men.

Rochelle Walensky, director for the Centers for Disease Control & Prevention, said during a conference call with reporters the U.S. government approaches the decline with “cautious optimism.”

“Over the past several weeks, we have also seen the racial and ethnic makeup of this outbreak evolve,” Walensky said. “While monkeypox cases were first seen predominantly in non-Hispanic white men, in the last week, among the cases for which we have race and ethnicity data, non-Hispanic Black men represented 38 percent of cases, Latino or Hispanic men represented 25 percent of cases, and non-Hispanic white men represented 26 percent of cases.”

Among the efforts the Biden administration has undertaken is a pilot program for vaccines reserved for large events and equity. Monkeypox vaccines have been administered to more than 10,000 people, including at Southern Decadence in New Orleans, Atlanta Black Gay Pride, Charlotte Pride, Boise Pride Festival, and Oakland Pride and Pridefest.

Demetre Daskalakis, the face of LGBTQ outreach for the Biden administration in monkeypox efforts and deputy director the White House monkeypox task force, was among those promoting the pilot program in equity efforts during a conference call with reporters.

“Health departments will use their local experience and connection to the community to identify hyperlocal strategies to improve vaccine access to communities of color, specifically those that are overrepresented in this outbreak,” Daskalakis said.

David Johns, executive director of the National Black Justice Coalition, said in the racial disparities in the monkeypox outbreak are consistent with other trends in public health.

“There have been so many opportunities to learn ways to address health inequities before they grow,” Johns said. “That Black people continue to be disproportionately impacted by this newest health epidemic is additional evidence of how white supremacy works and the importance of democratized responses to crises.”

Biden health officials, asked by the Washington Blade during the virtual meeting why the administration’s stated goal of equity in managing the monkeypox outbreak isn’t producing racial equity among new cases, restated their efforts and talked about the difficulty in achieving that goal.

Walensky, who has also had a lead role in the Biden administration combating the coronavirus pandemic, said racial disparities in the monkeypox outbreak “is not uncommon for many infectious diseases, quite unfortunately,” and defended the U.S. government’s approach to monkeypox.

“And it is exactly for these reasons why we started on these pilot projects before we even saw the shifts in data, as that is often the case in infectious diseases that we have more vulnerable population — racial and ethnic minorities — who are most impacted later on,” Walensky added. “And so, we anticipated this. We have embarked on these activities to address this in exactly this moment.”

Daskalakis, following up in defense of the Biden administration’s efforts on equity, said he’s “spoken to providers on the ground and also promoters at these events who have noted that this effort is really unprecedented in terms of reaching deeply into these communities.”

“I think all of our commitment in the administration is to really focus efforts on equity to resolve the issues that we’re seeing. It is a hard effort and it’s a challenge,” Daskalakis added. “And I think that the way to address equity is intentionally, and this is an example of intentional work to address equity.”

With the racial disparity in the monkeypox outbreak ongoing, health observers say additional efforts are needed to reach out to marginalized communities to ensure they have access to public messaging and vaccinations.

Cahill said although people of color in urban areas go to LGBTQ centers to receive health care, many of them are also getting care through other facilities that aren’t LGBTQ-specific, such as emergency rooms and urgent care clinics .

“I think providing some training and technical assistance to those healthcare organizations in how to provide affirming care to bisexual men could be an important approach and could make it so that people might be more likely to disclose same-sex behavior in those contexts,” Cahill said.

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National

Madonna roundup: Reviews, sales, and love for ‘Danceteria’

Pop legend’s new album ‘Confessions II’ earning raves

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Madonna isn’t just back, she’s ubiquitous. 

From a Times Square takeover to Graham Norton’s couch, the pop legend is busy promoting her new album, “Confessions II,” a sequel to 2005’s “Confessions on a Dance Floor,” that is earning rave reviews.

“Madonna’s back in peak form with a fresh and honest dance record that’s not only her best in 20 years, but a genuinely vital addition to her canon,” says Pitchfork.

“Facing grief and loss has made Madonna’s music deeper than it’s been in 20 years, but also more alive,” the Guardian proclaims.

“If everyone in the club is a work of art, as ‘Danceteria’ says, then to live loudly is to make an indelible mark,” according to Vulture.

The album features upbeat dance productions along with some melancholic views on death and loss. On the song “Betrayal,” she reflects on the recent death of her stepmother Joan, singing, “You’ll never take my mother’s place … you betrayed me, you enslaved me.”

