Sydney Bauer

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In the Southeast, heightened danger and few protections for trans people

Before the coronavirus pandemic tore through the U.S., resulting in nearly 600,000 deaths and a slew of collateral damage, transgender people across the Southeast were participating in self-defense classes catered specifically to them. The courses, organized by LGBTQ advocacy group Campaign for Southern Equality, had one goal: to teach trans people to protect themselves should they be the target of an attack. 

The campaign saw the classes as a necessity, with trans Americans facing disproportionate levels of violence — including record levels of reported fatal violence against the community.

“When folks are being attacked and murdered, helping with a name change doesn’t really do much good if we can’t keep our people alive,” Ivy Hill, the community health program director for the Campaign for Southern Equality, told NBC News.

Now, as it seems the worst of the pandemic may be in the rearview mirror for the U.S., Hill hopes these classes will resume — either through their own organization or local grassroots groups. While the damage spawned by Covid-19 is slowing down, the violence faced by transgender Americans — particularly trans women of color in the South — appears to be accelerating. 

This year is on track to be the deadliest on record for transgender Americans, with at least 28 trans and gender-nonconforming people fatally shot or violently killed so far, according to the Human Rights Campaign, which has been tracking trans deaths since 2013. 

2021 is outpacing 2020, when the group recorded a record 44 trans people killed due to violence. By this time last year, the group had tracked 13 trans deaths. Of this year’s 28 known transgender victims, 20 were trans women of color (16 of them Black trans women), and 14 were killed in the South. https://iframe.nbcnews.com/UdlwyyS?app=1

The disproportionate violence trans Americans face in the South, and more specifically the Southeast, is due to a combination of issues, according to advocates. These factors, they say, include a lack of discrimination protections, a flurry of recently introduced anti-LGBTQ state bills, high rates of poverty and a host of cultural factors. To combat this dangerous brew, local and regional advocacy groups, like the Campaign for Southern Equality, say they are working to fill the void left by their states to ensure trans people have some form of protection where they live. 

‘Institutional violence’

The Southeast in general is a hostile region for the transgender community due, in part, to “institutional violence,” according to Austin Johnson, an assistant professor of sociology at Ohio’s Kenyon College, who studies the trans community. Trans people face high barriers to health care and housing in the region, and state legislatures in recent years have put forward “persistent attacks” against the community with bills that seek to limit the everyday rights of trans people, he explained.

Add in the high rates of poverty in the region, along with religiosity that promotes a very conservative view of gender roles and sexuality, he said, and there is a combination of factors that contribute to the violence. https://iframe.nbcnews.com/YGXPfXs?app=1

“I think those kinds of norms, all of those intersect with the kind of economic deprivation, educational deprivation, we have in the South, and so when you have all of this deprivation, in terms of the different institutions, it’s going to affect every group,” Johnson said. “When there are some groups that are more disadvantaged, it’s going to affect them. So I think that’s why we’re seeing these really drastic rates of negative outcomes for LGBTQ people and trans people in particular in the South.”

Although there is a disproportionate number of reported killings of transgender people in the South, it does not mean the region is inherently more deadly, according to Eric A. Stanley, an assistant professor of gender and women’s studies at the University of California, Berkeley. 

The true number of trans people lost to violence each year is unknown, due in part to the lack of a national database to track anti-trans violence, police misgendering victims in official reports and some victims’ closeted status. Absent that, Stanley said, it is impossible to truly judge the regionality of anti-trans violence in proportion to other areas of the country. 

“I don’t think anywhere is necessarily safer, as the kinds of anti-trans antagonism that propels so much of the harm is any and everywhere,” Stanley said. 

Stanley did note, however, that the Southeast is “less resourced” when it comes to combating violence against the transgender community — and the LGBTQ community more broadly — due to the relatively high poverty in the region and the lack of a social safety net. 

Alabama, Louisiana and Mississippi — three Southeastern states — are also home to the highest homicide rates in the country, further adding to the climate of violence that trans people face in everyday life.

‘Dehumanized’ by state legislatures

Outside of housing and basic needs, transgender Americans only recently received federal protection from being fired for their gender identity, thanks to the Supreme Court’s 2020 ruling in Bostock v. Clayton County, Georgia. Besides that, there are no federal discrimination protections in other areas of life for trans people, according to the Movement Advancement Project, an LGBTQ think tank.

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Hill said trans people’s inability to safely access public spaces without fear of discrimination — and the issues being debated in state legislatures aimed at rolling back the rights of trans people — have created a climate that has “dehumanized” the trans community. That combined with a lack of legal protections such as nondiscrimination ordinances leaves trans people vulnerable and easy targets of violence.

Twenty-two states do not have public accommodation nondiscrimination laws protecting LGBTQ people from being discriminated against in public places due to their sexual orientation or gender identity, and 20 do not have such protections when it comes to housing, according to the Movement Advancement Project. Many of these states are clustered around the Southeast. 

In addition, only 15 states — none in the Southeast — have laws that make it illegal for a defendant to claim the victim’s sexual orientation or gender identity contributed to their violent actions, known as the “gay/trans panic” defense. 

“I think for a lot of us, what people kind of miss is just how dangerous or scary it can be just to move through public space, which is something that other folks who are cisgender generally don’t even have to think about,” Hill, who lives in South Carolina, said of being trans in the South. 

A number of Southeastern states have recently passed bills that restrict the rights of transgender Americans. Alabama, Florida, Mississippi and Tennessee all passed bills that bar trans student athletes from competing on sports teams that match their gender identity. 

Tennessee enacted an additional law that compels businesses to display signs that read, “This facility maintains a policy of allowing the use of restrooms by either biological sex, regardless of the designation on the restroom,” if transgender people are allowed to use bathrooms that match their gender identity. The state also enacted a law that restricts access to gender-affirming care for trans minors.

State bills targeting transgender people that did not pass in 2021 will likely be introduced next year, advocates warn. Advocacy groups, including the Human Rights Campaign, say serious political change must happen on the federal level to help stem the tide of rising anti-trans violence. 

HRC President Alphonso David said one of the most important things that can be done to help protect trans Americans is for Congress to pass the Equality Act. The federal legislation would explicitly create LGBTQ nondiscrimination protections in housing, credit, education, public spaces and services, federally funded programs and jury service.

“It is heartbreaking to see violence against transgender and gender-nonconforming people across our country,” David said in a statement. “The Equality Act that will provide legal recourse to incidents of discrimination, discourage discrimination, and work to reduce stigma against transgender and nonbinary people nationwide.”

