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Meth is still ravaging the LGBTQ community, we must address the crisis

Queer people at least twice as likely to use drug than straight counterparts

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(Photo by mikeledray/Bigstock)

As the opioid epidemic continues to dominate national news, another urgent crisis is wreaking havoc in communities throughout the United States. Methamphetamine addiction is on the rise, and it’s hitting communities hard, especially the LGBTQ+ community.

November 30 is National Methamphetamine Awareness Day, a poignant time to raise the alarm about the devastating impact of this drug and the reasons behind its growing prevalence within the LGBTQ+ community.

Based on 2020 and 2021 data compiled by the Substance Abuse and Mental Health Services Administration (SAMHSA), sexual minorities (gay, lesbian, or bisexual) adults were at least twice as likely to use stimulants in the past year as their heterosexual counterparts. Gay men were over four times more likely than straight men to have used meth in the past year.

As a mental health counselor and coordinator of the LGBTQ+ program at River Oaks Treatment Center in South Florida, I know firsthand how devastating meth addiction in this marginalized demographic can be. The National Institute on Drug Abuse notes that sexual minorities tend to enter treatment with more severe substance use disorders than those who identify as heterosexual, and I often find this to be the case in our patient population as well. Our LGBTQ+ patients face numerous challenges that may lead to substance use as a means of coping, such as discrimination, stigma, and trauma. 

Our LGBTQ+ patients talk often about feeling their needs and experiences are invalidated by those around them. Constantly feeling unsafe or unable to live as one’s true self at a young age can have a lasting impact on a person’s mental health and is a risk factor for problematic substance use as a tool to manage shame and emotional pain. 

Another complicating factor is that for many queer people, there are few safe spaces, and one of the first ones they encounter is gay bars, where drinking and/or substance use is the norm. Meth is popular in gay nightclubs and parties because it causes euphoria, increases libido, and raises energy, enabling people to party for many hours before crashing. But while use of the drug often begins voluntarily, it quickly becomes compulsive and very difficult to quit. 

The brain quickly learns to link certain people, places, and activities with drug use, triggering uncontrollable cravings. Meth use is ubiquitous in the social circles or “chosen families” of some sexual and gender minorities, making avoiding the drug uniquely difficult. Quitting meth may require them cutting ties and breaking contact with people they’ve come to love and care about deeply.

Our LGBTQ+ patients sometimes express fear they won’t be able to experience sex and other activities in the same way once they quit using meth. Indeed, it can take some time for someone’s brain and body to return to normalcy after quitting. Methamphetamine has a profound effect on dopamine activity, a brain chemical associated with motivation and the urge to repeat pleasurable activities. Over time, this effect can limit someone’s ability to experience pleasure from healthy activities. 

The effects of chronic meth use and withdrawal also complicate the early treatment and recovery process. Intense paranoia — a common long-term effect of meth use — makes it very difficult to trust people, a crucial facet of treatment that is necessary for building relationships with counselors, mentors, and peers. 

Distrust of clinicians and treatment programs is often heightened among LGBTQ+ patients, who often face even more stigma when entering treatment programs and have a distrust of institutions like law enforcement, which they may associate with addiction treatment. To further this point, some of our patients have had bad experiences in the past and worry about treatment being safe for them. Many of our LGBTQ+ patients also have complicated relationships with their families who might otherwise form the foundation of their support network in recovery.

These obstacles highlight the importance of specialized LGBTQ+ addiction treatment programs, in which patients are surrounded by peers who can relate to their experiences. It’s crucial that treatment centers don’t just claim to be accepting of sexual and gender minorities but do the necessary work to make these patients feel safe and welcome, protecting them from harassment and mistreatment from both staff and other patients.

These programs also must work to address common issues that co-occur with addiction among LGBTQ+ patients, such as trauma, emotional turmoil, and interpersonal conflicts. For example, utilizing effective, evidence-based therapeutic approaches, such as dialectical behavior therapy (DBT). 

