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Incoming AMA president: ‘We simply will not stand’ for anti-trans healthcare restrictions

Org will use ‘every avenue available’ to push back



Incoming American Medical Association Jesse Ehrenfeld at the AMA's Washington, D.C. office. (Washington Blade photo by Michael Key)

Doctor Jesse Ehrenfeld sat down with the Washington Blade on Tuesday, weeks ahead of the start of his tenure as the American Medical Association’s first openly gay president and amid an onslaught of legislative attacks targeting trans Americans’ access to healthcare.

“We see the attack on reproductive care, reproductive access, and transgender healthcare as a continuum of government overreach into patient-physician decision making,” Ehrenfeld said.

“We simply will not stand for the government coming in to interfere with the doctor-patient relationship,” such as by passing these laws that “outlaw what we know to be appropriate, evidence-based clinical guidelines-based care,” he said.

An anesthesiologist who served as the Joseph A. Johnson Jr. Distinguished Leadership Professor of anesthesiology, surgery, biomedical informatics & health policy at Vanderbilt University’s School of Medicine, much of Ehrenfeld’s professional background has been focused on matters of healthcare access, particularly for LGBTQ patients.

Ehrenfeld directs a $560 million philanthropic organization, Advancing a Healthier Wisconsin Endowment, while also serving as a consultant for the World Health Organization’s Digital Health Technical Advisory Group. He was special adviser to former U.S. Surgeon General Jerome Adams, who served during the Trump administration.

For his research on “understanding how can we use technology to work better for LGBTQ people,” in 2018 Ehrenfeld became the inaugural recipient of the NIH’s Sexual and Gender Minority Research Investigator Award.

He and his team did much of the work for that project at Vanderbilt’s Program for LGBTQ Health, which he co-founded and led for several years “before I took on my current clinical role in Wisconsin.”

“At the end of the day,” Ehrenfeld said, “we’re really about improving access to health care for LGBTQ people, which is a lot of the work that I have been involved in at the AMA and is a core piece of what we’re trying to do nationally through our policy activities.”

In testimony before the U.S. House Armed Services Committee in 2019, Ehrenfeld told lawmakers: “I would like to state unequivocally that there is no medically valid reason—including a diagnosis of gender dysphoria—to exclude transgender individuals from military service.”

Last year, far-right anti-trans pundit Matt Walsh targeted Vanderbilt’s Transgender Health Clinic on his podcast, leading conservative lawmakers in Tennessee to call for investigations of the institution based on information the university claims was “misrepresented” or taken out of context.

“It’s deeply personal for me,” Ehrenfeld said. “Almost everybody that I helped recruit and hire at Vanderbilt, their personal information was shared online. Their names were on TV. And that has had a chilling effect [both] there and in many places across the country, as there have been attempts to intimidate and threaten practitioners who are providing what we know is evidence based appropriate care.”

A big moment for Ehrenfeld and the AMA

Ehrenfeld will be inaugurated as AMA president on June 13, midway through Pride month. It will be an exciting time, he said. “The AMA will have our first contingent walking in the Chicago Pride Parade…so, my husband and the family and the kids will all be there with a bunch of AMA colleagues celebrating at the end of June.”

“It’s an exciting moment for the organization, but I think also for the community for a bunch of reasons,” Ehrenfeld said. “One is, you know, to be an out person in a very visible role, I think sends a message to patients in the community as well as LGBTQ physicians and other healthcare workers, that their needs are being heard in a way that hasn’t always happened,” notwithstanding “challenges that are happening in many places on the legislative level.”

On a personal level, he said, “growing up, I didn’t have a lot of LGBTQ role models in college and medical school who I saw as defining a career pathway for me.” This meant “I would often question, ‘would I have a role? Was there a place for me as an out person in medicine, in leadership, doing policy work, trying to make the community healthier and improve access to health care?'”

Ehrenfeld said his leadership of the AMA marks an “important moment” in the organization’s history, demonstrating what is now possible for LGBTQ people who historically were denied these types of opportunities.

Jesse Ehrenfeld (Washington Blade photo by Michael Key)

Anti-trans laws worsen systemic issues in healthcare

“The AMA opposes any policy “that creates a barrier between a patient and their doctor making a decision that’s in the patient’s best interests,” Ehrenfeld said, which includes “efforts to ban care for transgender people” at the state and federal level. “We stand for the science, the evidence, [and] the clinical guidelines that we know lead to better outcomes for patients.”