In addition, HRC cited actions the Biden administration took — such as reinstating the Equal Access Rule that allows people to access Department of Housing and Urban Development-funded housing without discrimination based on their gender identity and encouraging the Education Department to enforce Title IX with protections based on gender identity — as tangible solutions to help the trans community. 

Some advocates, however, are not optimistic about additional national actions, especially given the slim majority Democrats hold in Congress. That’s why groups like the Campaign for Southern Equality continue to focus on lobbying state legislatures and supporting more local, grassroots efforts.

‘Robust community of grassroots work’

A number of queer advocacy groups in the Southeast say they are filling in the gaps left by the federal, state and local governments. 

Organizations like Atlanta-based Southerners on New Ground are dedicated to keeping reports of anti-transgender violence in the news to ensure the public is aware of this ongoing issue. 

“Those folks are amplifying their voices and amplifying their stories,” Johnson said of advocates sharing the stories of trans people lost to violence. “I wonder if we didn’t have this robust community of grassroots work, that we wouldn’t even know many of their names.”

In Charlotte, North Carolina, the trans community has been racked by violence. Two Black women, Jaida Peterson and Remy Fennell, were killed in the span of two weeks in April. Ash Williams, an organizer with Charlotte Uprising and the House of Kanautica, which both support the local Black trans community, said the groups’ main goal has been to get money in the hands of struggling trans people so they can find stable housing. After Peterson’s death, the groups raised over $20,000 for trans people of color. Williams said if they had this kind of funding year-round, it may have saved Peterson’s life.

“We believe that how we are organizing is certainly in the spirit of what we understand to be happening across the country, which is, we hope, some kind of cultural awakening that says trans people matter and Black lives matter,” Williams said.

Thousands March For Trans Lives
Thousands march during a Transgender Resistance Vigil + March in Boston on June 13, 2020. Barry Chin / Boston Globe via Getty Images file

However, he added, distributing funds so the community members can take care of each other only goes so far when there is limited access to health care and other necessary services.

“Because of the way that power structures are, regular people have to show up,” Williams said. “And one of the things that we hope to be able to do is to get people mobilized and to show up for the trans folks where they live.”

Several groups in the Southeast are organizing to provide vulnerable trans communities with essential needs, such as housing, where they say state institutions have failed to provide a path to safety.

My Sistah’s House in Memphis, Tennessee, for example, has raised money to build homes for trans people of color to help provide safety. The group is currently in the process of building 20 tiny houses in the Memphis area.

“A big portion of the folks that we serve participate in survival sex or sex work. Therefore, they don’t have verifiable income,” Kayla Gore, co-founder of My Sistah’s House, told NBC News last year. “So that’s the reason that they can’t get housing or they’re underemployed, in a sense that they don’t necessarily have access to equitable jobs that will provide them an income that is enough to obtain stable housing.”

My Sistah’s House also provides emergency housing in an effort to keep the local trans population safe in the immediate term.

House of Tulip in New Orleans is renovating a multifamily home in hopes of creating a pilot program to house 10 transgender people facing housing insecurity. The group, according to its website, also plans to establish a “separate space that can serve as a community center” where transgender people have a safe space to visit, access resources and get a hot meal or shower. H

House of Tulip said 1 of every 3 trans people in Louisiana faces homelessness, emphasizing the need for immediate housing as well as investment to help trans people find long-term housing arrangements. 

Trans United Leading Intersectional Progress, or TULIP, is a nonprofit collective creating housing solutions for trans and gender-nonconforming people in Louisiana.
Trans United Leading Intersectional Progress, or TULIP, is a nonprofit collective creating housing solutions for trans and gender-nonconforming people in Louisiana.House of Tulip

Johnson said local grassroots groups in the Southeast have come to realize in the absence of institutional help, they have to rely on each other for survival. 

“When you have that kind of community building, it’s empowering, and people are not going to just roll over and expect this treatment that they’re getting,” Johnson said. “Also, they’re going to honor those who they’ve lost in their community, because they have people to rely on.”

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Anti-LGBTQ coalition targets Equality Act in the name of America’s children

A new initiative backed by a coalition of right-wing organizations is courting lawmakers and parents in an effort to stop the passage of the Equality Act — a federal LGBTQ rights bill — and promote policies targeting transgender Americans at the federal and state levels.

Backed by the Alliance Defending Freedom, Family Policy Alliance, Heritage Foundation and other national and local groups, the Promise to America’s Children coalition says it is fighting “a culture – and sadly, a government – around us seek to sexualize our children for the sake of a political agenda.”

“It’s no surprise that the ugly wave of state attacks on trans kids traces back to a few, very familiar national anti-LGBTQ groups.”

SARAH KATE ELLIS, GLAAD PRESIDENT AND CEO

As part of this effort, policymakers and parentsare asked to sign pledges protecting children’s “minds,” “bodies” and “relationships with their parents.” Elected officials can even sign up on the coalition website to receive model legislation on the policies it promotes.

“Every child deserves an education that is suited for their specific needs and development as guided by their parents, and one that is free from graphic sexual curriculum or content, the promotion of abortion, and politicized ideas about sexual orientation and gender identity,” the policymaker pledge reads.

On its website, the Promise to America’s Children coalition says anyone who signs the pledge is not signaling support or opposition to legislation, “with the exception of the federal Equality Act, which clearly violates all principles of this Promise.”

The Equality Act is federal legislation that seeks to prohibit discrimination based on sexual orientation and gender identity in employment, housing, credit, education, public spaces, public funding and jury service. The House passed the recently reintroduced legislation Thursday, but it will likely face an uphill battle in the Senate, where a 60-vote threshold is required to bypass a filibuster.

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Civil rights groups say this new conservative coalition is an attempt to roll back the rights of LGBTQ Americans, particularly the transgender community, and stall passage of comprehensive nondiscrimination laws on the federal and state levels.

“The same few sources have been responsible for peddling anti-LGBTQ legislation for many years, and this legislation is simply the latest iteration of their losing political fight against equality,” Cathryn Oakley, state legislative director and senior counsel for the Human Rights Campaign, said of state bills associated with the organizations in the coalition.

“While extremist groups push copycat bills down to states, these state legislators should understand that their constituents — including a large majority of Republicans — believe transgender people should be allowed to live freely and openly,” Oakley added. “The only thing these bills do is harm kids who are simply trying to navigate their adolescence.”

Emilie Kao, an attorney at the Heritage Foundation, said the coalition’s efforts were accelerated by the reintroduction of the Equality Act.

