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Cruel court decision makes it harder to prevent AIDS

Disease gets a boost from federal judge in Texas

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Just as the disease was on a glide path to extinction thanks to new drugs, HIV/AIDS got a boost from a federal court in Texas.

On Sept. 7, U.S. District Judge Reed O’Connor ruled that the government can’t require an employer-sponsored health care plan to cover a therapy that prevents the spread of a disease that has already killed more than 700,000 Americans. The decision in Braidwood Management Inc. v. Becerra is not just poorly argued; it is flat-out cruel.

Perhaps the best feature of the Affordable Care Act (ACA) of 2010, nicknamed Obamacare, was a requirement that insurance offer coverage of specified preventive care procedures and therapies, such as colon cancer screening and influenza immunizations.

In June 2019, the U.S. Preventive Services Task Force, an advisory panel of experts, issued a “Grade A” recommendation for pre-exposure prophylaxis, or PrEP, a medicine that is 99% effective in preventing HIV transmission during sex. The first PrEP drug, Truvada, had been approved seven years earlier by the Food & Drug Administration. On Jan. 1, 2021, the federal government required plans to cover PrEP with no copay, coinsurance, or deductible.

Even before the mandate, the Centers for Disease Control and Prevention (CDC) credited PrEP with helping reduce new HIV infections in the U.S. by 8% between 2015 and 2019 “after a period of general stability.” The CDC now calls PrEP “a key prevention strategy for ending the HIV epidemic in the U.S.,” a goal for 2030 set by both the Trump and Biden administrations.

The way to end AIDS once and for all is to get PrEP to those who need it most. Researchers are developing intravaginal rings, implants, antibodies, and long-lasting injectables. Although PrEP use has risen by a factor of eight in just five years, three-quarters of those most at risk are not using the therapy.

The success of the lawsuit by a group of self-described Christian business owners and employees will make access even more difficult. The plaintiffs argued that the preventive care mandate for PrEP violated their constitutional right to religious freedom. In the complaint, Dr. Steven Hotze said that he was unwilling to pay for a health plan covering PrEP “because these drugs facilitate or encourage homosexual behavior, which is contrary to [his] sincere religious beliefs.”

Hotze, whose vitamin company ran afoul of the FDA for COVID-19 claims, was indicted in April on aggravated assault charges involving a bizarre search for ballots after the 2020 election.

In the PrEP case, Hotze’s objection went beyond gay sex. He complained that providing coverage of the drugs facilitates and encourages “sexual activity outside of marriage between one man and one woman” as well as illegal drug use.

Judge O’Connor agreed. He went even further, ruling that members of the Preventive Services Task Force were “unconstitutionally appointed.”

In a previous case, O’Connor had ruled that the entire ACA was unconstitutional, but the Supreme Court reversed that decision last year. The current ruling draws on the Religious Freedom Restoration Act (RFRA) of 1993, which was enacted by Congress after the Supreme Court ruled in Employment Division v. Smith that the protection of the free exercise of religion in the First Amendment does not entitle anyone to a religion-based exception from a general law.

In recent years, writes Michael Dorf of the Cornell University Law School, “conservative Christians have increasingly relied on [RFRA] to obtain exceptions from laws involving insurance coverage for contraception and abortion.”

For example, in Burwell v. Hobby Lobby, a 2014 case, the Supreme Court held that a company owned by religious Christians could be excused from an obligation to pay for health insurance that covered “forms of contraception that the owners regarded as tantamount to abortion.”

But the ruling in the Braidwood case is far more sweeping. The Hobby Lobby plaintiffs considered abortion itself immoral. In this case, it’s not PrEP that Braidwood considers immoral; it’s certain kinds of sexual activities. By substantially lowering the risk of contracting HIV/AIDS, this twisted logic goes, PrEP is a facilitator of what Hotze considers immoral. And by offering insurance that covers PrEP, Braidwood says it becomes complicit.

There is a serious cost to this attenuated argument. By decreasing access to PrEP, people will needlessly become ill and, in some cases, die. The economy will also be burdened with the cost of treating a disease that can be prevented.

Modern science has developed therapies that are ending the spread of a dangerous, mortal virus. Easing access to these medicines is clearly a legitimate function of government — undoubtedly, a compelling interest. What can be more selfish and foolish than to erect needless obstacles for those who want to protect themselves and people around them?

