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Medical community must address injustices facing LGBTQ patients

Standards of care reinforce a binary, heterosexist model

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We are now living in a modern time where telemedicine can become one of the biggest solutions for the massive inequalities that LGBTQ communities have historically faced in healthcare. When I think back on my OB-GYN residency at Stanford University, I was trained to order a pregnancy test for every patient who could become pregnant who was undergoing surgery — patients were treated the same regardless of or without a discussion about sexual orientation, gender identity, or sexual behavior. 

This is just one example of the gaps in our system. I also witnessed an infertility doctor limiting his practice to married heterosexual couples, and even labor and delivery nurses caring for patients in same-sex relationships expressing discomfort with their assignments. 

I’ve often wondered why the FDA classifies testosterone as a controlled substance. According to the CDC, a drug or other substance is tightly controlled by the government because it may be abused or cause addiction. Labeling testosterone as a controlled substance makes gender affirming hormonal therapy for transgender men and non-binary individuals restrictive. 

Even further, think about the language around abortion, like the Dobbs decision by the Supreme Court in June 2022. “Erosion of women’s rights” implies a cis woman bias, which we all read in the media as well as in the language used from well-intentioned pro-choice groups. Tactics from anti-abortion groups on abortion clinics are now being repurposed. Movements in Florida and Texas exist to make gender transition-related medical care for minors a felony. 

What is the root of these issues? It’s clear: standards of care in clinical medicine have been based on the white male model and when sex assigned at birth mattered, reinforcing a binary and heterosexist model. Those in LGBTQ communities have been stigmatized as a homogenous group of sexual and gender minorities and subjects of relatively little health research. The health status of LGBTQ populations is limited mostly to mental health, HIV, and other sexually transmitted infections. 

Title VII of the Civil Rights Act of 1964 makes it unlawful to discriminate against someone on the basis of race, color, national origin, sex (including pregnancy, sexual orientation, and gender identity) or religion. However, religious entities may be exempt. Religious organizations still have the freedom to provide insurance policies and health care services consistent with their convictions. According to a publication in JAMA Network, the Catholic hospital market share was 18.4% in 2018. 

However, there’s momentum in changing these inequalities for LGBTQ patients. In 2011, the Institute of Medicine released the report “The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding.” The National LGBT Health Education Center (a program of the Fenway Institute) developed a “How To” for Providing Inclusive Services and Care for LGBT People: A Guide for Health Care Staff. 

We, in medicine, have continuous training in implicit bias. Patients want clinicians who can relate to them. This is especially true for historically disenfranchised and marginalized populations. Finding someone you can identify with feels validating, and it may increase your confidence about going to the doctor and your ability to actually adhere to medical advice. 

We need more underrepresented minority physicians and more female physicians in the U.S. healthcare system. What about LGBTQ physicians? Comprehensive data does not exist. We need to develop the LGBTQ physician workforce that values diversity, including LGBTQ identity, if we want to start seeing these changes. 

In the meantime, that IVF doctor with whom I trained now provides inclusive care, demonstrating hope for a new era where patients of all gender identities and sexualities are treated with dignity. 

The medical community is behind and needs to catch up with appropriate equal rights for the LGBTQ community. Telemedicine is one area where healthcare can move more quickly to end these disparities in care. The technology in telemedicine gives LGBTQ patients access to gender-competent, non-discriminatory care, which may be harder to find in rural areas and healthcare deserts. Inclusive online forms and language that are built into the patient experience can better serve all patients. Telemedicine is now our moment. It is THE opportunity to equalize health care and finally reduce these archaic stigmas and biases. 

Dr. Mary Jacobson is an OB-GYN who studied at Stanford University and has dedicated her career to women’s health. She serves as the Chief Medical Adviser at Alpha Medical.

