Federal Government
Rachel Levine and AVP on approaching anti-LGBTQ hate as ‘public health threat’
White House LGBTQI+ Safety Partnership ‘ramping up’
Admiral Rachel Levine, assistant secretary for health at the U.S. Department of Health and Human Services, told the Washington Blade in a statement: “We know that hate — whether fueled by homophobia, transphobia, or racism — is a public health threat.”
“I look forward to a day in the future where hate-fueled violence, is an unwelcome memory of the past and no longer incites fear amongst LGBTQI+ people, and all people who live in America,” she said, adding, “We all deserve to live in communities safe from violence.”
A pediatrician and four-star officer who serves as the highest-ranking openly transgender official in U.S. history, Levine’s statement came in response to an inquiry about her meeting on Thursday with New York City Anti-Violence Project (AVP) Executive Director Beverly Tillery.
Also in attendance were the assistant secretary’s senior adviser on LGBTQI+ health equity, Adrian Shanker, and Lynn Rosenthal, director of Sexual and Gender-based Violence at the agency.
“We talked about some of the recommendations we have developed specifically for HHS,” Tillery told the Blade during a phone interview on Friday.
These focused on three areas, she said: “more work that will approach hate violence as a public health issue”; incorporating this approach and addressing “the needs of safe spaces on the ground” when implementing the White House LGBTQI+ Community Safety Partnership; and exploring “opportunities for funding and technical assistance for safe spaces.”
Tillery said that “it was a real honor to be able to have a conversation directly with” Levine, adding that during their meeting, the assistant secretary explained she had made a point of visiting LGBTQ spaces in person.
HHS understands that these groups provide and administer the services it funds, like legal aid and referrals to affirming healthcare providers, she said.
The agency “prioritizes those spaces,” with the knowledge that “we’re talking about a really critical infrastructure in our community,” a network of organizations that “holds our community together in terms of physical and mental health,” Tillery said.
Noting the escalation of violence encountered by LGBTQ individuals and spaces, the White House in June announced plans to create an LGBTQI+ Community Safety Partnership led by the U.S. Department of Homeland Security in coordination with the U.S. Department of Justice and HHS.
“We are now looking to the beginning of next year, kind of having a plan in place for what we think needs to be happening for next Pride season, really early, and also thinking about the election,” Tillery said. “This is a really critical time where we need to make sure that we get as much information and resources and boots on the ground so they can be actively thinking about safety in a bunch of different ways.”
The White House explained the Partnership will “Provide dedicated safety trainings for LGBTQI+ community organizations and increase federal threat briefings for LGBTQI+ organizations,” “protect health care providers who serve the LGBTQI+ community,” and “support LGBTQI+ communities to report hate crimes and build cross-community partnerships to address hate-fueled violence” — all while working “to build trust between LGBTQI+ organizations and federal law enforcement agencies.”
So far, Tillery said, “the bulk of the work right now that has been done rests in” the Department of Homeland Security, but “I do feel like, right now, they’re ramping up and figuring out [questions like] ‘who is going to be responsible for this thing and what is it going to look like?'”
She added that during Thursday’s meeting, “One of the things that we asked HHS to think about and help us think about is, ‘could there be some very public, regular cadence of meetings between organizations and the agencies specifically about this Partnership'” such that the public might be kept apprised of its progress?
“We are really hoping,” Tillery said, “to make sure that there’s a process for AVP and other organizations to be in regular communication with [the agencies] involved in the White House Community Safety Partnership.”
Tillery said she also talked with Levine and the other officials about ways that HHS, which unlike DHS and DOJ does not represent law enforcement, can contribute — such as by “having them play a role in data collection,” especially provided how the agency is already “paying attention to” data on sexual orientation and gender identity “across the board” and is well positioned to identify gaps.
The full spectrum of hate incidents targeting all types and sizes of LGBTQ spaces
For the past few months, Tillery has met with the White House, HHS, and members of Congress to discuss the first of its kind survey conducted by AVP and its corresponding report published in July, “Under Attack: 2022 LGBTQ+ Safe Spaces National Needs Assessment.”
The document contains feedback from LGBTQ groups of all types and sizes from all 50 states on the hate incidents they have experienced and “the critical needs they have for future safety.”
