Connect with us

Opinions

Rollback of health IT standards will harm LGBTQ patients

Trump proposal would remove most data fields in medical records

Published

on

(Photo by JoPanuwatD/Bigstock)

For most Americans, the ability to change healthcare providers and easily have their health records transfer feels like a given. But it was not until the 21st century Cures Act was signed in 2020 that regulations on health technology mandated that electronic health records had to be able to collect, receive, and transfer specific data fields in a uniform way (known as the U.S. Core Data for Interoperability). Before that, if your new doctor and your prior doctor subscribed to different electronic health records systems, there was a very good chance that the data fields didn’t match up and some patient information would literally be lost in translation.

Through the Office of the National Coordinator for Health IT, created through executive order by President George W. Bush, the Biden administration advanced health IT policy specifically to ensure that LGBTQI+ patients records would transfer to new providers with unique information that patients need their providers to have access to. This includes data fields for chosen names, pronouns, and sex parameters for clinical usage – or in other words, what sex should be listed for lab work, regardless of the patient’s gender identity. There were also fields added for sexual orientation and gender identity. To be clear, the requirement was for the electronic health record systems to be able to collect, transfer, and receive these data points. There was never a requirement for providers to ask all these questions or for patients to be required to answer them. But if the IT systems aren’t mandated to have these fields in a uniform way, the impact of a provider asking the questions is limited only to the care that the specific provider offers to the patient. The Trump administration has proposed removing 34 of the 60 required data fields in electronic health records, including the fields for chosen names, pronouns, sexual orientation, gender identity, and sex parameters for clinical usage. 

There has been widespread support for these regulations on health IT companies. Having a lowest common denominator for health IT systems is good for patients and for healthcare providers. It also isn’t particularly controversial. Not surprisingly, the only folks cheering on deregulation are those ideologically opposed to any government regulations, and the specific companies who are subject to these health IT regulations.

The deregulators in the Trump administration would have us believe the myth that these regulations somehow hinder innovation and make it harder for tech startups to enter the health IT field. They gaslight us by calling this clear disservice to patients “prosperity.” But imagine what it would be like to go back to a time before these critical health IT regulations. When the new doctor you see doesn’t have very much if any information about the patient and the transfer of patient records was manual and cumbersome, often requiring someone to pay for their records to be printed, mailed, and then scanned into a different electronic health record system. This won’t lead to innovation, but it will lead to harm for the patient-provider relationship, and worsened health outcomes for the American people. 

HHS Secretary Robert F. Kennedy Jr. has been deliberate and unrelenting in his rollbacks of health equity measures for LGBTQI+ Americans. He has proposed rules that would ban hospitals from receiving federal funds if they offer gender affirming care for youth; he has gutted the Office of Infectious Disease and HIV/AIDS; he has rolled back civil rights protections in health care for LGBTQI+ Americans; and he has eliminated most federal health agency data collection of sexual orientation and gender identity. And this is just a small slice of his crusade at HHS to erase LGBTQI+ people. 

There are currently many proposed rules and administrative changes that would harm access to equitable, high quality healthcare for LGBTQI+ people. So it makes sense that LGBTQI+ Americans may not be aware of such a wonky area of policy as federal health IT regulations. But we want to stress that deregulating health IT, with a specific goal of removing the minimum requirements for electronic health record systems to collect, transfer, and receive basic data fields of importance to LGBTQI+ people’s clinical care, will worsen both access to as well as quality of even basic healthcare for LGBTQI+ Americans. And for healthcare providers it is uniquely scary. They rely on the data in patient’s electronic records. And they need the IT systems they use to be able to talk to each other. Deregulating health IT is akin to trying to charge an iPhone with an Android charger, but as if your life depended on it. 

There is an opportunity for public comment until Feb. 27, and anyone can make a comment. As a person who receives healthcare and/or a person who provides healthcare, speaking up is imperative. These health IT regulations are described by some as “woke” but really it’s very simple: when you go to the doctor, any doctor, you want them to have some basic information about who you are. Without that information, a healthcare provider could easily make an assumption about the patient that is inaccurate and that leads the provider to make different recommendations than what the patient needs. 