“Regardless of whether one agrees with the idea that people can have gender identities at odds with their biological sex, bills that treat Americans as criminals if they don’t agree with a government-imposed ideology about the treatment of gender dysphoria is a gross violation of our most basic freedoms of speech and conscience,” Kao told NBC News. “The Equality Act will turn disagreements over marriage and sexuality into discrimination by misusing civil rights law as a sword to coerce conformity rather than as a shield to prevent unjust discrimination.”

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Kao declined to disclose what model legislation the coalition is offering on its website. Prior to the coalition’s official launch this week, LGBTQ advocates said anti-transgender bills were introduced in 20 states in a coordinated assault by conservative groups. At least one of those conservative groups, the Alliance Defending Freedom, is part of this newly formed coalition.

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Bethany Moreton, a history professor at Dartmouth College, said the guise of protecting children when promoting conservative ideology is not uncommon. She cited Anita Bryant’s “Save Our Children” campaign in the late 1970s that worked to overturn gay nondiscrimination ordinances in Miami by referencing how such measures would harm local children. Over the past 20 years, the religious right has repeatedly lost political battles when it comes LGBTQ issues, so this new pledge is continuing in the “Save Our Children” vein in an effort to appeal to a broad base, according to Moreton.

“Their sort of arsenal of acceptable arguments have shrunk, and one of them is doubling down on child vulnerability,” Moreton said.

While the Promise to America’s Children coalition is new, groups within the coalition have already had success in assisting lawmakers with legislation intended to curtail transgender rights. One such example is Idaho’s HB 500, a bill that bars trans women from participating in high school sports that was passed in 2020, which was written with the help of the Alliance Defending Freedom, according to Barbara Ehardt, the legislator who drafted it. A similar bill in Montana was drafted directly from HB 500, Laura Sankey Keip, a staff attorney in the Montana Legislature, confirmed.

The coalition, which launched Tuesday, already has 24 state representatives as signatories to the group’s pledge, three of whom have introduced legislation targeting transgender individuals. Ohio state Rep. Jena Powell and North Dakota state Rep. Ben Koppelman, both Republicans, have introduced bills that would restrict trans women from participating in high school sports, mirroring HB 500, and Kansas state Sen. Mike Thompson, also a Republican, has introduced a bill that would criminalize doctors providing gender-affirming health care to teenagers.

There are more than 45 pieces of anti-transgender legislation making their way through statehouses this year, according to a legislation tracker from Freedom for All Americans. That is more than the legislative session of 2016, which produced the largest volume of anti-trans bills in statehouses, according to civil rights groups.

“It’s no surprise that the ugly wave of state attacks on trans kids traces back to a few, very familiar national anti-LGBTQ groups,” Sarah Kate Ellis, president and CEO of GLAAD, said. “They have opposed LGBTQ equality for decades, fighting marriage equality and now targeting trans youth. Bills claiming to protect children or women’s rights do neither and put trans kids in further danger.”

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LGBTQ Georgians hopeful following Warnock, Ossoff Senate victories

When news organizations projected that Democrat Raphael Warnock had won one of Georgia’s two critical Senate runoffs on Tuesday, Ian Webb sat in his Atlanta apartment and cried.

“I’ve grown up believing that Georgia is a red state, and that I was a blue dot,” Webb, 24, told NBC News. “Since I turned 18, I’ve been volunteering on Democratic campaigns at every level of government, and to be quite frank, I became accustomed to losing and essentially being told that as a queer individual, I don’t deserve the same rights as my straight brothers and sisters.”

Warnock and fellow Democrat Jon Ossoff, who won the other runoff, ran on a platform that explicitly backed pro-LGBTQ policies, including nondiscrimination protections at the federal level.

“I also am just excited to have two senators representing Georgia who believe that love is love, trans rights are human rights, and that everyone is equal under the law and the constitution,” Webb said. “We have leaders who represent Georgia with love and conviction.”

Both Ossoff and Warnock are on record as supporting the Equality Act, federal legislation that would modify existing civil rights protections to include protections against discrimination based on sexual orientation and gender identity in employment, housing, public accommodations, jury service, education, federal programs and obtaining credit.

The legislation passed in the Democrat-controlled House but was never given a vote in the GOP-controlled Senate. With Democrats now controlling both chambers of Congress, thanks to the results in Georgia, President-elect Joe Biden has said he hopes to sign the legislation within his first 100 days in office.

Organizers in Georgia told NBC News that the candidates’ support for the LGBTQ community goes beyond just supporting federal legislation.

Jeff Graham, executive director of Georgia Equality, a statewide LGBTQ advocacy group, said the Ossoff and Warnock campaigns were “the first time anyone from Georgia running for federal office actively engaged the LGBT community” in his 12 years leading the group.

Graham said the candidates’ efforts to actively engage with the LGBTQ community and develop platforms that cater to the community’s specific needs was an important part of their winning coalition. Georgia Equality, he added, engaged around 650,000 pro-equality voters — both LGBTQ Georgians and allies who support LGBTQ rights —as part of the organization’s comprehensive get-out-the-vote effort.

The Human Rights Campaign, the nation’s largest LGBTQ advocacy group, said it deployed a dozen staff members to the state and had hundreds of volunteers dedicated to mobilizing its 1.3 million “equality voters,” including its estimated 356,000 voting-age LGBTQ residents.

“I hope that, first and foremost, they will remember that the LGBT community helped them win their elections on Tuesday. But second of all, to really recognize that, as senators from the South, it’s incredibly important for them to continue to engage LGBT communities around the state,” Graham said. “This is not something that LGBTQ folks in Georgia, or frankly in the South, are used to having.”

The Rev. Jasmine Beach-Ferrara, executive director of the Campaign for Southern Equality, a North Carolina-based organization that works to promote LGBTQ equality across the South, said she would like to see the Democrat-controlled Senate prioritize LGBTQ discrimination protections at the federal level.

“For the one-third of LGBTQ Americans who live in the South, inaction from the federal government has caused significant harm, delaying solutions on everything from Covid-19 dangers, economic hardship and health care disparities to anti-LGBTQ discrimination and the violence of white supremacy,” Beach-Ferrara said. “Finally, following these important Senate victories, there is a pathway forward for addressing these societal challenges.”

‘Hoped for the best, expected the worst’

For some LGBTQ Georgians, like Roxy, a 36-year-old lesbian who lives in the Atlanta suburb of South Fulton, the election results came as a total shock. Roxy said she didn’t even bother to stay up late Tuesday night to see the results.

