Federal Government
Adm. Levine, Admin. Guzman visit LGBTQ-owned dental and medical practices
Officials talked with the Blade about supporting small businesses
The Washington Blade joined Assistant Secretary for Health Adm. Rachel Levine of the U.S. Department of Health and Human Services and Administrator Isabel Guzman of the U.S. Small Business Administration as they toured two LGBTQ-owned small businesses on Tuesday in Washington, D.C. — Big Gay Smiles and Price Medical.
The event provided an “amazing opportunity” to “talk about the different synergies in terms of small businesses and the SBA, and health equity for many communities,” including the LGBTQ community, Levine told the Blade.
Representation matters, she said, adding, “that’s true in dental care and medical care,” where there is a tremendous need to push for improvements in health equity — which represents a major focus for HHS under her and Secretary Xavier Becerra’s leadership, and in the Biden-Harris administration across the board.
“Small businesses identify needs in communities,” Guzman said. With Big Gay Smiles, Dr. Robert McKernan and his husband Tyler Dougherty “have clearly identified a need” for “dentistry that is inclusive and that is respectful of the LGBTQIA community in particular.”
She added, “now that they’re a newly established business, part of the small business boom in the Biden-Harris administration, to see their growth and trajectory, it’s wonderful to know that there are going to be providers out there providing that missing support.”
The practice, founded in 2021, “is so affirming for the LGBTQIA community and we certainly wish them luck with their venture and they seem to have a great start,” Levine said. “They’re really dedicated to ending the HIV epidemic, providing excellent dental care, as well as oral cancer screenings, which are so important, and they’re really providing a real service to the community.”
Big Gay Smiles donates 10 percent of its revenue to national and local HIV/AIDS nonprofits. McKernan and Dougherty stressed that their business is committed to combatting homophobia and anti-LGBTQ attitudes and practices within the dental field more broadly.
“We try to align our practices here within this dental office to align with the strategic initiatives being able to help reduce HIV transmission, reduce stigma, and help to ensure people have the knowledge and [are] empowered to ensure that they’re safe,” Dougherty said.
McKernan added, “With the Academy of General Dentistry, we’ve done a lot of discussions around intersex, around trans affirming care, in order to help educate our fellow dental providers. It’s very important that every dentist here in the [D.C. area] provide trans affirming care and gender affirming care because it’s very important that someone who comes to a medical provider not be deadnamed, not get misnamed, and have an affirming environment.”
Trans and gender expansive communities face barriers to accessing care and are at higher risk for oral cancer, depression, and dental neglect. Levine, who is the country’s highest-ranking transgender government official, shared that she has encountered discrimination in dental offices.
After touring the office, Levine and McKernan discussed the persistence of discrimination against patients living with HIV/AIDS by dental practices, despite the fact that this conduct is illegal.
“I’ve traveled around the country,” the assistant health secretary told the Blade. “We have seen that many FQHCs [federally qualified health centers] or community health centers as well as LGBTQIA community health centers have had dentists, like Whitman-Walker, to provide that care because many people with HIV and in our broader community have faced stigma and have not been able to access very, very important dental care.”
Prior to opening his practice, McKernan practiced dentistry at Whitman-Walker, the D.C. nonprofit community health center that has expertise in treating LGBTQ patients and those living with HIV/AIDS. Big Gay Smiles is a red ribbon sponsor for the organization’s Walk & 5K to End HIV.
After their visit with Big Gay Smiles, Levine and Guzman headed to Price Medical, a practice whose focus areas include internal medicine/primary care, HIV specialty care, immunizations, infectious disease treatment, and aesthetics like Botox.
There, the officials talked with Dr. Timothy Price about his office’s work advancing health equity and serving LGBTQ patients including those living with HIV/AIDS, as well as the ways in which small businesses like his have benefitted from access to electronic health records and telemedicine.

“People being able to access medical care from the comfort of their home or workplace can be very important,” Price said, with technology providing the means by which they can “ask questions and get an answer and have access to a health care provider.”
Often, LGBTQ patients will have concerns, including sexual health concerns, that need urgent attention, he said. For instance, “we’ve had patients need to access us for post-exposure prophylaxis for HIV,” in some cases when “people are vacationing and they have something that might be related to their health and they can reach us [via telemedicine] so that’s the way it’s really helped us and helped the patients.”
Access to technology for small businesses is an area in which the SBA can play a valuable role, Guzman noted.
