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U.S. health officials expand approach to monkeypox vaccines as cases crest

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With Southern Decadence coming up, Biden health officials have given an additional 6,000 monkeypox vaccines for New Orleans. (Blade file photo by Michael Key)

At the end of a summer when the number of cases in the monkeypox outbreak rose sharply, the increase in reported infections now appears to be cresting amid increased public messaging and access to vaccines, prompting U.S. health officials to expand their strategy with a new equity-based effort to combat the disease.

Although the reported number of cases, according to most data from the Centers for Disease Control & Prevention, has reached 18,417 in the United States, the number of additional cases decreased from the high at the start of the month, suggesting a downward trajectory in the spread of the disease as vaccines become more readily available.

The number of additional monkeypox cases in beginning to crest, per CDC data.

The numbers are also consistent with a new study finding a significant number of gay and bisexual men, as well as other men who have sex with men, have been limiting contact with casual sex partners, which has been the driving force in the spread of monkeypox. The report from the CDC last week found limiting one-time sexual encounters can significantly reduce the transmission of monkeypox virus, while about half of men who have sex with men are cutting down on sexual activity amid the outbreak, including one-night stands and app hookups.

With the trajectory of monkeypox on the decline, the Biden administration announced a new initiative with the goal of ensuring vaccine distribution is consistent with the value of equity, including on the basis of geographic, racial, and ethnic lines. A total of 10,000 doses of vaccines in the federal government’s supply will be earmarked for localities that have used 50 percent of their allocated supply to support equity interventions, such as outreach to Black and Latino communities, which have been disproportionately affected by the disease or a specific event and celebration for LGBTQ people, health officials announced Tuesday.

Demetre Daskalakis, the Biden administration’s face of LGBTQ outreach for monkeypox and deputy coordinator for the White House monkeypox task force, laid out the details for the new equity-based supplementary initiative in a conference call Tuesday with reporters.

“So what we mean by an equity intervention is what works in your state, county, or city to reach people who we may not be reaching, especially people of color and members of the LGBTQI+ population,” Daskalakis said. “What it means is: It can be working with a specific group or venue that reaches the right people for monkeypox prevention. Once these innovative strategies have been reviewed by CDC, vaccines will be supplied to jumpstart these ideas and accelerate reach deeper into communities.”

The additional equity-based approach to monkeypox vaccine distribution is consistent with the Biden administration’s efforts in recent weeks to distribute additional shots to localities hosting large-scale events for LGTBQ people at the end of the summer, such as Black Pride in Atlanta and Southern Decadence in New Orleans.

Louisiana Gov. John Bel Edwards joined the conference call with reporters on Tuesday and had high praise for the Biden administration for making the additional 6,000 doses of monkeypox vaccine available in time for Southern Decadence, which takes place in the final week of August through Labor Day weekend.

“This is an example — I think a really solid example — of what a federal-state-local partnership and — and then the community providers as well,” Bel Edwards said. “Because the public health folks in New Orleans have been tremendous, but also the community providers.”

Bel Edwards said health officials in the Biden administration have, in addition to providing more vaccines, sent down multidisciplinary teams to New Orleans to help the state organize and prepare as well as set up testing and vaccination sites “that are going to be convenient for the at-risk population.”

A reporter from the New Orleans Advocate on the conference call, however, asked a pointed question on the recent distribution of vaccines to New Orleans in advance of Southern Decadence: The current approach to vaccine administration requires a series of shots, and even with new distribution most people won’t have even had their second shot by that time, so how can Southern Decadence think they will be protected, especially when vaccines take time to become fully effective?

Daskalakis, while promoting the equity-based approach to vaccine distribution, said the Biden administration has been “very clear” that first shot of the monkeypox vaccine “doesn’t mean that you’re protected for the event.”

“We’re going to talk to them about lots of other strategies that they can reduce risk of acquiring monkeypox, but also make it clear that that shot is not for today; it’s for four weeks from now, plus two weeks after that second dose when you get maximum protection,” Daskalakis said.

First death of monkeypox patient reported

Although the number of cases is cresting, concern about monkeypox continues as well as the potential danger of the disease. Case in point: The death of a hospital patient in Texas who had monkeypox, but may have to succumbed to other factors, has drawn attention amid a conventional understanding the skin disease isn’t fatal. The case represents the first time in the United States that a patient with monkeypox died while having the condition.

The patient, as confirmed by the Texas Department of State Health Services on Tuesday, was an adult resident of Harris County who was “severely immunocompromised” and state health officials reviewing the case said it is under investigation to determine what role monkeypox played in the death.