“I didn’t have any expectations, especially with so many more people believing the rhetoric that progress equates to losing privileges,” she said. “I cast my vote, hoped for the best and expected the worst.”

“As a Black lesbian, I am glad that we have elected politicians that will push progressive policies,” she added, noting that she voted for both Warnock and Ossoff. “I have faith that, at least for these next four years, my rights are protected, but enforcement of those protections is yet to be seen. We are living in a very polarizing time in history.”

Roxy declined to have her full name published out of fear that being publicly identified as a Black lesbian could put her in danger.

Jen, a 45-year-old bisexual woman who lives outside Atlanta, said the election of Ossoff and Warnock brought relief for her and her transgender child. She said the exhaustion she felt after participating in volunteer efforts to get both Democrats elected was offset by seeing her child’s reaction on Wednesday morning upon learning of the election results.

Jen, who asked that her full name not be published to protect the privacy of her transgender child, said the real work has only just begun. She expressed hope that Congress and the incoming Biden administration will work to reverse the Trump administration’s rollback of LGBTQ rights, including its ban on transgender service members serving openly in the military and its removal of transgender discrimination protections in health care.

“I don’t feel our job is done,” she said. “LGBTQ issues and rights are human rights — they are everyone’s rights. We should all be fighting for these rights, and I want to see them fighting for them.”

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Getty Images and GLAAD Team up for New Transgender Photo Guidelines

Photographers around the world now have access to new guidelines aimed at helping them more accurately capture transgender subjects in their stock and commercial imagery. The guidelines were released Wednesday by Getty Images, one of the world’s largest stock photo agencies, and GLAAD, a national LGBTQ advocacy organization.

Stock images are photos that are licensed for use in a variety of places — from corporate websites to advertising campaigns and even on news sites. Examples could range from an image of child models playing with a toy for a retail company’s catalog to a photo of Hong Kong’s skyline for a news article about the world’s most expensive cities.

Nick Adams, GLAAD’s director of transgender representation, said the wide reach of Getty’s clients (NBC News among them) will hopefully mean people around the world will be exposed to — and eventually accustomed to — seeing transgender people in a variety of visual campaigns and stories that go beyond those that are specifically about transgender people. The guidelines hope to give trans individuals — who experience a disproportionate amount of discrimination and violence — exposure by making available stock images of them doing everyday things, like getting a cup of coffee or shopping with friends.

Portrait of a senior trans person from the LGBT community
Stock photo showing a portrait of a senior transgender person.trisha ward / Getty Images

“In the past, trans images in stock photography have included many tropes and cliches or even replaced actual transgender people with impersonal symbols like flags,” Adams said.

“Stock images tell a story without words,” he added. “When those images don’t reflect the full diversity that exists within the transgender community, then our story isn’t being told in an authentic way.”

Getty Images said there has been a demand from editorial and advertising clients for photos of transgender, nonbinary and gender-nonconforming people in its stock and editorial photo library, based on internal metrics, which prompted the company to begin working with GLAAD this year. Images in Getty’s library are used mainly for advertising, in-house corporate imagery and news and entertainment stories.

All of Getty’s contributors around the world will have access to the new guidelines, which have been translated into multiple languages, according to Guy Merrill, global head of art at Getty Images and iStock.

The guidelines cover a variety of different creative aspects for stock photos and ensure that models have control over how they are referred to in captions, making sure no assumptions are made about their gender identities. Additionally, photographers have a set of guidelines to make transgender subjects feel comfortable and empowered on set.

Merrill stressed that simply shooting trans people in stock photography is not enough, adding that there has to be an effort to consistently include the community in photographs and ensure that harmful stereotypes about trans people are not perpetuated. The goal of the partnership between Getty and GLAAD, he added, is to empower trans people in the realm of stock imagery, not use their likeness for any narrative.

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Merrill admitted that when Getty looked through its archives over the last five or six years, the company found “very little, if any” photos of the trans community and described the ones that were in the company’s archive as “tokenistic.”

“We are not looking for our contributors to go out and just shoot some portraits of transgender persons. That is not the point at all,” Merrill said. “It’s that level of nuance that brings in that authenticity in terms of people you choose. It is all those small moments that really kind of authentically tell that broader story.”

Gillian Branstetter, founding member of the Trans Journalist Association, said the new guidelines “could be really beneficial for both trans people who want to see our lived experiences in the world around us” and “cisgender people as well.”

“I think a lot of reporting tends to treat trans people as if we live in a vacuum and live on a separate planet and we don’t interact with the systems that cis people do,” she told NBC News. “I think the press, and photographers as well, could play a huge part in showing who trans people are instead of focusing on what’s most sensationalized and exploitative.”

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Pandemic Puts Added Strain on LGBTQ Mental Health

Sydney Duncan, 44, an attorney in Alabama, has been so focused on managing the increased legal needs of her clients that she rarely has time to address her own mental health needs, including her anxiety.

Since the start of the coronavirus pandemic, Duncan has devoted nearly her whole waking day to her work at Birmingham AIDS Outreach, an Alabama nonprofit. Helping her transgender clients obtain vital name changes has become a prolonged process due to court backlogs piling up, helping them acquire driver’s licenses has become harder while Social Security offices are closed, and increased unemployment among the community she serves has complicated a variety of services her nonprofit provides.

Image: Sydney Duncan
Sydney Duncan.Courtesy Sydney Duncan

“We’re so busy trying to resolve other people’s issues — which objectively are more pressing than anything I have going on in my life — that it’s hard to slow down and feel the weight of the problems in your own life,” Duncan said.

Duncan, who is transgender, is among many LGBTQ Americans grappling with the added strain of the coronavirus crisis as they continue to adjust to a “new normal.” Meanwhile, the United States is poised to deal with a third spike in Covid-19 cases and hospitalizations, nine months into the pandemic.

Prior to the global crisis, lesbian, gay, bisexual, transgender and queer Americans were already at greater risk of mental health problems, according to the Centers for Disease Control and Prevention. This elevated risk — due to a host of factors, including stigma and discrimination — combined with a global health crisis that has upended life as we once knew it, is presenting unique challenges for LGBTQ people.

“The physical distancing, economic strain and housing instability caused by Covid-19 have the potential to exacerbate these barriers among LGBTQ young people,” Dr. Amy Green, vice president of research at The Trevor Project, an LGBTQ youth crisis intervention and suicide prevention organization, told NBC News. 

‘Barely making it by’

Duncan had hoped to begin the year by supplementing her nonprofit salary by working as a comic-book writer. She made her debut with Dark Horse Comics at the end of last year but said her family is now “barely making it by” as opportunities have dried up.

