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The LGBTQ+ community, telehealth, and rural broadband access

Congress must act to preserve lifeline of remote healthcare

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The LGBTQ+ community has come to rely more and more on remote general and specialized healthcare as the pandemic continues to limit access to in-person services. This lifeline is in danger of going away unless Congress acts, delivering a serious blow to the diverse community of people who struggle to access care in-person in their communities. 

Telehealth allows doctors and other providers to provide care without an in-person visit. More specifically, telehealth refers to the health care services accessible through telecommunications services, including via audio and video (either real time or asynchronous). These services are best delivered via high-speed broadband services. Medical care appointments, consultations, prescriptions, follow-up visits, and more can be done safely and virtually. 

Telehealth is a modern necessity made even more relevant due to the ongoing COVID-19 pandemic, and demand for these resources is growing. The LGBTQ+ community in particular is experiencing a significant need for improved telehealth provisions and access. Recent relaxations of telehealth regulations have expanded the reach of telehealth and positively impacted marginalized communities including the LGBTQ+ community, especially in rural and remote areas. Effective and reliable broadband access is instrumental for telehealth services and as telehealth expands, advancements to universal broadband access will be critical to reach these communities.

Telehealth and the LGBTQ+ community

More than 18 million Americans identify as lesbian, gay, bisexual, transgender, queer, questioning, or intersex (LGBTQ+), and more younger Americans than ever before are identifying as LGBTQ+. The health concerns of these individuals deserve utmost respect and care, demonstrable through high-quality health care both in person and online. Telehealth plays an important role in connecting the LGBTQ+ community with competent and affirming health care providers and services. The LGBTQ+ community has always been more heavily reliant on internet connectivity, and healthcare is no different, with 81% of LGBTQ+ youth reportedly using the internet to search for health information.

LGBTQ+ communities face many of the same healthcare concerts as non-LGBTQ+ communities, though there are differences in rates of some chronic conditions including cancer, diabetes, obesity, HIV/AIDS and other sexually transmitted infections (STIs), and tobacco-related health conditions. LGBTQ+ individuals have higher rates of mental and physical disability, and the impact of loneliness on health quality is experienced at higher rates by LGBTQ+ individuals in both urban and rural settings. Routine healthcare for these conditions improves quality of life, but LGBTQ+ individuals often report high cost as a deterrent from going to the doctor. Telehealth provides an affordable avenue to routine health care.

Many individuals in the LGBTQ+ community report a history of medical trauma as a barrier to receiving healthcare. Gender-affirming health care is one major motivator for telehealth access in the LGBTQ+ community. Nearly one-fifth of transgender individuals have been refused healthcare due to their gender identity. Online servers such as Folx Health, Plume, and QueerDoc provide gender-affirming care including hormone therapy, mental health, and documents for gender marker change. Telehealth allows users to bypass the barrier of proximity to medical care and to access providers who are informed on medical concerns and considerations that uniquely impact the LGBTQ+ community. 

Regulations that previously restricted the delivery of telehealth have been eased since the onset of the COVID-19 pandemic. Specifically, rules previously limited telehealth to rural areas received in a clinical setting. The new rules allow urban and suburban patients to access telehealth from their home or other convenient setting. This makes sense as many urban areas lack convenient access to physicians and other providers. Individuals across America have benefitted from the ability to access basic health services at home, but those whose care has been most significantly enhanced are poor, elderly, members of marginalized communities such as the LGBTQ+ community, and/or those who live in remote areas of the country. For example, the total number of telehealth visits in Medicare increased from less than 1 million to more than 50 million during COVID. 

There are currently hundreds of proposals pending before state and federal legislatures that address extending or expanding telehealth beyond the pandemic’s public health emergency. Current changes to telehealth regulations include loosened restrictions around telephone-based check-ins and the allowance for telehealth visits between providers and persons across state borders. Before the pandemic, patients filled a prescription after first meeting with a doctor in-person, but telehealth expansion has eliminated the required in-person appointment. Telehealth treatment for addiction is also on the rise, with addiction-specific treatments available online. General mental health resources are also increasingly accessible virtually and by phone. Now that these practices are commonplace, regulators are looking to pass legislation that will maintain this ease of service.

