Opinions
This World AIDS Day, we must protect access to HIV medicines
We stand on the precipice of ending the epidemic

As a physician who has worked with patients living with HIV since the AIDS crisis in the 1980s, I’ve seen the darkness and the light.
Back then, it was a scary, anxious time—not only for patients, but also for clinicians. We lacked effective medical treatments. Patients swallowed handfuls of pills. These complex regimens often worked only for short periods of time and brought difficult side effects. Contracting HIV seemed like a painful death sentence—and one that too often lacked dignity, as many morticians then refused to embalm those who had succumbed to the disease.
Today, the reality is much brighter. I now regularly counsel my patients who contract the virus to plan on living a full life into their golden years. With longer lives, more people now access prescription HIV drugs from Medicare than ever before. While we still lack a cure, we stand on the precipice of ending the epidemic because we know people cannot transmit the virus through sex when they have undetectable levels of HIV. This incredible step forward—a concept known as U=U, or undetectable equals untransmittable—is due in large part to the steady supply of a wide variety of antiretroviral medications. So long as patients have access to quality care and the right medicine, HIV is now a manageable disease.
One important but unsung hero in this progress? An obscure federal law with long, bipartisan support, known as the “six protected classes” policy. It mandates that Part D prescription drug plans cover “all or substantially all” medications in six protected classes. It helps Medicare beneficiaries with some of the most serious health conditions: not only HIV, but also cancer, epilepsy, and those at risk of organ transplant rejection. Now that policy is under threat because pharmacy benefit managers—or the drug middlemen who decide which drugs your plans include and your pharmacy carries—are pressing the federal government to weaken the policy to pad their bottom lines.
For those living with HIV, the stakes could not be higher. Until we have a cure, patients must take drugs regularly and diligently for the rest of their lives. Thanks to decades of incredible innovation, there are now 23 different antiretrovirals in nine different drug classes available to those living with HIV. I have prescribed every single one. Sometimes, I’ll prescribe from nine different two- or three-drug single tablet co-formulated combinations to find the most effective option for a patient.
While patients have more options, they still face challenges adhering to their regimen. Some experience a gap in coverage due to loss of insurance or a switch in plans. Copayments can become a financial barrier. Others might experience side effects or have conditions making a particular medication unsuitable.
These antiretroviral medications are not interchangeable. If a patient doesn’t take the exact medicine they need, they risk side effects, problematic medication interactions, and possibly developing resistance to HIV. If the virus comes back, it is genetically unforgiving. Now resistant to an entire class, the virus steals precious options for the patient, particularly those who have been living with HIV for decades. To overcome this, I need—my patients need—every single option at their disposal. The only way I can keep my patients maximally suppressed, living well, feeling good, and able to live a full, healthy life is if they have access to the full range of drugs.
We have come a long way. Over the past decade, we have driven new deaths down by 70 percent and new infections down by 40 percent worldwide. But this progress is not guaranteed. If we eliminate the number of antiretrovirals available to patients, the danger of a backslide into resistant strains of the virus is real.
As we recognize World AIDS Day, let us not only remember the millions this disease has taken, but let us also recommit ourselves to the 40 million people worldwide living with HIV and many more who are at risk of contracting it.
Let’s protect this critical federally protected drug class policy that has delivered so much progress. We can’t slide back into darkness. We must keep pushing forward into the light.
Dr. James A. Sosman is a recognized leader in the field of HIV/AIDS medicine and serves as medical director for the Midwest AIDS Training and Education Center.
Opinions
TRAITOR: Treasury Secretary Scott Bessent has blood on his hands
Nation’s highest-ranking gay public official is a MAGA sell out

It’s an odd dichotomy: President Trump appoints the highest-ranking openly gay government official in history in Treasury Secretary Scott Bessent, yet he launches cruel attacks on transgender Americans.
Make no mistake: Those attacks are claiming lives. Trans people are killing themselves. I know of one trans person who died by suicide on Election Night, overwhelmed by fear of the incoming administration. Trump’s attacks have driven trans Americans and their families to flee the country and move to Canada, as the Blade has reported.
None of this is hypothetical or melodramatic. It’s real life and happening everywhere.
And so when Bessent was confirmed as Treasury Secretary, I wrote an op-ed urging him to educate Trump about the plight of trans Americans and the destructiveness of the attacks on the community. I waited 90 days for some sign that Bessent has a heart or at least a modicum of decency but sadly, I must report that he does not.