“The Biden-Harris administration has focused on a whole-of-government approach to making sure we can support the community, and that includes in entrepreneurship,” she told the Blade.
“There’s a surge in [small] businesses starting and that includes” those founded by members of the LGBTQ community “and so you see that there’s products and services that need to be offered,” and the administration is “committed to making sure that we can fund those great ideas.”
Guzman said she sees opportunities for future collaboration between her agency and HHS to help encourage and facilitate innovation in the healthcare space. “Small businesses are innovators creating the future of health tech,” she said.
Levine agreed, noting “we have been talking about that, about different ways that we can work together, because as we think about the social determinants of health and those other social factors that impact health, well, economic opportunity is absolutely a social determinant of health,” and small businesses are certainly a critical way to broaden economic opportunity.
Federal Government
Top Democrats reintroduce bill to investigate discrimination against LGBTQ military members
Takano, Jacobs, and Blumenthal sponsored measure
Multiple high-ranking members of Congress reintroduced the Commission on Equity and Reconciliation in the Uniformed Services Act into the U.S. House of Representatives and the U.S. Senate, aiming to establish a commission to investigate discriminatory policies targeting LGBTQ military members.
Three leading Democratic members of Congress — U.S. Rep. Mark Takano (D-Calif.), who is the House Veterans’ Affairs Committee’s ranking member and chairs the Congressional Equality Caucus; U.S. Sen. Richard Blumenthal (D-Conn.), who is the Senate Veterans’ Affairs Committee’s ranking member; and U.S. Rep. Sara Jacobs (D-Calif.) — introduced the bill on Tuesday.
The bill, they say, would establish a commission to investigate the historic and ongoing impacts of discriminatory military policies on LGBTQ servicemembers and veterans.
This comes on the one-year anniversary of the Trump-Vance administration’s 2025 Executive Order 14183, titled “Prioritizing Military Excellence and Readiness,” which essentially banned transgender servicemembers from openly serving in the Armed Forces, leading to the forced separation of thousands of capable and dedicated servicemembers.
In a joint statement, Takano, Blumenthal, and Jacobs shared statistics on how many service members have had their ability to serve revoked due to their sexual orientation:
“Approximately 114,000 servicemembers were discharged on the basis of their sexual orientation between WWII and 2011, while an estimated 870,000 LGBTQ servicemembers have been impacted by hostility, harassment, assault, and law enforcement targeting due to the military policies in place,” the press release reads. “These separations are devastating and have long-reaching impacts. Veterans who were discharged on discriminatory grounds are unable to access their benefits, and under the Trump administration, LGBTQ+ veterans and servicemembers have been openly persecuted.”
The proposed commission is modeled after the Congressional commission that investigated and secured redress for Japanese Americans interned during World War II. Takano’s family was among the more than 82,000 Japanese Americans who received an official apology and redress payment under that commission.
The press release notes this is a major inspiration for the act.
“Qualified servicemembers were hunted down and forced to leave the military at the direction of our government,” said Takano. “These practices have continued, now with our government targeting transgender servicemembers. The forced separation and dishonorable discharges LGBTQ+ people received must be rectified, benefits fully granted, and dignity restored to those who have protected our freedoms.”
“LGBTQ+ servicemembers have long been the target of dangerous and discriminatory policies—resulting in harassment, involuntary discharge, and barriers to their earned benefits,” said Blumenthal. “Establishing this commission is an important step to understand the full scope of harm and address the damage caused by policies like ‘Don’t Ask, Don’t Tell.’ As LGBTQ+ servicemembers and veterans face repugnant and blatant bigotry under the Trump administration, we will keep fighting to secure a more equitable future for all who serve our country in uniform.”
“Instead of righting wrongs and making amends to our LGBTQ+ service members and veterans who’ve suffered injustices for decades, I’m ashamed that the Trump administration has doubled down: kicking trans folks out of the military and banning their enlistment,” said Jacobs. “We know that LGBTQ+ service members and veterans have faced so much ugliness — discrimination, harassment, professional setbacks, and even violence — that has led to unjust discharges and disparities in benefits, but we still don’t have a full picture of all the harm caused. That needs to change. That’s why I’m proud to co-lead this bill to investigate these harms, address the impacts of discriminatory official policies like ‘Don’t Ask, Don’t Tell’ and the transgender military ban, and ensure equity and justice for our LGBTQ+ service members and veterans.”
Takano and Jacobs are leading the bill in the House, while Blumenthal is introducing companion legislation in the Senate.