This is not radical, this is the very premise of healthcare delivery. And LGBTQI+ patients stand to be left behind, deliberately and systematically, if these deregulations of health IT are put into effect. Without accurate, timely data, providers are unable to live up to the promise of precision medicine and will fail to ensure everyone receives the care that matches their unique needs.

Adrian Shanker is senior fellow at Lehigh University College of Health. He served as deputy assistant secretary for health policy and senior adviser on LGBTQI+ health equity at the U.S. Department of Health and Human Services in the Biden-Harris administration. Dr. Carl G. Streed, Jr. is Associate Professor of Medicine at Boston University Chobanian and Avedisian School of Medicine and Research Director at the GenderCare Center at Boston Medical Center. 

Advertisement
FUND LGBTQ JOURNALISM
SIGN UP FOR E-BLAST

Opinions

Capital Pride must be transparent about sexual misconduct investigation

More questions than answers after two board members resign

Published

on

A scene from last year's WorldPride Parade organized by Capital Pride. (Washington Blade file photo by Michael Key)

We are living through some very difficult times in our country. We have a felon in the White House who has surrounded himself with incompetent sycophants and fascists. A Congress that bows down to him, often based on his threats. Things have gotten so bad that his supporters are beginning to wake up to the fact that he cares not a whit for them. They are demanding he stop hiding his involvement with the convicted sex trafficker, Jeffrey Epstein, and come clean. So, to distract them from this, he began a war in the Middle East in which members of the American military have already lost their lives. He says more lives will be lost. He hopes this war of distraction will have Americans forget his failed domestic policies and the Epstein scandal. 

But at the same time that all of this is happening, I am forced to look around at organizations I support and ask if they are being open and honest in the way we are demanding of the felon in the White House.

Recently, I have received calls about an organization I have the utmost pride in: Capital Pride. The calls are about Capital Pride’s internal investigation of “a claim” made against a former board chair, who resigned and no longer has any role with the organization. There has been no public proof of any wrongdoing. At the time, Capital Pride announced it had retained an “independent firm” to investigate the complaint. Now, more than four months later, a second board member has resigned sharing her letter of resignation with the Blade. 

Taylor Lianne Chandler, a member of the Capital Pride board of directors since 2019 who served as the board’s secretary, submitted a letter of resignation on Feb. 24 that alleges the board has failed to address instances of “sexual misconduct” at Capital Pride. 

“This board has made its priorities clear through its actions: protecting a sexual predator matters more than protecting the people who had the courage to come forward. … I have been targeted, bullied, and made to feel like an outsider for doing what any person of integrity would do – telling the truth,” Chandler wrote in her resignation letter. 

The Blade reported the organization announced, “As we continue to grow our organization, we’re proactively strengthening the policies and procedures that shape our systems, our infrastructure, and the support we provide to our team and partners.” 

Again, it is four months later, and there has been no information from Capital Pride regarding that investigation.

Chandler said a Capital Pride investigation identified one individual implicated in a “pattern” of sexual harassment related behavior over a period of time. She added she was bound by a Non-Disclosure Agreement that applies to all board members and she cannot disclose the name of the person implicated in alleged sexual misconduct or those who came forward to complain about it. She added, “It was one individual, but there was a pattern and a history.” 

Again, reading that letter from Chandler and because of the news being full of the Epstein scandal, it makes me want assurances that no organization representing my community will ever think it can cover up issues like this. Capital Pride leadership must be totally transparent. 

Capital Pride is a wonderful organization with so many incredible people working and volunteering there. They make our community proud. I never want to see a blemish on the organization. So, I am calling on them to be open and transparent about the investigation they themselves announced, and let the community know what they found, in detail. More important even than the entire community knowing, is for their staff and volunteers to know what they found. No one should be bound by an NDA, which leads to people thinking something really bad is going on.