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Miss Major Griffin-Gracy paved the way for today’s transgender rights revolution

The annual Transgender Day of Remembrance is Nov. 20

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Miss Major at the 2024 Democratic National Convention in Milwaukee. (Washington Blade photo by Michael Key)

I’ll never forget the moment Miss Major Griffin-Gracy looked me in the eye and said, “Baby, you can’t wait for permission to exist. You take up space because you deserve to be here.” It was 2016, and I had just finished interviewing her at Northeastern University. What began as a professional encounter became something far deeper. She welcomed me into her chosen family with the fierce love that defined her life’s work.

That advice didn’t just change my perspective; it changed my life. Miss Major had an extraordinary ability to see potential in people before they saw it themselves. She offered guidance that gave permission to dream bigger, fight harder, and live unapologetically in a world that often told transgender people we didn’t belong.

Today, as we reflect on her legacy, we must remember that Miss Major didn’t simply join the transgender rights movement. She helped create it. Her activism laid the foundation for every victory we celebrate today and continues to shape how we fight for justice, dignity, and equality.

To understand her impact, we return to June 28, 1969, when a 27-year-old Black transgender woman stood her ground at the Stonewall Inn. While history often overlooks the transgender women of color at the heart of that uprising, Miss Major was there, refusing to back down when police raided the bar that night.

After Stonewall, she dedicated her life to building what became the infrastructure of liberation. When she fought that night, she wasn’t only resisting police brutality, she was declaring that transgender people, especially Black trans women, would no longer be invisible. Her message was simple: We exist. We matter. We’re not going anywhere.

Miss Major coupled courage with care. She knew that real change required systems of support. While many focused on changing laws, she focused on changing lives. Her work with incarcerated transgender women stands as one of her most powerful legacies. She visited prisons, wrote letters, sent commissary money, and made sure these women knew they weren’t forgotten. It wasn’t glamorous work, but it was transformative.

She built a model of organizing rooted in love and mutual aid communities supporting each other while demanding structural change. That approach became the blueprint for today’s transgender rights organizations, especially those centering Black trans women.

In a time when invisibility was often the safest choice, Miss Major chose visibility. She shared her story again and again, using her own life as proof of transgender resilience and humanity. Her openness created connection and understanding. People who heard her speak couldn’t ignore the truth of our existence or the strength it takes to live authentically.

Miss Major also believed leadership meant creating space for others. After our first meeting, she connected me with other activists, shared resources, and reminded me that my voice mattered. Talk to any transgender activist who came up in the last two decades, and you’ll hear a similar story. She saw something in others and nurtured it until it bloomed.

Her fingerprints are everywhere in today’s movement: in grassroots organizing, in the centering of the most marginalized voices, and in the insistence that liberation must be rooted in love and community. The victories we see (from healthcare access to broader public recognition) are built on the foundation she laid.

In one of our last conversations, Miss Major told me, “This movement isn’t about me. It’s about all of us. And it’s about the ones who come after us.” Her life reminds us that movements are sustained by love as much as protest, by the daily act of showing up for one another as much as by the marches and rallies.

As anti-trans violence rises and our rights face relentless attacks, we need Miss Major’s example more than ever. We need her fierce love, her unwavering defiance, and her belief that we deserve to take up space. Her legacy reminds us that the fight for our lives is also the fight for our joy.

This Transgender Day of Remembrance, we honor those we’ve lost and celebrate those who dared to live fully, people like Miss Major, who taught us that remembrance must come with responsibility. Her life calls us to protect one another, to build systems of care, and to keep fighting for a world where every trans person can live safely and proudly.

The mother of our movement may be gone, but the family she built lives on. The best way to honor her is to continue her work: to build, to protect, to love without limits, and to remind every trans person that they belong, they matter, and they are loved.

Chastity Bowick is an award-winning activist, civil rights leader, and transgender health advocate who has dedicated her career to empowering transgender and gender-nonconforming communities. She led the Transgender Emergency Fund of Massachusetts for seven years, opening New England’s first trans transitional home, and now heads Chastity’s Consulting & Talent Group, LLC. In 2025, she became Interim Executive Director of the Marsha P. Johnson Institute, continuing her mission to advance equity, safety, and opportunity for trans people. Her leadership has earned her numerous honors recognizing her impact on social justice and community care.