On “L.E.S. Girl,” she revisits her early days living on the Lower East Side and struggling to pay the rent. “Bizarre” seems to reference her failed 1980s marriage to actor Sean Penn. “Test” is a duet with daughter Lola Leon, in which she sings, “I wish I knew / The pain I’ve caused / My butterfly / Was always being watched.”

But the emotional high point of the album comes on “Fragile,” which she wrote about the death of her brother Christopher. The two were close early in Madonna’s career and he designed sets for early tours, including “Blonde Ambition.” But they had a falling out after her marriage to Guy Ritchie and he wrote a scathing tell-all book about his sister that led to years of estrangement. The two reconciled after Christopher’s cancer diagnosis and shortly before he died in 2024 at age 63. She sings, “Late last night I was fast asleep/You came to me in a dream/You said, ‘Don’t forget about me/Don’t forget to be happy.’”

Death emerges again but in a much more upbeat context in “Danceteria,” an ode to the iconic New York nightclub that has emerged as a gay favorite single and seems destined to be the song of the summer in queer nightlife. She recounts her pre-fame days trying to convince a DJ to play her first single “Everybody” at the club and name checks Jean-Michel Basquiat, Keith Haring, best friend Debi Mazar, and DJ Mark Kamins on the track. 

Streaming numbers and sales are strong for the new album with projected first week sales of 100,000 ensuring a No.1 debut in the U.S. 

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U.S. Federal Courts

Three overlooked court rulings limited White House anti-trans policies

Supreme Court narrowed trans rights, advocates saw victories in other decisions

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(Bigstock photo)

While the U.S. Supreme Court’s decision in West Virginia v. B.P.J. continues to dominate headlines about transgender rights, three recent federal court cases produced significant rulings that limited or temporarily blocked Trump-Vance administration policies attacking trans Americans.

Talbott v. USA

Trump issued Executive Order 14183, “Prioritizing Military Excellence and Readiness,” on Jan. 27, 2025, banning trans people from serving in the military. The following day, GLAD Law and the National Center for LGBTQ Rights filed a federal lawsuit in the U.S. District Court for the District of Columbia challenging the ban on behalf of six active-duty service members and two individuals seeking to enlist. The organizations argue the policy violates the Fifth Amendment’s guarantee of equal protection under the law.

The plaintiffs sought a nationwide preliminary injunction — a temporary block on enforcement of the executive order while the litigation continued. The district court granted that injunction and later rejected the Trump-Vance administration’s request to dissolve it, temporarily protecting trans service members from being discharged solely because of their gender identity.

That protection, however, was short-lived. In Shilling v. Trump, the Supreme Court stayed the lower court’s injunction, allowing the military to begin enforcing the trans service ban while litigation continued. The U.S. Air Force subsequently required trans service members facing involuntary separation proceedings to appear in uniforms and grooming standards corresponding to their sex assigned at birth and, in some cases, used their deadnames during those proceedings.

Despite that setback, the plaintiffs secured two significant legal victories during Pride month.

On June 1, a federal appeals court blocked the discharge of the trans service members involved in Talbott. Then, on June 30, a federal district court certified the case as a class action on behalf of all currently serving trans service members. That means future rulings in the case will apply not only to the original six plaintiffs but to all active-duty trans military personnel covered by the class.

The case remains ongoing, but class certification significantly strengthens the ability to protect trans service members as the litigation continues. Currently, there are 28 plaintiffs in total, including the two still attempting to enlist.

Z.A. v. Blanche

In Z.A. v. Blanche (formerly Z.A. v. Lucile Salter Packard Children’s Hospital at Stanford), the U.S. District Court for the Northern District of California issued an emergency order one day before a federal grand jury subpoena was set to be enforced on July 2. The order blocked the Department of Justice from obtaining confidential medical records belonging to California families whose children receive gender-affirming care.

The ruling relied in part on protections established under the Health Insurance Portability and Accountability Act (HIPAA), the 1996 federal law governing the privacy and security of medical records.

The decision represented a significant check on the administration’s efforts to obtain sensitive patient information, protecting the privacy of trans patients and their families while the legal challenge proceeds.

Doe v. Blanche

Doe v. Blanche, which remains ongoing, challenges Trump’s executive order, Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government. Under policies implementing that order, many trans women in federal custody would be housed in men’s prisons.