I thought twice, even three times, before writing this column. I don’t want it to be seen as casting aspersions on all of Capital Pride, or anyone who may have worked there, or volunteered there. But again, because of the focus on the Epstein scandal, and my writing about the felon and his Cabinet officials involved in it, my calling for them to come clean and tell us all they know, I feel compelled to say the same to the organization I have supported over the years, which even honored me as a Capital Pride Hero in 2016. I want them to move forward and be a beacon of light for our community for many years to come. The work they do makes a difference for so many. 

I wrote in my memoir that coming to a Pride event helped me to come out, and I am sure it has done the same for so many others in our community. What Capital Pride does is important and it must be as transparent as we demand of any other organization.


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

Continue Reading

Opinions

An undeclared war of distraction by the felon

Will Trump claim a national emergency to undermine midterms?

Published

on

President Donald Trump (Washington Blade photo by Michael Key)

The president of the United States in his rambling speech about our attack on Iran, recorded during a campaign trip, said, “The Iranian regime seeks to kill. The lives of courageous American heroes may be lost and we may have casualties — that often happens in war — but we’re doing this not for now. We’re doing this for the future, and it is a noble mission.” 

Well, the United States has not declared war on Iran, only Congress can do that, not the president. As I write this, the felon has yet to make a live speech to the American people about what he is doing, and Americans have already lost their lives. He is weekending as he usually does at Mar-a-Lago. I wonder if he has the balls to head out to the golf course while American lives continue to be at stake.

This operation is clearly the felon’s way of distracting the people of the United States from his failed domestic policies. From rising food prices, rents, and health insurance. From the loss of manufacturing jobs, as reported in November ”manufacturing shed another 6,000 jobs in September, for a total loss of 58,000 since April.” Had he not acted on Iran now every news outlet in the nation would have reported on the Epstein scandal with the release of the depositions, video and transcripts, of former Secretary of State Hillary Clinton and former President Bill Clinton, in front of the Congressional Oversight Committee.

Even more frightening is this may be his way of preparing to claim a national emergency to undermine the midterm elections, which he is clearly on target to lose, now that his Save America Act has been defeated in Congress.  

Americans must ask themselves how long they will put up with this warmonger, racist, sexist, lying, homophobic, SOB, who cares not a whit for them, but only for himself, and his rich colleagues, taking as much grift as they all can, while he is president. 

None of this is to say we shouldn’t put constraints on Iran, work to see they never have a nuclear bomb, and limit their production of missiles. We were working toward the goal of stopping them from having a nuclear bomb when the felon, in his first term, pulled us out of the agreement to move forward on that. Today, he has sidelined the State Department, and his Secretary of State, Marco Rubio, in negotiations, and has relied on his son-in-law, Jared Kushner, and Steve Witkoff.  The attack was commenced while negotiations were underway. At the end of last week it was reported, Oman’s Foreign Minister Badr Al-Busaidi, who mediated the talks in Geneva, said there had been “significant progress in the negotiation.” Al-Busaidi added, “Technical-level talks would continue next week in Vienna, the home of the International Atomic Energy Agency.” The United Nations’ atomic watchdog likely would be critical in any deal. 

So clearly this is all about what the two negotiators, who have sidelined the State Department, Kushner and Witkoff, secretly reported to the felon. My guess is some progress was being made, clearly it was not what the president wanted. So, what ruled was his immediate need for a distraction after the failure of his State of the Union address to make any impact on his sagging poll numbers. 

I have written often of the alternate universe Trump has us living in. I am just waiting for his MAGA cult to react to this. Will they still blindly follow everything he says, or will the Laura Loomers of the world finally say, “screw this, take care of us at home, do what you promised to make our lives better”. The first MAGA to say this was Marjorie Taylor Greene. Then Tucker Carlson added his slam against the felon. His PR flack, Karoline Leavitt, is getting confused by all the lies, recently saying “things are better than they were last year.” Clearly forgetting last year was 2025, and the felon was president for all except for 20 days of it, so is responsible for last year. 