DBT is among the techniques we use in our programs. Originally developed to treat borderline personality disorder (BPD), DBT has been expanded to treat many mental health disorders that involve emotional dysregulation, which is something we often see among our patients in early recovery from meth addiction. 

The approach functions to enhance one’s capabilities to regulate emotions, practice mindfulness, improve interpersonal effectiveness, and strengthen distress tolerance before practicing these skills and encouraging patients to apply them in their daily lives. DBT also works to improve a patient’s motivation to track and reduce their dysfunctional behaviors.

On a nationwide level, it will take significant work to disentangle the grip of methamphetamine on the LGBTQ+ community. With the pervasiveness of illicitly manufactured fentanyl — a synthetic opioid that causes overdose in very small doses — in the drug supply, the need for action has never been more immediate.

A large part of this work involves changing the perception of society toward methamphetamine addiction and especially queer people who struggle with this disease. Rather than viewing it as a moral failure, we need to see it for what it truly is: A public health crisis. Much like at the start of the HIV/AIDS epidemic, the disease of addiction is heavily stigmatized and too often, we place blame on those who are impacted rather than taking effective action to curb the crisis. 

In addition to culturally competent addiction treatment, we desperately need more sober, safe spaces for the LGBTQ+ community. Upon exiting treatment, many find themselves on uncertain ground and in desperate need of sober friendships and networks that support their recovery. Substance-free community centers provide a useful model that can be implemented on a larger scale.

While these are trying times, I sincerely believe we can make a profound difference by confronting this issue with compassion and understanding. It will take a multi-faceted approach that involves the cooperation of treatment centers, queer people in recovery, allies, and the broader LGBTQ+ community.

Karah Moody, LMHC, CPP, MCAP, is a counselor and LGBTQ2+ Coordinator at River Oaks Treatment Center, an American Addiction Centers facility.

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Unconventional love: Or, fuck it, let’s choose each other again

On Valentine’s Day, the kind of connection worth celebrating

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(Image by kotoffei/Bigstock)

There’s a moment at the end of “Love Jones” — the greatest Black love movie of the 21st century — when Darius stands in the rain, stripped of bravado, stripped of pride, stripped of all the cleverness that once protected him.

“I want us to be together again,” he says. “For as long as we can be.”

Not forever. Not happily ever after. Just again. And for as long as we can. That line alone dismantles the fairy tale.

“Love Jones” earns its place in the canon not because it is flawless, but because it is honest. It gave us Black love without sanitizing it. Black intellect without pretension. Black romance without guarantees. It told the truth: that love between two whole people is often clumsy, ego-driven, tender, frustrating, intoxicating—and still worth choosing.

That same emotional truth lives at the end of “Eternal Sunshine of the Spotless Mind,” my favorite movie of all time. Joel and Clementine, having erased each other, accidentally fall back into love. When they finally listen to the tapes that reveal exactly how badly they hurt one another, Clementine does something radical: she tells the truth.

“I’m not perfect,” she says. “I’ll get bored. I’ll feel trapped. That’s what happens with me.”

She doesn’t ask Joel to deny reality. She invites him into it. Joel’s response isn’t poetic. It isn’t eloquent. It’s not even particularly brave. He shrugs.

“Ok.”

That “OK” is one of the most honest declarations of love ever written. Because it says: I hear you. I see the ending. I know the risk. And I’m choosing you anyway.

Both films are saying the same thing in different languages. Nina and Darius. Clementine and Joel. Artists and thinkers. Romantics who hurt each other not because they don’t care — but because they do. Deeply. Imperfectly. Humanly.

They argue. They retreat. They miscommunicate. They choose pride over vulnerability and distance over repair. Love doesn’t fail because they’re careless — it fails because love is not clean. 

What makes “Love Jones” the greatest Black love movie of the 21st century is that it refuses to lie about this. It doesn’t sell permanence. It sells presence. It doesn’t promise destiny. It offers choice.