“I feel like I’m better off than most, so don’t want to take someone else’s place if they need it more,” said Duncan, who added that she has been having “more sleepless nights” amid the pandemic. However, “opportunities seem fewer,” she added, which has affected more than just her finances.

“I’ve buried myself in working constantly to not pay attention to anything, but at some point it’s going to crash, and I don’t know what I’ll do then.”

REBECCA MIX

“To make it to a level and have it erode from beneath you — the loss feels more profound,” she said. “Second chances for someone like me feel further away.”

Many LGBTQ people work in industries that have been disproportionately affected by Covid-19, according to research by the Human Rights Campaign. These industries include jobs that have been contracted due to the pandemic, as well as other industries that have put workers at direct risk of exposure to the virus.

The report found that in addition to being at risk for precarious employment conditions, LGBTQ people were less likely to have health insurance, putting them further at risk from Covid-19.

On the other side of the coin, as many work remotely, the lines between work and home life have evaporated, putting an additional strain on mental health.

Rebecca Mix, 25, a queer author from Michigan, said that being overworked has just become a normal part of her routine with little sign of that changing.

“I think I’m barreling towards burnout,” Mix told NBC News. “I’ve buried myself in working constantly to not pay attention to anything, but at some point it’s going to crash, and I don’t know what I’ll do then. But I feel like I don’t have any other option.”

Loss of community

One of the biggest losses Covid-19 has robbed Duncan of is her sense of community. Seeing friends and colleagues on video conferencing has become exhausting, she said, and a poor substitute for having a community to help lift one another up.

“For me, community is support,” Duncan said. “Without community, I feel less supported, less confident in my place in the world. I feel this underlying anxiety every day.”

Many around the country have begun feeling “zoom fatigue,” while working to implement social distancing measures at work and with friends.

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There is also worry about the long-term impact that the loss of in-person connections could have on LGBTQ people coming into their own with their sexual orientation and gender identity and presentation. A lack of a supportive community could stunt that formative time for many, according to research from Boston University’s School of Public Health.

A recent poll conducted by The Trevor Project showed that 40 percent of LGBTQ youth across the country said that “Covid-19 impacted their ability to express their LGBTQ identity,” with that number jumping to 56 percent for transgender and nonbinary youth. In addition, another report found that 2 in 5 LGBTQ youth in the United States have “seriously considered” suicide in the past year, highlighting the direness of the situation for many this year.

Access to therapy

The combination of economic strain and lack of available space to express themselves has also conspired against LGBTQ Americans by blocking access to a vital mental health resource: therapy.

Green, of the Trevor Project, said many LGBTQ youth have lost their job amid the pandemic and the health insurance that came with it.

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“Finding providers who are not only affordable and available but also well versed in LGBTQ youths’ identities and unique mental health challenges can prove incredibly difficult in many areas of the country,” she said. “And concerns around parental permission, being outed and privacy could be heightened for LGBTQ youth who find themselves confined to unsupportive home environments and isolated from affirming LGBTQ communities.”

One of the silver linings of the pandemic has been the increased access to teletherapy as health care providers shift to remote work. This has been particularly helpful for those who had little access to affirming mental health care in their physical area.

“By and large, I have found it has worked really well,” Dr. Alex Keuroghlian, director of the Fenway Institute’s National LGBT Health Education Center and Massachusetts General Hospital’s Psychiatry Gender Identity Program, told NBC News this year. “I’ve had almost no no-shows in my schedule, and patients are answering the phone very appreciative that we can give them care despite what’s happening.”

Remote therapy, while easier to access in some respects, still does not make it accessible for everyone. Mix, for example, began teletherapy during the pandemic, but then had to quit once the costs started piling up.

“At one point, I felt so spiraling-out-of-control depressed and anxious, but I had to stop because I couldn’t afford it,” Mix said. “I’ve noticed everything is harder and more exhausting — things as simple as phone calls to household tasks like laundry and dishes.”

Therapy in addition to medication helped stem feelings of spiraling out of control and depression, but the longer the pandemic rages on the harder it will be to stay on top of certain tasks and remain motivated in day-to-day life, Mix said.

Others, who are sheltering in place with people unsupportive of their LGBTQ identity, may not have a space to privately participate in a mental health video visit. And some may be skeptical of a new platform for accessing health services altogether.

Housing precariousness

A combination of unemployment, unsupportive families and reduced in-person services at LGBTQ centers have created an acute crisis of housing precariousness for the community.

Image: Wren
Wren.Courtesy Wren

Wren, 20, who is nonbinary and uses ze/hir pronouns and asked that hir surname not be published to protect hir privacy, has spent the past year moving to different parts of the country to avoid infecting family members, to keep job prospects alive and have space to finish college classes. For Wren, this involved moving in with hir partner on a farm in Appalachia, working in exchange for rent.

For around two months, Wren returned home to see hir family, but that only brought old traumas and threats of violence. Wren is back on the farm with hir partner, trying to navigate an uncertain future amid the pandemic.

“The uncertainty about where I would be living, the worry I felt for my community in the city who were at higher risk for Covid and were facing violence from police during the protests this summer, and stressed family relationships compounded pre-existing mental health issues I have been dealing with for years,” Wren said.

Mental health investment

The implications of the Covid-19 pandemic on the state of mental health care won’t be known for some time, the Trevor Project’s Green added, but the disparities in our current system show that urgent investment is needed before more LGBTQ people get left behind without access to care.

“Investing in mental health and social services is the best strategy for proactively preventing worse mental health consequences in the future,” Green said.

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.

If you are an LGBTQ young person in crisis, feeling suicidal or in need of a safe and judgment-free place to talk, call the TrevorLifeline now at 1-866-488-7386.

/ /

LGBTQ People of Color Keep Breaking Election Barriers

Kimberly Jackson, an Episcopal church leader in Atlanta, made history last week when she was the first Black lesbian elected to Georgia’s state Senate. She was excited about winning — and doing so with 80 percent of the vote — as well as making history. Then her election win got even sweeter.

Shortly after Election Day, a constituent approached Jackson at the gym and informed her that part of her district intersects with one represented by Karla Drenner, Georgia’s first openly gay state representative, who has been in the state House of Representatives for nearly 20 years.

“People are excited about that,” Jackson told NBC News shortly after Election Day. “I’m also incredibly humbled and really grateful for the people of District 41 for trusting me to do this work.”