AVP discovered that nearly nine in 10 LGBTQ community centers experienced hate incidents in person or over the phone. The findings are consistent with the increase, from 2021 to 2022, in hate crimes motivated by bias against the victim’s sexual orientation and, especially, gender identity that were reported by the FBI on Oct. 16.
What distinguishes AVP’s report, Tillery told the Blade during a previous interview on Sept. 13, is that “nobody had really looked at this issue of what’s exactly happening with [LGBTQ] spaces across the country.”
She noted the importance of broadening the focus on anti-LGBTQ hate incidents to include not just acts of violence like last year’s the mass shooting at Club Q, but the full range of ways in which LGBTQ people are targeted or made to feel unsafe, and in all types of community spaces from book stores to bars and beyond.
When discussing the report and its findings in meetings on Capitol Hill, Tillery said “people are surprised” to learn the extent of anti-LGBTQ violence as well as “the range of different kinds of incidents that are happening across the country” and “the way these attacks are happening.”
About half of the surveyed LGBTQ groups said they did not report hate incidents to the police, with many respondents explaining that when their spaces were targeted with anti-LGBTQ protests led by white nationalist groups like the Proud Boys, they felt local law enforcement was more closely allied with or sympathetic to the extremists, Tillery said.
She noted the “overlay of gun violence with this as well,” especially in communities that do not have strong gun safety laws; places where, in many cases, anti-LGBTQ protesters showed up heavily armed.
Understanding intimate partner violence within the LGBTQ community
Tillery said she was encouraged by how much of her conversation with Levine, Shanker, and Rosenthal concerned issues of intimate partner violence within the LGBTQ community within the context of anti-LGBTQ violence more broadly.
She explained that victims are often made vulnerable by their sexual orientation, gender identity, or HIV status, and targeted not just with physical violence but also other forms of intimate partner abuse such as forced “outing,” blocking access to medication, or isolation from community and support networks.
The problem was exacerbated by the Covid pandemic, Tillery said, which caused many people to be “stuck at home with people who might be causing them harm.” Likewise, she said, LGBTQ youth who do not live in affirming, supportive homes in many cases “had to relive some of the homophobia and transphobia while they were in isolation with family members.”
The conversation about intimate partner violence dovetailed into other matters Tillery discussed with HHS, such as areas in which there is a deficit in data collection, she said.
For example, she pointed to the results of the Centers for Disease Control and Prevention’s 2021 Youth Risk Behavior Survey that were published in April, which had “great data” about experiences with intimate partner violence among gay and bisexual men and women but very little with respect to transgender and gender nonconforming respondents, Tillery said.
Tillery added that strong data is crucial for the Partnership’s work and beyond, carrying implications “down the road for funding and resources and congressional action.”
Looking ahead to prepare for next year’s Pride and election seasons
Another topic addressed on Thursday, Tillery said, was how best to “get out in front” with the work that must be done on matters of community safety and securing LGBTQ spaces ahead of not just the next Pride season but also the 2024 elections.
She said AVP will continue working with the Biden-Harris administration and other partners on implementing measures to protect the various groups, activists, organizers, and volunteers who will be running voter registration programs, participating in “get out the vote” efforts, and campaigning on behalf of candidates.
“We are now looking to the beginning of next year, kind of having a plan in place for what we think needs to be happening for next Pride season, really early, and also thinking about the election,” Tillery said.
“This is a really critical time where we need to make sure that we get as much information and resources and boots on the ground so they can be actively thinking about safety in a bunch of different ways,” she said.
Tillery added, “Hopefully we can get out in front of it, so that we can provide some groups with some resources and tools before they start doing a lot of those activities as the election season heats up,” she said.
Federal Government
Holiday week brings setbacks for Trump-Vance trans agenda
Federal courts begin to deliver end-of-year responses to lawsuits involving federal transgender healthcare policy.
While many Americans took the week of Christmas to rest and relax, LGBTQ politics in the U.S. continued to shift. This week’s short recap of federal updates highlights two major blows to the Trump-Vance administration’s efforts to restrict gender-affirming care for minors.
19 states sue RFK Jr. to end gender-affirming care ban
New York Attorney General Letitia James announced on Tuesday that the NYAG’s office, along with 18 other states (and the District of Columbia), filed a lawsuit to stop U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. from restricting gender-affirming care for minors.
