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PrEP in transmasculine people

We need more studies on unique challenges facing trans men

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(Photo by Bowonpat/Bigstock)

A new article in “Physician’s Weekly” titled, “Q&A: Improving PrEP Access in Transgender Men, Other Transmasculine People” interviewed two leading HIV doctors on a study they conducted to assess how HIV prevention can best be implemented in the transmasculine population. Strangely — or maybe not so strangely — HIV prevention is not examined enough in transgender men and other assigned-female-at-birth (AFAB) individuals who choose to masculinize and decide to have sex with men. But it’s important, and crucial, to study how the HIV prevention medicine PrEP can best be administered to make sure that all genders are feeling its full and successful effect. 

Historically, as mentioned, PrEP has been used to treat cisgender gay men, especially in light of the HIV crisis of the 1980s and 1990s. Since then, groundbreaking treatments have been introduced to lessen HIV loads in patients and prevent transmission of the disease. 

Also known as pre-exposure prophylaxis, PrEP was approved in 2012 by the FDA as a leading anti-HIV medication going by the brand name Truvada. It quickly became a popular medicine among gay and trans folk. 

As a transgender man myself, there are three things to note when thinking about how PrEP can be better administered and studied in individuals like me. 

The first is barriers to care. Many transgender men might feel a barrier to accessing PrEP because they are unsure how to be prescribed it, who to turn to, and whether it’s socially acceptable to take among their friends. PrEP was traditionally made for cisgender gay men, so its use among that subpopulation is far more varied and spread than its use among transgender men. The happy truth, though, is that PrEP is cheap, if not totally free, and that blood tests required to go on it are also now federally mandated to be free as well. 

Currently, there are outstanding health centers like Whitman-Walker in D.C. that serve as almost free clinics to provide drugs like PrEP and other HIV treatment. Places like Whitman-Walker should continue to thrive without limits. 

The second issue concerning PrEP in transmasculine people is the fact that the drug was initially designed to treat cisgender men, and transgender men were female at birth. There are enough studies that prove or disprove how more effective or less effective PrEP is in individuals who were assigned female at birth. The effectiveness of certain medications on any individual does, sometimes, become affected by what gender they were born with. More studies need to be done to show the efficacy, or any lack of efficacy, in PrEP in gay transgender men versus gay cisgender men. 

Another issue to note is the epidemic among trans men of embarrassment surrounding being on PrEP and talking about gay issues. Currently, it is entirely socially acceptable for transgender men to date women, but some transgender men — if not many sometimes — shame others into being attracted to men. It’s perfectly OK to be a gay trans man, or to be gay in any way, shape, or form for that matter. 

Scientists should consider the above issues when studying transmasculine people who want to go on PrEP. They should study how hormone replacement therapy — including the injection of testosterone — could interfere with the effectiveness of PrEP. They should study how many of us are embarrassed to go on PrEP but still need it to protect our health. They should study how trans men choose to socialize with other gay men and have sexual encounters with men — be it through Grindr, Tinder, or some other dating platform. 

While PrEP was designed for those assigned male at birth, its implications vary widely across all genders and even sexual orientations. New research has even indicated that HIV is sometimes more prevalent, or exists at the same rate, among the straight population in Washington, D.C., and nationwide. As a result, studying PrEP is all the more important. PrEP should be designed and investigated as a non discriminatory drug that benefits people from all walks of life. 

Isaac Amend is a writer based in the D.C. area. He is a transgender man and was featured in National Geographic’s ‘Gender Revolution’ documentary. He serves on the board of the LGBT Democrats of Virginia. Contact him at [email protected] or on Instagram at: @literatipapi

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Opinions

Skipping Memorial Day crowds in Rehoboth Beach

After 30 years, I’ve become allergic to large gatherings

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(Washington Blade photo by Michael Key)

There are a lot of things about getting older that are great. I love retirement, love the cruises I take, time at my favorite coffee shops, both in D.C. and at the Coffee Mill in Rehoboth. Then there are some not so great things. I have had a few health issues, which luckily, I have fully overcome. Some issues you can do something about, others you can’t. One of the things I have come to realize is, I no longer enjoy big crowds, and this is something I can do something about. Just avoid them. 

I have spent every holiday weekend since buying my place in Rehoboth, and that is going on 30 years, at the beach. I go for Christmas and New Year’s, Martin Luther King, Jr. weekend, President’s Day, Memorial Day, and Labor Day. Add a few extra holidays I may be missing like Veterans’ Day, if it falls on a weekend. This is the first year I won’t be there on Memorial Day, and it is by choice. Instead, will be staying in D.C. Some will ask why, and my simple answer is to avoid the crowds. I keep thinking of the crowds last Memorial Day and decided to see how it goes skipping it this year. 

