The State Department on Tuesday announced PEPFAR has delivered the first doses of a groundbreaking HIV prevention drug to two African countries.

The lenacapavir doses arrived in Eswatini and Zambia.

The State Department in September unveiled an initiative with Gilead Sciences to bring lenacapavir “to market in high-burden HIV countries.”

Lenacapavir users inject the drug twice a year.

The State Department in its September announcement noted everyone who participated in Gilead’s clinical trials remained HIV negative. It also said lenacapavir “has the potential to be particularly helpful for pregnant and breastfeeding mothers, as it safely protects them during and after pregnancy to prevent mother-to-child transmission.”

“In our new America First Global Health Strategy, the Department of State is establishing a first-of-its-kind innovation fund to support American-led research, market-shaping, and other dynamic advancements in global health,” said PEPFAR on Tuesday in a press release.

“The arrivals of the first doses of lenacapavir in Eswatini and Zambia mark an important milestone in HIV prevention and reflect our commitment to supporting communities with the greatest need,” added Gilead CEO Daniel O’Day. “For the first time, a new HIV medicine is reaching communities in sub-Saharan Africa in the same year as its U.S. approval.”

The September announcement came against the backdrop of widespread criticism over the Trump-Vance administration’s reported plans to not fully fund PEPFAR and to cut domestic HIV/AIDS funding. The Washington Blade has previously reported PEPFAR-funded programs in Kenya and other African countries have been forced to curtail services or even close because of U.S. funding cuts.

The Human Rights Campaign Foundation on Nov. 18 released its 14^th annual Municipal Equality Index report showing that a record number of 132 cities across the country, including nine in Virginia and seven in Maryland, received the highest score of 100 for their level of support for LGBTQ equality through laws, policies, and services.

Among the D.C.-area cities and municipalities receiving a perfect score of 100 were Alexandria, Arlington County, Fairfax County in Virginia and College Park, Bowie, Gaithersburg and Rockville in Maryland.

The city of Rehoboth Beach is listed as the only city or municipality in Delaware to receive a score of 100. Rehoboth city officials released a statement hailing the high score as a major achievement over the previous year’s score of 61, saying the improvement came through a partnership with the local LGBTQ advocacy and services group CAMP Rehoboth.

The  HRC Foundation, which serves as the educational arm of the Human Rights Campaign, the nation’s largest LGBTQ advocacy organization, includes the District of Columbia in a separate State Equality Index rating system under the premise that D.C. should be treated as a state and receive full statehood status.

In its 2024 State Equality Index report, D.C. and 21 states, including Maryland, Virginia, and Delaware, were placed in the “highest rated category” called Working Toward Innovative Equality, which does not use a numerical score.

 “The 2025 MEI shows a record breaking 132 cities scoring the highest possible marks on the index, representing a combined population of approximately 49 million people,” the HRC Foundation said in a statement announcing the 2025 report.

“This high-water mark is critical as pressure continues from states that pass laws and policies that seek to shut transgender people – particularly trans youth – out of public life,” the statement continues. It adds that many cities that have put in place trans supportive laws and policies, including health insurance benefits, “are in many cases no longer able to provide that coverage in a meaningful way as a result of discriminatory decisions made by state legislatures.”

The statement goes on to say, “However, more cities than ever are doing what the MEI characterizes as ‘testing the limits of restrictive state laws’ – pushing back against various checks on municipal power or discriminatory state  laws – with nearly 70 cities doing so.” 

The HRC statement notes that this year’s Municipal Equality Index rated a total of 506 cities. It says that number includes the 50 state capitals, the 200 largest cities in the U.S., the five largest cities or municipalities in each state, the cities that are home to the state’s two largest universities, and the 75 cities or municipalities that have high proportions of same-sex couples.

The report shows this year’s index rated 11 cities or municipalities in Virginia with the following rating scores: Alexandria, 100; Arlington County,100; Fairfax County, 100, Richmond, 100; Charlottesville, 100; Chesapeake, 80; Hampton, 100; Newport News, 100; Norfolk, 91, Roanoke, 100, and Virginia Beach, 100.

In Maryland a total of 10 cities were rated: Annapolis, 100; Baltimore, 100; Bowie, 68; College Park, 100; Columbia, 100; Frederick, 100; Gaithersburg, 100; Hagerstown, 75; Rockville, 100 and Towson in Baltimore County, 85.

A total of eight cities were rated in Delaware: Rehoboth Beach, 100; Bethany Beach, 51; Milford, 83; Dover, 69; Wilmington, 76; Newark, 72; Smyrna, 59; and Middletown, 64.

The full 2025 HRC Foundation Equality Index Report can be accessed at hrc.org.

Our community has let marginalized people down. That’s the simple truth we need to hold on this Transgender Day of Remembrance. And, believe me, I don’t say this to accuse anyone. But marginalized trans people — including BIPOC, disabled and neurodivergent people, refugees and asylum seekers — are disproportionately affected by transphobic violence that too often goes unchecked, unreported, and unchallenged. And the wider LGBTQ community hasn’t done nearly enough to change this.