Jenny McQuiston, a CDC official who specializes in research on zoological diseases that spread from animals to people, said in response to a question on the casualty that health officials are also evaluating the death and the role monkeypox played.

“I think it’s important to emphasize that deaths due to monkeypox, while possible, remain very rare,” McQuiston said. “In most cases, people are experiencing infection that resolves over time. And there have been very few deaths even recorded globally. Out of over 40,000 cases around the world, only a handful of fatalities have been reported.”

Despite the cresting in the number of cases, many health experts aren’t sold on the new approach to vaccines announced earlier this month by the Biden administration, which sought to expand existing doses of vaccines fivefold as supply hasn’t met demand. The new vaccine approach calls for injecting the JYNNEOS vaccine from the subcutaneous route (delivery of the vaccine under the fat layer underneath the skin) to the intradermal route (delivery of the vaccine into the layer of skin just underneath the top layer).

Bob Fenton, a regional administrator for FEMA and the response coordinator for the White House task force, said about 75 percent of jurisdictions have already adopted the new approach to vaccine injection, while an additional 20 percent are working toward a “fully operational intradermal method.”

“We continue to be laser-focused on doing everything within our power to help jurisdictions and clinicians get shots in arms,” Fenton said. “We’re seeing more and more jurisdictions adopt the intradermal administration.”

Data of this new intradermal approach, critics have said, is insufficient to support the idea it will be as effective as subcutaneous injections, although the Biden administration continues to give assurances the new route for injections is tested and safe. According to a report earlier this month in the Washington Post, the manufacturer of the JYNNEOS vaccine in Denmark, Bavaria Nordic, privately threatened to cut off supply of the shots based on a conversation with health officials on objections the vaccine hasn’t been approved for intradermal use.

McQuiston, in response to a question on whether or not U.S. health officials are collecting newly available real-world information on the results of the new vaccine approach, said U.S. health officials continue to receive data on monkeypox and soon onboard information from additional states.

“CDC operates a system called VAERS — or the Vaccine Adverse Event Reporting System — and we’re actively looking at…different types of events that might be reported post-vaccination,” McQuiston said. ” And we are actively gathering information from the different jurisdictions and states and cities about which vaccines they’re administering — whether it’s subcutaneous or intradermal — and we are gathering those data now, as we speak.”

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U.S. Supreme Court

11 years after Obergefell, marriage equality remains under scrutiny

Landmark ruling issued on June 26, 2015

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(Washington Blade photo by Michael Key)

Friday marks 11 years since the U.S. Supreme Court ruled the Constitution protects same-sex marriage in Obergefell v. Hodges. Despite that major win for LGBTQ people nationwide, the case may be on shakier ground than originally thought.

Obergefell v. Hodges, the case that determined the Constitution extends its protection of rights to same-sex couples and that states must recognize marriage licenses for same-sex couples from other states, was decided using a combination of cases from several states.

The central arguments in the case rested on the 14th Amendment’s Equal Protection Clause, Due Process Clause, as well as collateral spousal and parental rights.

Cases in play

The first case came from Michigan with DeBoer v. Snyder, where a lesbian couple, who were not legally allowed to marry in the Mitten State, attempted to adopt their third child but could not both obtain legal parental rights. April DeBoer and Jayne Rowse initially received a favorable ruling in district court, with the judge finding that the Michigan Marriage Amendment — which barred same-sex marriage in the Midwestern state — violated the Equal Protection Clause. The same day, the case was appealed to the 6th U.S. Circuit Court of Appeals, eventually making its way, along with the other five cases, to the highest court in the land.

Ohio had multiple cases that ultimately contributed to the judicial acknowledgment of same-sex marriage rights in the U.S.

The Supreme Court case most commonly associated with the fight for same-sex marriage — Obergefell — originated in Ohio. Beginning as Obergefell v. Kasich in the state, James Obergefell knew his longtime boyfriend, John Arthur, was suffering from ALS. Knowing Arthur’s life would end shortly — and understanding the couple could not legally marry in Ohio — they boarded a medically equipped plane, accompanied by a nurse and Arthur’s aunt, Paulette, and flew to BWI Airport in Maryland. There, they were legally married. Over the next several months, Arthur’s health continued to decline until he eventually passed away in October.

The legal battle began after Arthur died, as Ohio law refused to acknowledge that Obergefell was his husband and would not list him as Arthur’s surviving spouse on his death certificate. Obergefell challenged the decision, arguing it was unconstitutional and pursuing legal action. The local Ohio registrar agreed that refusing to recognize their out-of-state marriage license — which Ohio had recognized for different-sex couples in the past — discriminated against the couple. Despite that, the state attorney general continued to defend Ohio’s same-sex marriage ban.

