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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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California

Calif. governor signs 6 pro-LGBTQ bills, vetoes 1

Gavin Newsom rejected measure he claimed is legislative overreach

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California Gov. Gavin Newsom, center, at the 2024 Democratic National Convention in Milwaukee. (Washington Blade photo by Michael Key)

Last week, California Gov. Gavin Newsom signed and vetoed a slew of bills into state law. Among them were seven pertaining to California’s LGBTQ community. Newsom signed six while vetoing one. His actions drew applause and scorn from advocacy groups in the state. 

The six signed bills:

Assembly Bill 1775 allows transgender veterans, who were banned from service last year by the Trump-Vance administration, to access housing assistance, use California’s discharge upgrade assistance program, and get support for gaining employment. 

Assembly Bill 1930 strengthens privacy protections for healthcare patients and providers by creating clear guidelines for California agencies, individuals, and corporations to respond to out-of-state subpoena requests relating to abortion or gender-affirming care. This includes a requirement to contact the California Attorney General at least seven days prior to responding to the subpoena or providing legal documents. This should add additional protection to those residing in California from investigations in states where abortion or gender-affirming care has more restrictions. 

Senate Bill 934 targets conversion therapy in California and increases the amount of time a patient has to bring a medical malpractice lawsuit against a provider for attempting to change the patient’s sexual orientation or gender identity. The bill takes aim at the widely debunked practice that treats queerness as a mental disorder that could be cured through psychotherapeutic methods. Conversion therapy has been illegal in California since 2012; however, a recent Supreme Court decision threw the ban into question, prompting lawmakers to write this new bill that legally defines it as medical malpractice. 

Senate Bill 1023 expands access to PrEP, a medication that protects people from contracting HIV. The bill requires insurers to cover the drug through the medical benefit and the pharmacy benefit pathways, allowing for more providers to give patients PrEP. 

Senate Bill 1114 strengthens privacy protections for voluntary self-identification data about sexual orientation and gender identity. The bill limits when California government agencies can share this data and bars it from being disclosed outside of the state government, with few exceptions. 

Senate Bill 1328 expands support for LGBTQ students and staff in California colleges. The bill requires any institution of higher education to designate an employee at any campus, satellite campus, branch campus, or outreach center to support the needs of LGBTQ individuals. 

Equality California, the largest statewide LGBTQ civil rights group in the country, commended the governor for his support of legislation that protects and supports the queer community amid escalating threats, attacks, and rollbacks from the federal government. 

Executive Director Tony Hoang said in a written statement, “California is once again demonstrating that when LGBTQ+ people are targeted, our state will respond with action,” adding, “We are grateful to Gov. Newsom for signing these measures.”

The vetoed bill:

Assembly Bill 2164 would have banned California from extraditing anyone residing in California for providing abortions or gender-affirming care in another state. Newsom vetoed this bill despite agreeing with its principles, claiming in a written statement that “extradition is an exclusively executive function” and that he did not want to limit the “executive authority of an incoming governor.” 

This bill was created in response to Louisiana’s attempt to extradite a California physician for allegedly sending abortion pills in the mail to a Louisiana woman. Newsom responded forcefully to the extradition request, publicly denying it and stating, “We will not allow extremist politicians from other states to reach into California and try to punish doctors based on allegations that they provided reproductive health care services.” 

In a written statement responding to the veto, Lizzy Hinkley, the legal director of the bill’s lead sponsor, Abortion Coalition for Telemedicine, criticized Newsom, stating, “[the] outgoing governor’s principled stance is cold comfort to Californians living and working in the real world post-Dobbs. A high-brow, academic justification for refusing to codify legal protections only reveals an ignorance for the lived reality of patients and providers — and does nothing to help them.” 

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HRC report: LGBTQ students face ‘far greater challenges’ in non-supportive states

Survey finds anti-LGBTQ school harassment, bullying highest in 17 states

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(Washington Blade photo by Michael Key)

The Human Rights Campaign Foundation, the educational arm of the national LGBTQ advocacy organization Human Rights Campaign, has released a report showing LGBTQ public school students are more likely to face bullying, harassment, and “other barriers” in states that have less overall supportive LGBTQ laws and policies.

The report is based on the HRC Foundation’s National Educator Survey of School Climate and Bullying, which was released on Sept. 17.

“The report finds that harassment, bullying, and other barriers to LGBTQ+ inclusion are more prevalent in states with limiting policies, where educators report widespread restrictions on LGBTQ+ resources, visible expressions of support, and assistance for transgender students,” a statement released by HRC says.

“As just one example,” the statement adds, “while 59 percent of educators in states with limiting policies report restrictions on supporting their transgender students, just 6 percent to 8 percent of educators in states with supportive policies report the same, underscoring the impact of these policies on school climate, student well-being, and the stakes of the upcoming midterm elections for LGBTQ+ youth and inclusive classrooms.”

The report says the survey consisted of responses by 826 educators in 42 states who worked as teachers, principals, counselors, administrators, and others who worked in support services. All worked at schools with students from pre-kindergarten to 12th grade, most being public schools and a smaller number being charter schools, the report says.

It says the survey was conducted between April 15 and May 21, 2026, and included a survey questionnaire with about 55 questions covering a wide range of LGBTQ related school issues.