Takano’s office has profiled and interviewed LGBTQ servicemembers who were harmed by discriminatory policies in the uniformed services.
The Commission on Equity and Reconciliation in the Uniformed Services Act is supported by Minority Veterans of America, Human Rights Campaign, Equality California, SPARTA, and the Transgender American Veterans Association.
In recent weeks, thousands of trans military members were forcibly put into retirement as a result of Trump’s executive order, including five honored by the Human Rights Campaign with a combined 100 years of service, all due to their gender identity: Col. Bree B. Fram (U.S. Space Force), Commander Blake Dremann (U.S. Navy), Lt. Col. (Ret.) Erin Krizek (U.S. Air Force), Chief Petty Officer (Ret.) Jaida McGuire (U.S. Coast Guard), and Sgt. First Class (Ret.) Catherine Schmid (U.S. Army).
Multiple career service members spoke at the ceremony, including Takano. Among the speakers was Frank Kendall III, the 26th U.S. Air Force secretary, who said:
“We are in a moment of crisis that will be worse before it is better. Members of my father’s and mother’s generation would ask each other a question: what did you do during the war? Someday we will all be asked what we did during this time. Please think about the answer that you will give.”
Federal Government
Trump-appointed EEOC leadership rescinds LGBTQ worker guidance
The EEOC voted to rescind its 2024 guidance, minimizing formally expanded protections for LGBTQ workers.
The U.S. Equal Employment Opportunity Commission voted 2–1 to repeal its 2024 guidance, rolling back formally expanded protections for LGBTQ workers.
The EEOC, which is composed of five commissioners, is tasked with enforcing federal laws that make workplace discrimination illegal. Since President Donald Trump appointed two Republican commissioners last year — Andrea R. Lucas as chair in January and Brittany Panuccio in October — the commission’s majority has increasingly aligned its work with conservative priorities.
The commission updated its guidance in 2024 under then-President Joe Biden to expand protections to LGBTQ workers, particularly transgender workers — the most significant change to the agency’s harassment guidance in 25 years.
The directive, which spanned nearly 200 pages, outlined how employers may not discriminate against workers based on protected characteristics, including race, sex, religion, age, and disability as defined under federal law.
One issue of particular focus for Republicans was the guidance’s new section on gender identity and sexual orientation. Citing the 2020 U.S. Supreme Court’s Bostock v. Clayton County decision and other cases, the guidance included examples of prohibited conduct, such as the repeated and intentional use of a name or pronoun an individual no longer uses, and the denial of access to bathrooms consistent with a person’s gender identity.
Last year a federal judge in Texas had blocked that portion of the guidance, saying that finding was novel and was beyond the scope of the EEOC’s powers in issuing guidance.
The dissenting vote came from the commission’s sole Democratic member, Commissioner Kalpana Kotagal.
“There’s no reason to rescind the harassment guidance in its entirety,” Kotagal said Thursday. “Instead of adopting a thoughtful and surgical approach to excise the sections the majority disagrees with or suggest an alternative, the commission is throwing out the baby with the bathwater. Worse, it is doing so without public input.”
While this now rescinded EEOC guidance is not legally binding, it is widely considered a blueprint for how the commission will enforce anti-discrimination laws and is often cited by judges deciding novel legal issues.
Multiple members of Congress released a joint statement condemning the agency’s decision to minimize worker protections, including U.S. Reps. Teresa Leger Fernández (D-N.M.), Grace Meng (D-N.Y.), Mark Takano (D-Calif.), Adriano Espaillat (D-N.Y.), and Yvette Clarke (D-N.Y.) The rescission follows the EEOC’s failure to respond to or engage with a November letter from Democratic Caucus leaders urging the agency to retain the guidance and protect women and vulnerable workers.
“The Equal Employment Opportunity Commission is supposed to protect vulnerable workers, including women, people of color, and LGBTQI+ workers, from discrimination on the job. Yet, since the start of her tenure, the EEOC chair has consistently undermined protections for women, people of color, and LGBTQI+ workers. Now, she is taking away guidance intended to protect workers from harassment on the job, including instructions on anti-harassment policies, training, and complaint processes — and doing so outside of the established rule-making process. When workers are sexually harassed, called racist slurs, or discriminated against at work, it harms our workforce and ultimately our economy. Workers can’t afford this — especially at a time of high costs, chaotic tariffs, and economic uncertainty. Women and vulnerable workers deserve so much better.”
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.
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