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Dr. Rachel Levine speaks with trans youth at D.C. health clinic

Youth Pride Clinic is one of the few clinics in the nation to provide primary care & mental health services to LGBTQ youth from ages 12 to 22

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Dr. Rachel Levine, Assistant U.S. Secretary for Health and Human Services (Washington Blade photo by Michael Key)

WASHINGTON – It’s not unusual for Rachel Levine as assistant secretary of health to visit medical facilities on behalf of the Department of Health & Human Services. But her visit last week to the LGBTQ youth clinic at the Children’s National Medical Center was special because she was able to meet with transgender youth as an openly transgender presidential appointee.

The visit on Thursday by Levine at the D.C.-based hospital comes not long after the U.S. Senate approved her appointment, making her the first openly transgender presidential appointee to win a Senate-confirmed position. As such, her visit to the LGBTQ youth clinic, where transgender kids come for transition-related care and health services, held particular significance for the patients.

Levine, speaking with the Washington Blade at the end of her visit, said having the opportunity to speak with both transgender youth and medical professionals testing them was “tremendously, tremendously rewarding”

“It’s tremendously gratifying to be able to speak to the medical professionals and the clinic personnel at beds, particularly to the youth and their families from my experience,” Levine added. “So I have two aspects of that. One is that I’m a pediatrician and adolescent medicine specialist. So I’ve been teaching to children and their families my entire career, but the other is coming from my lived experience as an openly transgender woman, and so I find it tremendously rewarding.”

The warm environment of the hospital for children is readily apparent upon entering the main atrium of the building. Lights dressed up as hot air balloons fill the tall ceiling while a nearby TV shows music videos consisting of squares of kids’ faces singing, followed by easy-listening country music and Asian K-pop. Children and their parents await their appointments seated in comfy plush red chairs before white blocks meant for use as tables.

Key to Levine’s visit was taking part in a discussion at the hospital auditorium with three transgender youth and their families who obtain services at the clinic. During the question-and-answer period, Levine shared her experience as a transgender person who underwent transition later in life and went on to tremendous success as a high-ranking presidential appointee.

For the transgender youth, Levine’s presence at the hospital — at a time when state legislatures are busy enacting bills to restrict their access to medical care and school activities — serves as a reminder that barriers based on gender identity are breaking down and the sky’s the limit for their future.

After the question-and-answer session, Levine told the Blade she “learned a lot” about the Children’s National Medical Center, which she called “a world-renowned children’s hospital and academic medical center.”

“I’ve known about it before,” Levine added. “I’m a pediatrician, adolescent medicine specialist, but I learned more about what they’re doing. And I learned specifically about their gender clinic, where they take care of transgender and gender non-conforming youth and got to meet some of the staff as well as the kids and their families.”

The Youth Pride Clinic, which opened in 2015, is one of the few clinics in the nation to provide primary care and mental health services to LGBTQ youth from ages 12 to 22. Among the services offered are hormone replacement therapy, STP/STI treatment and PrEP services as well as individual and family therapy for transgender youth.

Among the transgender youth patients at the clinic who spoke to the Washington Blade was Amir, a 15-year-old Georgia native whose last name as a minor is being withheld for confidentiality purposes.

“I started out in fifth grade coming out as lesbian,” Amir said. “I didn’t even really know, but when I came out to my grandma in Georgia, where I’m from, I still didn’t feel like myself. So then, later on, me and my friend researched, and next thing you know we came across the term transgender, and I was like, ‘This is who I am. This is me.’”

Amir said he began taking shots as part of care regimen in January. Being able to receive care from the Youth Pride Clinic, Amir said, means a lot because he has an opportunity not available to other transgender youths, who face challenges and even hostility as they make the journey to transition. The staffers at the Youth Pride Clinic, Amir said, are “like a second family” who work hard to provide the services they offer.

Sonia Murphy, Amir’s aunt who became his legal guardian, said when she began reaching out for medical help for Amir she found a two- or three-year wait list to get access to treatment, which she said makes her “saddened” such care isn’t widely available.