Kim Jackson, Democratic candidate for Georgia State Senate District 41.
Kim Jackson, Democratic candidate for Georgia State Senate District 41.Cindy M. Brown / Kim Jackson Campaign

Jackson’s victory was one of many for queer people of color last week, and that her district overlaps with Drenner’s underscores the increasing LGBTQ representation being seen across the country.

Jackson was one of at least 40 lesbian, gay, bisexual, transgender and queer people of color who won elections in state legislatures last week, and one of at least 16 nonincumbents. Their wins will bring LGBTQ representation in state legislatures to more than 150, for now, with only Louisiana, Mississippi and Alaska having never elected an out state representative (though there are currently three uncalled Alaska races that could change that), according to the LGBTQ Victory Fund.

Jackson told NBC News that she expects to draw experience from the LGBTQ Caucus in the Georgia House of Representatives, and expects her election to have tangible change in the state Senate. She said that by just being elected, it could help reduce the number of anti-LGBTQ pieces of legislation that get introduced, since lawmakers will have to debate Jackson’s rights to her face.

“I’m a firm believer of everyone being represented at the table.”

SHEVRIN JONES

She’s also keenly aware that her state is about to become the center of the political universe for the next two months as one of Georgia’s U.S. Senate races is going to a runoff on Jan. 5, and the other could also be headed for a runoff. The outcome could determine which party controls the Senate. Georgia is on track to vote for a Democratic candidate for president for the first time since 1992, and that statewide support will influence the 2021 legislative session in Atlanta, according to Jackson.

“What it means on a state legislative level is that Republicans know that we’re coming, and they’re going to have to learn how to work with us and how to have conversations with us,” Jackson said. “I think that the General Assembly already has some really good bipartisan work that takes place, but they’ll have to get more used to talking to Democrats, having to build relationships with people who most often don’t look like them, or love like them.”

In neighboring Florida, Shevrin Jones, 37, joined Kimberly Jackson in making political history. Jones, who had been serving in the Florida House of Representatives since 2012, was elected to and seated in the state Senate last week, making him the first LGBTQ representative in Florida’s Senate.

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After his victory, Shevrin told NBC News he and his partner had bought a French bulldog puppy to celebrate, and he said he plans to hit the ground running in the state Senate introducing bills to help small businesses in minority communities survive Covid-19; help modernize the state’s unemployment system so constituents get the benefits they need; and work on overhauling police to build on calls for change sparked by protests this summer across the country.

“I’m a firm believer of everyone being represented at the table, and it is not to say that the current LGBTQ allies can’t speak up for us, or speak for me, but it’s better to have someone from the community at the table,” Jones said. “I can tell you from experience what it means to be discriminated against. I can tell you from experience my story, which can help … move, whether it’s legislation, whether it’s to move the agenda or a particular item.”

Jones, who said his victory “feels amazing,” will be joined in the Florida state Legislature by Michelle Rayner, who made history on Election Day as the first Black LGBTQ woman elected to the state House.

In the northeast, Tiara Mack made history as the first Black LGBTQ member elected to the Rhode Island State Senate. Mack told NBC News that she would introduce herself to residents in her district as: “Tiara Mack, a queer Black, formerly low-income educator and activist.”

“All of those identities are political, whether or not we see them,” said Mack, who unseated an incumbent who represented the district for 15 years.

Adrian Tam, candidate for Hawaii State House District 22.
Adrian Tam, candidate for Hawaii State House District 22.Courtesy Adrian Tam campaign via Facebook

In Hawaii, Adrian Tam became the first openly gay Asian American representative in the state, overcoming alleged harassment in the process. Tam’s opponent in the race was Nicholas Ochs, a leader of the local chapter of the far-right group Proud Boys.

Cisgender people of color were not the only ones to make gains in state legislatures. In Kansas and Oklahoma, trans and nonbinary people of color made history by being elected to their state’s legislature.

Mauree Turner, who is Black and Muslim, won a seat in the Oklahoma House of Representatives, becoming the first nonbinary person elected to any state’s legislature.

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Stephanie Byers, a member of the Native American Chickasaw Nation, won a seat in the Kansas House of Representatives, becoming the first transgender woman of color elected to any state legislature in the U.S.

“We never know until we try, and we can step up there and make a difference,” Byers told NBC News when asked if she was surprised by her victory.

Two of Election Day’s biggest history-makers were Ritchie Torresand Mondaire Jones, both New York Democrats who became the first openly gay Black Americans every elected to Congress.

Torres, the youngest member of the New York City Council, won a deeply blue district in the Bronx with over 88 percent of the vote, while Jones was elected in a district just north of New York City with 54 percent of the vote, with 72 percent of ballots counted.

“Tonight we made history,” Torres tweeted on election night, calling it “the honor of a lifetime to represent a borough filled with essential workers who risked their lives so that New York City could live” during the pandemic.

Jones told NBC News he’s excited to serve in Congress along with Torres.

“He’s a tremendous candidate and a good friend,” he said. “This is a chance for us to be the role model we looked for growing up — for queer youth and especially queer youth of color.”

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While the two men will be the first LGBTQ Black members of Congress, they won’t be the first people of color to serve. They’ll be joining Reps. Mark Takano, D-Calif, an Asian American who in 2012 became the first person of color to serve in Congress, and Sharice Davids, D-Kan., who in 2018 became the first openly gay Native American member of Congress.

On the local level, Todd Gloria, who is half Native American and part Filipino, Puerto Rican and Dutch, became the first LGBTQ person elected mayor of San Diego. The mayor-elect, who is currently a member of the California state Assembly, will soon join Chicago’s Lori Lightfoot as the only LGBTQ people of color holding mayorships in major U.S. cities.

“It is an uphill battle for LGBTQ people of color to be in a position to run for high-level office, much less win, so Todd’s victory is a pivotal moment for San Diego and the country,” former Houston Mayor Annise Parker, who is currently president and CEO of the LGBTQ Victory Fund, said in a statement. “Todd shattered a rainbow ceiling and is now the second-highest ranking LGBTQ mayor in the country. His voice and his impact on critical issues — and especially civil rights — will extend far beyond the boundaries of his city and state.”

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3 LGBTQ Trailblazers Among 2020 MacArthur ‘Genius Grant’ Winners

Anthropologist Mary Gray, who said her research focusing on queer and other underrepresented communities often was seen as a “marginal topic” in some academic circles, never thought she would have access to a grant that would give her over half a million dollars with no strings attached.

