Opinions
PrEP in transmasculine people
We need more studies on unique challenges facing trans men
A new article in āPhysicianās Weeklyā titled, āQ&A: Improving PrEP Access in Transgender Men, Other Transmasculine Peopleā interviewed two leading HIV doctors on a study they conducted to assess how HIV prevention can best be implemented in the transmasculine population. Strangely ā or maybe not so strangely ā 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 itās 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 itās 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 ā if not many sometimes ā shame others into being attracted to men. Itās 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 ā including the injection of testosterone ā 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 ā 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 Geographicās āGender Revolutionā documentary. He serves on the board of the LGBT Democrats of Virginia. Contact him at [email protected] or on Instagram at: @literatipapi.Ā
Opinions
Activists around the world offer potential path forward for American counterparts
Trumpās re-election will not stop fight for LGBTQ rights
Donald Trump early on Nov. 9, 2016, declared victory over former Secretary of State Hillary Clinton. My husband and I arrived in Jerusalem less than 48 hours later.
A Wider Bridge, a group that “advocates for justice, counters LGBTQphobia, and fights anti-Semitism, and other forms of hatred,” months earlier had invited us to participate in one of their missions to Israel. It was my first time in the country.
Our first meeting was at the Shalom Hartman Institute, which describes itself as a “leading center of Jewish thought and education” that seeks “to strengthen Jewish peoplehood, identity, and pluralism; to enhance the Jewish and democratic character of Israel; and to ensure that Judaism is a compelling for good in the 21st century.”
The staffer who greeted us welcomed us to Israel. He then pointed out that Benjamin Netanyahu had been prime minister for nearly a decade.
“Now you will know what it will feel like,” he said.
His comment was cold comfort to many of us who were still reeling over Trump’s victory. It is also one that has repeatedly come to mind as I continue to process the results of the presidential election and what a second Trump presidency will mean for this country, for me as a gay man, for the community that I cover, and especially for transgender Americans and immigrants who the first Trump administration disproportionately targeted.
The U.S. is certainly not the only country in which voters in recent years have elected authoritarian figures who pose a threat to LGBTQ rights.
Viktor OrbĆ”n has been Hungary’s prime minister since 2010. Javier Milei has been Argentina’s president since December 2023. Jair Bolsonaro was Brazil’s president from 2019-2023.
Netanyahu was Israel’s prime minister from 1996-1999 and from 2009-2021. He became the country’s prime minister for a third time on Dec. 29, 2022.
Hungary, among other things, has enacted a so-called propaganda law and effectively banned same-sex couples from adopting children since OrbĆ”n took office. Milei’s government in August closed Argentina’s National Institute Against Discrimination, Xenophobia and Racism. Bolsonaro, among other things, encouraged fathers to beat their sons if they came out as gay and said people who are vaccinated against COVID-19 are at increased risk for AIDS.
Activists who protested against Netanyahu’s proposed judicial system reforms say they would have adversely impacted LGBTQ Israelis. The prime minister postponed these efforts in March 2023 after a nationwide strike paralyzed the country. Israeli lawmakers a few months later approved them after opposition lawmakers stormed out of the Knesset in protest.
Israel, Brazil, Argentina, and Hungary are four of the dozens of countries around the world in which LGBTQ rights have been under attack ā and the U.S. will certainly remain on this list once Trump takes office again on Jan. 20. It is certainly a frightening prospect for many in our community, but the activists in the aforementioned countries have not given up, and their American counterparts should not either.
“I’m not saying it’s not easy, but the direction is so clear,” AndrĆ”s LĆ©derer, the head of advocacy for the Hungarian Helsinki Committee, told me in April during an interview at a Budapest coffee shop. “They (the Hungarian government) can try to introduce setbacks. They can make life miserable, temporarily, but, you know, you just can’t go against the entire world in that sense.”
Hamas militants on Oct. 8, 2023, killed Israel Defense Forces Maj. Sagi Golan in Beāeri, a kibbutz that is near the Israel-Gaza border. His fiancĆ©, Omer Ohana, with the support of Israeli advocacy groups, successfully lobbied Israeli lawmakers to amend the country’s Bereaved Families Law to recognize LGBTQ widows and widowers of fallen servicemembers.
“It was a big effort, and a big success,” Yael Sinai Biblash, the CEO of the Aguda, the Association for LGBTQ Equality in Israel, told me last month after she attended Golan’s memorial service in a Tel Aviv suburb.
