This Proposed Michigan Law Would Force Trans People in Prison to Pay For Their Own Medical Care

In the last few years, incarcerated trans people have gained significantly more access to gender-affirming medical care. In January 2017, a California woman named Shiloh Quine made history by becoming the first trans person to receive gender confirmation surgery (GCS) in a U.S. prison. Since then, courts in Oregon, Missouri, and Idaho have struck down policies that prevented trans people from accessing hormones or GCS while on the inside.

But not everyone is happy with the development. In November, Michigan state legislator Beau LaFave introduced a bill that would force incarcerated people to pay for the full cost of any transition-related surgery. The proposed legislation, HB 6524, also called for prisoners to pay for any medical care related to acts of self-harm.

HB 6524 wasn’t even passed into committee during the 2018 legislative session and it stands little chance of becoming law in 2019. But the introduction of the bill is still important, because it indicates the continuing reluctance of some Republican legislators to accept that the legal landscape is changing – that in the eyes of the medical establishment, and increasingly in the eyes of the courts, GCS is not elective and therefore must be treated as a medically necessary procedure akin to any other.

Shawn Meerkamper is a staff attorney with the Transgender Law Center, the largest trans-led civil liberties organization in the country. HB 6524 is “pretty clearly an attempt to find a loophole” to the growing legal consensus that blanket-bans on GCS are unconstitutional, Meerkamper told INTO. “This level of really singling out and targeting transgender people, and the kinds of medical care they need, I don’t think would hold up in light of day.”


The road to HB 6524 began in 2016, when a transgender woman named Jami Naturalite wrote to the Southern Poverty Law Center (SPLC) to say she was being denied hormone therapy by the Michigan Department of Corrections (MDOC). The SPLC had just finished litigating a similar case in Georgia, securing a settlement that ensured trans people locked up in the state could access hormones even if they hadn’t been prescribed them before entering prison. The Georgia settlement marked an important shift in policy on the state and national level. In a statement of interest filed in the case, the Department of Justice reminded state officials that “prison officials have the obligation to assess and treat gender dysphoria just as they would any other medical or mental health condition.”

After Naturalite reached out to the SPLC, the organization contacted Michigan prison officials to explain why blanket prohibitions on transition-related care were unconstitutional. Their entreaties were successful. In June 2017, the MDOC released a new policy for the care of transgender prisoners, which facilitated access to hormone treatment and allowed for the provision of GCS on a case-by-case basis.

Naturalite was thrilled with the news, but Republican Representative Beau LaFave, who represents a district on the northern shore of Lake Michigan, was not. With the release of the new transgender care policy, LaFave grew concerned that transition-related care, like all other medical care provided to prisoners, would be paid for by state residents. “When I found out that taxpayers could be on the hook for [GCS] procedures I had the bill drafted and introduced,” he told INTO in an email.

Michigan Rep. Beau LaFave (R-Iron Mountain). Photo via
Michigan Rep. Beau LaFave (R-Iron Mountain). Photo via

“I have nothing but respect for all individuals regardless of their particular life choices or personal feelings,” Representative LaFave added. “That being said, I do not believe the taxpayers of the State of Michigan should pay for felons to get free gender reassignment surgery while in prison. Law abiding citizens do not get free gender reassignment surgeries. Why should felons at the taxpayers’ expense?”

Asked to respond to LaFave’s comment, Meerkamper explained that there’s now a broad consensus among medical professionals that GCS constitutes a medically necessary treatment for some transgender people. “You cannot ‘respect’ someone while writing legislation to deny them live-saving health care,” said Meerkamper.

Jay Kaplan, the staff attorney for the American Civil Liberties Union of Michigan’s LGBT Project, stressed the constitutional concerns raised by LaFave’s bill. “Singling out a group of people to say, you’re not entitled to health care to the same extent as other inmates might be entitled to medically necessary healthcare, raises equal protection concerns,” he said. As drafted, HB 6524 would arguably also violate protections against cruel and unusual punishment, said Kaplan, since it would amount to a denial of life-saving medical care to prisoners who cannot afford to pay for surgery out of pocket.

It’s unlikely that HB 6524 will ever become law. There appeared to be little support for the legislation in last year’s legislative session, and when asked by INTO, LaFave said he had no plans to introduce the bill again. Even if it somehow did pass through both legislative chambers, HB 6524 would likely to vetoed by the newly sworn-in Democratic Governor, Gretchen Whitmer, according to advocates. LaFave first won his seat in 2016 at the age of 24 and was re-elected last year. According to the Michigan Campaign Finance Network, one of LaFave’s top donors is the DeVos family, who have previously come under criticism for making contributions to anti-LGBT groups.

