Opinions
Border to border: modern slavery and human trafficking in refugee movements across East Africa
LGBTQ people disproportionately targeted for sexual exploitation
I did not choose to become a refugee. I did not choose to become a victim of trafficking. I only chose to live as myself. Yet in the world I come from, choosing to live as myself was enough to make me a target. As a transgender woman from Uganda, my identity alone placed me in danger. What followed was not just displacement, it was a journey through systems of exploitation that closely resemble modern slavery, hidden in plain sight along the borders and pathways that refugees are forced to travel.
People often imagine modern slavery as something that happens in secret: in locked rooms, in distant brothels, in hidden factories. Human trafficking is portrayed as a dark underworld run by organized criminals. But for many refugees in East Africa, exploitation does not hide in the shadows. It exists in the open, woven into the very routes of survival. It is present at border checkpoints, in refugee camps, in the hands of smugglers, and even in the institutions meant to protect us. It is not always marked by chains or cages. Sometimes it looks like a bus ticket, a border crossing, a promise of safety, or a demand for money that you cannot refuse.
My journey across borders is only one example of how these systems operate. But it is a story shared by many LGBTQI+ refugees whose lives are shaped by violence, silence, and the constant negotiation of safety.
In Uganda, being transgender is not simply misunderstood, it is dangerous. My family, deeply rooted in conservative religious beliefs, saw my identity as a disgrace. I was threatened, rejected, and made to feel that my life had no value. Outside the home, communities policed identity through violence. The legal environment offered no protection. Instead, it reinforced fear. Laws targeting LGBTQI+ people made it impossible to seek help from authorities. Reporting abuse often meant risking arrest. Every day became a calculation of risk: where to walk, who to trust, how to hide. Eventually, the threats became too real to ignore. Leaving was not a choice, it was survival.
My journey out of Uganda began through unofficial routes. Like many refugees fleeing persecution, I could not rely on safe or legal pathways. Instead, I was forced into networks of smugglers and traffickers operating along border regions. From Uganda through border points like Maraba, and later through movements connected to Kakuma Refugee Camp and into South Sudan, each step came with a cost financial, emotional, and physical. At border crossings, money speaks louder than rights. Payments were demanded at checkpoints. There was no transparency, no accountability. You either paid, or you risked being turned back or worse.
For LGBTQI+ refugees, these journeys are even more dangerous. Visibility can mean exposure. Exposure can mean violence. There is constant fear of being outed, harassed, or assaulted not only by traffickers but sometimes by those meant to enforce the law. This is how modern trafficking operates not always through chains, but through systems of dependency, coercion, and fear.
Human trafficking is often imagined as a distant or extreme phenomenon. But for many refugees, especially LGBTQI+ individuals, it exists in subtle and systemic ways. It is in the forced payments demanded at every step of the journey. It is in the exploitation of vulnerability by those offering “help.” It is in the silence of systems that fail to protect. Many LGBTQI+ refugees face extortion by smugglers and intermediaries, threats of violence or exposure, sexual exploitation and abuse, and discrimination by officials and communities. These experiences are rarely documented. Fear prevents reporting. Lack of access prevents justice. What remains is a hidden crisis, one that continues across borders.
Reaching South Sudan did not bring safety. I now live in Gorom Refugee Settlement Camp, where the reality for LGBTQI+ refugees remains harsh and dangerous. Discrimination is part of daily life. Access to food, water, and healthcare is often affected by stigma. Moving freely within the camp can be risky. Violence and threats are constant. As a transgender woman, I am highly visible. This visibility increases my vulnerability. I have faced harassment, intimidation, and threats from both host communities and other refugees. Some blame LGBTQI+ refugees for misfortunes accusing us of bringing curses or problems. These beliefs, rooted in stigma and misinformation, fuel violence and exclusion. Safety, even in a refugee camp, is not guaranteed.
Despite these challenges, I have chosen not to remain silent. In Gorom, I serve as a leader and representative of an LGBTQI+ Refugees and Asylum Seekers Network. Our community includes individuals who are traumatized, isolated, and often unable to advocate for themselves. Many cannot read or write. Some are dealing with serious medical conditions. Others are too afraid to speak. I support them by helping fill out applications and forms, writing emails to organizations, connecting them with protection pathways, and providing peer support and coordination. Through this work, several members of our community have managed to access opportunities for relocation and protection. Some have received case numbers and are progressing through international processes. While I am proud of this work, it comes with a cost. My visibility as a leader makes me a target. The more I help others, the more I am exposed.