“There’s a population of kids and parents out there who need the services and just can’t access it because there’s not enough bandwidth, not enough manpower,” Murphy said.

Amir said he’s getting other avenues of support from his two cousins, one who is older at age 18 and one who is younger at age 12. “They’re like sisters to me, so I call them my sisters,” Amir said. Amir also identified two other male cousins as well as his uncles and his aunt.

“They’re all very supportive of me,” Amir said. “My auntie Tonya, for example, Pride month came up, first day, she sent me a paragraph, saying, ‘I’m glad you’re yourself and you’re open to who you are and things like that,” and that I’m not afraid to be who I am around anybody. It’s just things like that. And for my birthday, I had tons of Pride shirts, and I got a rainbow shirt with the fist in the middle for Black Lives Matter, and it was a ton of different things.”

Lawrence D’Angelo, director of the Youth Pride Clinic and an occupational health adolescent medicine specialist, told the Blade being able to start the facility in 2015 in and of itself was one of the key victories for the initiative, although he said the Children’s National Medical Center has been providing transition-related care since 1998.

“When we started it…we thought that we were going to be running a PrEP clinic, that we were going to be providing preventive services to LGBTQ kids,” D’Angelo said. “The first day, the first patient actually came in and asked for PrEP, and the other six patients that were scheduled that day all wanted transgender services. So, suddenly, it became obvious what we were going to be spending 90 percent of our time doing, which is exactly what we think we should be doing, because that’s where the need is the greatest.”

Despite the advantages of having access to the Youth Pride Clinic, transgender youth have clear challenges and face hostility based simply on their gender identity, especially in a year when state legislatures have in an unprecedented manner enacted legislation against them. The Youth Pride Clinic, in many ways, is an oasis of support.

Arkansas, for example, enacted a measure that would make criminal the kind of services provided at the clinic. Other states have enacted measures prohibiting “biological boys” from participating in sports, which essentially bars transgender girls from participating in sporting events.

While anti-trans measures aren’t being enacted in D.C. or any nearby states, the advancement of anti-trans legislation in states has had a negative effect on transgender patients at the Youth Pride Clinic.

D’Angelo, based on conversations he’s had with the patients, said they’re aware of the wave of legislation, which he said has led to fear, anger and being “unable to understand what is happening and why it’s happening.”

Amir said watching states enact legislation against transgender youth “makes me feel some type of weight,” pointing specifically to the anti-trans sports measures because he said he’d welcome the opportunity to participate in athletics.

“I’m athletic,” Amir said. “I do all types of sports. I play basketball, soccer, I’m going to do boxing…With sports and stuff, I just feel like I want to be able to do everything, just as a regular cisgender person will be able to do,”

Amir, despite the enactment of anti-trans laws, has an optimistic outlook and said the enactment of state measures against transgender youth demonstrates they’re now “on the radar” of the social conservative movement.

“I feel like if everybody who’s a part of LGBTQ and trans together, we can stand up and we can overcome this because the thing is, there are so many people out there who don’t understand what we do, and the thing is that they’re noticing us, so that’s a start to something big.”

Amir (Photo by Michael Key)

With many states hostile to transgender youth, others are looking to the federal government for support under the Biden administration. On his first day in office, Biden signed an executive order directing federal agencies to implement the U.S. Supreme Court’s decision against anti-LGBTQ discrimination to the fullest extent possible.

Levine cited an announcement from HHS that resulted from this order on implementing regulations prohibiting anti-LGBTQ discrimination in medical care, reversing a policy under the Trump administration that green lighted discrimination, as one of the ways it has answered that call and helped families like the Youth Pride Clinic.

“So the Affordable Care Act says that you cannot discriminate based upon sex,” Levine said. “The Department Health & Human Services and the Office of Civil Rights has interpreted sex to include sexual and gender minorities, to include sexual orientation and gender identity, which means LGBTQ individuals under that. So we need to look at all aspects of the Affordable Care Act, and to work to implement that interpretation of the statute. That was only done a month or so ago, so we’re going to be working on that now.”