While it might not pose an immediate threat to the well-being of Michigan’s trans prisoners, HB 6524 does reflect how some Republicans in the socially conservative state think about trans rights.

“This is such a flawed [bill], and obviously it’s an attack on trans people,” said the ACLU’s Kaplan. “What it’s saying is you’re not entitled to healthcare the way everybody else is.”  

Michigan has lagged behind many other states when it comes to protecting transgender residents. The ACLU of MI had to sue the state to make it easier for transgender people to change their gender marker. Many residents still struggle to access transition-related care under Medicaid, said Kaplan. In Michigan and 18 other states across the country, there are no statutes in place that specifically protect people who are discriminated against on the basis of their gender identity.

“[We] have a long way to go in making things more supportive and better for trans people in the state,” said Kaplan.

For now, the question may be how to ensure that the MDOC lives up to the policy it put in place in 2017. Kaplan said he was not aware of any prisoner in Michigan who has received GCS – which may indicate that while the transgender care policy looks good on paper, it isn’t actually enabling trans prisoners to receive comprehensive care.

Before Shiloh Quine received her surgery, when she thought the California state prison administration would never approve the procedure, she tried to kill herself. For her and many other trans prisoners across the country, GCS can be lifesaving. “Whenever the state incarcerates someone, the state is taking that person’s life into their hands,” Shawn Meerkamper told INTO. “And then to take care of their needs, and their medical care is chief among them.”

‘Lindsay Lohan’s Beach Club’ is a Mess, and I’m Not Sure It’s in a Good Way

Lindsay Lohan isn’t a regular boss — she’s a cool boss.

In her new MTV reality show, Lindsay Lohan’s Beach Club, we see the former child star in a novel role: reformed messy celebrity-turned-business owner. Beach Club tells the story of Lohan and her horny new brand ambassadors recruited from all over the United States to come work at her beach club in Mykonos — the very same beach club where Lohan was filmed doing her strange dance a few months ago.

The cast members all sleep in the same place, some sharing rooms, in the style of MTV’s reality show classic, The Real World. Before I watched the pilot, I accidentally watched a promotional episode that showed brief vignettes to introduce us to Lohan’s new employees. If I hadn’t, I would have absolutely no idea what makes any of these people distinct, because besides one of them having blue hair, they’re virtually all the same. They’re all used to working in nightlife as promoters and bartenders, and now they’re traveling to Mykonos together.

The first episode of Beach Club basically follows the brand ambassadors on their first couple of days in Mykonos, meeting Lohan and training for their first day of work. All of the ambassadors are straight aside from Mike, who is the hunky bisexual from New Jersey. I sense that we’ll get one experimental kiss between Mike and another castmate by the end of season two.

On the first night, we watch the brand ambassadors enjoying dinner at the table before undressing and jumping in the pool for some flirty tension. But then — surprise: Lindsay shows up at their residence to meet them for the first time. Perfectly natural for your boss to show up at your house at night for a surprise visit after you and your coworkers get hammered. Not at all produced. In this scene, Lohan expresses some doubts about how serious some of her new ambassadors are, but really it’s just badly-manufactured tension.

Throughout the entire pilot, the producers frame Lindsay both as a reformed mess and also as an authority figure — and that’s a weird balance to try and strike. While an unannounced visit is something that might happen on a more competitive show like America’s Next Top Model or The Bachelor, that is not what Beach Club is supposed to be. It’s moments like this that make it extra hard to find Lohan convincing as a boss.

BILBAO, SPAIN - NOVEMBER 04:  Lindsay Lohan poses at the MTV EMAs 2018 studio at Bilbao Exhibition Centre on November 4, 2018 in Bilbao, Spain.  (Photo by Gareth Cattermole/MTV 2018/Getty Images for MTV)
Reformed mess Lindsay Lohan hawking for the brand.

The first day follows one brand ambassador in particular. Brent, the resident douche of the cast, is put in charge of managing the pool’s VIP cabana area while everyone else is… off doing other work things? It’s unclear and the show doesn’t really care. A lot of the episode revolves around the flirty relationship between him and the female VIP client — they go swimming together, into dressing rooms together, they kiss. This later comes up when another ambassador, Jonitta, points out that if she were doing anything that Brent was doing with a man, she would get attacked for it, and she’s annoyed at the double standard. That is pretty much the main drama for this episode.