The systems I have experienced reflect a form of modern slavery that is not always recognized. It is not defined by ownership, but by control. It is not enforced by chains, but by fear and dependency. When refugees are forced to rely on informal and unsafe systems to survive, exploitation becomes inevitable. International frameworks like the Palermo Protocol recognize trafficking as involving coercion, exploitation, and abuse of vulnerability. By these definitions, what many refugees experience during displacement falls within this reality. Yet, these experiences are rarely acknowledged in policy or response.
My story is one thread in a much larger tapestry of exploitation. Across East Africa, displacement has created informal systems where movement is controlled not by law, but by power, money, and vulnerability. Within these systems, trafficking and modern slavery are not isolated crimes; they are embedded in the everyday experiences of refugees. The blurred line between smuggling and trafficking becomes clear when a voluntary agreement turns into coercion. Payments increase unexpectedly. Conditions worsen. Threats emerge. At this point, smuggling begins to resemble trafficking. People are forced to pay additional fees under threat, detained or abandoned if they cannot pay, and subjected to coercion, intimidation, or violence. The journey becomes one of survival under control, rather than movement by choice.
Checkpoints are one of the most visible forms of exploitation. Across multiple borders, movement is regulated not only by official policies but by informal practices. Travelers are often required to make payments to pass through, regardless of their legal status. These payments are rarely documented. They are negotiated at the moment, often under pressure. Failure to comply can result in detention, forced return, physical intimidation, or exposure to further risks. For those already vulnerable, checkpoints become sites of control and exploitation. This system benefits from a lack of accountability. It thrives in environments where oversight is weak and corruption is normalized.
Modern slavery is not always about physical confinement. It can also take the form of economic exploitation. During transit, individuals may be required to pay escalating fees at each stage of the journey, surrender money or belongings, or depend entirely on intermediaries for movement. In some cases, individuals are left stranded if they cannot meet financial demands. This creates a cycle of dependency: you rely on the network to move, the network controls the cost, and the cost determines your safety. Such systems exploit vulnerability in a way that aligns closely with definitions of modern slavery particularly the abuse of power and the extraction of value through coercion.
Reaching a destination, such as a refugee settlement, does not necessarily end exposure to exploitation. In many camp settings, individuals continue to face restricted access to resources, dependency on aid systems, and informal economies that can be exploitative. Where formal support systems are overstretched or under-resourced, informal structures emerge again. These structures may involve gatekeeping access to services, manipulation of aid distribution, or continued financial or social exploitation. The conditions that enable trafficking do not disappear; they evolve.
Beyond East Africa, modern slavery takes other forms that mirror the same patterns of vulnerability and exploitation. Labor trafficking to the Gulf has become a major issue for migrants from Uganda, Kenya, and Tanzania.
Recruitment agencies promise good jobs, but many migrants end up in forced domestic labour, with confiscated passports, unpaid wages, and conditions amounting to slavery. Some never return home. Organ trafficking has also been documented, with victims from Africa ending up in countries such as Thailand, Malaysia, Russia, and China. Kidneys are the most commonly trafficked organs. Some victims are coerced; others are deceived; some are killed. Women, girls, and LGBTQI+ individuals are disproportionately targeted for sexual exploitation. For refugees, “survival sex” becomes a coping mechanism in the absence of protection and resources. Modern slavery thrives because the global economy rewards cheap labour. Migrants from East Africa are used in construction, domestic work, agriculture, and manufacturing. Their exploitation is hidden behind the products the world consumes.
From a humanist perspective, the existence of such systems raises urgent ethical questions. If all human beings have equal dignity, why are some forced to risk exploitation to survive? If rights are universal, why are they not accessible in practice? Human trafficking and modern slavery in refugee movements are not only criminal issues, they are moral failures. They reflect a gap between principles and reality. They expose the distance between what we claim to value and what we allow to happen.
Addressing these issues requires more than isolated interventions. Safe and legal migration pathways must be expanded. Border accountability must be strengthened. Anti-trafficking measures must be integrated into refugee protection. Refugee-led initiatives must be supported. Those with lived experience are best positioned to identify risks and solutions.