The expansion of telehealth has proven especially effective for the LGBTQ+ community. Easing accessibility of telehealth and prescriptions reduces the cost of care for routine medicines and check-ups for conditions that disproportionately affect the LGBTQ+ community, such as HIV. Increased availability of telehealth mental resources is critical for all youth, but especially for those in the marginalized LGBTQ+ community. Through online resources, transgender adults can safely and reliably access gender-affirming healthcare including hormone replacement therapy and counseling with specialized professionals. Additionally, telehealth access can reduce or eliminate the stigma and discrimination that LGBTQ+ individuals face daily when selecting providers, especially in remote or rural areas where there may be few providers to choose from and even fewer knowledgeable about and sympathetic to the special health care needs of LGBTQ+ individuals.   Making permanent the COVID-19 exemptions currently in place that regulate telehealth services will have far-reaching, positive impacts for the LGBTQ+ community.

Rural need for telehealth

An estimated 2.9 to 3.8 million Americans living in rural and remote parts of the country identify as LGBTQ+ and deserve high-quality and informed healthcare. Accessing a healthcare provider is, in general, more challenging in rural areas. Consider, for example, costs associated with distance. To add insult to injury, where providers are available in rural communities, the potential for discrimination against LGBTQ+ individuals and misdiagnosis of medical conditions is prevalent. Lack of access to sympathetic providers or specialized providers makes telehealth a crucial tool for the rural LGBTQ+ community. 

Given the need for broadband access to ensure quality telehealth services (to access video consultations, for example), the quality of an individual’s access to broadband services will directly affect their health care experience. Rural Americans are routinely left behind in broadband deployment, contributing to the digital divide, or the gap in use of online resources. Improvements to broadband access is key for expanding the reach of telehealth services across the country, especially in rural America. The recently enacted infrastructure law includes $65 billion in new broadband funding. It must be rolled out quickly to ensure marginalized communities in rural areas gain from improvements to broadband access and the telehealth resources that come along with it. 

Telehealth has become a critical tool to expand access for all patients, but especially the LGBTQ+ community. Marginalized individuals benefit the most from increased telehealth access and those living in rural areas may be the most significantly impacted. Telehealth offers a number of benefits including facilitating community health and social wellness, the delivery of gender-affirming medical care, accessible mental health care, and ease of prescription access.

Recently relaxed regulations around telehealth delivery have increased the reach of these services and provided healthcare to individuals who may have gone without care. Rural and remote marginalized communities, such as the LGBTQ+ community, will experience an especially positive impact from telehealth, and increasing rural broadband access is critical to expanding high-quality, informed healthcare to LGBTQ+ individuals across America.  Crucially, Congress can permanently expand telehealth services and capitalize on the recent infrastructure law to roll out high-speed broadband that facilitates telehealth in areas with limited internet access.  Without congressional action, many of the benefits marginalized communities have experienced from telehealth services will expire thereby reducing or eliminating supportive and specialized care options for these communities.  

For more information visit www.LGBTQ+tech.org/telehealth.

Carlos Gutierrez is deputy director and general counsel for the LGBT Technology Partnership & Institute, which works to improve access, increase inclusion, ensure safety and empower entrepreneurship for LGBTQ+ communities around technology.

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Opinions

The felon in the White House must be stopped

Are there any decent Republican members of Congress left?

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President Donald Trump (Screen capture via White House/YouTube)

We are up shit’s creek if the felon in the White House actually thinks he has a Nobel Peace Prize. If he believes he deserves one, or Venezuelan opposition leader Maria Corina Machado had any other reason to give him hers, than it was easier, and less degrading, than going on her knees to him, as a number of men already have. I don’t know if she understood how many millions the medal could be worth. Instead, she could have used it for her people, if she didn’t want to keep it. 

Machado was awarded the Nobel Prize for her work for the Venezuelan people. She spoke up for them, and fought for them. The felon couldn’t care less about them. He proved that by invading, and then supported Maduro’s vice president as president. He said he, and his fascist cohorts, would run the country, and is now stealing their oil and personally deciding what to do with it. After U.S. troops captured Venezuelan President Nicolás Maduro, Trump said, Venezuelan opposition leader Maria Corina Machado “doesn’t have the support within Venezuela to be its next leader, she was not consulted prior to the operation.” He went on to say, “I think it would be very tough for her to be the leader. She doesn’t have the support within or the respect within the country.” This is the slime bag she gave her Nobel Peace Prize medal to. I hope she is not naïve enough to believe he really cares about her, or her countrymen, and women. 