A federal district court in D.C. granted a preliminary injunction blocking enforcement of a Bureau of Prisons policy that would require incarcerated trans women to be housed in men’s facilities regardless of individualized safety assessments or the risk of sexual assault.

The Bureau of Prisons policy also conflicts with the goals of the Prison Rape Elimination Act (PREA), enacted by Congress in 2003 to address sexual abuse in correctional facilities through standards, research, funding, and prevention measures. Federal data has consistently shown that trans people in custody experience sexual assault at dramatically higher rates than the general prison population.

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Commentary

When a church fears the rainbow

Puerto Rico pastor objected to Pride symbols outside congregation

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(Washington Blade photo by Michael Key)

There are moments when an incident stops being merely a local story and begins to reveal something much deeper. What happened on June 28 outside One Church, in Comerío, Puerto Rico, belongs in that category.

I do not know who painted the rainbow colors on the asphalt and on a roadside guardrail. I do not know what motivated them, and it is not my place to justify their actions. If someone believes a law was broken, there are authorities and legal mechanisms to address that. That is not the point of this reflection.

The point is the words that followed.

Hours after those colors appeared, Pastor Jorge J. Santiago Reyes went live on social media. He said he felt threatened. He described what happened as a physical attack against his church. He appeared angry and disappointed. He called those who painted the rainbow “cowards” and “charlatans.” He expressed frustration with the support that, according to him, the municipal government of Comerío has shown toward the LGBTQ community, and with those who support posts related to that community. He repeated several times that the people responsible had “crossed the line.” He ended his message by saying, “These charlatans have to be stopped.”

As I listened to his words, I stopped thinking about the paint.

I began thinking about fear.

There is one phrase the pastor repeated again and again: “They crossed the line.” Yet he never explained what that line was. If he was referring to a possible violation of the law, that is for the authorities to determine. If he meant respect for property, there are also procedures to deal with that. But when that line remains undefined and the message begins to associate a rainbow with a threat, the question changes. It is no longer only about a guardrail or a road. It becomes a question about what boundary, in the pastor’s view, was actually crossed.

Paint can be erased.

A brush can cover the asphalt and return a guardrail to its original color.

What does not disappear so easily is the meaning of those colors.

And perhaps that is where the real conflict begins.

It is significant that this happened precisely on June 28, the day when the LGBTQ community remembers a history marked by exclusion, violence, and the struggle for dignity. What represents memory, hope, and the possibility of living without hiding for millions of people was presented by others as a threat.

I do not know why someone painted that rainbow. I do not need to know in order to ask whether those were the words society should expect from a pastor.

A religious leader may feel hurt, frustrated, or angry. What he cannot forget is the responsibility that comes with every public expression. His words do not end when a livestream ends. They move beyond the space of his church, reach people who may never share his faith, and help shape the way others see those who think differently. When a pastor calls other people “charlatans” and “cowards,” says they “have to be stopped,” and turns a rainbow into evidence of an attack, he is no longer speaking only from frustration. He begins to build a discourse that can feed rejection toward a community far larger than the people responsible for that act.

There was another moment in the livestream that caught my attention. The pastor reminded viewers how much he has served Comerío, how much he has accompanied his community, and how much he has worked for it. I have no reason to question that service. I am sure many people can testify to the good he has done.

That is precisely why it was difficult to hear.

Pastoral vocation is not about reminding a town of everything one has done for it when conflict appears. Service does not lose its value when it goes unrecognized; it loses something when it becomes an argument to claim a moral position from which to speak down to others. A person who serves does so because that is the nature of the calling, not because that service grants authority to discredit those who think differently.

As a pastor, that part of the message left me deeply uneasy. Not because I expect ministers of God to be perfect. We are not. But because our words carry weight, we are called to speak with greater responsibility. Some expressions build bridges. Others raise walls. Some words invite encounter. Others end up justifying rejection.

The paint will disappear. A brush will be enough to cover the asphalt and return the guardrail to its original color.

The words will not disappear as easily.

They will remain recorded in a video, shared again and again on social media, and remembered by those who heard them. They will remain long after the last trace of paint has been erased.

When this episode is remembered, it probably will not be because of the rainbow that appeared outside One Church, in Comerío, Puerto Rico.

It will be because of the words a pastor chose to use when speaking about it.

And that difference changes everything.

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