Is there anything more the federal government can do to support the clinic? D’Angelo cited a number of key things already secured, including the hospital being able to offer insurance to patients and the affirmation from HHS against anti-LGBTQ discrimination. More research dollars and greater focus from the National Institutes of Health on gender diverse and sexual minority individuals, D’Angelo said, would also be welcome.

“There are things out there that the federal government can do, but I think…there are limitations of what they can do,” D’Angelo said. “They can’t, unfortunately, effect what’s going on in individual states, which is, in some cases draconian. That’s an awful thought if we were practicing medicine in Arkansas, we could be in jail.”

Meanwhile, Levine said the Biden administration, including Secretary of Health & Human Services Xavier Becerra, is working on both internal and external policies to facilities like the Youth Pride Clinic to help them secure their place in the health system and reach transgender youth.

“The secretary and I will be doing everything we can to advocate for the LGBTQ community,” Levine said. “So I think we’re going to be working externally, in terms of advocacy, and then we’re going to be working internally in terms of policy.”

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Coronavirus

Fauci says CDC may now back masks as Delta variant explodes

Caused by the Delta variant, 40% of all cases reported in the United States occurred in three states, Texas, Missouri and Florida.

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WASHINGTON – Dr. Anthony Fauci told CNN’s Sunday morning political talk show “State of the Union” that he’s taken part in conversations about the U.S. Centers for Disease Control and Prevention altering its masking guidelines, which he described as being “under active consideration.”

Fauci, the chief medical advisor to President Joe Biden, also acknowledged that in some jurisdictions where infection rates are surging are already mandating individuals to wear masks in public regardless of their vaccination status. He added those mandates are not incompatible with the CDC’s recommendation that the vaccinated don’t need to wear masks in public.

CNN’s Jake Tapper pointed out that in the most recent surge caused by the Delta variant, 40% of all coronavirus cases reported in the United States occurred in three states, Texas, Missouri and Florida. Tapper and Fauci both noted that the sudden explosion in COVID-19 was primarily caused by those Americans, 12-years-old and older who remained unvaccinated.

Politico reported that the Republican governor of Arkansas on Sunday said resistance to the coronavirus vaccine “has hardened” in some areas of the state, blaming the hesitancy on “false information” and “myths.”

“I don’t know if I underestimated it, but, certainly, the resistance has hardened in certain elements, and is simply false information,” Gov. Asa Hutchinson said in an interview on CNN’s “State of the Union.”

“It is myths. As I go into these town hall meetings, someone said: Don’t call it a vaccine. Call it a bioweapon. And they talk about mind control,” Hutchinson said. “Well, those are obviously erroneous. Other members of the community correct that.”

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Coronavirus

Breakthru LA COVID cases at 20% in June but only .0059% hospitalized

The Delta variant is one of the most aggressive and infectious respiratory diseases and currently makes up over 80% of cases in L.A. County

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Photo Credit: County of Los Angeles

LOS ANGELES – As the number of coronavirus cases continue to explode across the Los Angeles region and the nation, there is now also focus as to the number of cases of fully vaccinated individuals getting infected with COVID-19.

According to the Centers for Disease Control and Prevention, (CDC) the indicators and thresholds for community transmission of COVID-19, Los Angeles County is now at the level of high community transmission. This is due to the more infectious Delta variant and the intermingling of unmasked individuals where vaccination status is unknown.

CDC officials and Public Health officials stress that while breakthrough cases are occurring, being fully vaccinated offers protection against risk of hospitalization and even death.

Available data from the California Department of Health details that break-through cases reached 20% in June in Los Angeles County, but only .0059% of those cases were hospitalized.

While overall the COVID-19 cases are still at a much lower point than they were during any of the previous surges, the rate of increase between July 3 and 16 was 135%. The last time cases rose as quickly as they are now was in early December of last year during the winter surge.

