Federal Government
USAID highlights work to promote LGBTQ, intersex rights in Latin America, Caribbean
Blade spoke with Deputy Administrator Paloma Adams-Allen on Oct. 24
Deputy U.S. Agency for International Development Administrator Paloma Adams-Allen during a recent interview with the Washington Blade highlighted USAID’s efforts to promote LGBTQ and intersex rights in the Caribbean, Latin America and around the world.
Adams-Allen on Oct. 24 noted USAID has “invested” in programs that seek to fight gender-based violence against LGBTQ and intersex people in Honduras and Guatemala.
She, like Vice President Kamala Harris and other U.S. officials, acknowledged violence based on gender identity and sexual orientation is among the “root causes” of migration from the two countries and neighboring El Salvador.
“Migration is a human right,” said Adams-Allen. “Folks are allowed to migrate, but what we’ve discovered, particularly with the LGBTQI+ population is that, not surprisingly, violence against this community is a driver.”
Adams-Allen noted USAID in Guatemala through its Electoral Governance and Reforms Project provides what she described as “technical assistance to help advance LGBTQI+ rights through legal reforms initiatives.” Adams-Allen also told the Blade that USAID in Guatemala supports efforts to invest “more directly in local organizations as implementing partners” for election observation and in other areas.
“We’re looking to strengthen local LGBTQI+ organizations to enhance their capacity,” she said.
USAID continues to support the implementation of Colombia’s peace agreement that specifically includes LGBTQ and intersex people through the Youth Resilience Activity, a program that works with vulnerable young people across the country. USAID also works with the U.N. Development Program’s Being LGBTI in the Caribbean initiative that seeks to promote LGBTQ and intersex rights in the Dominican Republic, Haiti, Jamaica and Barbados.
USAID Senior LGBTQI+ Coordinator Jay Gilliam last week announced during the initiative’s second National LGBTI+ Dialogue in the Dominican Republic that USAID will donate an additional $2 million for economic programs for transgender women.
Adams-Allen noted USAID supports the Astraea Lesbian Foundation for Justice’s Multi-Donor LGBTI Global Human Rights Initiative that supports efforts to decriminalize consensual same-sex sexual relations in countries throughout the Caribbean and to reduce stigma, discrimination and violence against LGBTQ and intersex people. Adams-Allen also highlighted CuéntaNos, an initiative in El Salvador, Guatemala and Honduras that provides information about access to safe housing, health care and other basic services for LGBTQ and intersex people and other vulnerable groups who are fleeing from natural disasters.
“It helps guide them to where safe places are,” said Adams-Allen.
Adams-Allen, who was born in Jamaica, was previously the president and CEO of the Inter-American Foundation. Adams-Allen was a deputy assistant USAID administrator and a senior advisor in the Bureau for Latin America and the Caribbean from 2010-2016.
Jamaica is among the countries in the Caribbean in which consensual same-sex sexual relations remain criminalized.
Then-President Barack Obama in 2015 applauded Angeline Jackson-Whitaker, a prominent Jamaican LGBTQ and intersex rights activist, during a town hall meeting in Kingston, the country’s capital. Adams-Allen referenced the trip to the Blade, noting there was “definitely pushback, even against him.”
The Blade spoke with Adams-Allen a few days after Fox News reported USAID gave a $20,600 grant to a cultural center in the Ecuadorian city of Cuenca that hosts drag shows.
Adams-Allen declined to specifically comment on the report, but she did say USAID does “support the full richness of the LGBTQI+ community in Latin America and the Caribbean and that may include folks that Fox may not be interested in working with.” Adams-Allen further stressed that President Joe Biden’s 2021 memo that committed the U.S. to promoting LGBTQ and intersex rights abroad as part of his administration’s overall foreign policy is “a North Star for our work to advance LGBTQI+ programming, but also just our broader, truly development.”
USAID co-hosted 2022 Hispanic Serving Institutions/LatinX Conference in Miami
Adams-Allen on Oct. 20 delivered the keynote address at the 2022 Hispanic Serving Institutions (HSIs)/LatinX Conference in Miami that USAID co-hosted with Florida International University.
