Opinions
Rollback of health IT standards will harm LGBTQ patients
Trump proposal would remove most data fields in medical records
For most Americans, the ability to change healthcare providers and easily have their health records transfer feels like a given. But it was not until the 21st century Cures Act was signed in 2020 that regulations on health technology mandated that electronic health records had to be able to collect, receive, and transfer specific data fields in a uniform way (known as the U.S. Core Data for Interoperability). Before that, if your new doctor and your prior doctor subscribed to different electronic health records systems, there was a very good chance that the data fields didn’t match up and some patient information would literally be lost in translation.
Through the Office of the National Coordinator for Health IT, created through executive order by President George W. Bush, the Biden administration advanced health IT policy specifically to ensure that LGBTQI+ patients records would transfer to new providers with unique information that patients need their providers to have access to. This includes data fields for chosen names, pronouns, and sex parameters for clinical usage – or in other words, what sex should be listed for lab work, regardless of the patient’s gender identity. There were also fields added for sexual orientation and gender identity. To be clear, the requirement was for the electronic health record systems to be able to collect, transfer, and receive these data points. There was never a requirement for providers to ask all these questions or for patients to be required to answer them. But if the IT systems aren’t mandated to have these fields in a uniform way, the impact of a provider asking the questions is limited only to the care that the specific provider offers to the patient. The Trump administration has proposed removing 34 of the 60 required data fields in electronic health records, including the fields for chosen names, pronouns, sexual orientation, gender identity, and sex parameters for clinical usage.
There has been widespread support for these regulations on health IT companies. Having a lowest common denominator for health IT systems is good for patients and for healthcare providers. It also isn’t particularly controversial. Not surprisingly, the only folks cheering on deregulation are those ideologically opposed to any government regulations, and the specific companies who are subject to these health IT regulations.
The deregulators in the Trump administration would have us believe the myth that these regulations somehow hinder innovation and make it harder for tech startups to enter the health IT field. They gaslight us by calling this clear disservice to patients “prosperity.” But imagine what it would be like to go back to a time before these critical health IT regulations. When the new doctor you see doesn’t have very much if any information about the patient and the transfer of patient records was manual and cumbersome, often requiring someone to pay for their records to be printed, mailed, and then scanned into a different electronic health record system. This won’t lead to innovation, but it will lead to harm for the patient-provider relationship, and worsened health outcomes for the American people.
HHS Secretary Robert F. Kennedy Jr. has been deliberate and unrelenting in his rollbacks of health equity measures for LGBTQI+ Americans. He has proposed rules that would ban hospitals from receiving federal funds if they offer gender affirming care for youth; he has gutted the Office of Infectious Disease and HIV/AIDS; he has rolled back civil rights protections in health care for LGBTQI+ Americans; and he has eliminated most federal health agency data collection of sexual orientation and gender identity. And this is just a small slice of his crusade at HHS to erase LGBTQI+ people.
There are currently many proposed rules and administrative changes that would harm access to equitable, high quality healthcare for LGBTQI+ people. So it makes sense that LGBTQI+ Americans may not be aware of such a wonky area of policy as federal health IT regulations. But we want to stress that deregulating health IT, with a specific goal of removing the minimum requirements for electronic health record systems to collect, transfer, and receive basic data fields of importance to LGBTQI+ people’s clinical care, will worsen both access to as well as quality of even basic healthcare for LGBTQI+ Americans. And for healthcare providers it is uniquely scary. They rely on the data in patient’s electronic records. And they need the IT systems they use to be able to talk to each other. Deregulating health IT is akin to trying to charge an iPhone with an Android charger, but as if your life depended on it.
There is an opportunity for public comment until Feb. 27, and anyone can make a comment. As a person who receives healthcare and/or a person who provides healthcare, speaking up is imperative. These health IT regulations are described by some as “woke” but really it’s very simple: when you go to the doctor, any doctor, you want them to have some basic information about who you are. Without that information, a healthcare provider could easily make an assumption about the patient that is inaccurate and that leads the provider to make different recommendations than what the patient needs.
This is not radical, this is the very premise of healthcare delivery. And LGBTQI+ patients stand to be left behind, deliberately and systematically, if these deregulations of health IT are put into effect. Without accurate, timely data, providers are unable to live up to the promise of precision medicine and will fail to ensure everyone receives the care that matches their unique needs.
Adrian Shanker is senior fellow at Lehigh University College of Health. He served as deputy assistant secretary for health policy and senior adviser on LGBTQI+ health equity at the U.S. Department of Health and Human Services in the Biden-Harris administration. Dr. Carl G. Streed, Jr. is Associate Professor of Medicine at Boston University Chobanian and Avedisian School of Medicine and Research Director at the GenderCare Center at Boston Medical Center.
When we’re out with friends, we ask a question that sometimes surprises people: Are you on PrEP?
PrEP is a medication that reduces the risk of getting HIV by about 99 percent when taken as prescribed. We’re both on it. And we both talk about it openly because too many people in our communities still haven’t heard of it, can’t access it, or have been made to feel like asking for it says something about who they are.