James K. Glassman, a former Under Secretary of State in the George W. Bush administration, is an adviser to health care companies and non-profits.

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Let love and compassion guide our response to Joe Biden’s cancer diagnosis

Former president is diminished, but he and family deserve love and prayers

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(Washington Blade photo by Michael Key)

When I heard Joe Biden had serious prostate cancer, I felt immediate compassion for him and his family. I am a prostate cancer survivor myself. Then I heard how Trump, and some of his MAGA Republicans, responded and was amazed at how they are able to constantly sink to new lows. Trump’s son posted on X “What I want to know is how did Dr. Jill Biden miss stage five metastatic cancer or is this yet another cover-up???” Clearly, they will never give up on being vile human beings. 

The equally disgusting Joe Scarborough had on a doctor who declared he positively knows Biden must have known about his cancer years ago, although he knows nothing about the case. The reality, coming from many specialists, is at this time only Biden’s doctors know when he was diagnosed, and whether he even had regular PSA tests done, and when. Based on the latest research, the American Urological Association (AUA) age guidelines are that they do not recommend routine PSA screening for men 70 or older. This is because prostate cancer is normally very slow growing, and if you were to be diagnosed after 70, you will likely die of something else. Then you had the felon in the White House talking about “stage nine” cancer. Is he really so dumb? Guess he is as he tries to prove it nearly every time he opens his mouth. Talk about diminished. 

Now is Biden diminished from what he was years ago? It is clear he is. Should the people around him have tried to hide that in order to have him run again, no! But the-then president’s hiding health issues is nothing new. Wilson was severely impaired and it is said his wife Edith ran the country for his last year in office. The same was said about Nancy Reagan when they hid Reagan’s Alzheimer’s. Kennedy hid his Addison’s disease and other infirmities, and Trump hid how sick he was from COVID, when being helicoptered to the hospital. Is it wrong to hide these things from the American public, yes, but clearly not unusual. Actually, the media is often complicit in this, which many said they were in Biden’s case. Then you have a guy like Jake Tapper who is happy to be complicit, so he can now write a book about it and make loads of money. Very sad.

I think the time has come in the case of Joe Biden, for us to just offer him and his family some love and prayers, and the hope he will be able to manage his cancer and live a long life. Then turn the page and deal with the things that will matter more to the lives of the American people today. 

Those are the things the felon in the White House, and his Nazi sympathizing co-president, along with the MAGA Congress, are trying to do to them. Things like taking away their healthcare, and thereby also causing the closure of some rural hospitals. Things like the mass firings of federal workers, including thousands of veterans. Things like making it harder for our veterans to access their healthcare by cutting services at the Veterans hospitals. Things like increasing costs for groceries, and other items, due to the felon’s ineffective use of tariffs. Things like seeing college costs go up, as foreign students who pay the full fare at most schools, are sent home or denied visas. Things like making it harder to file for social security by closing so many offices, and pretending to lower drug prices, but not really doing it. Things like cutting research looking for cures for cancer, Alzheimer’s, MS, HIV/AIDS, and a host of other diseases, which will hurt people for decades to come. Things like creating havoc in the world, and bowing down to dictators. Things like walking away from our allies and making the world a less safe place for all of us, including abandoning Ukraine, and cozying up to his friend Putin. I always believed Putin has some dirt on him. Trump said Zelenskyy would be responsible for WW III. But it’s Trump who will be, if it happens. Then we must put a focus on the idiot who is secretary of HHS, RFK Jr., and whether he will allow the flu and covid vaccines, being readied for the fall, to be available in a timely manner. Will he continue to disparage all vaccines, and by doing so, cause deaths here, and around the world. Things like abandoning the fight against climate change and thereby screwing the planet and future generations. 

These are the things the American public really needs to know about, and care about. It may have been wrong to hide Biden’s being diminished, but he is no longer in office, and he no longer impacts people’s lives on a daily basis. The felon in the WH does, and that is where the focus must be. 

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Frank Kameny’s legacy lives on

May 21 marks pioneering activist’s 100th birthday

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May 21 would have been Frank Kameny's 100th birthday. (Washington Blade photo by Michael Key)

A first generation American from Queens, N.Y., Kameny was a decorated WWII veteran. With a prodigious 148 I.Q., he earned a Ph.D. in astronomy from Harvard University. In 1957 he was recruited by the Army Map Service, a pioneering agency in space exploration. 