Bru Pereira and Gui Mohallem, co-directors of VoteLGBT, a Brazilian organization established in 2014 with a mission to increase LGBTQ representation in politics, in response to Trump’s reelection said they and others in Brazil are “witnessing how grassroots efforts, particularly from marginalized communities, are crucial in defending LGBTQ+ rights under right-wing governments.”
Donald Tusk became Polandās prime minister last December after a group of coalition parties that he leads won a majority of seats in the Sejm, the lower house of the countryās parliament. President Andrzej Duda, an ally of the conservative Law and Justice party who opposes LGBTQ rights, remains in office as part of the governing coalition.
Deputy Justice Minister Krzysztof Åmiszek is openly gay. His partner, former MP Robert BiedroÅ, a member of the European Parliament.
Magda Dropek is an activist who ran for the Lesser Poland Regional Assembly in KrakĆ³w, Polandās second-largest city, in April. Lesser Poland is among the provinces that had declared themselves āLGBT-free zonesā ahead of the 2020 presidential election.
Dropek noted in her X post in response to the U.S. election results that Sarah McBride last week became the first openly transgender woman elected to Congress.
Dropek, like others, pointed out Russian President Vladimir Putin and other politicians respond to “antagonized societies” with “populism and (sacrifice) human rights.” Dropek, however, stressed the new Polish government presents an opportunity.
“What happened in Poland a year ago is still an important story that brings hope to others,” she said. “It’s a huge responsibility, but also work, because this is the time to change mentalities and educate using democratic tools. Because we’ve been coping with everything else, grassroots support and organization for so many years, you know yourselves.”
Trump leaves office on Jan. 20, 2029.
Opinions
Racism and misogyny are alive in America
Trumpās confounding victory will hurt many people who voted for him
A smart, compassionate, African-American/Asian woman, in a mixed marriage, runs for president and loses to a felon, found liable of sexual assault, twice impeached, and leader of a failed coup. What could be the reason?
I understand people are unhappy with the economy, immigrants coming into our country illegally, and many with their lives in general. But none of this can account for the huge numbers of white, African American, and Latino men, who voted for Trump. In a major shift, Trump won Latino men 54%-44% over Harris, and 50%-39% of white men according to NBC exit polls, and 20% of male Black voters nationally. We need to call that what it is and begin to have a real conversation in this country about it. They are all ending up voting for a man whose policies will hurt them. Whether it be a tax on all the goods they buy, or being anti-union, applauding Elon Musk for firing strikers, or giving tax breaks not to them, but to millionaires and billionaires. African-American men should know he refused to rent them apartments in New York. Latino men should understand he will be knocking on their doors looking for possible family members to deport. All of this overridden by their macho fear of being in a country led by a woman. We have seen this before in Hillary Clintonās race in 2016. Unless we have an open conversation about this, it will continue to happen.
Donald Trump is a threat to all decent people around the world. He admires dictators and he will emulate them. He will override our judicial system, using the Justice Department to get back at his enemies. We know this.
On the abortion issue it appears women voted overwhelmingly to pass every ballot initiative, except the one in South Dakota, to keep abortion legal. It went down in Florida because though 57% voted for it the legislature managed to say it would only pass if it got 60% of the vote. Yet clearly, even many of the white women who voted for these initiatives, didnāt see the danger in then voting for Trump. It is very hard to rationalize. I hear all sorts of explanations on the various news/talk fests on cable TV. People pontificating on all sorts of things. Trying to determine who in the Democratic Party is to blame. In 2016 they blamed the candidate, Hillary. She didnāt do enough, went to the wrong states at the end, didnāt connect with voters. This year they are trying not to blame Harris who was thrown into a campaign only three months before the election. So, many are blaming President Biden for not announcing two years ago he wasnāt going to run again and allowing Democrats to hold a real primary. Who knows, maybe they are right. Harris could never escape the animus toward the Biden administration. She tried valiantly, and I think ran an amazing campaign. As I wrote online, we may have lost an election, but many like me ended up falling in love with Kamala Harris.