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Democratic Socialism won’t win the whole country

We must work toward a blowout on Nov. 3, 2026

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Mayor-elect Zohran Mamdani (Screen capture via Zohran Mamdani for NYC/YouTube)

It was a great win for Zohran Mamdani, and his voters, in New York City. His message of hope and change clearly resonated with younger generations, and that is exciting. But while Democratic Socialism, and Eugene Debs, may be the future of New York City, they won’t win the country. Mamdani is a young, smart, charismatic, politician. He is a great speaker, and in his campaign made many promises. Keeping those promises won’t be easy, but whether he can keep them will be what he is judged on. I wish him much success as what he envisions is important. But as Democrats, we need to understand, his brand is not going to be what wins it for Democrats in 2026. It will not win the swing Districts we need. We know that by looking at history. 

I am a proud New Yorker by birth. When traveling the nation as a teenager with the Boy Scouts, going by bus across the country to the 25th Jamboree in Colorado Springs, I understood we in New York were the different ones, not the rest of the nation. I understood at an early age how important it is to respect those differences and they still exist today. If we are to move the nation forward, we have to do it with respect, and together. 

I looked at how Mikie Sherrill won the governorship in New Jersey, and Abigail Spanberger won in Virginia. Their strong messages, more in line with the majority of voters in the nation who see themselves as moderates, are likely to resonate with Democratic voters across the swing congressional districts Democrats need to win in 2026, if they are to take back the House. Based on exit polling their messages also invigorated many young voters. We will need everyone to take back Congress and doing so is a must if we are to save our country from the felon in the White House. 

There are countless reasons to stop Trump. He wants to be a king, and has said so. He acts like a despot declaring war on foreign countries without congressional consent, and even declaring war on American cities. He doesn’t understand the United States is a nation of immigrants and without them we are in trouble. I guess the only immigrants he found of value were two of his wives, and he even screwed around on them. He uses ICE as if it were his personal Gestapo. He sends National Guard troops across the nation and into D.C. where some picked up trash in the parks and spread mulch. Not what they signed up for, and a total waste of taxpayer’s money. He threatens the world’s nations, allies, and foes alike, with tariffs that end up being a heavy tax on the American taxpayer. He pretends to negotiate deals, like one with China, not even getting us back to the positive relationship we had with them when Biden was president. Trump screws up everything he touches.  He plays footsie with Putin. He refuses to actively support the brave people of Ukraine whose war against Russia is in essence, a proxy war with the West. He gives tax breaks to the rich, and is willing to close the government instead of ensuring everyone has affordable healthcare. He threatens the poor with starvation, and screws with the nation’s healthcare, destroying the CDC, and the National Institutes of Health (NIH), the world’s premier medical research institute. He threatens law firms, universities, and the media, holding them hostage for money. He uses the Department of Justice as his personal law firm to get revenge on anyone he thinks did him wrong. He fires thousands of government workers, and when his incompetent appointments screw up, has to rehire many. He is a grifter, exchanging favors for money for himself, with countries around the world. A plane from Qatar, and billions for his crypto company. 

What Americans are seeing as the result of his incompetence, are prices for food, rent, and education, all going up. Farmers are suffering. All this is what Democrats will campaign on across the nation. 

But they must also campaign on what they will do to make things better. They must talk to their constituents in each District, and determine the focus of their campaigns. What issues to campaign on. Those campaigns could look different in each District. That is how Democrats will win. That is how Democrats won last Tuesday, and that great start will lead to a huge Blue Blowout, on Tuesday, Nov. 3, 2026.


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

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Building on victory

The bloom is off Trump’s stink-blossom

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President Donald Trump (Washington Blade photo by Michael Key)

Voters handed Democrats a sweeping victory across the country in the Nov. 4 elections. Donald Trump’s Republicans paid dearly for their inability to restrain or conceal their recklessness and cruelty.