Even beyond healthcare restrictions that are passed legislatively, “we have a lot of backseat drivers trying to tell doctors what to do,” Ehrenfeld said, like “insurance companies who put up barriers around prior authorization for getting approval for care and services.”

“Those things are real and they cause people to give up trying to get the care they need,” he said.

Six states have passed laws criminalizing certain healthcare interventions for the treatment of gender dysphoria, which carry the specter of felony charges for healthcare providers. These, Ehrenfeld said, are the most “heartbreaking” for him personally.

Survey data says one in five physicians is experiencing signs of burnout, with an increase beginning with the COVID-19 pandemic, Ehrenfeld said. “That burnout is only exacerbated when you find yourself practicing in a place where a law is passed that tells you how to practice or [tells you] that you can’t practice.”

“That causes moral injury to a physician who finds an untenable choice: provide the care that they know is in the patient’s best interests, or break the law and [potentially] go to jail,” Ehrenfeld said. “And that stress is real. There’s not a week that goes by that I don’t hear from a colleague who says I can’t take it anymore.”

Beyond impacts felt by individual healthcare workers, “we’ve seen a drop in the number of physicians who are applying for training positions in states where care is being restricted,” he said. “When, suddenly, you don’t have specialists and internists and primary care providers working in a state, that impacts care for everybody.”

Anti-trans legislative restrictions on healthcare are increasingly targeting adults, too. Florida’s S.B. 254, which would allow the state to take children away from parents who facilitate their access to best-practices treatments for gender dysphoria, would also bar all Floridians from accessing gender affirming care via telehealth, or that which is administered by nurse practitioners and physicians’ assistants.

“Telehealth is particularly important for a lot of LGBTQ people because of access distance challenges and the need to seek care in places that often is not immediately local,” Ehrenfeld said.

“There’s this cascading effect of, unfortunately reducing access to care that’s very concerning to me and to the AMA,” he said.

When laws proscribe healthcare interventions that “we know to be appropriate,” Ehrenfeld said, “we use every avenue available” – from pressuring the National Governors Association to filing lawsuits and amicus briefs in coordination with other stakeholders as well as “work on the policy side at the federal level and with our state partners.”



Asian American and LGBTQ: A Heritage of Pride

May is Asian American, Native Hawaiian and Pacific Islander Heritage Month



Glenn D. Magpantay (Photo courtesy of Glenn D. Magpantay)

Asian Americans and Pacific Islanders (APIs) are the nation’s fastest growing racial minority group by 2040, one in 10 Americans will be of Asian ancestry. And, while many Americans think that anti-Asian hate and racism towards Asian Americans has disappeared, the community disagrees.

The Asian American Foundation which found that Asian Americans are continually subjected to hate, violence, and discrimination, baldly reveals that disparity. 

  • 33 percent of Americans think hate towards Asian Americans has increased in the past year, compared to 61 percent of Asian Americans themselves.
  • In the past year, 32 percent of Asian Americans across the country reported being called a racial slur; 29 percent said they were verbally harassed or verbally abused.
  • Southeast Asian Americans report even higher incidences of being subject to racial slurs (40 percent), verbal harassment or abuse (38 percent), and threats of physical assault (22 percent).
  • Many Asian Americans live in a state of fear and anxiety with 41 percent of Asian American/ Native Hawaiian/Pacific Islander (AANHPI) believing they will likely be the victims of a physical attack due to their race, ethnicity, or religion. These numbers are disturbing.  

I serve as the only Asian American Pacific Islander member on the U.S. Commission on Civil Rights. And, I am the first and only queer AAPI on the U.S. commission. I am deeply honored to both serve my country and represent my Asian Americans and Pacific Islander community.    

Last year, the commission investigated the Federal Response to Anti-Asian Racism in the United States. With congressional authorization, the report documented the experiences of AANHPIs in the U.S. since the dubbing of COVID-19 as the “China Virus” infecting people with the “Kung Flu” by government leadership. Words matter, as this report shows.