The attacks on the LGBTQ community under Trump keep coming. Last week’s news that the U.S. Department of Health and Human Services is planning to retire the national 988 crisis lifeline for LGBTQ youth on Oct. 1 is just the latest evidence that this administration doesn’t just dislike us — they want us dead.
“Ending the 988 Suicide and Crisis Lifeline’s LGBTQ+ youth specialized services will not just strip away access from millions of LGBTQ+ kids and teens — it will put their lives at risk,” Trevor Project CEO Jaymes Black said in a statement.
The service for LGBTQ youth has received 1.3 million calls, texts, or chats since its debut, with an average of 2,100 contacts per day in February.
Make no mistake: cutting this service will kill young LGBTQ people.
Just a couple of weeks earlier, Trump’s administration announced the Office of Infectious Disease and HIV/AIDS Policy would be gutted.
“In a matter of just a couple days, we are losing our nation’s ability to prevent HIV,” said HIV+Hepatitis Policy Institute Executive Director Carl Schmid.
And prior to that, Trump issued a series of executive orders targeting the trans community — restricting access to affirming healthcare, banning trans service members from the military, barring trans women and girls from playing sports, eliminating the “X” gender marker on passports, and barring students assigned male at birth from using women’s restrooms.
Let’s be very clear: When you deny someone the ability to use the bathroom, you deny their humanity.
So back to Scott Bessent, the billionaire hedge fund manager now running our economy into the ground. As many Trump protesters have noted: silence is complicity. And Bessent has been silent on all of these horrific attacks on trans Americans and their basic humanity. He is spineless and a traitor to the LGBTQ community.
Bessent runs the U.S. Treasury and reportedly has Trump’s ear on all matters related to the economy. He could easily push Trump in a better, more compassionate direction, yet there is no evidence he has done that.
“The LGBTQ+ community is counting on openly LGBTQ+ nominees like Scott Bessent to step up for the community,” said Human Rights Campaign President Kelley Robinson after the inauguration. Sadly, it’s become clear we cannot count on Bessent. As I wrote in January, Trump likes his queer people gay, white, cis, rich, and obedient.
Bessent has ignored the Blade’s interview requests. (And after this is published, I have no illusions he will change his mind.) The mainstream media, increasingly cowed by Trump, have failed to ask Bessent even the most basic questions about his views on trans equality and Trump’s attacks.
As a member of the LGBTQ community, Bessent has a responsibility to at least speak up on behalf of trans people who are suffering. But Republicans today have lost their spines. They genuflect before their Dear Leader, line their own pockets, and leave the rest of us to deal with the consequences.
The crisis is real. People are dying. Trans people especially are suffering. The rest of us must do what we can to mitigate that suffering and to speak out in defense of our trans friends.
Kevin Naff is editor of the Washington Blade. Reach him at [email protected].
Opinions
Congressional Equality Caucus should participate in WorldPride
Make bold statement about our commitment to LGBTQ rights

The Trump administration, by its actions, has already hurt WorldPride. By attacking trans people, they have gotten many nations to suggest to trans citizens they not come to the United States. Canada’s queer group has said it is advising its people not to come. It is sad in so many ways. But despite what the felon in the White House is doing, WorldPride will be a success. It can be a time to not only have fun, but to make a point to the administration and the world. What was the old saying, “We’re here, we’re queer, and we’re not going anywhere, so get used to it.” The LGBTQ community in the United States has made great strides since Stonewall in 1969, and there is no way we are going back into the closet.
One way we can make a strong statement is if every member of the Congressional Equality Caucus would come out and join hands with constituents from their state, who are coming to D.C. for WorldPride. Together, they can take a stand for equality. Together, they can make a statement about our country to the world; that the United States values and supports its LGBTQ community.
This year from May 17-June, we are anticipating huge crowds in Washington, D.C. for WorldPride. Let us together make sure they are all safe and that they have an exciting and fun time while here. But at the same time we should use this gathering to speak out, for our community here, and the LGBTQ community around the world.
We must show the felon in the White House, and his MAGA acolytes in Congress, and around the nation, all those who would keep us down, we can, and will, stand up for ourselves. We are only willing to move one way, and that is forward toward full equality. Many years ago, during the early fight for recognition of the HIV/AIDS epidemic, there was an event staged by the group ACT UP, called ‘hands around the White House.’ It is time to stage something like that again.