Trump is vile, sick, and mentally deranged. He is threatening foes and allies alike. They see bending a knee to him only works for the moment, but has no long-term impact on his tiny brain. Today, he is threatening Greenland, and our NATO allies are moving their military to Greenland to protect it against the United States. Now he is threatening them with new tariffs. That would have once been unfathomable. He is saber rattling over Iran, Colombia, even Mexico. He is bombing Nigeria and Syria. 

If that weren’t enough, he threatens to use the Insurrection Act to send the military into cities here. He has already sent in thousands of ICE agents. ICE is classified as a federal law enforcement agency under the Department of Homeland Security. They have authority to arrest, detain, and investigate immigration violations. However, the law is clear; ICE agents do not have unlimited power. They face significant constitutional restrictions that many people don’t realize, especially when it comes to entering homes and private spaces. But what is clear, in Minneapolis today, some of the agents are acting like the Gestapo. They are smashing car windows, pulling people out of their cars, invading homes, and workplaces, all without first having any proof the people they are going after are guilty of anything. I believe we need fair immigration laws, and they should be enforced. But this is clearly not what the felon is doing. The felon in the White House and his incompetent stooge at Homeland Security, Kristi Noem, who has no idea what the hell she is doing, are acting egregiously, and making a mockery of our democracy.  

The president, Noem, Hegseth, Bondi, and the other incompetents in the felon’s Cabinet, simply pretend to forget the history of the United States. They don’t want to accept the truth; we are a nation of immigrants. It is immigrants who built our country, and are still building it. My parents were immigrants escaping from Hitler, and they came here and built a life, and in doing so, added to the greatness of our country. I want every person around the world who needs to escape from dictators, and despots, to be able to do the same as my parents did. We need to build an immigration system that allows them to do that. Instead, because of what this felon is doing, we are seeing American citizens thinking of leaving this country, and looking for asylum in others. That is really sick, but it’s happening.   

Sitting in the Oval Office today we have a felon who is reveling in becoming the war president. He is taking the United States down an incredibly dangerous path, threatening our own citizens with violence here at home, and doing the same to our allies around the world. He, and the incompetents and fascists surrounding him, need to be stopped. If there are any decent Republican members of Congress left, they need to join with Democrats, and the voters, to stop him.


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

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Commentary

The power of no

Pick one priority this year, not 10

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(Photo by Damian Palus/Bigstock)

January arrives with optimism. New year energy. Fresh possibilities. A belief that this could finally be the year things change. And every January, I watch people respond to that optimism the same way. By adding.

More workouts. More structure. More goals. More commitments. More pressure to transform. We add healthier meals. We add more family time. We add more career focus. We add more boundaries. We add more growth. Somewhere along the way, transformation becomes a list instead of a direction.

But what no one talks about enough is this: You can only receive what you actually have space for. You don’t have unlimited energy. You have 100 percent. That’s it.  Not 120. Not 200. Not grind harder and magically find more.

Your body knows this even if your calendar ignores it. Your nervous system knows it even if your ambition doesn’t want to admit it. When you try to pour more into a cup that’s already full, something spills. Usually it’s your peace. Or your consistency. Or your health.

What I’ve learned over time is that most people don’t need more motivation. They need clarity. Not more goals, but priority. Not more opportunity, but discernment.

So this January, instead of asking what you’re going to add, I want to offer something different. What if this year becomes a season of no.

No to things that drain you. No to things that distract you. No to things that look good on paper but don’t feel right in your body. And to make this real, here’s how you actually do it.

Identify your one true priority and protect it

Most people struggle with saying no because they haven’t clearly said yes to anything first. When everything matters, nothing actually does. Pick one priority for this season. Not 10. One.  Once you identify it, everything else gets filtered through that lens. Does this support my priority, or does it compete with it?

Earlier this year, I had two leases in my hands. One for Shaw and one for National Landing in Virginia. From the outside, the move felt obvious. Growth is celebrated. Expansion is rewarded. More locations look like success. But my gut and my nervous system told me I couldn’t do both.

Saying no felt like failure at first. It felt like I was slowing down when I was supposed to be speeding up. But what I was really doing was choosing alignment over optics.

I knew what I was capable of thriving in. I knew my limits. I knew my personal life mattered. My boyfriend mattered. My family mattered. My physical health mattered. My mental health mattered. Looking back now, saying no was one of the best decisions I could have made for myself and for my team.

If something feels forced, rushed, or misaligned, trust that signal. If it’s meant for you, it will come back when the timing is right.