And at the end — just like “Eternal Sunshine” — the choice is made again, this time with eyes wide open.

When Nina asks, “How do we do this?” Darius doesn’t pretend to know.

“I don’t know.”

That’s the point.

Love isn’t a blueprint. It’s an agreement to walk forward without one.

I recently asked my partner if he believed in soul mates. He said no—without hesitation. When he asked me, I told him I believe you can have more than one soul mate, romantic or platonic. That a soul mate isn’t someone who saves you — it’s someone whose soul recognizes yours at a particular moment in time.

He paused. Then said, “OK. With those caveats, I believe.”

That felt like a Joel shrug. A grown one.

We’ve been sold a version of love that collapses under scrutiny. Fairy tales promised permanence without effort. Celebrity marriages promised aspiration without truth. And then reality — messy, public, human—stepped in. Will and Jada didn’t kill love for me. They clarified it.

No relationship is perfect. No love is untouched by disappointment. No bond survives without negotiation, humility, and repair. What matters isn’t whether love lasts forever. What matters is whether, when confronted with truth, you still say yes.

“Love Jones” ends in the rain. “Eternal Sunshine” ends in a hallway. No swelling orchestras. No guarantees. Just two people standing at the edge of uncertainty saying: Fuck it. I love you. Let’s do it again. 

That’s not naïve love. That’s courageous love.

And on Valentine’s Day — of all days — that’s the kind worth celebrating.

Randal C. Smith is a Chicago-based attorney and writer focusing on labor and employment law, civil rights, and administrative governance.

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Trans sports bans rooted in eugenics

Key Supreme Court rulings will be future litmus tests

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(Washington Blade photo by Michael Key)

The United States and the world are waiting for the Supreme Court to hand down its decisions in two cases (Little v. Hecox and West Virginia v. BPJ) that would rule on whether young trans women can play women’s sports at their schools. As trans journalist Erin Reed explained, these two cases are not just about transgender sports. These cases are litmus tests for trans rights at the nation’s highest courts and will have wide-reaching implications for the rights of trans and nonbinary people in the United States.

And these cases will impact cis women. As Orien Rummler reported for the 19th and them, anti-trans legislation and rulings threaten the rights of all women, especially cis women of color. The best example is the allegations that woman boxer Imane Khelif faced at the last Paris Olympics.

The gender policing that Khelif faced shows how sports bans that police who are considered a man or woman legitimize and mandate invasive medical testing, a form of medical abuse, against all women and girls who want to play sports. And let’s be clear — there is historical precedence for this.

The Nazi regime did use genetic screening in order to police who could have children as part of their “racial hygiene” programs, including marriage partner hereditary testing that flagged anyone with “tainted” genetic lineages. While prisoners in concentration and detention camps were subjected to horrifying medical experimentation, Nazi officials experimented with their own followers, facilitating reproduction only among people with desirable characteristics — notably those with blonde hair and blue eyes — and sterilizing those with undesirable genetics.

In fact, trans and gender non-conforming people were some of the first targeted by Nazi violence, with one of the first book burnings occurring in 1933 when Nazi youth and members of the Sturmabteilung ransacked the Institute for Sexual Science and burned one of the largest libraries of medical texts about gender affirming care. Nazi officials first exerted control over gender before extending this to race and religion.

And this was not confined to Nazi Germany. As I’ve written about before, the United States has used eugenics to justify the forced sterilization of women of color, disabled women, poor women, and incarcerated women. Forced sterilization was one part of forced or coerced medical testing that targeted Black and Indigenous women.

This medical violence, along with non-consensual experimentation including Dr. James Marion Sim’s gynecological experimentation on enslaved Black women, was rooted in systemic racism and medical abuse, and has contributed to legacies of mistrust and health disparities in medical institutions and practitioners.