“The Delta variant is one of the most aggressive and infectious respiratory diseases known, and currently makes up over 80% of sequenced cases in L.A. County. We do, however, have a very powerful tool in the COVID vaccinations. With unvaccinated individuals comprising over 90% of those currently hospitalized, the ability of the three vaccines to protect us from serious illness caused by the Delta variant is well established,” said Barbara Ferrer, Director of Public Health.

“If we didn’t have 5.3 million people fully vaccinated in L.A. County, we would probably be seeing almost double the number of cases today,” said Ferrer. “As cases continue to rise, many of us are trying to figure out what steps to take to minimize exposure to the virus.” 

Ferrer added that “now would be an important time” for those eligible to get the vaccine but haven’t yet.

“For everyone, common-sense precautions including masking when indoors, frequent handwashing and avoiding crowds, will reduce your risk while allowing you to continue to enjoy the activities you love,” she said.

In one of the more widely reported Delta related breakthrough clusters occurring over the 4th of July holiday weekend break in Provincetown, Massachusetts, the Massachusetts Department of Public Health said in a statement Friday that genetic sequencing of initial samples associated with the the Provincetown cluster tested positive for the variant.

It said two labs, the Massachusetts State Public Health Laboratory and the Broad Institute of MIT and Harvard, have “identified the Delta variant in cases associated with this cluster.”

Provincetown, Massachusetts is a major holiday and summer designation for the LGBTQ community and there have been multiple reports of holiday travelers returning home from the July 4th weekend testing positive for coronavirus.

“The Delta variant is known to be more transmissible than the original COVID-19 virus,” the department said. “Individuals infected with the Delta variant tend to have more virus in their respiratory tract than other variants and infected individuals may carry the virus longer.”

About 83 percent of new Covid-19 cases in the U.S. this month are Delta variant infections, and experts say the variant is behind the new wave of nationwide infections.

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Health

COVID claims life of anti-vaxer from SoCal Hillsong Church

He also was defiant once admitted to hospital declaring; “… I will not be getting vaccinated once I am discharged and released.”

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Graphic via KCAL CBS LA

LOS ANGELES – A Corona, California man who tweeted about his refusal to get a coronavirus vaccination and mocking the severity of the disease died from complications of COVID-19 after being intubated at Corona Regional Medical Center, about an hour East of Los Angeles in Riverside County.

Stephen Harmon, 34-year-old, in what was his last tweet from his now-protected Twitter account was written Wednesday, just before he was intubated.;

“I’m choosing to go under intubation, I’ve fought this thing as hard as I can but unfortunately it’s reached a point of critical choice & as much as I hate having to do this I’d rather it be willingness than forced emergency procedure. don’t know when I’ll wake up, please pray.”

In the weeks leading up to his death, Harmon had tweeted modified Jay-Z lyrics, “If you’re having email problems, I feel back for you, son. I got 99 problems, but a vax ain’t one.” He also tweeted; “Biden’s door to door vaccine ‘surveyors’ really should be called JaCovid Witnesses. #keepmovingdork.”

He also was defiant once admitted to hospital suffering from serious Covid-19 complications, declaring on his now private Instagram account “… I will not be getting vaccinated once I am discharged and released.” He had also posted photos of himself from his hospital bed. He wrote that he had pneumonia and was at risk of brain damage due to his low oxygen levels. The next day he was intubated and later died.

Hillsong Church founder global senior pastor Brian Houston announcing Harmon’s death on social media wrote; “Stephen was just a young man in his early 30s. He was one of the most generous people I know and he had so much in front of him.”

Houston expanded on his social media posts in a statement to CNN, saying that “any loss of life is a moment to mourn and offer support to those who are suffering and so our heartfelt prayers are with his family and those who loved him.”

“On any medical issue, we strongly encourage those in our church to follow the guidance of their doctors,” Houston said, emphasizing that the church’s focus was on spiritual well-being.

KCLA CBS Los Angeles reports, WATCH:

 

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