According to the report, its classification of LGBTQ supportive and non-LGBTQ supportive states is based on a detailed analysis of the LGBTQ related laws and policies of all 50 states, D.C., and U.S. territories conducted by the Movement Advancement Project, or MAP, which describes itself as an “independent, nonprofit thinktank.”  

The report includes a chart consisting of 51 boxes representing the 50 states and D.C., with 32 plus D.C. colored as blue and said to have overall LGBTQ supportive policies. The 17 boxes colored in red are said to have overall non-LGBTQ supportive policies and laws, Each of the boxes has the initial of a state or D.C. printed inside it.

In addition to D.C., the chart shows Maryland, Virginia, New York, California, and Massachusetts as among the supportive states. Florida, Texas, West Virginia, and Ohio are among the states shown to be non-LGBTQ supportive.  

The HRC statement includes these “key” findings from the survey:

  • In states with restrictive LGBTQ+ inclusion policies, 59 percent of educators report restrictions on supporting transgender students, compared to just 6-8 percent of educators in states with supportive LGBTQ+ inclusion policies.
  • In states with restrictive policies, nearly 50 percent of educators reported restrictions on LGBTQ+ books or resources, compared to just 7 percent of educators in states with supportive policies.
  • Roughly 32 percent of educators in states with restrictive policies reported anti-LGBTQ+ harassment was a moderate or serious problem, compared with 11 percent of educators in states with supportive LGBTQ+ inclusion policies.
  • In states with restrictive LGBTQ+ inclusion policies, 29 percent of educators were very worried about anti-LGBTQ+ harassment, compared to 15 percent in states with supportive LGBTQ+ inclusion policies.
  • In states with restrictive LGBTQ+ inclusion policies, 36 percent of educators witnessed anti-LGBTQ+ student bullying, compared to 27 percent in states with supportive LGBTQ+ inclusion policies.
  • In states with supportive LGBTQ+ inclusion policies, 75 percent of educators reported no restrictions on LGBTQ+-supportive displays, highlighting a substantially more supportive school environment than in states with restrictive policies.
  • Educators in states with restrictive LGBTQ+ inclusion policies also reported significant harassment of students based on appearance (57 percent), race or ethnicity (43 percent), sexual orientation (42 percent), and gender identity or expression (39 percent). (No direct comparison figure from supportive-policy states is provided in the data above.)

“Every young person deserves to feel safe and supportive at school, but this report makes clear that for too many LGBTQ+ students, especially transgender youth, are being failed by policies designed to exclude them,” said HRC President Kelley Robinson in the HRC statement.

“We know that when students feel seen, supported, and affirmed, they are more likely to thrive, but when schools become places of exclusion or hostility, young people pay the price through lower engagement, missed opportunities to learn, and poorer mental and physical health,” Robinson said.

The HRC statement notes that the survey findings come at a time when a growing number of states have passed laws targeting LGBTQ students and the school officials and teachers who support them. It says that for the first time, the survey found that “educators themselves are also experiencing anti-LGBTQ+ harassment, highlighting the growing impact of these policies on school staff as well as students.”

The full survey findings and report can be accessed here:

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U.S. Supreme Court

Trump asks Supreme Court to allow restrictions on gender-affirming care in prisons

SCOTUS could further restrict rights of trans inmates

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The U.S. Supreme Court with an LGBTQ Pride flag flying in front of it. (Washington Blade Photo by Michael Key)

The Trump administration has asked the Supreme Court to allow its policy limiting gender-affirming treatment for federal inmates to take effect while a legal challenge plays out in court.

U.S. District Judge Royce Lamberth ordered the government to continue providing gender-affirming care, such as hormone therapy, which had become policy nearly a decade ago for inmates who were transitioning.

The Trump administration argues in its application that its policy restricting transgender rights was properly adopted and that the judge overstepped, posing nationwide “security and prison-administrative concerns.”

If allowed, the policy would halt surgeries, hormones and social accommodations such as wigs while allowing mental health therapy to continue as the legality of the policy reversal is litigated.

The government also argues in the application that the Bureau of Prisons had “determined that sex-trait-modification surgeries, hormone interventions in general, and social accommodations could no longer be justified as treatment for gender dysphoria.”

American Civil Liberties Union attorneys for the inmates said the policy is “a direct threat to the well-being of transgender people in federal custody and an open violation of their fundamental rights,” and said withholding necessary gender-affirming healthcare constitutes cruel and unusual punishment.

The Blade has covered the ongoing developments surrounding changes to Federal Bureau of Prisons transgender inmate policy that went into effect earlier in Trump’s term. The changes primarily focus on rolling back Biden-era protections for trans inmates.

Earlier this year, the Blade published a joint letter from multiple senators in response to the rollback of the policy. Multiple senators — including Edward Markey (D-Mass.), Jeffrey A. Merkley (D-Ore.) and Mazie K. Hirono (D-Hawaii) — sent a letter to Attorney General Todd Blanche and Federal Bureau of Prisons Director William Marshall III calling for them to reverse the policy change, saying it endangers inmates’ health and safety.

The senators described how the policy shift, along with President Trump’s Executive Order 14168, titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” is forcing policy changes they argued are rooted more in political rhetoric than in medical research or evidence-based correctional practices.

Federal Bureau of Prisons responded to the Blade’s request for comment in May, declining to reconsider its transgender inmate policy.

The Blade reached out to the Federal Bureau of Prisons once again over the application to the Supreme Court, but did not hear back before publication.

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