In 1953 in the wake of McCarthyism, President Eisenhower issued Executive Order 10450 that prohibited homosexuals from military or civilian employment. Having nothing to do with workplace conduct, the Army learned that Kameny might be a homosexual. When confronted, he equivocated and was terminated. Unlike then thousands of other homosexuals terminated from government employment, Kameny fought back.

He took on the military and Civil Service Commission including being the first openly gay man to file an appeal about gay rights to the U.S. Supreme Court. He helped co-found and chair the Mattachine Society of Washington, the first gay rights organization in the nation’s capital.

He wrote letters to, among others, FBI Director J. Edgar Hoover. He founded and chaired the Eastern Conference of Homophile Organization, the nation’s first regional gay organization.

In the 1960s homosexuality, even with a consenting adult in the privacy of one’s bedroom was criminal. The police entrapped and extorted gay men. The American Psychiatric Association classified homosexuality as a mental illness. A bar could lose its license if there was more than one homosexual in their establishment. Homosexuals were considered dangerous, deviant and demented.

Kameny coined the phrase “Gay Is Good.” He organized picketing called Annual Reminders each July 4 from 1965 to 1969 at Independence Hall. The picketers were the first to call for gay equality. The 1965 Annual Reminder had 39 activists making it then the largest demonstration for gay rights. In the mid-1960s the country had an estimated 300 gay and lesbian activists.

He published a newsletter that became the Washington Blade, now the nation’s oldest LGBTQ weekly newspaper. Kameny and Barbara Gittings, the mother of the movement that demonstrated for the right to be heard at the 1971 American Psychiatric Association meeting. Their panel at the 1972 meeting with a masked psychiatrist using a pseudonym and voice modulator was so impactful that the APA created a panel to determine if homosexuality as a mental illness was based on science or discrimination. In 1973, that classification was removed.

He advised gays and lesbians who were the subject of discharge from federal government service. He identified test cases and referred them to the ACLU, Lambda Legal and other counsel. Slowly, but surely those cases began a process for LGBTQ equality.

His efforts led D.C. to be the first city to overturn its sodomy criminal laws. He helped found the first national LGBTQ organization, the North American Conference of Homophile Organizations. His efforts laid the groundwork for HRC and National LGBTQ Task Force.

After Stonewall in June 1969, he chaired a meeting of NY, Philadelphia and D.C. activists that authorized and helped organize to help remember Stonewall the first New York Pride Parade. He believed that Stonewall could be the movement’s Boston Tea Party. He marched in that 1970 parade holding a picket emblazoned with “Gay Is Good.”

He was the first out person to run for Congress as the D.C. delegate. Money left over from his campaign was used to fund the first gay rights television commercial. In July 1975, he was the first to be advised by the Civil Service Commission that it would eliminate homosexuality as a basis for not hiring or for firing a federal civilian employee. In 1977, he attended the White House’s first meeting with gays and lesbians.

Kameny died on Oct. 11, 2011, National Coming Out Day. He lived to see marriage equality approved in several states. He attended the signing by President Obama of the repeal of “Don’t Ask, Don’t Tell,” which enabled gays and lesbians to serve openly in the military. Kameny is buried in the Congressional Cemetery. On his tombstone is inscribed “Gay Is Good.” Over 70,000 of his documents are in the Library of Congress and picket signs from the pioneering demonstrations are housed in the Smithsonian Institution.

On May 21 LGBTQ national organizations gather in front of the Supreme Court. One hundred activists will each hold a candle for his 100th birthday. Fifteen national leaders will engage in picketing similar to the 1965 picketing at the White House and Independence Hall. They will honor Frank Kameny; celebrate the 10th anniversary of marriage equality (Obergefell v Hodges, 2015); and push back on those who would attempt to render us invisible, deny our history and undermine our equality. We will remember the nation’s loss when it fired a Harvard Ph.D. in astronomy because of his status as a homosexual. History repeats itself. This month the U.S. Supreme Court allowed the federal government to terminate transgender servicemembers solely because of their sexual orientation. How far we have come. How much farther we have to travel.