In the press release, Attorney General James stressed that the push by the Trump-Vance administration’s crusade against the transgender community — specifically transgender youth — is a “clear overreach by the federal government” and relies on conservative and medically unvalidated practices to “punish providers who adhere to well-established, evidence-based care” that support gender-affirming care.
“At the core of this so-called declaration are real people: young people who need care, parents trying to support their children, and doctors who are simply following the best medical evidence available,” said Attorney General James. “Secretary Kennedy cannot unilaterally change medical standards by posting a document online, and no one should lose access to medically necessary health care because their federal government tried to interfere in decisions that belong in doctors’ offices. My office will always stand up for New Yorkers’ health, dignity, and right to make medical decisions free from intimidation.”
The lawsuit is a direct response to HHS’ Dec. 18 announcement that it will pursue regulatory changes that would make gender-affirming health care for transgender children more difficult, if not impossible, to access. It would also restrict federal funding for any hospital that does not comply with the directive. KFF, an independent source for health policy research, polling, and journalism, found that in 2023 federal funding covered nearly 45% of total spending on hospital care in the U.S.
The HHS directive stems directly from President Donald Trump’s Jan. 28 Executive Order, Protecting Children From Chemical and Surgical Mutilation, which formally establishes U.S. opposition to gender-affirming care and pledges to end federal funding for such treatments.
The American Medical Association, the nation’s largest and most influential physician organization, has repeatedly opposed measures like the one pushed by President Trump’s administration that restrict access to trans health care.
“The AMA supports public and private health insurance coverage for treatment of gender dysphoria and opposes the denial of health insurance based on sexual orientation or gender identity,” a statement on the AMA’s website reads. “Improving access to gender-affirming care is an important means of improving health outcomes for the transgender population.”
The lawsuit also names Oregon, Washington, California, Colorado, Connecticut, Delaware, the District of Columbia, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Mexico, Pennsylvania, Rhode Island, Vermont, and Wisconsin as having joined New York in the push against restricting gender-affirming care.
At the HHS news conference last Thursday, Jim O’Neill, deputy secretary of the department, asserted, “Men are men. Men can never become women. Women are women. Women can never become men.”
DOJ stopped from gaining health care records of trans youth
U.S. District Judge Cathy Bissoon blocked an attempt by the Department of Justice (DOJ) to gain “personally identifiable information about those minor transgender patients” from the University of Pittsburgh Medical Center (UPMC), saying the DOJ’s efforts “fly in the face of the Supreme Court.”
Journalist Chris Geidner originally reported the news on Dec. 25, highlighting that the Western District of Pennsylvania judge’s decision is a major blow to the Trump-Vance administration’s agenda to curtail transgender rights.
“[T]his Court joins the others in finding that the government’s demand for deeply private and personal patient information carries more than a whiff of ill intent,” Bissoon wrote in her ruling. “This is apparent from its rhetoric.”
Bissoon cited the DOJ’s “incendiary characterization” of trans youth care on the DOJ website as proof, which calls the practice politically motivated rather than medically sound and seeks to “…mutilate children in the service of a warped ideology.” This is despite the fact that a majority of gender-affirming care has nothing to do with surgery.
In United States v. Skrmetti, the Supreme Court ruled along party lines that states — namely Tennessee — have the right to pass legislation that can prohibit certain medical treatments for transgender minors, saying the law is not subject to heightened scrutiny under the Equal Protection Clause of the Fourteenth Amendment because it does not involve suspect categories like race, national origin, alienage, and religion, which would require the government to show the law serves a compelling interest and is narrowly tailored, sending decision-making power back to the states.
“The government cannot pick and choose the aspects of Skrmetti to honor, and which to ignore,” Judge Bissoon added.
The government argued unsuccessfully that the parents of the children whose records would have been made available to the DOJ “lacked standing” because the subpoena was directed at UPMC and that they did not respond in a timely manner. Bissoon rejected the timeliness argument in particular as “disingenuous.”
Bissoon, who was nominated to the bench by then-President Obama, is at least the fourth judge to reject the DOJ’s attempted intrusion into the health care of trans youth according to Geidner.
Federal Government
HHS ‘peer-reviewed’ report calls gender-affirming care for trans youth dangerous
Advocates denounce document as ‘sham science’
The U.S. Department of Health and Human Services on Nov. 19 released what it called an updated “peer reviewed” version of an earlier report claiming scientific evidence shows that gender-affirming care or treatment for juveniles that attempts to change their gender is harmful and presents a danger to “vulnerable children.”