USAID in a readout notes Adams-Allen’s speech highlighted “the importance of diversity, equity, inclusion, and accessibility in USAID’s recruiting, programming and partnerships.” Adams-Allen noted the conference is the second such event that USAID has organized “to really to start to gin up more interest among Hispanic and Latino-serving institutions in working at USAID as well as being implementing partners, potentially, of USAID.”
“I wanted to go down and really to try to put some more energy into just underscore, now that we’re coming out of the virtual world, I wanted to do this in person, to really underscore quickly to this population … that there’s a place for Hispanic Americans, Latino Americans, Latinx Americans, at USAID if they’re interested, particularly in international careers, but even if they’re not,” she said.
“I think students tend to think that they have to be technical experts in global health issues and maternal and child health or emergency response. And they don’t realize necessarily that we need everyone, we need writers, we need lawyers, we need communicators,” added Adams-Allen. “That particularly this community has certain, what I would say, cultural competencies that makes them particularly aligned with USAID’s whether it be experience living in Latin America in the Caribbean, or family from those regions, experience navigating several languages at home or in school, in the workplace. So they already have some inbuilt some inbuilt strengths, that makes them particularly well suited to consider careers at USAID. And I really wanted to just bolster folks’ confidence and let them know that there’s a place for them if they’re interested in their support for them if they’re interested. And so that was really the thrust of my participation.”
Adams-Allen noted LGBTQ and intersex people were among those who participated in the conference, which took place at Florida International University’s Miami campus.
“LGBTQI+ issues are sort of crosscutting of the ethnic group that we are engaging,” she said. “We are always engaging with full diversity of that ethnic group, in that ethnic community. We definitely had participation from folks representing the LGBTQI+ community at FIU and among the Hispanic-serving institutions, so we’re always thinking about that population as part of our diversity efforts, our retention efforts, our inclusion and equity efforts with the workforce, as well as looking at our programming.”
“It’s so crucial to have that voice,” she said. “As we are thinking about our programming … it’s important to have people with the lived experience of the populations for which you’re designing, whether they be long term development programs, short term projects, or responding to humanitarian crisis, who really understand that experience. So, we need them, we need that population as a part of our team and we also do quite a bit of programming focused on protecting the human rights, the civil rights, defending the equal rights of LGBTQI+ populations in Latin America and the Caribbean.”
Federal Government
Advocates push back on proposed FCC warning labels
New rating system public notice seeking comments issued on April 22
The Federal Communications Commission is considering a new rating system that would require a warning label to appear before any television content that includes LGBTQ characters.
On April 22, the FCC issued a public notice asking Americans to submit comments on whether the TV Oversight Management Board should create new TV ratings to alert viewers to “transgender and gender nonbinary programming” and “the discussion or promotion of gender identity themes.”
This proposed warning would appear before content, similar to warnings that explain a program contains sexual content, drug use, or violence — categories that Congress explicitly included in the Telecommunications Act of 1996 on the grounds of obscenity and violence that some parents “believe is harmful to their children.”
The public notice says that “recently, parents have raised concerns that controversial gender identity issues are being included or promoted in children’s programs without providing any disclosure or transparency to parents.”
It goes on to say that not having a warning for trans and nonbinary people is “undermining the ability of parents to make informed choices for their families.”
LGBT Tech is an organization that works to provide LGBTQ representation in mainstream media or entertainment. The group notes 81 percent of trans respondents it surveyed said these representations had a positive impact on them discovering or learning about their identity.
“These numbers reflect a basic truth: for many people, and especially young people, seeing LGBTQ+ lives represented in ordinary media is not harmful. It is formative, affirming, and often lifesaving.”
Since the public notice’s publication, more than 40 organizations have come out against the proposed alert.
GLAAD President Sarah Kate Ellis issued a statement in May on the proposal, highlighting what she described as a concerted effort by the Trump-Vance administration to other trans and nonbinary people.
“The FCC does not set TV ratings, but under this administration the FCC has repeatedly tried to control what Americans can see on their own televisions. This government overreach is dangerous and a threat to our community and our democracy,” Ellis said.
“LGBTQ+ people and their families deserve to see their lives represented in the media they watch. And media companies must have the freedom to create programming that appeals to their viewers and subscribers without interference from a government pursuing its own anti-LGBTQ+ political agenda.”
Human Rights Campaign President Kelley Robinson pointed out that this is an act of politically motivated policy, not one based on any rhyme or reason.