Malcolm Lazin is the national chair, Kameny 100. He is the executive director, LGBT History Month and executive producer of three LGBTQ documentaries including Gay Pioneers. He was an adjunct professor of LGBT History and Rights at New College of Florida. www.kameny100.org

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Returning to Alcatraz: Memory through a queer lens

Trump would like to ‘rebuilt and reopen’ notorious island prison

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Alcatraz Island in San Francisco Bay (Photo courtesy of Estuardo Cifuentes)

When I arrived at Alcatraz Island, what I felt wasn’t curiosity — it was discomfort. Standing before such a photogenic landscape, something felt off. As if the place was trying to erase what it truly was: a mechanism of punishment, a machine built to control and define who should be excluded. I couldn’t walk those corridors without thinking about what this place represents for so many of us: a symbol of how the state has decided, time and again, that some lives matter less.

As a queer person, what struck me wasn’t just the past Alcatraz holds — but how that past is still alive in today’s policies. As I looked into the empty cells, I thought about the many LGBTQIA+ people who have been punished simply for existing. People like Frank Lucas Bolt, the first prisoner of Alcatraz — not convicted for violence, but for “sodomy,” a label the legal system used to persecute gay men.

He was not the only one. For decades, being gay or trans was enough to end up in a federal prison or a psychiatric hospital. Not for a crime, but for defying the norm. The legal and medical systems worked hand in hand to suppress any deviation from prescribed gender and sexuality. In prisons, queer people were subjected to physical punishment, solitary confinement, and even conversion therapy. Alcatraz was not an exception — it was one of the system’s most brutal epicenters.

But the queer memory of this place isn’t found in tourist brochures. To uncover it, you have to read between the lines, search through archives that are never taught in schools, and listen to those who still carry the scars. Walking among those walls, I realized that remembering isn’t enough — we have to contest the meaning of memory itself. What isn’t told, is repeated.

That’s why, when a few weeks ago President Trump said he’d like to “rebuild and reopen Alcatraz,” I didn’t take it as just another symbolic gesture. I took it as a warning. In times of crisis, punishment becomes an easy offer: lock them up, expel them, make them disappear. And in that narrative, queer, migrant, and racialized bodies are always the first to be targeted.

The danger isn’t just in the idea of a reopened prison, but in what it represents: The longing to return to a social order that was already deeply unjust. The nostalgia for “tough-on-crime” prisons is the same one that criminalizes unhoused people, persecutes migrants, and stigmatizes queer and trans youth in public spaces. Anyone who dreams of locking up more people isn’t thinking about justice — they’re thinking about control.

In 1969, a group of Native American activists occupied Alcatraz for over a year. They did it to denounce land theft and the government’s betrayal of treaties. During their occupation, they painted a message on the island’s water tower: “Peace and Freedom. Home of the Free Indian Land.” That gesture was a radical reclamation of space, a way of saying: this island can also be a place of resistance.

Alcatraz holds many layers. It was a high-security prison, yes, but it also became the stage for one of the most powerful acts of civil disobedience in the 20th century. That tension still lingers. The question is not just what happened at Alcatraz, but what we want it to represent today. A renewed model of punishment — or a site of memory that helps us prevent more harm?

As I walked its halls, I couldn’t stop thinking about the migrant detention centers that are still full today. About trans people held in inhumane conditions. About arbitrary detentions. About those of us who, like me, crossed borders just to survive. The distance between that Alcatraz and our present is not as wide as we’d like to believe. The walls may change, but punishment still operates on the same bodies.

Standing before the empty cells, I felt what many must have felt there: the weight of abandonment, the state’s mark upon their body, the feeling that their existence was a problem. But I also felt something else: conviction. The certainty that we will no longer walk into those spaces in silence. That we will not let ourselves be labeled as “mistakes” or “deviants.” That if they try to lock us up again, they will find us organized, with memory, with dignity.

Alcatraz does not need to be rebuilt. It needs to be understood. And we — queer, racialized, migrant communities — need to transform that understanding into action: to push back against hateful rhetoric, to protect those still living under threat, and to tell our full stories. Let no one be punished again for being who they are. Let history not become a locked cell once more.

The views expressed in this article are solely my own and do not necessarily reflect those of my employer, colleagues, or any affiliated organization. They are shared from a personal perspective shaped by lived experience and advocacy work.

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