Don’t get me wrong, I am thrilled for all the businesses at the beach when they are swamped with people. And glad those people who want to be there are having a great time, and don’t mind when the lines to get into Aqua and Diego’s are around the block. Or when my favorite place for coffee, The Coffee Mill, has a line when I get there at 7 a.m. When you can’t get a reservation at the Pines or even Ava’s. But last year it finally occurred to me why I wasn’t having as much fun as I used to, and realized it was because I have become allergic to crowds. So, for the first time this year, I determined I was going to stay away and see how it feels. I may regret it after a few hours at home in D.C., or when seeing friends’ posts on Instagram and Facebook. But am going to take that chance. One thing I do regret missing is the incredible annual brunch thrown by my friend Robert, and his husband, but am determined to see what it feels like not being at the beach for the kick-off holiday weekend of the summer. 

To wean myself away, I did go last weekend. Had a great time seeing friends. Had fun at Aqua each evening for happy hour; went to a great party at CAMP in honor of their new Executive Director Dr. Robin Brennan. I’ve had a chance to chat with her, and believe they made a great choice when hiring her. Then on Friday evening I went to the Washington Blade annual season kick-off party at Diego’s and met the new Steve Elkins Fellow, Thomas Weaverling, and am sure he will do a great job. It was wonderful to see Ashley Biden there accepting the award given posthumously to Beau Biden for all he did for the LGBTQ community. Then on Saturday I stopped in at Freddie’s Beach Bar for the Cloud Nine reunion. That brought back so many good memories. It was coordinated by the inimitable Fay Jacobs. It was back then when I did like crowds, the more the merrier, and remember dancing all evening on the small crowded dance floor. Some people at the reunion reminded me of all the years I hosted an annual Memorial Day party, actually the first 10 years I had my place at the beach. It was catered by the Blue Moon, when my friend Rob was there, and they brought the Champagne, hors d’oeuvres, and even a bartender. I just had to have fun, and I did. The thought of doing that today is a little overwhelming, and I think it is about age. 

So, this year I will see how much I miss being at the beach for the holiday weekend. Then after my June trip to France, will decide whether I want to do the same for the Fourth of July. I kind of look forward to seeing what my thoughts on it are, and how it goes. 

For those of you at the beach, I hope the place is a zoo, of the best kind, and you all have a fabulous time. 


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

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Opinions

GLAA’s 2026 primary election ratings show candidates agree on basics

We applaud all who are standing up for human rights in D.C.

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(Graphic by Fredex/Bigstock)

Our local elections in D.C. this year will be the most consequential in a long time, as we will get a new mayor, several new Council members, and a new delegate to Congress. It also comes amid the most intensive and far-ranging federal attacks on our self-determination in the history of Home Rule, along with concerted efforts to deprive members of our communities of their rights and well being. As always, GLAA publishes our policy brief and ratings on candidates to help inform voters as they make these momentous decisions. This year, our policy brief and candidate questionnaire are a recommitment to promoting the basics: basic human rights, basic human needs, and basic human decency.

Though GLAA does not issue endorsements, we do rate candidates. Of the candidates who responded, mayoral candidate Janeese Lewis George, and Ward 1 Council candidates Rashida Brown, Miguel Trindade Deramo, and Aparna Raj received a +10, the highest possible rating a candidate can receive from GLAA. This indicated strong agreement with GLAA, thoughtful answers, and an impressive record of action on the issues presented in our brief and policy questionnaire. Other high scores include Oye Owolewa, the highest scoring candidate for the Council At-Large primary election, with a score of 9, and Doni Crawford, who scored the highest in the Council At-Large special election, with 6.5.  

For the 2026 primary and special elections, candidates are in broad agreement with GLAA’s policy priorities. In seven out of 10 of our priorities, each candidate indicated agreement. Total consensus on core issues signals that whomever is elected to Council and mayor, we should expect to hold our elected officials accountable to our goals of protecting home rule, resisting federal overreach, advancing transgender healthcare rights, and eliminating chronic homelessness in the District. Other areas of agreement include ending food insecurity, building equitable energy infrastructure, and ensuring robust access points to public benefits. While candidates agree on the basics, they distinguish themselves in the depth and creativity in their responses, and their record on the issues. To read and review their responses in depth, visit glaa.org or outvotedc.org.  

As D.C.’s oldest LGBTQ advocacy organization, we know the power that queer people have in local elections. Our queer siblings are among the privileged and the dispossessed. For our communities, this can be an opportunity and an obligation. GLAA’s policy brief is an invitation and call to action. When we do better to support those at the margins, we see an increase in our collective wellbeing. Using a “queer lens” we can see radical and concrete ways that the District can use our power to uplift us all.

We hope the candidate ratings, their responses, and our policy brief are useful to the community as we make decisions during this consequential year. We applaud all who are standing up for D.C., for human rights, for civil rights. We invite you to join us in the work to create the queer future we all deserve.


Benjamin Brooks is president of GLAA; Darby Hickey is secretary.

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Ghana

Intersex lives, constitutional freedom, and the dangerous future of Ghana’s Human Sexual Rights and Family Values Bill

Lawmakers continue to consider draconian measure

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(Bigstock photo)

There is a dangerous silence surrounding intersex lives in Ghana — a silence shaped by fear, misinformation, cultural misunderstanding, and institutional neglect. Today, amid discussions around the possible passage of the Human Sexual Rights and Family Values Bill, 2025, that silence risks becoming law, reinforcing exclusion and deepening the marginalization of already invisible lives. 