Modern slavery and human trafficking are not always visible in chains or confinement. In many cases, they exist within systems that appear as ordinary border crossings, transit routes, and refugee settlements. Recognizing these systems is the first step toward change. The movement of people across borders should not come at the cost of their dignity, safety, or freedom. Yet, for many, it does. Until safe alternatives exist, and accountability is enforced, these hidden systems of exploitation will continue.
The question is not whether they exist.
The question is whether we are willing to confront them.
Aby lives in the Gorom Refugee Settlement Camp in South Sudan.
Opinions
Insured on paper, excluded in practice
How fertility coverage definitions discriminate against LGBTQ+ workers
Pregnant workers in the LGBTQ+ community often encounter greater barriers than their cisgender or heterosexual counterparts, particularly when accessing company-sponsored health insurance. The challenges for pregnant workers are especially prevalent in obtaining fertility care, such as intrauterine insemination (IUI) and in vitro fertilization (IVF). Section 1557 of the Affordable Care Act prohibits sex discrimination in any federally funded health program, and a growing body of federal litigation now applies that prohibition to insurer-administered fertility benefits that exclude LGBTQ+ workers. Presently, 18 states and Washington, D.C. have infertility insurance laws, with requirements ranging from mandating private insurers to cover fertility treatments to merely offering coverage, which employers may choose not to select (MAP – Movement Advancement Project, “Fertility Healthcare Coverage”). Of these, six states and Washington, D.C. have language that is explicitly inclusive of LGBTQ+ people, while three states have language that may exclude LGBTQ+ people or couples. Where this coverage is not offered or is exclusionary, LGBTQ+ people must spend thousands of dollars for fertility care, while it may be guaranteed for other individuals. Today, 53% of LGBTQ+ adults live in states with no private-insurer fertility mandate, and a single IVF cycle can exceed $18,000 out-of-pocket.
Legal Framework: Section 1557 of the Affordable Care Act
Section 1557 of the Affordable Care Act protects individuals from sex discrimination in any health program or activity that receives any funding from the Department of Health and Human Services. It specifies that in terms of sex discrimination, an individual’s sex, including pregnancy, childbirth, and related medical conditions are protected. In turn, many claims challenging health insurance’s fertility policies invoke Section 1557 to argue that definitions of infertility or proof requirements that exclude same-sex couples constitute unlawful discrimination. Recently, the Ninth Circuit held that Section 1557 of the Affordable Care Act applies to an insurer if any part of the entity receives federal funds, even when the specific health plans at issue are not federally funded, though whether the insurer is ultimately liable under that section is a fact-specific inquiry. Pritchard v. Blue Cross Blue Shield of Illinois, No. 23-4331, slip op. (9th Cir. Nov. 17, 2025). Specifically, how insurers can be held liable in the context of fertility care to LGBTQ+ employees remains to be tested.
Case Study: Kulwicki v. Aetna Life Insurance Company
In 2022, a lesbian registered nurse, Tara Kulwicki, filed a complaint alleging that the medical plan offered by her employer, Wellstar Health System Inc. and Wellstar Cobb Hospital Inc., and administered by Aetna, Inc. and Aetna Life Insurance Company imposed discriminatory barriers on homosexual couples to seeking access fertility care. Under Kulwicki’s medical plan, fertility treatment such as intrauterine insemination (IUI) and in vitro fertilization (IVF) is covered only for couples who can meet the plan’s definition of “infertile.”
The medical plan’s definition for “infertile” is as follows: “For a woman who is under 35 years of age: 1 year or more of timed, unprotected coitus, or 12 cycles of artificial insemination; or [f]or a woman who is 35 years of age or older: 6 months or more of timed, unprotected coitus, or 6 cycles of artificial insemination. For heterosexual couples, infertility could be established by showing that six to twelve months of unprotected sex without contraception did not result in a pregnancy. The plan, however, defines “unprotected sex” as exclusively sexual intercourse between a man and woman. This definition effectively excludes homosexual couples as they do not have the capacity to become pregnant through unprotected sex with their partner. If couples are unable to prove they meet the definition, as in Kulwicki’s case, they are forced to pay high out-of-pocket costs, often totaling thousands of dollars, for IUI and IVF treatments before they qualify for coverage.