All that changed when Gray was chosen as one of this year’s MacArthur Fellows, which will provide her with a $625,000 grant from the MacArthur Foundation that she can use in any way she chooses. The fellowship, commonly referred to as the MacArthur “genius grant,” counts essayist Susan Sontag, journalist Ta-Nehisi Coates, filmmaker Errol Morris and playwright Lin-Manuel Miranda among its past recipients. This year, there are 21 fellows from fields as varied as astrophysics and choreography, and each will receive the same amount of money, which will be disbursed over five years.

Gray, 51, is one of three LGBTQ MacArthur “geniuses” in the Class of 2020 who spoke with NBC News about their work, their plans for the grant money and the diversity of voices in this year’s class. She is joined by writer Jacqueline Woodson and econometrician Isaiah Andrews.

“This is for every queer kid out there,” Gray said of her selection. “The last thing I would have thought was that the work I do would be acknowledged in this way.”

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Gray’s recent academic work explores how the digital economy has transformed labor, identity and human rights. Driving this research is her past research on how queer people in rural America have used the internet to form communities around their identities, which stems from her upbringing in California’s rural Central Valley. She is currently a faculty associate at Harvard University’s Berkman Klein Center for Internet and Society, while also maintaining faculty positions in the anthropology and gender studies departments at Indiana University.

Gray said she doesn’t know exactly how she’ll use her MacArthur grant money, but she said it will likely be used to help with her pandemic response network research, which is being run through Duke University’s health center to support the marginalized communities hit hardest by the Covid-19 health crisis.

The McArthur grant means Gray “can look at the projects I’m doing and the political activism I care about and feel like I can support that work and support myself at the same time.” She described the ability to pursue any direction she wants in her research as liberating, but also a reminder of the immense privilege being bestowed the grant means.

“If anything, it is galvanizing me to push people to think about who’s not supported right now,” she said. “This is a moment of solidarity. None of us really move forward if we’re not holding each other together and moving forward together.”

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Andrews, 34, is a professor in Harvard’s economics department whose work explores new statistical methods to counter potential biases in the field of econometrics. Andrews, who is Black and gay, said it’s important for people to see people of color and LGBTQ people at the highest levels of his field.

“I hope that my getting this grant will help to demonstrate and show that there is room for success from a wide variety of folks in the economics profession,” the Massachusetts native said. “While the profession is not as diverse as it should be and has a lot of work to do, to its credit, is at least it’s trying to do some of that work.”

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As he continues his research, Andrews said having a secure source of additional income for the next five years is thrilling. Like Gray, he does not have an immediate plan for what the money will be used, but he said he hopes it will put a “spotlight on the importance of thinking carefully about statistical methods” that are developed and can contain hidden biases.

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Woodson, 57, said she already knows how her MacArthur grant money will be used: to expand an artist residency program she runs in Brewster, New York, for people of color, called Baldwin for the Arts. The author of numerous children’s books, a memoir and adult fiction novels, the Brooklyn resident was also one of the founding faculty members of Vermont College’s MFA in Writing for Children and Young Adults.

The goal of the residency is to give writers and visual artists a community and safe space to invest in their work and the time to grow and create. The residency was started with a grant from the Swedish government and has slowly been expanding through personal contributions by Woodson. Now, with the grant money, the long-term, expanded dreams of the residency feel closer than ever, she said.

“I learned very young what it meant to be in a space where I felt 100 percent inside my body, and be around people I didn’t have to explain to,” Woodson said. “I think that a lot of us do know what we need, but can’t even fathom it. A space like this would allow people to start thinking about the importance of self-care and this kind of attention to creation of their own art.”

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Majority of LGBTQ Youth Experiencing Anxiety, Depression amid Covid, Poll Finds

A majority of LGBTQ youth reported experiencing symptoms of anxiety or depression amid the pandemic, according to poll released Friday by Morning Consult and The Trevor Project, an LGBTQ youth suicide prevention and crisis intervention organization.

The poll surveyed 1,200 people across the U.S. between the ages of 13–24 in late July, including 600 lesbian, gay, bisexual, transgender and queer youth and 600 non-LGBTQ youth.

Stay-at-home orders have led to some LGBTQ youth being stuck inside in unsupportive households, which could lead to adverse mental health affects, as well as limited opportunities to get needed care, according to the survey. Nearly 1 in 4 LGBTQ youth who responded said they were unable to access mental health care because of the pandemic.

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Three-fourths of LGBTQ respondents said they were suffering from increased loneliness since the pandemic began, with 55 percent reporting symptoms of anxiety and 53 percent reporting symptoms of depression in the two weeks preceding the poll. The survey found non-LGBTQ respondents were 1.75 times more likely than LGBTQ youth and 2.4 times more likely than trans and nonbinary youth to exhibit no signs of either anxiety or depression.

Over one-third of LGBTQ youth surveyed said they were unable to be themselves at home, and nearly one-third of transgender and nonbinary youth reported feeling unsafe in their living situation since the start of the pandemic.

“This year has been difficult for everyone, but it has been especially challenging for LGBTQ youth, and particularly Black LGBTQ youth, who have found themselves at the crossroads of multiple mounting tragedies,” Amit Paley, CEO and executive director of The Trevor Project, said in a statement.

Paley said that since the onset of the pandemic, the volume of youth reaching out to his organization’s crisis services programs has, at times, been double its pre-Covid-19 volume.

“We’ve known that LGBTQ youth have faced unique challenges because of the countless heartbreaking stories we’ve heard on our 24/7 phone lifeline, text, and chat crisis services; but these findings illuminate the existence of alarming mental health disparities that must be addressed through public policy,” he stated.

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Compounding the negative effects of stay-at-home orders related to the public health crisis are the ongoing news reports and social media videos of violence against Black Americans and reports of police violence against people of color.

A majority of LGBTQ youth said the ongoing unrest had negatively affected their well being, with 78 percent of Black LGBTQ youth saying they had been negatively affected. Of that, 44 percent of Black LGBTQ youth said their well being had been negatively affected “a lot.”

Only 8 percent of Black LGBTQ youth said police in their neighborhood were there to protect them, which reflected a larger trend of 71 percent of LGBTQ youth in total reporting that they deeply distrust the police.

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.

If you are an LGBTQ young person in crisis, feeling suicidal or in need of a safe and judgment-free place to talk, call TrevorLifeline now at 1-866-488-7386.

/ /

Coronavirus Pandemic Strains LGBTQ Health Clinics

Lyon-Martin Health Services in San Francisco has served the health needs of lesbians, transgender women and other underserved women in the Bay Area since 1979. Named after pioneering lesbian activists Phyllis Lyon and Del Martin, the clinic had until recently been seeing 3,000 patients a year for such needs as physical exams, gynecologic services and consultations for gender-affirming surgeries.