When sports organizations, like the U.S. Olympic and Paralympic Committee, require women to undergo “sex verification,” they set a precedent of forced genetic testing that violates everyone’s privacy and could very well exclude many cis women from sports if they fall outside the bounds of what is defined as a “woman.”

The best example is cis women with Polycystic Ovary Syndrome. Some people with PCOS have hyperandrogenism, an excess of androgen, or experience hirsutism (i.e. the development of more traditionally masculine features like increased muscle mass and more pronounced facial hair.) Mandatory sex verification may diagnose or “out” women as intersex without their consent. Differences of Sex Development, another term used to describe intersex experiences, is more common than most people would expect.

Would women with PCOS not be considered women? What about women with more pronounced facial hair or greater muscle mass because of natural variation? It’s important to note what is considered American standards of womanhood are rooted in White supremacy — one of the reasons why women of color have been and will be targeted by anti-trans violence.

The very people making these decisions are also beginning to ask these questions. According to Erin in the Morning, Supreme Court Justice Amy Coney Barrett is even worried about the implications of these two Supreme Court decisions. As Alejandra Carabello, a Harvard Law educator, told Erin in the Morning, a decision supporting anti-trans sports bans “could result in the segregation of women in a host of other areas of public life under the rationale that biologically, men are different and they need to be segregated.”

Barrett, a conservative justice who was appointed by Trump in 2020, seems to acknowledge these risks, saying “your whole position in this case depends on there being inherent differences.”

There is not. According to science, gender is not a strict binary but a spectrum determined by biological, psychological, and social factors, including cultural norms surrounding gender.

The best indication of this is that intersex people exist. Intersex people are individuals born with sex hormones and characteristics that differ from a strict male to female binary. Some people are born with atypical genitalia, specifically external genitals that don’t look male or female or are underdeveloped. Some are born with phallia, a condition where a baby is born without a penis, some born with a “mismatch” between their internal and external organs.

In all of these cases, the idea of normal, mismatched and properly developed genitalia and bodily presentation is conditional upon a male and female binary reinforced by the medical establishment — and to be clear, this gender binary has hurt people. For decades, intersex babies have suffered medical abuse because doctors perform unnecessary surgeries to “fit” these children into a female/male binary. These medically nonessential surgeries performed on children who cannot consent are a form of medical assault.

To be clear, this is not the same as gender affirming care performed on consenting individuals who are receiving hormone therapy and surgery to align their gender presentation with their identity. As major medical and mental health organizers assert, gender-affirming care is medically necessary and lifesaving healthcare for trans and nonbinary people.

And the vast majority of children who are having gender affirming surgery are cis ones. A June 2024 study found that the vast majority of minors undergoing gender-affirming surgeries were cis children. This did not include intersex people who underwent surgery or people who received surgery for an illness or injury. About 97 percent of 150 cases where minors received gender affirming surgery in 2019 were chest reduction surgery performed on cis boys. This surgery is commonly performed on boys with gynecomastia, or develop enlarged breasts due to a hormone imbalance.

So for many, the decisions expected on these Supreme Court cases may seem confined to sports but in actuality, they have profound ramifications not only for cis women but also amid the growing escalation and legitimization of eugenics in the United States.

It’s no mistake that earlier this month, Dr. Elisa von Joeden-Forgey, president of the Lemkin Institute, stated that the U.S. is in the “early-to-mid stages of a genocidal process against trans and nonbinary and intersex people.” Dr. Gregory Santon, former president of the International Association of Genocide Scholars, flags “a hardening of categories” surrounding gender in a “totalitarian” way.

Stanton argues that this is rooted in Nazi ideology’s surrounding gender — this same regime that killed many LGBTQIA individuals in the name of a natural “binary.” As Von Joeden-Forgey said, the queer community, alongside other “minority groups, tends to be a kind of canary in the coal mine.”