From the very beginning, Transgender Day of Remembrance was about marginalized trans lives. 

In 1999, transgender activists Gwendolyn Ann Smith, Nancy Nangeroni, and Jahaira DeAlto founded TDoR a year after the killing of Rita Hester, a Black trans woman, to honor her memory and the memory of all trans people lost to hate-motivated violence. Hester was openly trans, courageous, and ready to speak up against transphobia. Her death was noticed, but not all marginalized trans people are so lucky.

Now, as I prepare a speech for my city’s TDoR vigil — a speech about intersectionality, because I’m a trans, autistic, ADHDer refugee from a mixed background — I’m not even sure where to begin. You could write entire books and academic studies, hundreds of pages, about why and how marginalized trans people are under attack. But none of that fully captures how deeply normalized these risks have become in our daily lives. 

We trans people living at multiple intersections have become targets of jokes about the “woke agenda.” If characters like us appear in mass culture, countless people try to convince the world that we can’t be real. When a celebrity like us exists, they’re treated as a curiosity. And meanwhile, the very real violence against people like us goes unnoticed.

It is known that trans adults are more likely to be disabled than cisgender adults, in part because of the failures and biases within medical systems. We also know there is a significant overlap between trans identity and autism for reasons we don’t yet fully understand. But what we do understand is this: disabled trans people and autistic trans people are often denied autonomy, recognition, and basic respect. Worse, we face a bigger risk of violence and hate crime. 

And in the context of the modern U.S., this danger is multiplied. 

The country is experiencing the largest coordinated wave of anti-trans legislation in its history: hundreds of bills targeting every aspect of trans existence, from healthcare to public spaces. At the same time, the immigration system has become increasingly hostile. When the government targets both trans communities and refugees, trans refugees end up trapped in the gap between two systems that refuse to take responsibility for protecting them.

For many trans refugees, especially autistic and disabled ones, the greatest danger starts not when they are deported, but the moment they enter the U.S. immigration system. U.S. Immigration and Customs Enforcement detention is notoriously unsafe for trans people, particularly trans women who are often placed in men’s facilities, denied hormones, subjected to harassment, or put in solitary confinement under the excuse of “protection.” ICE excluded trans statistics from its public reports, trying to erase trans people on a systematic level, to make this discrimination invisible. 

For autistic trans women, the sensory overload of detention — the noise, the lights, the shouting, the unpredictability — can be unbearable. ICE facilities almost never have staff trained in autism, mental health, disability communication, or even basic general and cultural competency. Many autistic trans refugees simply cannot navigate complaint procedures, medical requests, or legal paperwork without support that does not exist inside the system.

The problems don’t stop after release. 

The U.S. asylum process demands documentation and formal proof of persecution that many refugees, especially autistic people, people with mental health issues or learning disabilities simply do not have. The violence they experience is often undocumented precisely because they were trans, because they were autistic, or because the police in their countries refused to recognize them. Immigration judges frequently misinterpret autistic communication as “inconsistency,” or dismiss their stories because they express trauma differently. For Black and brown trans refugees, the credibility gap is even wider.

And where are they supposed to turn for help? To refugee organizations that often have no training in trans issues, no understanding of gender-affirming care, and no knowledge of hate-crime risks? Or to LGBTQ groups, which may be strong advocates but rarely have immigration lawyers, disability-trained staff, autistic-friendly politics or experience dealing with ICE? What does a trans refugee woman do if she is also autistic and struggles with bureaucracy, communication, or social interactions? Who takes her seriously? Where does she go to report violence when the police misgender her, the immigration office overlooks her, and the community organizations don’t have the tools to protect her?

Let’s not forget that autistic people are also under attack in the current American political climate. 

Disability rights — including the right to live independently, the right to healthcare, and the right to refuse institutionalization — are being eroded. Studies suggest that up to 90 percent of autistic women experience some form of abuse or violence in their lifetimes. Can you imagine the data for trans women? Or men, or nonbinary people? Combine that with transphobia, racism, xenophobia, and the fragility of the asylum system, and you create a situation where a trans autistic refugee is left almost completely unprotected.

As a trans autistic person who has worked with trans communities, autistic communities, and refugees for over 11 years, I can say with absolute clarity: you cannot separate one form of discrimination from another. Institutions don’t know how to handle cases at the intersection. Even in the best-case scenarios, in the “best” countries, police, and social services struggle to understand the needs of someone who is trans, autistic, disabled or mentally ill, racialized, and displaced. From Ukraine to Russia, from the UK to the U.S. — in every place I have lived or worked — LGBTQ organizations still lack a proper strategy for protecting trans people who live at these intersections.

And until we confront this honestly, until we build structures that acknowledge the reality of those who are hit hardest, Transgender Day of Remembrance will continue to mourn the same people we keep failing to protect. Or worse, the death of the most vulnerable victims of transphobia would still go unnoticed and undocumented.