The Long Game of Pride.
The Long Game of Pride
This is a difficult time, but we cannot lose sight of our goal to create change that leads to healthier lives for all and for generations to come, writes Michael Stein in a note in honor of Pride Month.
Viewed with a half century perspective, a narrative of the LGBTQ+ community provides a story of many setbacks and more gains. There has been an astonishing uptick in the political, social and legal status of LGBTQ people in America and around the world over these fifty years. Yet this year, the month of Pride arrives with a ringing of alarms, a nervous sense of living under a regime of fear, and the expectation that the cultural transformation and improvement begun decades ago will be set back by the cruel ideology of the moment.
How did we get here? First, a brief look on the history of Pride and the progress and setbacks in the rights of LGBTQ populations.
Pride Month commemorates the anniversary of the Stonewall uprising, the June 1969 riot set off by a police raid on a gay bar in New York City. The moral courage of the citizens of that time remains hard to appreciate. Throughout history, homosexuality had been condemned as a sin, a crime, a sickness, or all three. Only in 1973 did members of the American Psychiatric Association vote to remove homosexuality from the DSM’s designation of mental illness. The first National March on Washington for Lesbian and Gay Rights occurred only in 1979. The onset of the HIV/AIDS Epidemic in 1981 steered much of the LGBTQ movement and American cultural politics for the next fifteen years. Only in 1995 did the count of AIDS-related deaths of gay men begin to fall, at the same time that the torture and murder of gay men began to pick up, and the arrival of “Don’t Ask, Don’t Tell” entered the cultural conversation.
Yet still, we saw some positive progress in the two decades that followed. In 2003, the Supreme Court case Lawrence v. Texas finally decriminalized gay sex across the United States. The historic success of the same-sex marriage movement led to the Court’s Obergefell v. Hodges decision that certified the fundamental right to marry is guaranteed by both the Due Process Clause and the Equal Protection Clause of the Fourteenth Amendment of the Constitution.
Generational changes led to increased awareness of a broader, more inclusive framework affirming the rights of nonbinary and transgender populations. And concurrently, there was a rise in legislative battlegrounds and cultural debates—bathrooms, sports, and “gender ideology.”
The work done over this half century has powerfully demonstrated that social justice work is inherently intersectional. For example, queer Black women were founders behind the Black Lives Matter movement; queer organizers are central in the fight for immigrants’ rights; and two of the country’s largest labor unions, Service Employees International and the American Federation of Teachers, are led by lesbians.
This brings us to where we are now, today. In public health broadly, we are facing the greatest threats of the past fifty years. Research projects with the potential to save lives have been abruptly shut down. The political attack on science in general has had particular targets. Studies of LGBTQ+ health are considered “junk science” by the current federal administration. Grants have been terminated, researchers’ careers have been devastated, and the people, families, and communities those researchers investigate, the people who joined studies to share their stories, have been abandoned. In the first week after inauguration, the NIH pages for the Sexual & Gender Minority Research Office disappeared and in the subsequent four months the Department of Health and Human Services eliminated 215 grants totaling half a billion dollars for research or education on gender-affirming treatment. The National Institute on Health’s official strategic plan language “to advance equitable biomedical research” has been sneered at, then ignored.
Since 2015, the NIH has been funding studies to advance research on the health and well-being of LGBTQ populations. Based on limited information, it appears that LGBTQ people disproportionately experience certain cancers, including anal and colorectal cancers, breast and cervical cancers, skin cancer, prostate cancer, and lung cancer. Surveys conducted by The Trevor Project on the mental health of LGBTQ youth find that this population considers and attempts suicide at frighteningly high rates, and nearly one third say their mental health is poor “most of the time or always” presumably due to mistreatment and stigmatization and the experience of anti-LGBTQ policies and legislation.
What remained inconceivable for too many of the past fifty years was a positive image of gay life and love. We sometimes forget that before the current era of Queer Eye and Drag Race such images seemed revolutionary and were rarely reflected in mainstream media. Pride month then is not only a celebration of the 7.1 percent of Americans who identify as LGBT, but also a recognition of the support of parents, siblings, aunts, uncles, grandparents, and friends. Respect from family members and the community makes a big difference in the lives of those who feel harassed, where the sense of isolation can feel profound. Virginia Apuzzo, once the head of the National Gay Task Force, describes shedding shame as “having the right to breathe out loud.”
But the vision of acceptance and integration remains shadowy. Roughly one quarter of the corporate donors to this year’s New York City annual Pride festivities have either canceled or scaled back their support. Many CEOs fear that the current administration could punish those viewed as supporting a celebration of gay and transgender rights. Money aside, not everyone can speak out. Researchers fear professional retaliation or personal attack. LGBTQ people remain wary of self-identifying. Access to clinical services in many states for gender affirming care has been limited and physicians threatened.
The sounds of celebration in the LGBTQ community have become decidedly muted in 2025. For a community with a history of accomplishments, more struggle lies ahead. Pride is a long game, and it is on us in public health to do all in our power to protect and to continue to advance the health of LGBTQ populations. This is a hard time, but we cannot lose sight of our goal to create change to create healthier lives for all and for generations to come.
Michael D. Stein, MD
Dean Ad Interim
Boston University School of Public Health
mdstein@bu.edu
Previous Public Health Matters are archived at: https://www.bu.edu/sph/news/articles/category/public-health-matters/