Even the fact that discussions of the trans sports ban foreground its potential implications for cis women (or that this is the primary concern voiced by Barrett) showcases whose bodies take priority. 

This framework reflects how members of the feminist movement have used and presently do use the movement to justify the very anti-trans exclusion that will harm them. Some call themselves trans-exclusionary radical feminists (TERFs); these women believe that codifying and protecting trans women’s rights threatens the rights of cis women and have even partnered with some conservative groups because of their commitment to enforce what it means to be a “biological woman.” 

As history can show us, it’s exactly the opposite — first, feminism is rooted in equity for all people, all women, not just cis women. Because protecting trans women from medical violence like sex verification testing and challenging people and organizations that police who a woman is, protects all women.

Emma Cieslik is a museum worker and public historian.

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Just when you think Trump can’t sink any lower, he does

We must depose him with our votes

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President Donald Trump (Washington Blade file photo by Michael Key)

The racist felon in the White House has sunk to what many people consider a new low, with his posting the disgusting depiction of the Obamas on his social media site. The depths to which he will sink would be considered unfathomable to many. But there is nothing we should think him incapable of. With this latest post, and refusal to apologize, I have to question the principles and decency of anyone, who still in any way, is willing to support him. 

I once thought to give people taken in by his lies and carnival barker routine, the benefit of the doubt. I had the benefit of always knowing Trump was a liar and slimeball, having met him years ago in New York. I understood he learned well at the feet of his mentor, Roy Cohn, who was one of the more disgusting figures in New York politics. But not everyone knew that history. But now, after his behavior and actions, during the first year of his second term, I will not give the benefit of the doubt to anyone. If you still stand with the felon, you are a person with no principles, or decency, yourself. If you still support him you are standing with a man who first glorified the murder of a VA nurse, Alex Pretti, in Minneapolis, calling him a domestic terrorist. A man who said the ICE agents who did it were just doing their job. He did the same when they murdered Renee Good in cold blood, calling her a ‘domestic terrorist.’ He supported his agents acting like the Gestapo when taking a five-year-old boy into custody on his front stoop. 

The felon went to Davos and in a stunning attack on our allies, claimed the men and women in their military never joined us on the front lines in Afghanistan, insulting all those who fought, and died, with our troops. He was either too dumb to know, or chose to disregard, that Article 5, a critical clause in the NATO pact, which means an armed attack on one member of the alliance will be treated as an attack on all members, was only invoked once in NATO’s history, and that was after the Islamist terrorists attacked the U.S. on Sept. 11, 2001. 

He is destroying our country, and all our credibility around the world. He bows down to Putin and other despots. He clearly wants to be King of our country, and now an Emperor in the eyes of the world, as he threatens Greenland, and threatens to attack numerous other countries.

The problem those sycophants have, is I believe the people of the United States will finally understand he is destroying what is best in their lives. They will rise up and depose him; they will do it with their votes. Many of those who believed his lies and promises, are now seeing him as the “Emperor with no clothes.” He lied to them, and fooled enough of them, to win the election. They are waking up to the fact he is more senile than they thought Biden was, and clearly much less intelligent. They are seeing him for the grifter he is and finding out he cares not a bit for them, or their welfare. He clearly couldn’t care less that their grocery prices are going up, their rents are going up, their heating costs are going up, and for some, their healthcare costs are tripling. None of that bothers him in the least. He cares more about getting gift planes from Qatar, selling crypto coins, seeing Melania make money on a weird so-called documentary, and giving tax breaks to his rich friends and corporations. 

The American people have fought a revolution before. We fought a king and won. This revolution may look different from that, and from the French Revolution. We may man/woman the barricades but will do so without guns. We will win with our votes. 

The wealthy like Jeff Bezos, and others who see themselves as American nobility, corporate and media giants, who think the felon will make them even richer if they kneel before him, will in the long run be very disappointed. He has some power for a few more years, but even that will be curtailed when Democrats take back Congress in January 2027. 


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

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