And that’s kind of the problem. Aside from Lindsay, we don’t know these people and none of them know each other, so it’s hard to understand what the stakes are. In contrast, there are many reasons why Vanderpump Rules works as a show centered around Lisa Vanderpump’s employees. First, the cast members all knew each other before the show started. In fact, according to a profile in Vogue, Lisa Vanderpump pitched the show with “an outrageous diagram of hookups, breakups, cheating, and fights between her servers, bartenders, and bussers, all of whom, as in Los Angeles restaurants at large, were very good looking.” The point of the show is that the story was already baked-in, and the audience is just along for the ride. Plus, the heart of the show comes pretty naturally because Lisa Vanderpump herself fits very nicely in the role of omnipotent ruler. She’s believable as an authority figure and as a boss, which is super important for a show centered around a workplace and its ensuing staff drama

One of the better scenes of the Beach Club pilot is when Lindsay is comforting May, another new ambassador, who is feeling overwhelmed on her first day. It’s the one time in this episode Lindsay seems convincing as a boss. Then, just a couple scenes later, Lindsay is trying to tell Gabi, one of the other castmates, that May is feeling down — and asks Gabi to check in on how May is feeling. The problem is, Lindsay literally doesn’t remember May’s name. She keeps describing her as “one of the other ambassadors,” and all the heart that they put into their tender moment kind of goes away.

These scenes serve as a nice summary of what Lindsay Lohan’s Beach Club feels like so far. The premise, the cast, the Lindsay, all of them feel too removed from each other. I’m not asking for authenticity in my reality television, but I would appreciate an attempt at believability.

One of the Only Federal Laws That Protects LGBTQ People Expired in the Shutdown

The U.S. is three weeks into what is about to become the longest federal government shutdown in history, and a whole lot of people are angry. Caused by the congressional impasse over President Trump’s insistence on getting millions of dollars to fund a wall at the U.S.-Mexico border, the shutdown has forced roughly 800,000 workers to go without pay since before Christmas.

Over a thousand of those workers have turned to GoFundMe to raise money for rent and food, two federal employee unions have filed lawsuits demanding pay, and government workers protested outside the White House today, yelling: “Pay the workers, furlough Trump.”

But amid all the chaos — and there is chaos, with food safety inspections going unperformed, people destroying unsupervised national parks, and TSA officers quitting en masse — there’s also an important federal law that quietly expired about two weeks ago. And that law is one of the only federal laws that explicitly includes LGBTQ people in nationwide protections.

The Violence Against Women Act (VAWA) allows federal funds to be distributed to programs that work to end sexual assault, domestic violence, stalking, and harassment. Despite the name, it applies to people of all genders, and when it was reauthorized in 2013, a nondiscrimination clause included sexual orientation and gender identity. In 2018, $553 million was appropriated for VAWA programs, a massive amount of money that funds things like domestic violence shelters, rape crisis groups, campus programs, emergency housing, and other programs.

But the Violence Against Women Act was set to expire in December unless Congress voted to reauthorize it — and the federal government shut down just before that could happen.

“This is important for LGBTQ people in part because VAWA is one of the few federal laws with SOGI nondiscrimination protections written into the law explicitly, and that recognizes LGBTQ people as an underserved population,” said Lambda Legal’s law and policy director Jennifer Pizer in an email to INTO on Wednesday. “These aspects of VAWA represent important breakthroughs in federal lawmaking.”

But Pizer stressed that inclusion isn’t the only reason the law should matter greatly to LGBTQ people. VAWA is especially important for queer and trans people because they  are so often victims of violence.

According to the Centers for Disease Control, about one in three women and one in six men experience sexual assault within their lifetimes. But those numbers are even higher for some segments of the LGBTQ community; studies have shown that around half of all bisexual women and transgender people say they’ve been sexually assaulted.

Lesbian and bisexual women are particularly vulnerable to intimate partner violence, according to a 2017 report by the National Center for Anti-Violence Programs (NCAVP) — with lesbians being five times more likely to report violence at the hands of a current partner. More than 60 percent of bisexual women reported violence at the hands of a current or former intimate partner, according to the Centers for Disease Control’s 2010 National Intimate Partner and Sexual Violence Survey.

The response of law enforcement is crucial to the safety of survivors. But nearly half of all LGBTQ survivors of domestic violence surveyed for the NCAVP report said police were “indifferent” when they reported, showing the need for more education on the unique needs and experiences of queer and trans survivors of violence.