“LGBTQ+ stories matter and deserve to be told, seen, and heard,” Robinson said. “The Trump administration does not get to use the FCC to try and erase us simply because they want to pretend to live in a world where we don’t exist. This is a brazen form of political interference that will hurt the ability of all people to appreciate, understand, and learn about the world and people around them.”
Brian Dittmeier, director of LGBTQI+ equality at the National Women’s Law Center Action Fund, echoed Robinson’s concerns that this is attempted censorship for the sake of political gain.
“The FCC is cloaking itself in purported concern for parents in an attempt to censor content, intimidate industry, and silence depictions of our trans siblings and neighbors,” Dittmeier wrote. “The FCC is overstepping its authority to undermine the existing ratings system, which is well understood by parents and enjoys broad public support. The FCC’s presumption that it knows better does not reflect parents’ priorities and reeks of government overreach.”
PFLAG National Vice President of Policy and Government Affairs Diego Sanchez said this is federal government overreach into censorship — something the First Amendment protects against.
“The FCC has given us yet another example of what ‘small government’ means: small enough to fit in your living room; to interrupt family movie night; small enough to make home feel unsafe,” Sanchez said. “Parents and families with transgender loved ones in particular know too well how big government actions impact their families directly, because they feel those impacts before everyone else.”
This proposed warning follows a slew of other federal actions targeting trans people in America, including Executive Order 14168, “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” which mandated that only sex assigned at birth be used on federal government documents regardless of gender identity, as well as broad-based restrictions on gender-affirming care, particularly for trans minors.
Federal Government
Texas Children’s Hospital reaches $10 million settlement with DOJ over gender-affirming care
Clinic specializing in detransition care will be established
The Justice Department announced May 15 that it has reached a settlement with Texas Children’s Hospital, one of the nation’s top pediatric hospitals.
Under the agreement, the hospital will pay more than $10 million in damages and civil penalties related to its provision of gender-affirming care and will establish a clinic specializing in detransition care.
The DOJ partnered with Texas Attorney General Ken Paxton’s office to resolve allegations that the hospital submitted false billings to public and private insurers to secure coverage for pediatric gender-affirming procedures. The department alleges the conduct violated the Federal Food, Drug, and Cosmetic Act, the False Claims Act, and federal fraud and conspiracy laws.
The settlement was reached out of court, meaning neither party formally admitted wrongdoing. Both the DOJ and Texas Children’s Hospital denied liability.
“The Justice Department will use every weapon at its disposal to end the destructive and discredited practice of so-called ‘gender-affirming care’ for children,” Acting Attorney General Todd Blanche said in a DOJ press release. “Today’s resolution protects vulnerable children, holds providers accountable, and ensures those harmed receive the care they need.”
The DOJ’s hardline stance on gender-affirming care sharply contrasts with the positions of major medical organizations, transgender healthcare advocates, and human rights groups, which broadly support gender-affirming care as an evidence-based treatment for gender dysphoria.
Adrian Shanker, former Deputy Assistant Secretary for Health Policy and Senior Advisor on LGBTQI+ Health Equity at the U.S. Department of Health and Human Services under during the Biden-Harris administration, told the Washington Blade the settlement could have sweeping consequences for trans youth and healthcare providers nationwide.
“The Trump administration’s framing of gender-affirming care is wildly inaccurate, scientifically implausible, and frankly, just mean-spirited,” Shanker told the Blade. “What’s really clear is that the science hasn’t changed, the evidence hasn’t changed — it’s only the politics that have changed. Unfortunately, the people that lose out the most with a settlement like this one are the patients that are denied access to care where they live.”
According to Shanker, the agreement also requires Texas Children’s Hospital to revoke privileges for physicians involved in providing gender-affirming care, potentially limiting their ability to practice elsewhere.
“This is a weaponized Department of Justice doing absurd investigations against providers that are providing care within the established standard of care,” he said. “They’ve come up with an absurd remedy in their settlement to require a so-called ‘detransition clinic’ to open at Texas Children’s. It’s harmful to science, it’s harmful to trans people, and it’s harmful to the medical profession.”
Shanker argued the case reflects a broader politicization of trans healthcare.
