National
AIDS 2012: Clinton announces ‘blueprint’ for ‘AIDS-free generation’
Identifies new funding streams to confront global epidemic
Secretary of State Hillary Clinton spoke Monday at the 19th International AIDS Conference (Blade photo by Michael Key)
Secretary of State Hillary Clinton announced on Monday that the United States would prepare a “blueprint” to confront the global AIDS epidemic and realize her previously stated vision of an “AIDS-free generation.”
In a speech before attendees in D.C. at the 19th International AIDS Conference, Clinton said she directed U.S. Global AIDS Coordinator Eric Goosby to develop the plan and said it would be unveiled before Dec. 1 on World AIDS Day.
“I have asked Ambassador Dr. Goosby to take the lead on developing and sharing our blueprint of the goals and objectives for the next phase of our effort and to release this blueprint by World AIDS Day this year,” Clinton said. “We want the next Congress, the next secretary of state, and all of our partners here at home and around the world to have a clear picture of everything we’ve learned and a roadmap that shows what we will contribute to achieving an AIDS-free generation.”
Clinton first articulated the idea of an “AIDS-free generation” during remarks she delivered on World AIDS Day last year.
A number of HIV/AIDS advocates praised the idea of a blueprint in the global fight against HIV/AIDS as they called for the strategy to include certain enumerated provisions.
Chris Collins, vice president of policy for amFAR, said he’s hoping the plan would articulate the way forward in confronting the global AIDS epidemic, which has claimed the lives of more than 25 million across the globe.
“When you want to accomplish a complex goal you need a clear plan of action,” Collins said. “Creation of a blueprint is an important step forward because it directs our planning, policy and funding toward achieving clear outcomes and goals and will help everyone engaged monitor progress toward an AIDS-free generation.”
In a joint statement, 65 advocacy and implementation organizations said the blueprint needs to contain several key points to succeed, such as defining specific outcome targets for HIV incidence, morbidity and mortality; requiring full transparency of U.S. government budgets; and requiring detailed annual reporting on progress.
During the same speech, Clinton unveiled five new funding streams aiming to target populations that are particularly affected by HIV/AIDS overseas, touting a “combination prevention” strategy of treatment and prevention.
The five new funding streams total $157 million:
• an additional $80 million to support approaches that ensure HIV-positive pregnant women receive treatment to protect themselves and prevent them from spreading the disease to their children and partners;
• an additional $40 million to support South Africa’s plans to provide voluntary medical male circumcisions for almost half a million boys and men in the next year;
• $15 million for implementation research to identify the specific interventions that are most effective for reaching key populations;
• $20 million to launch a challenge fund to support country-led plans to expand services for key populations; and
• a $2 million investment in the Robert Carr Civil Society Networks Fund to bolster the efforts of civil society groups in addressing key populations.
Clinton said keeping women in Africa with HIV healthy is important to keep them from transferring the disease to their unborn children, which she said the United States is committed to ending by 2015.
A number of female HIV/AIDS advocates at the conference called for greater attention to the disease’s impact on children. In sub-Saharan Africa, which has been particularly affected by AIDS, an estimated 60 percent of those living with HIV are women.
“When women are identified as HIV-positive and eligible for treatment, they are often referred to another clinic, one that may be too far away for them to reach,” Clinton said. “As a result, too many women never start treatment. Today, I am announcing that the United States will invest an additional $80 million to fill this gap. These funds will support innovative approaches to ensure that HIV-positive pregnant women get the treatment they need to protect themselves, their babies and their workers.”
Clinton’s speech was highly anticipated among the estimated 25,000 people in attendance at the conference. Organizers sent attendees to overflow rooms a full half-hour before she came on stage because the large room in which she was set to speak was already filled to capacity.
Upon her arrival, Clinton was greeted with a standing ovation from attendees. But not everyone received her favorably.
A group of protesters could be heard shouting at the secretary as she approached the podium. They held up a sign calling on Clinton to take “Trans Pacific” action against AIDS — apparently out of concern of insufficient funds for trans people affected by AIDS overseas. Clinton responded, “What would an AIDS conference be without a little protesting? We understand that.”