For trans women, the protections offered by VAWA are especially important in light of recent comments made by Department of Housing and Urban Development head Ben Carson, who in March said the agency would back away from LGBTQ-inclusive policies because cisgender women were not always comfortable sharing shelters with “somebody who had a very different anatomy.”

But according to the NCAVP report, transgender and bisexual women were two times more likely to experience violence or harassment at a domestic violence shelter.

“The programs and shelters funded by VAWA are crucial resources for transgender people of color, in particular, too many of whom are frequently the targets of violence, marginalization, and erasure by our society,” National Center for Transgender Equality executive director Mara Keisling told INTO. “The temporary expiration of VAWA is a betrayal of the some of the most vulnerable people in our country today, and yet another immoral price Americans are being forced to pay for this President’s reckless shutdown.”

The expiration of VAWA doesn’t mean programs all over the country have to close immediately. Many have already received and allocated their federal funding. But for those which depend on upcoming funds, the shutdown could mean a host of obstacles. And it’s not entirely clear which programs will be impacted first. According to a December Roll Call story published the day VAWA expired, most of the act’s funding is administered through two federal agencies: the Department of Justice and the Department of Health and Human Services (HHS).

In September, Congress approved 2019 funding for HHS, meaning that most VAWA programs administered there will receive money allocated for this year only. But the Department of Justice is effectively inoperable during the shutdown and has not been funded for this year. In an ironic twist, Trump’s stubborn insistence on keeping the government from operating until Congress approves his border wall, which he says is needed to stave off a national security crisis at the border, has resulted in at least 5,000 FBI agents being furloughed — which the FBI Agents Association told The Atlantic this week is the real national security crisis.

On Friday, Congress voted to authorize some emergency funding to a handful of federal agencies despite the shutdown. But even that last-minute measure is unlikely to pass through the Republican-controlled Senate, especially because the agencies Congress asked to immediately fund are the Environmental Protection Agency, Department of the Interior, and the U.S. Forest Service — not exactly GOP priorities. And VAWA was not on the table at all today.

Lambda Legal’s Pizer recalled “distressingly overt anti-LGBTQ (and anti-immigrant) hostility from conservative Republicans” in 2013, as Congress battled over the most recent reauthorization of the Violence Against Women Act with provisions added to protect those communities.

“But the fact that those callously ideological voices ultimately failed to block the bill is due to leaders of goodwill in both parties, all of whom deserve credit for caring about victims of violence and other terrible abuse,” said Pizer. “Those who are still in Congress should look in the mirror, reflect on those in fear and pain who need VAWA-supported help, and act immediately to reopen our federal government and reauthorize this essential statute.”

LGBTQ Nicaraguans in Costa Rica: The Refugees That Ran From President Ortega’s Persecution

None of them have reached the age of 30. All of them have sadness and pain in their faces, but also hints of hope.

More than a hundred Nicaraguans that have entered Costa Rica legally and illegally are LGBTQ, and they are organized into a group called Asociación Hijos del Arcoiris LGBTI (The Children of the Rainbow LGBTI Association). They had to leave their country to save themselves from political, homophobic and transphobic persecution from the government of the current president, Daniel Ortega, after a social and economic crisis broke out in the Central American country on April 18 last year, pushing them to protest in the streets and openly oppose Ortega’s regime.

Today, the LGBTQ Nicaraguans are safe on the other side of the border, most of them in Costa Rica’s capital city of San José. They are struggling to find housing, jobs, education, food, and clothing, but mostly they are trying to heal from the pain of leaving their country, and integrate themselves in a society where the government pushes new policies with the help of international organizations to help and protect them, but where transphobia, homophobia and xenophobia are also at their worst.

Six Months of Protests and Refugees

19,720 Nicaraguans asked the Costa Rican Government for refuge between April and November of 2018, according to official data given by the Immigration Office of Costa Rica. Before that, only 473 Nicaraguans had become refugees; that’s a 4,000 percent increase in only seven months.

Marcela Rodríguez, the Protection Officer leader of all the Protection Programs of the United Nations High Commissioner for Refugees (UNHCR) office in Costa Rica, explained: “Before, three types of Nicaraguans came to the country asking for refuge: farmers who opposed the dredging of their lands for the construction of the interoceanic canal, women fleeing the misogynistic and patriarchal violence of men, mostly of their partners; and people of low income looking for more opportunities and a better life.”