Now, however, it is fighting to keep its doors open amid the coronavirus pandemic. Thanks to emergency funding from the city and private donors, it will be able to operate until July 1 without deep cuts to its services — which now include screening for COVID-19 — but its future is uncertain after that.

“The city needs to see how long COVID is going to play out,” J.M. Jaffe, the transgender health manager at Lyon-Martin, told NBC News. “They wanted to do a short-term contract so that we could re-evaluate what the situation will be in two months. I think they were just wary to make a commitment to continue to support us, but we did get kind of like a wink and a nod that they would like to support us to the end of the calendar year.”

Lyon-Martin Health Services is one of over 200 LGBTQ health clinics across the United States that provide affirming and competent care to lesbian, gay, bisexual, transgender and queer patients. And like Lyon-Martin, a number of these centers are struggling to adjust to — and in some cases survive — the new normal spawned by the global pandemic.

‘A gap of a support network’

Approximately 13 percent lesbian, gay and bisexual individuals in the U.S. reported getting their regular health care from an LGBTQ-centered clinic, according to a 2019 study from UCLA’s Williams Institute. A separate study found nearly 40 percent of transgender people reported having been to an LGBTQ clinic in the previous five years.

“We provide services to a population that may not seek care elsewhere or even if they do seek it elsewhere, they may not get what they need,” Jaffe said.

Jen Kates, director of global health and HIV policy at the Kaiser Family Foundation, said if some of these clinics do not survive the pandemic, the void will be felt deeply, especially in areas of the country where LGBTQ people face high levels of discrimination.

“It leaves a gap of a support network, but also may not provide another opportunity or option in some communities to get nondiscriminatory care, which is a concern,” she told NBC News.

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LGBTQ discrimination in health care is not uncommon. A 2018 studyfrom the liberal Center for American Progress found 8 percent of lesbian, gay, bisexual and queer people and 29 percent of transgender people reported that a doctor or health care provider had refused to see them because of their sexual orientation or gender identity. The study also found that 9 percent of LGBQ people and 21 percent of trans people reported having a health provider use harsh or abusive language when treating them.

With the Trump administration moving to end Obama-era discrimination protections on the basis of sexual orientation and gender identity, LGBTQ advocates fear there could be an uptick in this type of discrimination.

Scrambling to adjust

The Callen-Lorde Community Health Center in New York City, the epicenter of the U.S. pandemic, is doing all it can to stay open and provide patient care amid stay-at-home orders and declining revenues.

The COVID-19 crisis has forced the center, which sees over 17,000 patients annually, to pivot to virtual health care and cut a number of services, leading revenues to plummet nearly 60 percent, according to Executive Director Wendy Stark. But with many of their patients not feeling comfortable seeking care elsewhere, Stark said she and her team are “being innovative” to stay open.

“We have lived through traumas and pandemics. We know how to take care of ourselves and each other.”

CALLEN-LORDE EXECUTIVE DIRECTOR WENDY STARK

Callen-Lorde is currently helping clients by providing a number of online services, including video visits for primary medical care, behavioral health and counseling, along with legal aid and insurance consultation services by phone. The center’s in-person services include appointments for those who do not have access to smartphones or internet connections, and those who are pre-authorized for in-person visits.

The clinic is also working to protect its own front-line workers, approximately 20 percent of whom contracted the coronavirus, according to Stark. She said regular floor nurses are now “acting as intensive care unit nurses,” and everyone’s “being stretched to their maximum clinical capacity” and “having to learn on the spot.”

“I’m sure, deeply rewarding but also deeply frightening,” she added.

While providing health services, Stark and her team are also applying for “every possible” relief fund or grant available to help make it through the crisis.

“We are shapeshifters,” she said. “We have lived through traumas and pandemics. We know how to take care of ourselves and each other.”

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In Philadelphia, the Mazzoni Center, which typically sees over 7,500 patients a year, is also trying to adapt. This has meant a combination of limiting in-person appointments on a case-by-case basis, implementing and expanding its remote health care offerings and finding ways to continue as many community programs as possible online.

Larry Benjamin, a spokesperson for the center, said the clinic has had to furlough some staffers and reduce the hours of others to keep it viable “in the short term”.

The center is still allowing abbreviated in-person appointments for things like HIV services and gender-affirming care, but Benjamin said staffers have been careful to ensure “the risks associated with exposure to the coronavirus” from patients to staff and vice versa don’t outweigh the benefit of in-person visits. Behavioral health services, such as medication management, support groups and counseling services, are being offered exclusively online, as are counseling for COVID-19 stressors. Most community programs have also been moved online, but those that cater to the “most vulnerable clients” and their basic needs, like food and shelter, are still operating in-person, according to Benjamin.

Image: Fenway Health
Fenway Health in Boston.Courtesy of Fenway Health

Fenway Health in Boston, which saw 33,500 patients in 2019, has also seen a loss in revenue amid the pandemic, leading it to furlough some staffers and operate at an “unsustainable deficit,” according to Chris Viveiros, a spokesperson for the center. To help weather the storm, he said the center has increased its virtual offerings.

“Some medical patients have chosen to reschedule nonurgent appointments, but we have ramped up our medical telehealth capacity so that we can provide care remotely to patients who don’t require an in-person visit,” he said. “We have also moved our behavioral health and addiction and wellness care to telehealth.”

Fenway Health has also changed its Access Drug User Health program from being held in drop-in centers to having staff visit at-risk people in the community to limit contact.

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There have been some drawbacks to Fenway’s remote health services: Some patients are sheltering in place with unsupportive people and have nowhere to privately participate in a video visit, while others may be skeptical of a new platform for accessing health services altogether.

“Many of our community served have a history of medical mistrust and ongoing mistrust of the health care system due to structural discrimination and victimization,” explained Dr. Alex Keuroghlian, director of the Fenway Institute’s National LGBT Health Education Center and Massachusetts General Hospital’s Psychiatry Gender Identity Program.

However, Keuroghlian said there have been some silver linings to Fenway’s new remote offerings. Primarily, many patients are able to access health care from the safety and comfort of their own home without having to venture outside, potentially exposing themselves to anti-LGBTQ abuse — or the coronavirus.

“By and large, I have found it has worked really well,” he said. “I’ve had almost no no-shows in my schedule, and patients are answering the phone very appreciative that we can give them care despite what’s happening.”