“The report, released through the Office of the Assistant Secretary of Health, finds that the harms from sex-rejecting procedures — including puberty blockers, cross-sex hormones, and surgical operations — are significant, long term, and too often ignored or inadequately tracked,” according to a statement released by HHS announcing the release of the report.
“The American Medical Association and the American Academy of Pediatrics peddled the lie that chemical and surgical sex-rejecting procedures could be good for children,” said HHS Secretary Robert F. Kennedy Jr. in the HHS statement, “They betrayed their oath to first do no harm, and their so-called ‘gender affirming care’ has inflicted lasting physical and psychological damage on vulnerable young people,” Kennedy says in the statement.
The national LGBTQ advocacy organizations Human Rights Campaign and GLAAD issued statements on the same day the HHS report was released, denouncing it as a sham based on fake science and politics.
HRC called the report “a politically motivated document filled with outright lies and misinformation.”
In its own statement released on the same day the HHS report was released, HRC said HHS’s so-called peer reviewed report is similar to an earlier HHS report released in May that had a “predetermined outcome dictated by grossly uninformed political actors that have deliberately mischaracterized health care for transgender youth despite the uniform, science backed conclusion of the American medical and mental health experts to the contrary.”
The HRC statement adds, “Trans people’s health care is delivered in age-appropriate, evidence-based ways, and decisions to provide care are made in consultation with doctors and parents, just like health care for all other people.”
In a separate statement, GLAAD CEO Sarah Kate Ellis called the HHS report a form of “discredited junk science.” She added the report makes claims that are “grossly misleading and in direct contrast to the recommendations of every leading health authority in the world … This report amounts to nothing more than forcing the same discredited idea of conversion therapy that ripped families apart and harmed gay, lesbian, and bisexual young people for decades.”
In its statement announcing the release of its report, HHS insists its own experts rather than those cited by its critics are the ones invoking true science.
“Before submitting its report for peer review, HHS commissioned the most comprehensive study to date of the scientific evidence and clinical practices surrounding the treatment of children and adolescents for ‘gender dysphoria,’” the statement continues. “The authors were drawn from disciplines and professional backgrounds spanning medicine, bioethics, psychology, and philosophy.”
In a concluding comment in the HHS statement, Assistant Secretary for Health Brian Christine says, “Our report is an urgent wake-up call to doctors and parents about the clear dangers of trying to turn girls into boys and vice versa.”
President Donald Trump on Wednesday signed a bill that reopens the federal government.
Six Democrats — U.S. Reps. Jared Golden (D-Maine), Marie Gluesenkamp Perez (D-Wash.), Adam Gray (D-Calif.), Don Davis (D-N.C.), Henry Cuellar (D-Texas), and Tom Suozzi (D-N.Y.) — voted for the funding bill that passed in the U.S. House of Representatives. Two Republicans — Thomas Massie (R-Ky.) and Greg Steube (R-Fla.) — opposed it.
The 43-day shutdown is over after eight Democratic senators gave in to Republicans’ push to roll back parts of the Affordable Care Act. According to CNBC, the average ACA recipient could see premiums more than double in 2026, and about one in 10 enrollees could lose a premium tax credit altogether.
These eight senators — U.S. Sens. Catherine Cortez Masto (D-Nev.), Dick Durbin (D-Ill.), John Fetterman (D-Pa.), Maggie Hassan (D-N.H.), Tim Kaine (D-Va.), Angus King (I-Maine), Jacky Rosen (D-Nev.), and Jeanne Shaheen (D-N.H.) — sided with Republicans to pass legislation reopening the government for a set number of days. They emphasized that their primary goal was to reopen the government, with discussions about ACA tax credits to continue afterward.
None of the senators who supported the deal are up for reelection.
King said on Sunday night that the Senate deal represents “a victory” because it gives Democrats “an opportunity” to extend ACA tax credits, now that Senate Republican leaders have agreed to hold a vote on the issue in December. (The House has not made any similar commitment.)
The government’s reopening also brought a win for Democrats’ other priorities: Arizona Congresswoman Adelita Grijalva was sworn in after a record-breaking delay in swearing in, eventually becoming the 218th signer of a discharge petition to release the Epstein files.
This story is being updated as more information becomes available.
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