The judge ultimately ruled that “a marriage solemnized outside of Ohio is valid in Ohio if it is valid where solemnized,” marking another step toward marriage equality. Ohio appealed the ruling, and the case ultimately contributed to the establishment of same-sex marriage protections under the federal Constitution.

The second Ohio case, Henry v. Wymyslo, much like DeBoer v. Snyder, involved parental rights for adopted children. The case included four couples — three lesbian couples who lived in Ohio and adopted children while residing there, and one gay couple from New York with an adopted son born in Ohio. The four couples filed a lawsuit against Ohio, seeking to require the state to list both parents on their children’s birth certificates.

Eventually, the judge — the same one who presided over Obergefell v. Kasich — ruled that the state must list both parents on their children’s birth certificates. Like many cases that make their way to the Supreme Court, it went through multiple appeals before ultimately reaching the nation’s highest court.

Kentucky also had two cases that contributed to the legal battle for same-sex marriage.

The first, Bourke v. Beshear, revolved around Gregory Bourke and Michael DeLeon, a same-sex couple married in Canada in 2004, and Randell Johnson and Paul Campion, who were married in California in 2008. Like DeBoer v. Snyder and Henry v. Wymyslo in their respective states, the plaintiffs challenged Kentucky’s ban on same-sex marriage and its refusal to recognize same-sex marriages performed in other jurisdictions so that both parents could be acknowledged on their children’s birth certificates.

The judge ultimately ruled, much like in Obergefell v. Kasich, that states constitutionally must recognize legally performed out-of-state marriages.

Love v. Beshear is the second case from the Bluegrass State.

Maurice Blanchard and Dominique James were denied a marriage license by Kentucky county clerks. The couple’s legal team filed to join Bourke v. Beshear, another case actively challenging the state’s ban on same-sex marriage, and the motion was approved, with the case restyled as Love v. Beshear. The judge ultimately ruled that Kentucky’s bans on same-sex marriage explicitly “violate the Equal Protection Clause of the Fourteenth Amendment to the United States Constitution, and they are void and unenforceable.”

The final case, Tanco v. Haslam, involved four same-sex couples who filed suit in Tennessee. Each couple had married outside Tennessee before moving to the state, with nearly all relocating for employment. One worked for the military, whose marriage was already recognized by the Department of Defense; one worked for the state; and two were professors. Seeking to have their out-of-state marriages recognized in Tennessee, the four couples filed Tanco v. Haslam in U.S. District Court for the Middle District of Tennessee. The court eventually granted a preliminary injunction requiring the state to recognize the marriages of the three plaintiff couples but denied the request to overturn Tennessee’s same-sex marriage ban.

To SCOTUS

All of these cases contributed to the legal challenge against same-sex marriage bans across the country and ultimately led to a 5-4 ruling that allowed same-sex couples to have their marriages recognized in all 50 states, Guam, Puerto Rico, and D.C.

The justices voted as follows: Anthony Kennedy, who authored the majority opinion, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, and Elena Kagan supported Obergefell while Chief Justice John Roberts, Antonin Scalia, Clarence Thomas, and Samuel Alito all dissented.

The court held that the 14th Amendment — specifically its Due Process Clause — guarantees the right to marry as one of the fundamental liberties it protects, regardless of the gender of those getting married.

The court also ruled that another provision of the 14th Amendment — the Equal Protection Clause — extends the right to marry enjoyed by different-sex couples to same-sex couples, finding that denying same-sex couples that right violates their right to equal protection under the law.

Some of the Supreme Court justices who dissented argued that this was a state issue, not a federal one, because the Constitution makes no mention of same-sex couples. They said it was beyond the purview of the court to decide whether states must recognize or license such unions. The dissenters argued that the majority was engaging in judicial policymaking, which they contended is not permitted under U.S. law.

Another argument made by the dissenting conservative justices was that the majority opinion infringed on religious freedom by engaging in this “judicial policymaking” rather than allowing state legislatures to determine the laws governing marriage.

Since the ruling

According to data from the Williams Institute, 823,000 same-sex couples are now legally married — more than twice the number in 2015 — as a result of the Supreme Court’s decision.

The ruling also increased the number of same-sex families raising children, largely because it removed legal barriers and paperwork restrictions that had prevented same-sex couples from being listed as parents. The data shows there are nearly 299,000 children under the age of 18 being raised by married same-sex couples as a result of Obergefell.

The states that saw the largest increases — and the most favorable changes to marriage rates — were in the South. The percentage of cohabiting same-sex couples who were married between 2014 and 2023 increased from 38 percent to 59 percent.