Look inside before you look outside

So many of us are chasing who we think we’re supposed to be— who the city needs us to be. Who social media rewards. Who our resume says we should become next. But clarity doesn’t come from noise. It comes from stillness. Moments of silence. Moments of gratitude. Moments where your nervous system can settle. Your body already knows who you are long before your ego tries to upgrade you.  

One of the most powerful phrases I ever practiced was simple: You are enough.

I said it for years before I believed it. And when I finally did, everything shifted. I stopped chasing growth just to prove something. I stopped adding just to feel worthy.  I could maintain. I could breathe. I could be OK where I was.

Gerard from Baltimore was enough. Anything else I added became extra.

Turning 40 made this clearer than ever. My twenties were about finding myself. My thirties were about proving myself. My forties are about being myself.

I wish I knew then what I know now. I hope the 20 year olds catch it early. I hope the 30 year olds don’t wait as long as I did.

Because the only way to truly say yes to yourself is by saying no first.

Remove more than you add

Before you write your resolutions, try this. If you plan to add three things this year, identify six things you’re willing to remove. Habits. Distractions. Commitments. Energy leaks.

Maybe growth doesn’t look like expansion for you this year. Maybe it looks like focus. Maybe it looks like honoring your limits. January isn’t asking you to become superhuman. It’s asking you to become intentional. And sometimes the most powerful word you can say for your future is no.

With love always, Coach G.


Gerard Burley, also known as Coach G, is founder and CEO of Sweat DC.

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Greenland

The Greenland lesson for LGBTQ people

Playbook is the same for our community and Europeans

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(Photo by Maridav/Bigstock)

I understand my own geopolitical limits and don’t pretend to know how Europeans should respond to U.S. threats to seize Greenland or retaliate against anyone who opposes them. However, as I mentioned in March, it’s clear that for Europeans and LGBTQ+ people alike, hug-and-kiss diplomacy is over.

In practice, that means responding to the U.S. administration’s provocations with dialogue, human‑rights rhetoric, and reasoning may now be counterproductive. It looks weak. At some point, Europeans will have to draw a line and show how bullying allies and breaking international agreements carry a cost — and that the cost is unpredictable. On the surface, they have few options; like LGBTQ+ communities, they are very behind in raw power and took too long to wake up. But they still have leverage, and they can still inflict harm.​

Maybe it is time for them to call the bluff. America has a great deal to lose, not least its reputation and credibility on the world stage. Stephen Miller and Pete Hegseth, with all their bravado, obviously underestimate both the short‑ and long‑term geopolitical price of ridicule. Force the United States to contemplate sending troops into an ally’s territory, and let the consequences play out in international opinion, institutions, and markets.​

In the United States, LGBTQ+ communities have already endured a cascade of humiliations and live under constant threat of more. In 2025 our symbols and heroes were systematically erased or defaced: the USNS Harvey Milk was quietly renamed after a straight war hero, Admiral Rachel Levine’s title and image were scrubbed from official materials, Pride flags were banned from public buildings, World AIDS Day events were defunded or stripped of queer content, the Orlando memorial and other sites of mourning were targeted, the U.S. lead a campaign against LGBTQ+ language at the U.N., and rainbow crosswalks were literally ripped up or painted over. We cannot simply register our distress; we must articulate a response.​

In practice, that means being intentional and focused. We should select a few unmistakable examples: a company that visibly broke faith with us, a vulnerable political figure whose actions demand consequences, and an institution that depends on constituencies that still need us. The tools matter less than the concentration of force — boycotts, shaming, targeted campaigning all qualify — so long as crossing certain lines produces visible, memorable costs.​

A friend suggested we create what he called a “c***t committee.” I liked the discipline it implies: a deliberate, collective decision to carefully select a few targets and follow through. We need a win badly in 2026.

These thoughts are part of a broader reflection on the character of our movement I’d like to explore in the coming months. My friends know that anger and sarcasm carried me for a long time, but eventually delivered diminishing returns. I am incrementally changing these aspects of my character that stand in the way of my goals. The movement is in a similar place: the tactics that served us best are losing effectiveness because the terrain has shifted. The Greenland moment clarifies that we must have a two-pronged approach: building long-term power and, in the short term, punching a few people in the nose.

Fabrice Houdart published this column on his weekly Substack newsletter. The Washington Blade has republished it with his permission.

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