It doesn’t. Taking PrEP is about taking control of your health. It’s that simple.
But getting there wasn’t simple for either of us. Our paths to PrEP looked different.
Del. Martinez learned this firsthand. When he asked his primary care doctor about PrEP, the response wasn’t medical — it was judgment. Instead of a prescription, he got a lecture. He had to leave Maryland entirely and go to Whitman-Walker in D.C. just to get basic preventive care. He serves on the Health Committee and sits on the public health subcommittee. Even he couldn’t access HIV prevention in his own state. That reality was soul-crushing, not just for him, but because he immediately thought about every person in his community who doesn’t have the resources to find another way.
Phillip came to PrEP through his work at FreeState Justice, where he was learning about HIV transmission rates and the gap in PrEP access for queer people of color. Black Marylanders account for 65 percent of new HIV diagnoses but only about 35 percent of PrEP users. Latino Marylanders account for nearly 19 percent of new diagnoses but fewer than 8 percent of PrEP users.
Seeing those numbers, he had to ask himself why he wasn’t on it. When he walked into Chase Brexton’s HIV Prevention clinic in Baltimore, the experience was easy and affirming, exactly what it should be for everyone. No judgment, just care. That’s the kind of experience every Marylander deserves.
A proposed bill would make it the standard in Maryland. HB 1114 would let people walk into their neighborhood pharmacy and access PrEP without waiting months for a doctor’s appointment, remove insurance barriers that slow things down, and connect them to ongoing care.
Our stories are not unusual. When we talk to friends about PrEP — and we do, regularly — we hear the same things. People who didn’t know about it. People who tried and gave up. People who assumed it wasn’t for them. People who couldn’t afford it or couldn’t find a provider. There’s still misinformation out there, and there’s still stigma. Among women in Maryland, most new HIV diagnoses come from heterosexual contact, but PrEP is still rarely part of the conversation from their doctors.
When we talk to our friends about PrEP, we lead with honesty. Here’s what it does, here’s what it costs, here’s where to go. We talk about the different options: daily pills or long-acting shots. Generic options are available, and in many cases, free. If you’re sexually active, it might be right for you. It’s not a morality question. It’s a health question.
We try to make it feel approachable, because it should be. We answer every question, because sometimes we’re the first person someone has had this conversation with. It’s a conversation between people who trust each other. And it works, but it can only go so far when the system itself is still in the way.
We have the medical tools to virtually end new HIV transmissions. What we need now are the policies to make sure everyone can reach them. At a time when the future of federal HIV prevention programs is under attack, Maryland has both the opportunity and the responsibility to lead.
We’re asking our friends to take charge of their health. We’re asking Maryland to make it possible.
If PrEP sounds right for you, talk to your provider. If you know someone who could benefit, share what you know. And if you want to see Maryland get this right, tell your legislators to support HB 1114.
State Del. Ashanti Martinez represents District 22 in Prince George’s County in the Maryland House of Delegates, where he serves as Majority Whip and sits on the Health Committee. Phillip Westry is the executive director of FreeState Justice, Maryland’s statewide LGBTQ+ advocacy organization.
Opinions
A dream: Democrats focus on candidates who can win
Defeating every Republican has to be the goal in 2026, 2028
I know this is just a dream, but I am a dreamer and continue to hope Democrats can get beyond Black or white, gay or straight, man or woman; to look at who can win in 2026, and then in 2028. It’s often said each election is the most consequential in our lifetime. The next two actually are.
The reality is without change; we face losing our democracy. We have a racist, sexist, homophobic, lying felon, in the White House. He has a Cabinet of vile incompetents, and a cadre of fascist advisers, controlling our government. They threaten our freedoms, and even our health. They think the military is theirs to use at will, without restrictions. Again, my dream for elections in 2026 and 2028, is we put our personal desires aside, for the good of the nation.
Everyone is being hurt by Trump. Black women being fired in huge numbers. Transgender people literally having their lives threatened. The LGBTQ community facing new threats. Civil rights are being undermined, and the Latino community across the country is targeted. Women are losing the right to control their bodies. Our voting rights are being threatened, and all this is happening with the consent of the Republican sycophants in Congress who are either in complete agreement with the felon, or threatened into submission by him, and his fascist cohorts. This is what we are facing in the next two election cycles as we try to take back our country. As the opposition party, we must first take back Congress in 2026. If we succeed, we must replicate that success as we work to reclaim the White House in 2028.
I believe we must all be represented in our elected officials. For years I felt comfortable looking at the equality issue in choosing a candidate, as even in the worst-case scenarios, when losing meant the election of the likes of a Richard Nixon or Ronald Reagan, I never believed my country’s existence was threatened. They, and others like them, may have been vile, but none professed wanting to be king. They didn’t go to court seeking full immunity for anything they did and getting it from judges they appointed.