Many of the married same-sex couples surveyed said marriage improved their sense of safety and security (83 percent), life satisfaction (75 percent), and relationship stability (67 percent).

“Marriage equality has significantly benefited the lives and well-being of same-sex couples, their families, and the communities where they live,” said Christy Mallory, interim executive director and legal director at the Williams Institute.

Future of Obergefell

While same-sex marriage remains the law of the land, there have been multiple attempts by conservative and religious figures in America to reverse it.

In 2025, Kim Davis, the clerk of Rowan County, Ky., who made headlines 10 years earlier after refusing to issue marriage licenses following the striking down of same-sex marriage bans, approached the Supreme Court with the goal of getting Obergefell overturned.

She argued that the ruling put her religious beliefs at odds with her job and asked the court to strike it down. The consensus was nearly unanimous, holding that when a person serves as an agent of the state, they cannot place their personal religious beliefs above state policy because they are acting on behalf of the government.

Thomas, one of the Supreme Court’s most conservative justices, has also attempted to plant the seeds for overturning Obergefell.

In Dobbs v. Jackson Women’s Health Organization, which ultimately restricted abortion access in the country, he wrote a concurring opinion suggesting that Obergefell, along with several other precedents, should be “reconsider[ed].”

Later, without directly addressing Obergefell, Thomas told an audience at Catholic University’s Columbus School of Law that he didn’t “think that … any of these cases that have been decided are the gospel.”

While President Donald Trump has not implemented any executive restrictions on same-sex marriage during his presidency, his administration has made it clear that it opposes continued efforts to expand protections for same-sex couples, particularly when doing so conflicts with claims of “religious freedom.” The administration has attempted to remove sexual orientation and gender identity from federal health care and housing nondiscrimination protections and has significantly restricted the rights of transgender Americans.

Currently, same-sex marriage remains federally protected by the Respect for Marriage Act, and the Supreme Court has thus far declined to overturn Obergefell.

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New York

Judge blocks DOJ from obtaining transgender patients’ medical records

Advocacy groups sued White House

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Protesters pushed for protections for transgender children’s right to healthcare outside the D.C. Attorney General’s office in 2025. (Washington Blade photo by Michael Key)

A judge for the U.S. District Court for the Southern District of New York has granted a request from multiple transgender people for a temporary restraining order, blocking the disclosure of plaintiffs’ and class members’ medical information to the Justice Department.

Judge Katherine Polk Failla approved the Temporary Restraining Order and Provisional Class Certification, preventing any further information from being provided to the Trump-led DOJ.

The medical data was requested through subpoenas issued by the Trump-Vance administration’s DOJ to multiple hospitals in New York City — most notably NYU Langone — which halted its Transgender Youth Health Program in May following a federal push to stop providing trans minors with gender-affirming care.

In May 2026, NYU Langone Hospitals received a subpoena from a federal grand jury in Fort Worth, Texas, demanding that the hospitals turn over the identities and sensitive health information of any patient who had received medical treatment for gender dysphoria while under the age of 18 at NYU Langone between January 2020 and May 2026.

Lambda Legal, the American Civil Liberties Union, and the New York Civil Liberties Union filed a lawsuit, “Coe, et al. v. Blanche, et al.,” against the Trump-Vance administration on behalf of three families with trans youth and two trans young adults who were minors when they began care, in June 2026.

The lawsuit requests a temporary restraining order blocking the DOJ from violating the patients’ constitutional privacy rights by obtaining identifying and sensitive health information as part of its investigation into unspecified health offenses. The DOJ issued subpoenas to NYU Langone and other similar healthcare institutions in New York City, including Mount Sinai, that provide or have provided gender-affirming medical care to trans minors. All plaintiffs have filed under pseudonyms to maintain their privacy and anonymity.

Multiple leaders of organizations that helped push for the restraining order provided quotes about the ongoing situation and what it means for the fight for trans children’s access to healthcare in the U.S.

“Today’s order from the court is a victory for the basic privacy of our clients and all families like theirs across New York City. It is no secret that this administration will use every lever in its power to attack transgender people and fulfill its misguided goal to ‘end’ gender-affirming medical care — care that is legal and protected in New York State. Using subpoenas to attain the identities and sensitive health information of transgender young people to effectuate such goals should send chills down the spine of every American. Our laws and our Constitution recognize that we all have a right to confidentiality about the most intimate and private information about ourselves,” said Omar Gonzalez-Pagan, senior counsel and health care strategist at Lambda Legal. “Whether a young person receives any type of medical care is a decision for that patient, their family, and their doctor, not for political appointees to decide, interfere with, or know. The government cannot abuse its powers to violate the constitutional rights of transgender young people and their families. It is an enormous relief for these families that the court has stopped them from doing so as this case proceeds.”