Some HIV/AIDS advocates have criticized the Obama administration for not doing enough to fight the global epidemic. The president’s budget request for fiscal year 2013 cuts half a billion dollars from the President’s Emergency Plan for AIDS Relief, a program established by President George W. Bush to confront the global epidemic, as the White House maintained the program is doing more with less because of the reduced cost of drugs.
Protesters shout at Clinton during remarks at AIDS conference (Blade photo by Michael Key)
Despite this proposed cut, Clinton emphasized new accomplishments for PEPFAR under the Obama administration, saying the program is funding 600,000 more people since December. She said this increase means PEPFAR is reaching nearly 4.5 million people and is on track to meet the administration’s goal of treating 6 million people by the end of 2013, which President Obama announced on World AIDS Day last year.
“Now since that time I’ve heard a few voices from people raising questions about America’s commitment to an AIDS-free generation, wondering whether we are really serious about achieving it,” Clinton said. “Well, I am here today to make it absolutely clear: the United States is committed and will remain committed to achieving an AIDS-free generation. We will not back off, we will not back down, we will fight for the resources necessary to achieve this historic milestone.”
Additionally, Clinton said PEPFAR is reaching more than 370,000 women globally and has supported more than 400,000 male circumcisions, which has been shown to reduce HIV transmission, since December.
“You know and we want the world to know that this procedure reduces the risk of female-to-male transmission by more than 60 percent and for the rest of the man’s life, so the impact can be phenomenal,” Clinton said. “In Kenya and Tanzania, mothers asked for circumcision campaigns during school vacations so their teenage sons could participate. In Zimbabwe, some male lawmakers want to show their constituents how safe and virtually painless the procedure is, so they went to a mobile clinic and got circumcised. That’s the kind of leadership we welcome.”
But as she emphasized U.S. efforts in confronting the epidemic, Clinton also called for partner nations to step up their game to confront the disease in their own countries, saying reaching the goal “is a shared responsibility.”
“I spoke earlier about how the United States is supporting country ownership, but we also look to our partner countries and donors to do their part,” Clinton said. “They can follow the example of the last few years in South Africa, Namibia, Botswana, India and other countries who are able to provide more and better care for their own people because they are committing more of their own resources to HIV/AIDS. And partner countries also need to take steps like fighting corruption and making sure their systems for approving drugs are as efficient as possible.”
As part of this commitment, Clinton called on other countries to contribute to the Global Fund to Fight AIDS, Tuberculous and Malaria. Obama’s most recent budget request affirms the administration’s commitment to provide $4 billion over three years to the fund, and Clinton said Saudi Arabia, Japan, Germany, the Gates Foundation and others have stepped up their efforts.
Paul Zeitz, vice president of policy for the D.C.-based ACT V: The End of AIDS, joined in the call for other countries to step up their efforts in confronting HIV/AIDS as he commended Clinton for announcing her plan to produce a blueprint in the global fight.
“As we all know, money is the oxygen for action for creating an AIDS-Free Generation,” Zeitz said. “Action speaks louder and we need to make sure that governments around the world step up to pay their fare share, including my own government. U.S. leadership in the global battle to end AIDS is an essential catalyst.”
National
United Methodist Church removes 40-year ban on gay clergy
Delegates also voted for other LGBTQ-inclusive measures
The United Methodist Church on Wednesday removed a ban on gay clergy that was in place for more than 40 years, voting to also allow LGBTQ weddings and end prohibitions on the use of United Methodist funds to “promote acceptance of homosexuality.”
Overturning the policy forbidding the church from ordaining “self-avowed practicing homosexuals” effectively formalized a practice that had caused an estimated quarter of U.S. congregations to leave the church.
The New York Times notes additional votes “affirming L.G.B.T.Q. inclusion in the church are expected before the meeting adjourns on Friday.” Wednesday’s measures were passed overwhelmingly and without debate. Delegates met in Charlotte, N.C.
According to the church’s General Council on Finance and Administration, there were 5,424,175 members in the U.S. in 2022 with an estimated global membership approaching 10 million.
The Times notes that other matters of business last week included a “regionalization” plan, which gave autonomy to different regions such that they can establish their own rules on matters including issues of sexuality — about which international factions are likelier to have more conservative views.