In Kulwicki’s case, Section 1557 is used as the basis for the claim. Kulwicki alleged Aetna administered Wellstar’s plan, denied her IUI precertification for not meeting “infertility,” and that the plan and Aetna’s policy tied infertility to unprotected heterosexual intercourse or multiple insemination cycles, resulting in out-of-pocket costs for non-heterosexual women.
The United States District Court for the District of Connecticut later denied Aetna’s renewed motion to dismiss for failure to join Wellstar, holding Aetna could face Section 1557 liability for its own role and that damages could provide complete relief without Wellstar. Most recently, on September 24, 2025, the court denied Aetna’s motion for partial summary judgment, finding factual disputes about Aetna’s collaborative role in shaping the plan language and its reserved contractual rights to align plan terms with Aetna systems, policies, and governing law. As a result, Tara Kulwicki’s class action will continue against Aetna. The court noted Aetna’s active role in shaping the plan’s infertility definition and retaining authority to ensure terms aligned with its systems, policies, and governing law.
Comparative Cases: Echoes of Kulwicki
Courts addressing similar infertility definitions have allowed claims to proceed where LGBTQ+ members face cost or proof burdens not imposed on heterosexual couples.
In Berton v. Aetna Inc. et al. (4:23-cv-01849, 2023), Mara Berton filed a suit against Aetna in violation of the Affordable Care Act after her insurance denied coverage for fertility treatment. This case raises question of first impression as to the “burden of proof” required to demonstrate infertility. In this case, the court denied Aetna’s motion to dismiss a Section 1557 claim where the plan formerly required “frequent, unprotected heterosexual sexual intercourse” or donor insemination cycles, and postJanuary 2023 language still required “eggsperm contact,” allowing heterosexual couples to attest through intercourse while same-sex couples had to incur costs for donor insemination cycles. The court found these allegations plausibly facially discriminatory. The court also rejected Rule 12(b)(7) arguments, concluding complete relief through damages could be afforded without joining the employer plan sponsor.
In Murphy v. Health Care Service Corporation (Blue Cross Blue Shield of Illinois) (No. 22-cv-2656, 2023), the court denied a motion to dismiss, holding that even under a 2020 policy listing multiple infertility pathways, the definition of “unprotected sexual intercourse” as malefemale intercourse left similarly situated samesex participants with no costfree route to establish infertility, plausibly alleging intentional discrimination under Section 1557 standards.
Two parallel actions against Aetna have already produced settlements that reshape the landscape. In Goidel v. Aetna Life Insurance Co., No. 1:21-cv-07619 (S.D.N.Y.), the court granted final approval on October 14, 2025 of a class settlement that aligned Aetna’s infertility definition with American Society for Reproductive Medicine guidelines and made intrauterine insemination a standard medical benefit. Weeks later, in Berton v. Aetna Inc., No. 4:23-cv-01849 (N.D. Cal.), the Northern District of California preliminarily approved a settlement under which most eligible class members who submit a qualifying claim will receive approximately $11,000 in compensation, with claims due by June 29, 2026.
Conclusion
Recent litigation underscores that insurers cannot avoid responsibility where they actively shape, interpret, or administer plan terms that disadvantage LGBTQ+ patients, including fertility coverage definitions and proof requirements. Section 1557 of the Affordable Care Act applies to health programs or activities receiving federal funding, and courts have allowed claims to proceed where infertility definitions or evidentiary burdens effectively exclude same-sex couples. The court in Kulwicki allowed a class action to proceed based on allegations that the insurer administered a plan tying “infertility” to unprotected heterosexual intercourse or multiple insemination cycles and played an active, collaborative role in shaping infertility language while reserving contractual rights to align plan terms with its policies. Other courts have similarly denied motions to dismiss Section 1557 claims where plans with definitions of “unprotected sexual intercourse” limited to male-female intercourse, leaving same-sex participants with no cost-free route to establish infertility. Taken together, courts are scrutinizing not only employers’ selection of plans but also insurers’ roles in designing and administering plan terms that may impose discriminatory barriers.
Employers should be proactive in counteracting harmful policies by incorporating specific protective language into their company policies and providing robust support systems for their transgender, nonbinary, and intersex employees. Employees who suspect their plan’s infertility definition imposes additional cost or proof burdens on same-sex couples should preserve all denial letters, plan booklets, and out-of-pocket receipts, and consult counsel promptly.