“Every American should be concerned about the weaponized Department of Justice and their obsession with trans people and their access to care,” he said. “These hospitals that provide gender-affirming care, the providers of gender-affirming care, have done nothing wrong. They followed the standards of care that are well established and followed the mountain of evidence.”
Karen Loewy, senior counsel and director of constitutional law practice at Lambda Legal, echoed those concerns.
“For Texas Children’s to capitulate to this pressure campaign of both Paxton and the Trump administration and end this care, and go after physicians who had been lawfully and faithfully taking care of their patients, it’s hard to see that as anything other than bending the knee in the face of political pressure,” Loewy told the Blade. “That’s not putting your mission above politics. Your mission is to provide health care for kids that need it.”
Loewy said the settlement reflects years of efforts by Paxton and the Trump-Vance administration to target gender-affirming care providers. Paxton has pursued investigations into providers across Texas since 2022 and supported a 2023 law banning gender-transition-related medical care for minors. Meanwhile, the Trump-Vance administration moved quickly in its second term to restrict trans healthcare access, including through Executive Order 14187, titled “Protecting Children from Chemical and Surgical Mutilation.”
“This is a perfect storm of Ken Paxton’s own mission to stigmatize and target trans young people and their healthcare in Texas with the Trump administration’s targeting of trans people and gender-affirming medical care,” Loewy said. “It is the two of them together. Without that, you wouldn’t have had this settlement.”
Loewy also emphasized that the settlement is part of a broader legal strategy targeting providers nationwide.
“You can’t view this one in isolation from all of the other administrative subpoenas that have been sent to hospitals or other kinds of medical providers that have provided gender-affirming medical care to trans adolescents,” she said. “It is all part and parcel of the same direct line from the executive orders that were issued in the first days of this Trump administration.”
“Every court that has considered those subpoenas has found them illegitimate and issued for an improper purpose, or at least narrowed them really dramatically,” she added. “Courts agree these hospitals didn’t do anything wrong. It’s the DOJ that has the problem here.”
Shanker also criticized the settlement’s requirement that the hospital establish a detransition clinic, arguing the move contradicts existing medical evidence.
“The irony shouldn’t be lost on anyone that the Trump administration is claiming that gender-affirming care lacks a scientific basis, and then is requiring the opening of a so-called detransition clinic, which certainly lacks a scientific basis,” Shanker said. “There’s less than a 1% regret rate when it comes to gender-affirming care. That’s lower than knee surgery, lower than bariatric surgery, lower than childbirth, lower than breast reconstruction, and lower than tattoos.”
Loewy was similarly blunt in her criticism.
“This is the most craven, political, ridiculous elevation of ideology over evidence,” she said. “They are creating a program built on an outcome that almost never happens. It is unprecedented and politically mandated rather than healthcare mandated.”
She said the settlement’s broader effect will be to intimidate providers and further marginalize trans people.
“The real effect here is to further stigmatize trans people and intimidate healthcare providers,” she said. “This is about sending a message nationwide that the DOJ is coming after the doctors. These are committed, faithful, law-abiding physicians and healthcare providers who just want to provide the healthcare their patients actually need.”
Both Loewy and Shanker warned that restricting access to gender-affirming care could deepen health disparities for trans people.
“We know that when transgender Americans lack the care that they need, we end up with higher rates of depression, higher rates of anxiety, higher rates of self-harm and suicidal ideation,” Shanker said. “We know that gender-affirming care is a medically appropriate, scientifically grounded form of care that resolves these challenges and leads us toward health equity. It’s unfortunate that the Trump administration has politicized not only transgender medicine, but the very basis of public health.”
Shanker said the restrictions are already prompting some trans people to relocate in search of care.
“We’re already seeing medical refugees leave states that have restricted access to care to move to states where it’s still available,” he said. “Frankly, we’ve already seen some trans people go to other countries to receive care or maintain access to care.”
Loewy said the DOJ’s recent subpoenas targeting hospitals, including those issued to NYU Langone Health in New York, suggest the administration is escalating its legal strategy.
“We’ve seen the DOJ escalate this by convening a grand jury and issuing grand jury subpoenas to hospitals,” she said. “That is going to be the next front in this fight.”
In addition to , there has been as large increase in anti-trans legislation in the past few years — with 126 federal pieces of legislation introduced this year and 26 state level policies passed across the country.