I am a proud gay man but will not automatically vote for an LGBTQ candidate in the next elections. In 2024, I worked hard, and proudly, to see two strong Black women elected to the United States Senate. In the 2008 primary I was proud to stand with Hillary Clinton, then support Barack Obama when he won the nomination. In 2016, I again stood with Hillary. In 2020, I proudly supported Kamala Harris as vice president and then supported her for president in 2024.
Today, I am looking at the next two election cycles differently. I have written the only way to win back my country is to look at which Democrat can win in a particular race. I will support a Democrat committed to voting for the Democratic leadership in the House and the Senate, and in their state legislature, even if they don’t support fully everything I want. Because when Democrats win the leadership, they set the agenda. The Democratic platform has been about the same for many years. It stands for equality in every area. Have we accomplished all we stand for, clearly NO. Have we made progress, clearly YES.
In these upcoming elections each Democrat may win their race with a different set of issues at the forefront. I have suggested in the morning they go to the diners in their district, and in the evening to the bars, to find out what people are talking about, and concerned about. Then respond to that by running on those issues. If there is a primary, demand each candidate pledge to fully support the winner. Think about what is said about Democrats and Republicans, “Democrats fall in love; Republicans fall in line.” Well in the next two election cycles, Democrats need to fall in line with every Democrat on the ballot in the general election willing to say, “if elected I will vote for, and support, the Democratic leadership.”
If we don’t commit to doing that in the next two election cycles, we may actually not have future elections. It is the only way we can stop the felon, and his fascist government, from winning. Defeating every Republican in 2026 and 2028, has to be the goal for all who care about our country, and moving on to the next 250 years. Not winning is not an option.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
Opinions
Capital Pride must be transparent about sexual misconduct investigation
More questions than answers after two board members resign
We are living through some very difficult times in our country. We have a felon in the White House who has surrounded himself with incompetent sycophants and fascists. A Congress that bows down to him, often based on his threats. Things have gotten so bad that his supporters are beginning to wake up to the fact that he cares not a whit for them. They are demanding he stop hiding his involvement with the convicted sex trafficker, Jeffrey Epstein, and come clean. So, to distract them from this, he began a war in the Middle East in which members of the American military have already lost their lives. He says more lives will be lost. He hopes this war of distraction will have Americans forget his failed domestic policies and the Epstein scandal.
But at the same time that all of this is happening, I am forced to look around at organizations I support and ask if they are being open and honest in the way we are demanding of the felon in the White House.
Recently, I have received calls about an organization I have the utmost pride in: Capital Pride. The calls are about Capital Pride’s internal investigation of “a claim” made against a former board chair, who resigned and no longer has any role with the organization. There has been no public proof of any wrongdoing. At the time, Capital Pride announced it had retained an “independent firm” to investigate the complaint. Now, more than four months later, a second board member has resigned sharing her letter of resignation with the Blade.
Taylor Lianne Chandler, a member of the Capital Pride board of directors since 2019 who served as the board’s secretary, submitted a letter of resignation on Feb. 24 that alleges the board has failed to address instances of “sexual misconduct” at Capital Pride.
“This board has made its priorities clear through its actions: protecting a sexual predator matters more than protecting the people who had the courage to come forward. … I have been targeted, bullied, and made to feel like an outsider for doing what any person of integrity would do – telling the truth,” Chandler wrote in her resignation letter.
The Blade reported the organization announced, “As we continue to grow our organization, we’re proactively strengthening the policies and procedures that shape our systems, our infrastructure, and the support we provide to our team and partners.”
Again, it is four months later, and there has been no information from Capital Pride regarding that investigation.
Chandler said a Capital Pride investigation identified one individual implicated in a “pattern” of sexual harassment related behavior over a period of time. She added she was bound by a Non-Disclosure Agreement that applies to all board members and she cannot disclose the name of the person implicated in alleged sexual misconduct or those who came forward to complain about it. She added, “It was one individual, but there was a pattern and a history.”
Again, reading that letter from Chandler and because of the news being full of the Epstein scandal, it makes me want assurances that no organization representing my community will ever think it can cover up issues like this. Capital Pride leadership must be totally transparent.
Capital Pride is a wonderful organization with so many incredible people working and volunteering there. They make our community proud. I never want to see a blemish on the organization. So, I am calling on them to be open and transparent about the investigation they themselves announced, and let the community know what they found, in detail. More important even than the entire community knowing, is for their staff and volunteers to know what they found. No one should be bound by an NDA, which leads to people thinking something really bad is going on.
I thought twice, even three times, before writing this column. I don’t want it to be seen as casting aspersions on all of Capital Pride, or anyone who may have worked there, or volunteered there. But again, because of the focus on the Epstein scandal, and my writing about the felon and his Cabinet officials involved in it, my calling for them to come clean and tell us all they know, I feel compelled to say the same to the organization I have supported over the years, which even honored me as a Capital Pride Hero in 2016. I want them to move forward and be a beacon of light for our community for many years to come. The work they do makes a difference for so many.
I wrote in my memoir that coming to a Pride event helped me to come out, and I am sure it has done the same for so many others in our community. What Capital Pride does is important and it must be as transparent as we demand of any other organization.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
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