There are a few high points from Tuesdayās election, like the victories of two Democratic, African-American women senators, Lisa Blunt Rochester from Delaware, and Angela Alsobrooks from Maryland. Then Delaware had a double victory, electing Sarah McBride to Congress, where she will become the first elected transgender woman to serve in the House of Representatives. When I write this it looks as if Democrats may actually lose only three senators: Sherrod Brown in Ohio, Jon Tester in Montana, and Republicans won the open seat in West Virginia. Tammy Baldwin will keep her seat from Wisconsin, and in races still too close to call we could see Bob Casey in Pennsylvania, and Jacky Rosen in Nevada, keep their seats. Then Ruben Gallego in Arizona, and Elissa Slotkin in Michigan, have a shot at winning their races in what were open seats. All these results potentially showing the schizophrenia in the electorate in states that Trump won. They all out-performed Harris in their states. After all, a woman senator they know may be OK, but not a strong, African-American/Asian woman, as president.Ā
We will be dissecting this election for years to come, historians will be looking at how Trump could have won. But the reality for those of us living in the United States now, those who Trump has insulted and degraded, including women, African Americans, immigrants, the LGBTQ community, the disabled, nearly everyone one can think of, we will have to live with him and fight back where we can. Hopefully joining hands to do it, as there is strength in numbers. We shall overcome!
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
Opinions
Whatās next for the LGBTQ movement?
Trumpās win requires us to organize, focus on protecting trans community
These are frightening times for those of us on the target list of Project 2025, the blueprint for Donald Trumpās second term that he secured in landslide fashion on Tuesday.
Many of us are wondering how this could happen again. Kamala Harris is one of the most qualified presidential candidates to run in our lifetime. She ran against a 34-times convicted felon who staged an insurrection against the government and who faces a sentencing hearing in just three weeks for his crimes. A man who was twice impeached, who courts Vladimir Putinās attention and approval, and who was found liable for sexual assault. Despite that last fact ā and Trumpās bragging about overturning Roe v. Wade ā 44 percent of women voters supported him, far more than the polls and pundits predicted.
Those polls turned out to be pretty accurate and Harris was brought down by lingering concerns over the economy and the toll inflation has taken on lower and middle class Americans. Sure, sexism, and racism played a role in this, but too many of us live in a bubble, insulated from the everyday concerns of disaffected blue collar Americans. While many of us crowed about last weekās Wall Street Journal lead story on the booming U.S. economy being the envy of the world, voters in the former āBlue Wallā states were struggling to put food on the table. When you canāt feed your family, youāre not going to vote for the incumbent vice president.Ā
So whatās next? Weāve seen this movie before. Trump will appoint a series of sycophants to run the government; he will undermine the federal workforce and try to fire as many longtime civil servants as he can. He will have a compliant GOP-majority Senate to rubberstamp his Cabinet and judicial appointees. He will probably ban transgender service members from the military on day one. The list goes on.
āThe next conservative President must make the institutions of American civil society hard targets for woke culture warriors,ā Project 2025 begins. āThis starts with deleting the terms sexual orientation and gender identity, diversity, equity and inclusion, gender, gender equality, gender awareness, gender-sensitive ā¦ out of every federal rule, agency regulation, contracts, grant regulation, and piece of legislation that exists.ā
Indeed, Project 2025 seeks to send us all back to the closet. But, as Harris rightly intoned throughout her short campaign: We are not going back.
The good news ā and there is some ā is that voters for the first time elected two Black women to the U.S. Senate to serve at the same time, Angela Alsobrooks in Maryland and Lisa Blunt Rochester in Delaware. Sarah McBride becomes our nationās first out transgender member of Congress. Sheās a formidable figure and will be an important voice for trans equality in the face of Trumpās inevitable attacks. At this writing, control of the House hasnāt been decided. If the Democrats can manage to flip it, Rep. Hakeem Jeffries, a capable strategist, becomes the face of our resistance.
We need our LGBTQ allies and advocacy groups more than ever. If you have the resources, donate to Lambda Legal and other legal groups gearing up for the many battles ahead, including over marriage equality. (Some more good news on that front, as California voters overwhelmingly approved Prop 3, which will enshrine marriage rights in the constitution of our largest state.) Volunteer your time with your local equality group, especially if you live in a state like Florida with draconian anti-LGBTQ laws on the books.
No one said being part of a social justice movement would be easy. Sometimes pioneers in these fights donāt live to see the end of the road. Nowās the time to double down on hard work, determination, and compassion, especially for the trans community, which sadly will take the brunt of the incoming attacks. Those of us who are a bit older need to reassure younger voters and activists that their efforts this time are not in vain. Harrisās meteoric ascent to the top of the Democratic ticket and the incredible campaign she ran will make it easier for the next woman to run. That final, ultimate glass ceiling will fall in our lifetime.
So for now, take a breath. Hug the dog. Take a walk in the woods, whatever you need to refocus. Four years is a blip and will fly by. The Democratic bench is deep. And the march toward full equality for our community is unstoppable. Setbacks are inevitable but we learned a long time ago that love wins. So fight on.
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