Isabelle Megosh, Lily Miller, and Ting Cheung are with Sanford Heisler Sharp McKnight, a national civil rights and employment law firm that represents employees in discrimination, harassment, and benefits-related litigation.
Opinions
Suzanne Goode is not good for Rehoboth Beach
Voters should reject divisive candidate in Saturday’s mayoral election
I understand why some will say I shouldn’t be so negative about a candidate. But the reality is, Suzanne Goode is one person who deserves the negativity. She has shown herself to walk with MAGA Republicans, and that is not the vibe conducive to the welcoming place Rehoboth is today. While I believe there may be a change coming to the country in the mid-term congressional elections, we still see our lives impacted by local mayors, and town commissions, as much as by Congress.
Goode has been a commissioner for two years. Fellow commissioners find her difficult to work with. It isn’t just that she doesn’t agree with them, often on the losing end of 6-1 votes, but she has shown herself to be nasty and insulting to the people she was elected to work with, including city employees.
She has shown she has no real respect for the business community, or for that matter, the truth. She has said of Rehoboth, “They really are in trouble. I never expected to get involved, but once I saw how dysfunctional everything was, that’s what inspired me.” Well Rehoboth is neither in trouble, nor dysfunctional. She lies suggesting Rehoboth is on the brink of bankruptcy, while the truth is, there will be a budget surplus at the end of this budget year, and projected surpluses through 2030. She claims she supports the LGBTQ community but then speaks out in ways that show she really doesn’t. Things like objecting to rainbow crosswalks. I figure that is something she got from Florida Gov. Ron DeSantis, whom she has supported. She said, “Unfortunately, the rainbow crosswalks have potentially reduced the upkeep of conventional crosswalks.” That is not the person we want as mayor of Rehoboth who would oppose spending the very few dollars to maintain the rainbow crosswalks.
She pretends to be more in tune with the community by cleaning up her Facebook page. At one time it showed support for DeSantis, and attacks on Hillary Clinton, President Barack Obama, and the ACA. Sounds very similar to the felon in the White House.
I love Rehoboth Beach. Today it is a place where everyone is welcome. A place where everyone can live in harmony. Where young people from around the world are welcomed for summer jobs, and residents and visitors enjoy learning from them about their lives, and cultures.
Those of you who are older will remember that wasn’t always the case. When I first visited in 1984, I heard the stories about incidents occurring when Joyce Felton and Victor Pisapia opened the Blue Moon, in 1981. Some locals would drive by the patio on Baltimore Avenue, throw eggs, and shout insults at those standing there. People were being beat up on the boardwalk for just being who they were. These, and other incidents, are why Murray Archibald and Steve Elkins co-founded CAMP Rehoboth, the LGBTQ community center. They, supporters, and dedicated volunteers, along with some commissioners, and a supportive police chief, worked hard to make Rehoboth what it is today: A safe and welcoming place for all. CAMP trained police officers to work with those that may be different from themselves. They worked to change Delaware laws. They made it comfortable for members of the LGBTQ community to open businesses here, to move here, and live in a place that not only respected them, but wanted them.
Rehoboth has come too far to elect someone who could take the city backwards. Someone who tried to get her husband elected to the Commission to get another vote. Someone who will try to do it again if she is elected mayor. That is not what Rehoboth is about. People here are better than that. I hope the people of Rehoboth are smarter than that. While we can always disagree on some things, that is only natural, we must do it both honestly, and respectfully. It is unfortunate that Goode does neither.
Suzanne Goode does not in any way live up to her name. Suzanne Goode is really not good for Rehoboth. There are four candidates running for mayor, and they could split the vote enough to let her win. So, I suggest to the voters, coalesce around the person who appears to have the most support at the moment, Susan Stewart, and cast a ballot for her. She will make a positive difference for the city. Electing Stewart as mayor is the way to ensure the Rehoboth Beach we love, will continue to be a wonderful place for all to work, live, and visit, for years to come. Voting takes place on Saturday, Aug. 8, from 10 a.m.-6 p.m. at the Rehoboth Beach Convention Center.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
Opinions
Continue to engage in community after Pride month
Parades are performative; we have work to do
Everyone has now had more than a month to recover from Pride 2026. Even for those who have not yet put away all their seasonal rainbow paraphernalia or are still finding glitter in unexpected places, June is now a memory; hence, community members and allies have work to do.