This report has a deep personal connection for me. I am the survivor of a hate crime of 25 years ago for being gay, and the victim of a hate crime for being Asian 25 months ago 

The Stop AAPI Hate Coalition reported that bias incidents against individuals who are Asian and lesbian, gay, bisexual, transgender or queer (LGBTQ) were most prominent between 2019 and 2022, highlighting the intersectional nature of these incidents. For example, two transgender Asian women stated: 

“I was with my new boyfriend at a restaurant. When we walked in the server started calling me names … a b—h, ch—k, tra—i.e. … He said I have a big fat p—s, and told me to go back to China. Then my boyfriend proceeded to walk in the restaurant and when I took a step forward, the server hit me, so I left.” 

“Left a restaurant with friends in the Asian district of town. A man began to follow me calling out ‘Hey you f—got c—k!’ and ‘Come here you virus!’ I began to walk fast towards a crowd until he stopped following me.”

To address these and other equally appalling experiences, I helped shepherd the bipartisan Commission on Civil Rights recommendations to the president, Congress, and the nation that: 

  • Prosecutors and law enforcement should vigorously investigate and prosecute hate crimes and harassment against Asian Americans, as well as Asian Americans who are LGBTQ.
  • First responders should be trained to understand what exactly constitutes a hate crime in their jurisdiction, including the protections of LGBTQ people.
  • Federal, state, and local law enforcement and victim services should identify deficiencies in their programs for individuals with limited English proficiency

Greater language access will make an enormous impact for the Asian American community as one in five Asian individuals speak a language other than English at home. A third (34 percent) is limited English proficient. The most frequently spoken languages are Chinese, Korean, Vietnamese, Tagalog, Thai, Khmer, Bengali, Gujarati, Hindi, and Punjabi.   

For me, this report comes full circle. Since 1988, I’ve lobbied for passage of LGBTQ-inclusive federal and state laws to prevent hate crimes. Since 2001, I’ve supported South Asian and Muslim victims of post 9/11 violence. In response to the shootings at the Pulse nightclub in Orlando, Fla, in 2016; Atlanta Spa in Georgia in 2021; and Club Q in Colorado Springs, Colo., in 2022, I‘ve trained over 3,000 lawyers, law students, and community leaders on hate crimes law.  

And yet, our work is not yet done. 

May is Asian Pacific American Heritage Month. June is LGBTQ Pride Month. Despite these challenges, we are resilient. Let us join together in celebrating our Heritage of Pride 

Glenn D. Magpantay, Esq., is a long-time civil rights attorney, professor of law and Asian American Studies, and LGBTQ rights activist. Glenn is a founder and former Executive Director of the National Queer Asian Pacific Islander Alliance (NQAPIA). He is principal at Magpantay & Associates: A nonprofit consulting and legal services firm. In 2023, the U.S. Senate (majority) appointed Glenn to the U.S. Commission on Civil Rights to advise Congress and the White House on the enforcement of civil rights laws and development of national civil rights policy. 

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CDC issues warning on new ‘deadlier strain’ of mpox

WHO says epidemic is escalating in Congo



JYNNEOS mpox vaccine (Photo courtesy of the CDC)

The Centers for Disease Control and Prevention has issued a health advisory regarding a deadlier strain of the Mpox virus outbreak which is currently impacting the Democratic Republic of Congo.

According to the CDC, since January 2023, DRC has reported more than 19,000 suspect mpox cases and more than 900 deaths. The CDC stated that the overall risk to the U.S. posed by the clade I mpox outbreak is low.

The risk to gay, bisexual, and other men who have sex with men who have more than one sexual partner and people who have sex with men, regardless of gender, is assessed as low to moderate the agency stated.

While no cases of that subtype have been identified outside sub-Saharan Africa so far, the World Health Organization said earlier this week that the escalating epidemic in Congo nevertheless poses a global threat, just as infections in Nigeria set off the 2022 outbreak according to a WHO spokesperson.

The spokesperson also noted that as Pride Month and events happen globally, there is more need for greater caution and people to take steps at prevention including being vaccinated.

The CDC advises that while there are no changes to the overall risk assessment, people in the U.S. who have already had mpox or are fully vaccinated should be protected against the type of mpox spreading in DRC. Casual contact, such as might occur during travel, is not likely to cause the disease to spread. The best protection against mpox is two doses of the JYNNEOS vaccine.

The CDC also noted the risk might change as more information becomes available, or if cases appear outside DRC or other African countries where clade I exists naturally.