Still, Loewy pointed to recent court victories as evidence that challenges to these policies can succeed.
“Just yesterday, a state court in Kansas struck down that state’s ban on gender-affirming medical care in one of the most meticulous recognitions of the medical consensus and the harm of denying care to trans young people,” she said. “When courts actually look at the science and the impacts on trans people, they still can rule the right way.”
Asked whether there is any optimism to be found amid the ongoing legal battles, Loewy said she continues to draw hope from advocates, families, and community organizers fighting back.
“The solidarity of the community is really what brings hope,” she said. “There are incredible lawyers, advocates, families, and organizations fighting every day to protect these kids and their privacy and safety. It is that community strength and collaborative effort that continues to give me hope.”
Federal Government
Bureau of Prisons declines to reconsider transgender inmate policy
Democratic lawmakers raised concerns this week, lawsuit filed
Following a letter sent Monday by several Democratic senators raising concerns about the Federal Bureau of Prisons’ updated transgender inmate policy, the BOP responded to a request for comment from the Washington Blade, saying it does not plan to reverse the changes implemented earlier this year.
The policy was revised in 2025 to comply with President Donald Trump’s Executive Order 14168, titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.”
In a statement to the Blade, BOP spokesperson Donald Murphy said the updated policy is rooted in medical guidance and data-driven decision making.
“The BOP implemented the February 2025 policy to ensure that inmates with gender dysphoria are properly diagnosed and treated consistent with best medical practices,” he said. “Unlike the prior administration’s one-size-fits-all approach, the BOP’s new policy ensures individualized assessments and treatments. And while the previous administration’s policies on treating inmates with gender dysphoria was driven by radical ideology, the BOP’s current policy is based on medical studies, medical expert opinions, state correctional policies, caselaw, and penological concerns. Absent court order, there are no plans to reconsider or revisit the policy.”
U.S. Sens. Ed Markey (D-Mass.), Jeff Merkley (D-Ore.), and Mazie Hirono (D-Hawaii) signed the letter, arguing that the policy change fails to adequately prioritize the safety of trans inmates — protections they say are guaranteed under the Constitution.
This inquiry comes days after a federal lawsuit was filed against the Justice Department specifically on the concern that trans inmates are not receiving adequate care.
Earlier this month, the National Center for LGBTQ Rights, a legal organization focused on LGBTQ rights since 1977, filed a lawsuit in District Court of the District of Columbia against the Trump-Vance administration in collaboration with GLAD Law, Lowenstein Sandler LLP, and Wardenski P.C.
The suit, filed on May 6, alleges the administration is “ignoring federal protections” designed to prevent sexual abuse of incarcerated trans people.
“Transgender people in prison are sexually abused or assaulted at nearly 10x the rate of the general prison population,” the press release announcing the lawsuit states, adding that federal legislation was enacted to address those risks.
The plaintiff in the lawsuit, Paulina Poe, is a trans woman currently incarcerated in a men’s facility. According to the complaint, she has been “propositioned, groped, sexually harassed, and assaulted” by male inmates and subjected to strip searches by male officers — circumstances the Prison Rape Elimination Act regulations were intended to prevent.
The lawsuit also argues that the policy changes violate constitutional protections and deny trans inmates medically necessary care.
“The Eighth Amendment requires prisons and jails to provide ‘adequate medical care’ to incarcerated people which includes adequate treatment for people diagnosed with gender dysphoria,” says the Transgender Law Center. “‘Adequate medical care’ should be delivered according to accepted medical standards, such as WPATH’s Standards of Care. Some courts have said that in some circumstances ‘adequate medical care’ for gender dysphoria includes providing gender-appropriate clothing and grooming supplies, and the ability to present yourself consistent with your gender identity.”
GLAD Law Staff Attorney Sarah Austin also issued a statement when the lawsuit was announced, saying those responsible for the policy changes — and the rollback of protections under the Prison Rape Elimination Act — will be “held accountable for this egregious and lawless action.”
“The federal government’s unlawful attempt to roll back binding Prison Rape Elimination Act regulations is an especially dangerous step in its ongoing campaign to strip transgender people of legal protections,” Austin said. “The targeting of transgender incarcerated people is a deliberate choice to put vulnerable people in harm’s way simply because of who they are.”
The Justice Department has not responded to the Blade’s request for comment.