The LGBTQ community of Washington, D.C., and the DMV region, is not defined (or limited) by any specific month, annual event, or organization. There is no singular agenda, arbiter, or leader. Considering the efficacy of some organizations and the competency and integrity of certain individuals, that is a good thing. This creates more opportunities for more people.
June is Pride month, but some LGBTQ celebrations in D.C. happen annually in May. Others, including several in Maryland and Virginia, occur on dates in July through October. Regardless of scheduling, the planning process begins (or at least should begin) immediately following the current year’s festivities. With the end of the fiscal year rapidly approaching, time is of the essence. It behooves organizers not to wait until January or the spring to secure funding.
Money is one thing all nonprofits and community organizations need, especially those without corporate sponsorship. A donation or sponsorship of any amount can make the biggest impact if the recipient is a new or smaller organization. Also, be intentional with your spending; patronize LGBTQ businesses, purchase tickets to LGBTQ events, and subscribe to or advertise with LGBTQ media. If organizing events, book local LGBTQ performers, DJs, and hosts/emcees, and offer free resource tables to organizations when you can.
Donating your time and talents can also be impactful, especially to organizations without salaried staff. Some LGBTQ organizations need people for events, and others need help with data entry or miscellaneous administrative tasks. Outdoors, indoors, or online, you can help with something that limited staff or volunteers have put on the proverbial back burner, such as updating graphics or a website. If you seek a leadership role, there are often opportunities to become a board member of a local LGBTQ organization. At the very least, make an effort to like and share information about events, fundraising, and calls for volunteers on social media.
For some people, looking beyond LGBTQ organizations may be a good use of their time and energy. Help create the inclusion that may be missing from “mainstream” organizations. With this being an important election year, registering voters, working at a polling location, or supporting a candidate might be the best use of your time for the next several months.
Whatever inquiries you make, don’t expect immediate responses, immense gratitude, or an enthusiastic welcome. (Unless you contact Team Rayceen Productions; I try to provide all three.) Many organizations have poor communication, often because of personnel limitations or inquiry volume, so your email or DM may not be answered quickly, or at all. Some “groups” are essentially run by an individual, so be patient and, when necessary, persistent.
That leads to something else very important to consider: whether an organization is worthy of your time, talents, and/or money.
Reviewing a website and reading a mission statement is a good start, but that is just a starting point. What is their reputation? What have they accomplished? Do they put their resources to good use?
If they are a tax-exempt organization, information such as their revenue and executive compensation is available on the ProPublica Nonprofit Explorer website. The Charity Navigator website provides additional data and tools. However, the most helpful information may come from members of the community.
Unfortunately, some individuals use their positions to enrich themselves. One such person sits in prison today. Despite receiving numerous accolades and positive media coverage, many people had an idea that something was amiss long before charges were filed. Not that embezzlement, fraud, or other shenanigans are commonplace, but it certainly happens. Look out for red flags. Be leery if asked to sign a non-disclosure agreement. Remove yourself from uncomfortable or inappropriate situations. Report inconsistencies, irregularities, and unethical behavior. Demand transparency and accountability. Don’t let your interest in helping your community lead to your reputation being sullied by association.
If you are unable to find an organization you want to support, consider starting your own. Create whatever it is you cannot find. Start small; your focus could be helping people in need, organizing community events, or forming an activity group. You could create programming for LGBTQ History Month in October. If you want a new Pride month event in your county, town, or neighborhood, start planning now. (Shameless Plug: Rayceen Pendarvis, Empress of Pride, is available for booking.)
Pride should be more than parties and parades, but I hope those things motivate people to be more involved in their communities. The LGBTQ community and its members exist 12 months a year. Whatever your schedule and capacity may be, there is probably something you can do to help.
Zar is a mononymous D.C.-based LGBTQ community advocate, speechwriter, and songwriter who co-founded and served as creative director for Team Rayceen Productions.
Flanagan beats Craig in Minn. Senate primary after winning key LGBTQ endorsements
Gay ANC commissioner sues D.C. over police ‘failure’ to pay reward money
New LGBTQ visitor center slated for Wilmington, Del.
Jason DePuy on coping with homophobia in ‘Big Brother’ house