“We’re thankful the court has granted our emergency request to protect the privacy interests of transgender New Yorkers and their families,” said Chase Strangio, co-director of the ACLU’s LGBTQ & HIV Rights Project. “Patients and families trust their doctors with their most intimate, private information and should trust in turn that this information will be protected from impermissible and harassing demands for disclosure from the federal government or anyone else. For the past year, the Trump administration has not only decided that it knows better than these families and their doctors what their medical needs are, but has also sought to obtain troves of sensitive information about patients in New York. We will continue to fight on behalf of these families and the fundamental liberty of all transgender New Yorkers and those who come here to seek needed medical care.”

“New York’s laws recognize that transgender youth deserve fundamental privacy protections for their sensitive medical records and unobstructed access to the care they need,” said Bobby Hodgson, deputy legal director at the New York Civil Liberties Union. “As the Trump administration tries to bully transgender youth, scare families, and intimidate healthcare providers into dropping their patients, we’re thankful the court found these tactics are likely unconstitutional and put a stop to them here in New York.”

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Federal Government

Trump holds housing bill hostage to anti-trans SAVE Act

President’s SAVE Act failed in the Senate

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People protesting the restrictive and anti-trans SAVE Act in March. (Washington Blade photo by Michael Key)

President Donald Trump is refusing to sign a new bipartisan housing bill unless his SAVE Act is approved by the legislative branch.

The bill being prevented from being enacted into law is the “21st Century ROAD to Housing Act.” The legislation is an attempt by Congress to make buying a home in the U.S. Senate more affordable in response to various factors — including housing shortages and regulatory constraints — that have made homeownership increasingly difficult. The total number of homeowners has nearly stopped growing, with high interest rates and surging home prices pushing more Americans toward renting.

The housing bill was considered highly bipartisan, something that is rare in this Congress. The House voted to pass the bill 358-32 on Tuesday after the Senate approved the measure 85-5 a day earlier. The legislation was led by U.S. Sens. Elizabeth Warren (D-Mass.) and Tim Scott (R-S.C.) in the Senate and U.S. Reps. Maxine Waters (D-Calif.) and French Hill (R-Ark.) in the U.S. House of Representatives.

Some of the highlights of the legislation are aimed at increasing the supply of affordable housing while making homeownership more accessible. The bill would streamline environmental reviews and direct the U.S. Department of Housing and Urban Development to provide guidance to communities on reforming zoning and land-use policies that can create barriers to housing development.

The legislation would also expand the definition of “manufactured housing,” making it cheaper and easier to mass-produce homes built in factories before being transported to their sites. To encourage additional development, the bill would provide grants and loans for the construction of new housing, the rehabilitation of aging properties, and the conversion of vacant buildings into residential units. It would also increase certain banks’ Public Welfare Investment cap, allowing them to direct more capital toward low-income and affordable housing projects.

In an effort to help more Americans purchase homes, the legislation would create a program to expand access to small-dollar mortgages, which are often used to finance lower-cost homes, while also seeking to improve housing opportunities for veterans. The bill would further promote homeownership by limiting the number of single-family homes that large institutional investors can own and requiring them to disclose how many such properties they control, a measure intended to prioritize American families over corporate buyers.

The bill the president wants enacted — the SAVE Act — is a restrictive and anti-transgender piece of proposed legislation.

The bill would impose a number of new limitations on voter registration across the country by amending the National Voter Registration Act of 1993 to require in-person proof of citizenship for anyone seeking to vote in U.S. elections. The bill would also limit acceptable forms of identification to documents such as a birth certificate or passport — records that the Brennan Center for Justice estimates more than 21 million Americans do not possess — effectively restricting access to the ballot. It would also ban online voter registration, DMV voter registration efforts, and mail-in voter registration.

Trump pushed for the SAVE Act to include a provision that would ban gender-affirming medical care for trans minors, even with parental consent, and prohibit trans people from participating in school or professional sports consistent with their gender identity rather than their sex assigned at birth.

Trump also pressed Senate Majority Leader John Thune (R-S.D.) to eliminate the filibuster so the Republican-controlled Congress could pass the SAVE Act, saying Republicans will never win another election without it.

It is expected that Congress will override the president’s veto and pass the 21st Century ROAD to Housing Act, as it requires a two-thirds supermajority vote in both the House of Representatives and the Senate — a threshold the legislation currently exceeds.

It is not expected that the SAVE Act will pass the Senate in its current form. It passed the House, but every Democrat and four Republicans voted against it in the Senate.

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