Rev. Kipp Nelson of St. Johns’s on the Lake Methodist Church in Miami shared a statement praising the new developments:
“It is a glorious day in the United Methodist Church. As a worldwide denomination, we have now publicly proclaimed the boundless love of God and finally slung open the doors of our church so that all people, no matter their identities or orientations, may pursue the calling of their hearts.
“Truly, all are loved and belong here among us. I am honored to serve as a pastor in the United Methodist Church for such a time as this, for our future is bright and filled with hope. Praise be, praise be.”
Federal Government
Republican state AGs challenge Biden administration’s revised Title IX policies
New rules protect LGBTQ students from discrimination
Four Republicans state attorneys general have sued the Biden-Harris administration over the U.S. Department of Education’s new Title IX policies that were finalized April 19 and carry anti-discrimination protections for LGBTQ students in public schools.
The lawsuit filed on Tuesday, which is led by the attorneys general of Kentucky and Tennessee, follows a pair of legal challenges from nine Republican states on Monday — all contesting the administration’s interpretation that sex-based discrimination under the statute also covers that which is based on the victim’s sexual orientation or gender identity.
The administration also rolled back Trump-era rules governing how schools must respond to allegations of sexual harassment and sexual assault, which were widely perceived as biased in favor of the interests of those who are accused.
“The U.S. Department of Education has no authority to let boys into girls’ locker rooms,” Tennessee Attorney General Jonathan Skrmetti said in a statement. “In the decades since its adoption, Title IX has been universally understood to protect the privacy and safety of women in private spaces like locker rooms and bathrooms.”
“Florida is suing the Biden administration over its unlawful Title IX changes,” Florida Gov. Ron DeSantis wrote on social media. “Biden is abusing his constitutional authority to push an ideological agenda that harms women and girls and conflicts with the truth.”
After announcing the finalization of the department’s new rules, Education Secretary Miguel Cardona told reporters, “These regulations make it crystal clear that everyone can access schools that are safe, welcoming and that respect their rights.”
The new rule does not provide guidance on whether schools must allow transgender students to play on sports teams corresponding with their gender identity to comply with Title IX, a question that is addressed in a separate rule proposed by the agency in April.
LGBTQ and civil rights advocacy groups praised the changes. Lambda Legal issued a statement arguing the new rule “protects LGBTQ+ students from discrimination and other abuse,” adding that it “appropriately underscores that Title IX’s civil rights protections clearly cover LGBTQ+ students, as well as survivors and pregnant and parenting students across race and gender identity.”
Federal Government
4th Circuit rules gender identity is a protected characteristic
Ruling a response to N.C., W.Va. legal challenges
BY ERIN REED | The 4th U.S. Circuit Court of Appeals ruled Monday that transgender people are a protected class and that Medicaid bans on trans care are unconstitutional.
Furthermore, the court ruled that discriminating based on a diagnosis of gender dysphoria is discrimination based on gender identity and sex. The ruling is in response to lower court challenges against state laws and policies in North Carolina and West Virginia that prevent trans people on state plans or Medicaid from obtaining coverage for gender-affirming care; those lower courts found such exclusions unconstitutional.
In issuing the final ruling, the 4th Circuit declared that trans exclusions were “obviously discriminatory” and were “in violation of the equal protection clause” of the Constitution, upholding lower court rulings that barred the discriminatory exclusions.
The 4th Circuit ruling focused on two cases in states within its jurisdiction: North Carolina and West Virginia. In North Carolina, trans state employees who rely on the State Health Plan were unable to use it to obtain gender-affirming care for gender dysphoria diagnoses.
In West Virginia, a similar exclusion applied to those on the state’s Medicaid plan for surgeries related to a diagnosis of gender dysphoria. Both exclusions were overturned by lower courts, and both states appealed to the 4th Circuit.
Attorneys for the states had argued that the policies were not discriminatory because the exclusions for gender affirming care “apply to everyone, not just transgender people.” The majority of the court, however, struck down such a claim, pointing to several other cases where such arguments break down, such as same-sex marriage bans “applying to straight, gay, lesbian, and bisexual people equally,” even though straight people would be entirely unaffected by such bans.