In response to being roundly repudiated at the polls, Trump boasted, lied, made insults and threats. Mind you, this is a man who confuses dementia screening with an IQ test. And he once proposed nuking hurricanes.

Trump’s howlers, including the claim that every election he loses is rigged, are persuading fewer and fewer people.

You would never know, on this bright autumn morning, that a pitched battle is underway for the soul of America. As I sip my coffee in the McDonald’s, a little girl walking by with her daddy climbs into the chair at the next table. She is holding a TV remote control for some reason. I ask her not to point it at me because I don’t want to be switched off.

To be honest, there are people I wouldn’t mind switching off, at least from my newsfeed. For example, I saw this headline concerning an obnoxious congresswoman: “Nancy Mace escalates fallout from foul-mouthed airport meltdown with legal threats after criticism from fellow Republicans.”

Is it possible that Rep. Mace, who is running for governor of South Carolina and has been calling trans people crazy, is so starved of attention that she has to scream at officers in airports and threaten lawsuits? I stress that I’m just a humble commentator and do not mean to provoke her.

I can’t help recalling that the phrase “Trump Derangement Syndrome” arose not as a reference to Trump’s own mental health issues but as an effort to deflect such concerns onto his critics. Lately, however, we who wish to be rid of the Worst President Ever have gone from being mad to being domestic terrorists in the eyes of Trump diehards. We are also called insurrectionists, despite never having incited a riot at the U.S. Capitol, because the leading insurrectionist—who deems himself above the law—is considering invoking the Insurrection Act to consolidate dictatorial power.

Are you keeping up with all this? I know it sounds crazy. You never know what jarring images you’ll stumble upon. On election night I switched to CNN, saw former Chicago mayor Rahm Emanuel, and immediately reached for my remote control like that little girl in the McDonald’s. And Rahm is a Democrat!

New York City Mayor-elect Zohran Mamdani is an immigrant who grew up in New York. I am a native Washingtonian who grew up in Maryland’s 8th congressional district, currently represented by constitutional scholar Jamie Raskin. Raskin has happily dubbed Mamdani an FDR Democrat.

You might think comparing a gifted young politician to Franklin Delano Roosevelt would not scandalize anyone at this point; but you would be wrong. Lots of Republicans still decry FDR as a socialist. These are the same people set on robbing millions of their healthcare and nutritional assistance.

Trump, who hosted a Great Gatsby-themed party at Mar-a-Lago hours before millions of Americans lost their SNAP benefits, touted the Roaring Twenties as a high point in America’s past. I don’t want to burst his bubble, so please don’t tell him that the 1920s ended in a stock market crash that ushered in the Great Depression. God forbid his tariffs lead to another crash. He would likely blame it on Mamdani, rebrand it a communist Islamic jihad, and deport it to Eswatini.

Democrats like me support capitalism, but with guardrails. By contrast, the oligarchs—epitomized by Elon Musk with his recently approved $1 trillion pay package—love to blame others for the harm they cause, while making off with the moolah. Do not fall for it.

I am rooting for Mamdani, who wants working people to be able to afford to live in New York. He includes trans people in his vision. His victory speech was a far cry from the Islamophobic caricature painted by his detractors, who range from right-wing pundits to Andrew Cuomo.

Based on the smears, you might expect the mayor-elect to rush to Washington to demolish part of the White House, had the president not beaten him to it. Yet in the wake of Mamdani’s historic victory, billionaires who fought tooth and nail to defeat him bent the knee and pledged their help.

Mamdani is not the model for all Democrats; he reflects but one part of our diverse coalition. The midterm elections are a year away. All our voices and votes will be needed to defeat the authoritarians.

Copyright © 2025 by Richard J. Rosendall. All rights reserved.


Richard Rosendall is a writer and activist who can be reached at [email protected].

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