Much of the national debate surrounding the bill has focused on LGBTQ+ identities. Yet buried within it are implications for intersex persons that many Ghanaians do not fully understand because intersex realities remain largely invisible. 

Intersex persons are born with natural variations in chromosomes, hormones, reproductive anatomy, and/or genital characteristics that do not fit typical definitions of male or female bodies. Intersex is not a sexual orientation or gender identity. It is a biological reality. Ghana’s Commission on Human Rights and Administrative Justice (CHRAJ) has clearly acknowledged this distinction. 

Despite this distinction, the bill mistakenly collapses intersex realities into a legal framework linked to LGBTQ+ criminalization. 

Although the bill contains only limited references to intersex persons, under certain medical exceptions, these references do not amount to recognition or protection. Instead, they frame intersex bodies as abnormalities requiring regulation, correction, and institutional management. This approach is inconsistent not only with Ghana’s constitutional guarantees of dignity, equality, privacy, and liberty, but also with emerging African and international human rights standards. The African Commission on Human and Peoples’ Rights Resolution on the Promotion and Protection of the Rights of Intersex Persons in Africa – ACHPR/Res.552 (LXXIV) 2023 affirms protections relating to bodily integrity, dignity, freedom from discrimination, and against harmful medical practices. Additionally, the United Nations has repeatedly condemned medically unnecessary and non-consensual interventions on intersex children. Rather than affirming the humanity and autonomy of intersex persons, the bill risks legitimizing systems of surveillance, coercion, violence, and institutional erasure. 

This is not protection.

It is managed erasure.

A child born intersex in Ghana already enters a society shaped by secrecy and stigma. Families are often pressured to hide intersex children or seek “correction” to make their bodies conform to social expectations. 

The bill risks intensifying this pressure.

Clause 17 creates space for “approved service providers” to support interventions relating to intersex persons, yet offers little protection around informed consent, bodily autonomy, confidentiality, or coercive treatment. Under the language of “correction” or “support,” harmful interventions may become normalized. 

The intersex community has documented painful lived experiences of intersex Ghanaians that reveal the devastating consequences of stigma and invisibility. 

One heartbreaking case involved intersex twins born in Ghana’s Eastern Region in 1993, who were repeatedly forced to move from village to village because of rejection and ridicule. After losing their father, their main source of protection and support, they became even more vulnerable and reportedly experienced severe emotional distress, including suicidal thoughts linked to years of stigma and exclusion. This is what invisibility looks like in practice. 

Another painful example is the story of Ativor Holali, whose lived experience exposed the cruel realities intersex persons face in sports and public life. Ativor Holali endured invasive scrutiny, public humiliation, and social suspicion because her body did not conform to rigid expectations of femininity. Rather than being protected as a Ghanaian athlete deserving dignity and privacy, she became the subject of speculation, gossip, and institutional discomfort.

Her experience reflects a broader social crisis: when society insists that every body must fit a narrow binary definition, intersex people are forced to defend their humanity in spaces where dignity should already be guaranteed.

Intersex Persons Society Of Ghana (IPSOG)’s Ŋusẽdodo research further revealed that approximately 70 percent of intersex respondents reported depression, anxiety, trauma, or severe emotional distress linked to medical mistreatment, family rejection, bullying, and social exclusion.

The bill risks transforming these existing prejudices into institutional policy. Several provisions risk deepening surveillance, restricting advocacy, weakening confidentiality, and discouraging public education around intersex realities. Intersex-led organizations providing healthcare guidance, legal referrals, psychosocial support, and community services may face serious challenges.

This places IPSOG and other intersex-led organizations in Ghana at serious risk.

For many intersex Ghanaians, these spaces are not political luxuries.

They are survival mechanisms.

Governments derive legitimacy by protecting the natural rights of all persons, including dignity, liberty, bodily autonomy, and freedom from arbitrary interference. The bill raises concerns because it risks weakening these protections for intersex persons through surveillance, coercive interventions, and restrictions on advocacy.

Ghana’s Constitution declares that “the dignity of all persons shall be inviolable.” Articles 15, 17, 18, and 21 specifically protect dignity, equality, privacy, expression, and freedom of association. These protections should apply equally to intersex persons. 

Intersex persons are not threats to Ghanaian culture.

Intersex children are not moral dangers.

Intersex bodies are not political weapons.

They are human beings deserving dignity, healthcare, safety, and constitutional protection. 

The true measure of a democracy is how it protects those most vulnerable to exclusion. At this moment, Ghana faces a choice: deepen fear and silence, or uphold dignity, bodily autonomy, and constitutional freedom for intersex persons. 

History will remember the choice we make.

Fafali Delight Akortsu is the founder and president of the Intersex Persons Society of Ghana (IPSOG).

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