With all the attacks on the trans community, and as threats to the entire LGBTQ community continue, we need to stand together, and stay strong. We need to join with everyone else who is fighting back against the felon, and his Nazi sympathizing co-president, in the White House. To join in the demonstrations, fight back, and not fall for the distractions meant to take us from our goals. Those goals must include defeating every Republican in elections in 2025, and taking back Congress in 2026. I say every Republican, only because today there is no longer a rational Republican Party. That party has become a MAGA Party, or ‘Cult of Trump.’ That is sad, but it’s true. It is not up to Democrats, or independents, to change the Republican Party; it is up to us to ensure their defeat until they change themselves.
Until then we must work hard to elect Democrats across the nation. From school board, to county council, from statehouse to Congress. For the LGBTQ community that is the only way we will move forward on equality. It is the only way we can defeat those who want to ban books about our lives, and try to force us back in the closet. We must say a resounding NO to that.
We must vote for Democrats because history shows us, any other vote, a vote for a third party, helps Republicans win. The reality, like it or not, is today there are only two parties that can win a general election. Yes, in a few rare districts, a third party has won. But this is rare and let’s not take the chance of that happening if there isn’t a history in your state, or district, or community, where it happened in the past. Be smart! While you may not like everything the Democratic Party stands for, it has proven, its members stand for the rights of the LGBTQ community. The incredible progress since Stonewall has been because the Democratic Party has worked with the activists in our midst, to make that progress. Let’s not give up now and move backwards with the MAGA Party. Together, let’s retake our government, and continue to move forward until we have full equality. That must be the goal we join hands for, and pledge to work toward.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.

With legislation making it more difficult for transgender and gender non-conforming people to change their passports and other documents, it is now a race against the clock to change as many of them as possible.
Trans Maryland and Advocates for Trans Equality are among the groups that offer workshops and online resources.
Here’s how I did it in Maryland:
A letter from your primary care provider
The first thing you’ll need to get any of this rolling is a document from your primary care provider that shows proof of hormone therapy, gender incongruence, or both. In my experience, this is important to have prior to getting anything started because some states require some sort of proof in order to certify the change.
Some courts may need a therapist’s letter as well, but it depends on what state you live in. With this document, you’ll be able to bring it to the respective offices and it will give a valid reason for you to get your desired gender marker.
A court order
The next thing you will need is a court order that recognizes your gender identity. It is a precaution just to avoid any wasted time or confusion at any offices going forward. You will go to the circuit court website for what state/county you reside in and find a document that is a petition to change your gender. Here is an example from Maryland.
You will print that document and fill out the petition for your respective titles with or without a name change and take it to the Circuit Court. Some courts may require the appointment. There, you will present the petition and letter and pay a fee — Maryland’s fee is $165, however there are fee waivers for those that apply. After, you will wait some weeks for the court order to show up.
Social Security card
Unfortunately, as of January 2025, the Social Security Administration has ceased any gender changes in their system. As with the fight for passports reflecting the holder’s proper gender identity, the Human Rights Campaign and the American Civil Liberties Union may bring a case to regain access in the future.
Identity card/driver’s license
After getting your primary care letter and court order, make a standard appointment for Identification Services at the local DMV and bring the paperwork. Though the Maryland Court’s website says there is no need to get a court order to change any documents, the clerk at the Maryland Motor Vehicle Administration (Maryland’s DMV) stressed that I needed the updated Social Security card changed in order to get an updated ID.
I was able to get it changed prior to the Trump-Vance administration, however given the current circumstances, if there is any pushback from any clerk or official who say they require a Social Security card, very adamantly cite the official gov website if applicable, and use the court order, despite the fact you should not need one to get your ID updated.
Birth certificate
Should all have gone well with the ID, the last document to amend is the birth certificate.
Unfortunately, this may be the most difficult document that you are able to amend because it must be done within your home state and some states, such as Oklahoma, Florida, Tennessee, and Texas, have already banned altering birth certificates.
In D.C., where I changed my own, there have been no known issues or legislation passed for changing the name and gender marker on the document. You will search your state government websites for the vital records department, find a Gender Designation Application and fill out the necessary information. The D.C. application is here:
On D.C.’s application, you must sign the document in front of a notary in order for it to be valid. Several mail offices, such as UPS, offer notary services for relatively cheap. Upon getting the application notarized, you can bring all documents you have already updated along with the court order and primary care letter to an appointment at the vital records office. All the previous work done should make this fairly easy if you are in a state that hasn’t made heavy strides to halt the process.
All in all, with about a month of your time, about $300, and a state that supports your right to self-actualization, you should still be able to change most of your documents.
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