I am an optimist and believe our democracy will survive him, and his fascist cohorts’ blatant attacks. We won a revolution against one king, and survived a civil war, becoming even stronger as a united nation. We helped Europe defeat Hitler. I believe Sen. Mark Kelly (D-Ariz.) when he says the military will reject illegal orders. Orders that ask them to act against their fellow countrymen and women. I believe the American people will come to their senses before it’s too late. They will finally reject the POS in the White House, and the sycophants, and fascists, surrounding him in time to reclaim our nation for all the people. 


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

Continue Reading

Commentary

Finding community through tragedy

Death of my dog opens floodgates of condolences

Published

on

(Photo by Liliya/Bigstock)

I recently lost my dog, Argo.

He was a pit bull, big, sweet, endlessly cuddly, and for 15 years he was my constant. The kind of presence you stop consciously noticing until they’re gone and the quiet hits you all at once. Pit bulls have a reputation. Argo never got the memo. He just loved people, completely and without condition, from the moment he met them until his last day.

I wasn’t prepared for what happened next.

My phone filled up. Instagram lit up. Texts came in from people I hadn’t heard from in months, in some cases years. Hugs from neighbors. Messages from colleagues. Condolences from people I’d lost touch with, some through nothing more than the slow drift of busy lives in a busy city, and some honestly through small tiffs and misunderstandings that neither of us ever bothered to resolve.

And sitting with all of that love pouring in, I found myself asking a question I wasn’t expecting: Why has it taken this long?

We do this in D.C. We get caught in our heads, our calendars, our ambitions. We let weeks turn into months. We let a small misunderstanding calcify into distance because nobody wants to be the first one to reach out, nobody wants to seem like they need something. We perform resilience so well that sometimes the people who care about us most don’t know we need them.

And then something breaks open, a loss, a moment of real vulnerability, and suddenly people show up. And you realize the connection was always there. It just needed permission.

Argo gave people permission. Even in dying, he did what he always did when he was alive. He brought people together.

I’ll be honest with you about where I’ve been lately. As I’ve climbed the entrepreneurial ladder, something quietly shifted. People stopped seeing Gerard. They started seeing a title, a resource, someone who could give them something or who owed them something. A character. Not a person. And when most of your day is spent inside other people’s problems and crises, you can start to feel it, a slow creep of cynicism that you don’t even notice until one day you realize you’ve gone numb.

And I’m not alone in that. Look around. We just watched innocent people die while those in power looked us in the face and called it something else. We watched people erupt over a 10-minute halftime performance like it was the greatest threat to our country. Everywhere you look there is something designed to make you angry, or exhausted, or both. Anger and numbness have become survival strategies. I understand it. I’ve lived it.

But here is what Argo reminded me.

The world is not what the loudest voices say it is. The world is what shows up when something real happens. And what showed up for me, after losing my sweet boy, was people. Caring, loving, present people who put down whatever they were doing to reach out to a friend. Some of them I hadn’t spoken to in too long. Some of them I’d had friction with. All of them showed up anyway.

That is the world. That is what it actually is underneath all the noise.

I think we’ve forgotten that. Or maybe we haven’t forgotten it, maybe we’re just so tired and overstimulated and battle-worn that we’ve stopped letting ourselves feel it. Because feeling it requires vulnerability, and vulnerability feels dangerous right now. It’s easier to scroll. It’s easier to stay mad. It’s easier to keep a wall up and call it wisdom.

Argo spent 15 years showing me a different way. He never met a stranger. He never held a grudge. He never saved his love for people who deserved it on paper. He just gave it, freely, every single time. Not a reward. Not a transaction. Just the most natural thing in the world.

Grief burns off everything that isn’t essential and leaves only what matters. What’s left for me is this: the world is full of good people. You may be surrounded by more of them than you know. And if you’ve gone numb, or angry, or so busy surviving that you’ve stopped connecting, I want you to know that the feeling can come back. It came back for me.

Reach out to someone today. Close a distance you’ve let grow. Tell someone they matter. Not because everything is perfect, but because connection is how we survive when it isn’t. Living disconnected, mad and closed off isn’t living at all. It’s a slower kind of dying.

Death came to teach me how to live. I hope this saves you some time.


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

Continue Reading

Popular