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Journalists are not the enemy

Wednesday marks five years since Blade reporter detained in Cuba



The Hungarian Parliament in Budapest, Hungary, on April 4, 2024. Prime Minister Viktor Orbán and his government over the last decade has cracked down on the country's independent media. (Washington Blade photo by Michael K. Lavers)

Wednesday marked five years since the Cuban government detained me at Havana’s José Marti International Airport.

I had tried to enter the country in order to continue the Washington Blade’s coverage of LGBTQ and intersex Cubans. I found myself instead unable to leave the customs hall until an airport employee escorted me onto an American Airlines flight back to Miami.

This unfortunate encounter with the Cuban regime made national news. The State Department also noted it in its 2020 human rights report.

Press freedom and a journalist’s ability to do their job without persecution have always been important to me. They became even more personal to me on May 8, 2019, when the Cuban government for whatever reason decided not to allow me into the country.  

Washington Blade International News Editor Michael K. Lavers after the Cuban government detained him at Havana’s José Marti International Airport on May 8, 2019. (Washington Blade photo by Michael K. Lavers)

‘A free press matters now more than ever’

Journalists in the U.S. and around the world on May 3 marked World Press Freedom Day.

Reporters without Borders in its 2024 World Press Freedom Index notes that in Cuba “arrests, arbitrary detentions, threats of imprisonment, persecution and harassment, illegal raids on homes, confiscation, and destruction of equipment — all this awaits journalists who do not toe the Cuban Communist Party line.” 

“The authorities also control foreign journalists’ coverage by granting accreditation selectively, and by expelling those considered ‘too negative’ about the government,” adds Reporters without Borders.

Cuba is certainly not the only country in which journalists face persecution or even death while doing their jobs.

• Reporters without Borders notes “more than 100 Palestinian reporters have been killed by the Israel Defense Forces, including at least 22 in the course of their work” in the Gaza Strip since Hamas launched its surprise attack against Israel on Oct. 7, 2023. Media groups have also criticized the Israeli government’s decision earlier this month to close Al Jazeera’s offices in the country.

• Wall Street Journal reporter Evan Gershkovich, Washington Post contributor and Russian opposition figure Vladimir Kara-Murza and Radio Free Europe/Radio Liberty’s Alsu Kurmasheva remain in Russian custody. Austin Tice, a freelance journalist who contributes to the Post, was kidnapped in Syria in August 2012.

• Reporters without Borders indicates nearly 150 journalists have been murdered in Mexico since 2000, and 28 others have disappeared.

The Nahal Oz border crossing between Israel and the Gaza Strip on Nov. 21, 2016. Reporters without Borders notes the Israel Defense Forces have killed more than 100 Palestinian reporters in the enclave since Hamas launched its surprise attack against Israel on Oct. 7, 2023. (Washington Blade photo by Michael K. Lavers)

Secretary of State Antony Blinken in his World Press Freedom Day notes more journalists were killed in 2023 “than in any year in recent memory.”

“Authoritarian governments and non-state actors continue to use disinformation and propaganda to undermine social discourse and impede journalists’ efforts to inform the public, hold governments accountable, and bring the truth to light,” he said. “Governments that fear truthful reporting have proved willing to target individual journalists, including through the misuse of commercial spyware and other surveillance technologies.”

U.S. Agency for International Development Administrator Samantha Power, who is a former journalist, in her World Press Freedom Day statement noted journalists “are more essential than ever to safeguarding democratic values.” 

“From those employed by international media organizations to those working for local newspapers, courageous journalists all over the world help shine a light on corruption, encourage civic engagement, and hold governments accountable,” she said.

President Joe Biden echoed these points when he spoke at the White House Correspondents’ Association Dinner here in D.C. on April. 27.

“There are some who call you the ‘enemy of the people,'” he said. “That’s wrong, and it’s dangerous. You literally risk your lives doing your job.”

I wrote in last year’s World Press Freedom Day op-ed that the “rhetoric — ‘fake news’ and journalists are the ‘enemy of the people’ — that the previous president and his followers continue to use in order to advance an agenda based on transphobia, homophobia, misogyny, islamophobia, and white supremacy has placed American journalists at increased risk.” I also wrote the “current reality in which we media professionals are working should not be the case in a country that has enshrined a free press in its constitution.”

“A free press matters now more than ever,” I concluded.

That sentiment is even more important today.

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