Other cases cited included literacy tests, a tax on wearing kippot for Jewish people, and interracial marriage in Loving v. Virginia.
See this portion of the court analysis here:
Of particular note in the majority opinion was a section on Geduldig v. Aiello that seemed laser-targeted toward an eventual U.S. Supreme Court decision on discriminatory policies targeting trans people. Geduldig v. Aiello, a 1974 ruling, determined that pregnancy discrimination is not inherently sex discrimination because it does not “classify on sex,” but rather, on pregnancy status.
Using similar arguments, the states claimed that gender affirming care exclusions did not classify or discriminate based on trans status or sex, but rather, on a diagnosis of gender dysphoria and treatments to alleviate that dysphoria.
The majority was unconvinced, ruling, “gender dysphoria is so intimately related to transgender status as to be virtually indistinguishable from it. The excluded treatments aim at addressing incongruity between sex assigned at birth and gender identity, the very heart of transgender status.” In doing so, the majority cited several cases, many from after Geduldig was decided.
Notably, Geduldig was cited in both the 6th and 11th Circuit decisions upholding gender affirming care bans in a handful of states.
The court also pointed to the potentially ridiculous conclusions that strict readings of what counts as proxy discrimination could lead to, such as if legislators attempted to use “XX chromosomes” and “XY chromosomes” to get around sex discrimination policies:
Importantly, the court also rebutted recent arguments that Bostock applies only to “limited Title VII claims involving employers who fired” LGBTQ employees, and not to Title IX, which the Affordable Care Act’s anti-discrimination mandate references. The majority stated that this is not the case, and that there is “nothing in Bostock to suggest the holding was that narrow.”
Ultimately, the court ruled that the exclusions on trans care violate the Equal Protection Clause of the Constitution. The court also ruled that the West Virginia Medicaid Program violates the Medicaid Act and the anti-discrimination provisions of the Affordable Care Act.
Additionally, the court upheld the dismissal of anti-trans expert testimony for lacking relevant expertise. West Virginia and North Carolina must end trans care exclusions in line with earlier district court decisions.
The decision will likely have nationwide impacts on court cases in other districts. The case had become a major battleground for trans rights, with dozens of states filing amicus briefs in favor or against the protection of the equal process rights of trans people. Twenty-one Republican states filed an amicus brief in favor of denying trans people anti-discrimination protections in healthcare, and 17 Democratic states joined an amicus brief in support of the healthcare rights of trans individuals.
Many Republican states are defending anti-trans laws that discriminate against trans people by banning or limiting gender-affirming care. These laws could come under threat if the legal rationale used in this decision is adopted by other circuits. In the 4th Circuit’s jurisdiction, West Virginia and North Carolina already have gender-affirming care bans for trans youth in place, and South Carolina may consider a similar bill this week.
The decision could potentially be used as precedent to challenge all of those laws in the near future and to deter South Carolina’s bill from passing into law.
The decision is the latest in a web of legal battles concerning trans people. Earlier this month, the 4th Circuit also reversed a sports ban in West Virginia, ruling that Title IX protects trans student athletes. However, the Supreme Court recently narrowed a victory for trans healthcare from the 9th U.S. Circuit Court of Appeals and allowed Idaho to continue enforcing its ban on gender-affirming care for everyone except the two plaintiffs in the case.
Importantly, that decision was not about the constitutionality of gender-affirming care, but the limits of temporary injunctions in the early stages of a constitutional challenge to discriminatory state laws. It is likely that the Supreme Court will ultimately hear cases on this topic in the near future.
Celebrating the victory, Lambda Legal Counsel and Health Care Strategist Omar Gonzalez-Pagan said in a posted statement, “The court’s decision sends a clear message that gender-affirming care is critical medical care for transgender people and that denying it is harmful and unlawful … We hope this decision makes it clear to policy makers across the country that health care decisions belong to patients, their families, and their doctors, not to politicians.”
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Erin Reed is a transgender woman (she/her pronouns) and researcher who tracks anti-LGBTQ+ legislation around the world and helps people become better advocates for their queer family, friends, colleagues, and community. Reed also is a social media consultant and public speaker.
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The preceding article was first published at Erin In The Morning and is republished with permission.
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