Now, all types of citizens from the Central American country make up that huge number. From cities and from the countryside; young and old; professionals, students and workers; men, women and children; they “all have something in common: they are running from political persecution,” Rodríguez told INTO. But they’re also fleeing persecution based on their sexual orientation or gender identity and expression, as government propaganda has used these aspects of the dissidents to attack and discredit them in a violent and most harmful way, as the Asociación Los Hijos del Arcoíris LGBTI and other LGBTQ Nicaraguan refugees have denounced.

This persecution started in April this year when a tense situation exploded. In a report from Centro Nicaragüense de Derechos Humanos (CENIDH) (Nicaraguan Center of Human Rights), titled “Derechos Humanos en Nicaragua 2018” (Human Rights in Nicaragua 2018), the origins of the crisis are explained: the constitutional reform pushed by Ortega that established indefinite reelection and has allowed him to stay in power for eleven years now; the violations of the human rights of anyone that opposed Ortega, such as political participation, a fair trial and freedom of speech; and government corruption. Nicaragua was rated the most corrupt country in Central America by the World Corruption Perception Index of the International Transparency organization. The report also cited the extreme poverty that Nicaraguans suffer: 8.7 percent of them live in poverty, according to a survey from the Fundación Internacional para el Desafío Económico Global (International Foundation for the Global Economic Challenge) this year.

But the spark that ignited the crisis was Ortega’s decision to reform the public pension system on April 18, increasing the contribution the workers must give to face a shortfall of $76 million. The opposition claims this is the result of corruption: their leaders say Ortega’s government has been using the pensions as a fund to finance their parties and trips.

Because of the pension issue, an open and fierce opposition started. Under the leadership of students and other young people, workers, families and pensioners organized and took to the streets to protest. The government’s response was a brutal and violent repression that has escalated, the CENIDH narrates in its report; while the army and the police attacked people, dissolved the protests and incarcerated the dissidents, the president and other entities restrained and violated human rights, from freedom of speech and freedom of assembly to the right to health. And the public health system denied medical assistance to those who were hurt by the armed forces.

According to CENIDH’s report, “The governmental repression and violence has been characterized by the unproportioned use of force and the execution of murders, incarcerations, forced disappearances and torture. This violence has reached almost every social group: during these six months of protests 320 people have been murdered, 22 of them minors, 40 young students, 22 police officers and 1 journalist.”

In December of 2018, Ortega outlawed non-governmental organizations, including the CENIDH, and expelled the Grupo Interdisciplinario de Expertos Independientes (Interdisciplinary Group of Independent Experts), and the Mecanismo de Seguimiento para Nicaragua (Follow Up Mechanism of Nicaragua) of the Inter American Commission of Human Rights. Both groups were in Nicaragua looking to stop the violation of human rights, and to promote a dialogue between the government and its opposition through a “Table of National Dialogue” that failed multiple times over months.  

In the case of LGBTQ people and opposition leaders, the persecution and attacks are more personal. While the Immigration Office of Costa Rica says only seven people have self-identified as LGBTQ at the moment they asked for refuge, there are more than a hundred members of Asociación Los Hijos del Arcoíris LGBTI. Their founder and spokesman, Ulises Rivas, explains that “There are more that are too afraid to self-identify as part of this community or are in precarious situations: depressed, without money, food, documents or clothes, and even living on the streets.”

At a December event in San Jose called “Ya Ni Sé” (I Don’t Even Know Anymore), Beyardo Siles, a spokesman from the National LGBT Dialogue Table of Nicaragua, presented a preliminary report about the violence and repression leaders of the opposition that are LGBTQ have faced. Siles explained that Ortega’s government started a hate campaign against them, looking to diminish and discredit the young men and women that became the face of the opposition, calling them Maricones (faggots) y Lesbianas (lesbians) with images that went viral on social media. There were also physical attacks and persecution because of their sexual orientation, gender identity and expression.

A presentation at Ya Ni Sé, an LGBTQ refugee speakout in Costa Rica in December 2018. Photo by Jess Marquez Gaspar.
A presentation at Ya Ni Sé, an LGBTQ refugee speakout in Costa Rica in December 2018. Photo by Jess Marquez Gaspar.

“From April to July we received reports of 45 LGBTQ leaders affected, 44% of which are Human Rights Activists, 15 leaders of different types of organizations and 5 LGBTQ activists,” said Siles.  

The LGBTQ leaders reported  144 incidents: the worst ones were 3 murders and 1 sexual assault, Siles explained. He added that: “there also have been 41 death and physical harm threats and 7 physical attacks”, and said they have yet to process dozens of new reports they have received since August.

Fleeing to Costa Rica and becoming an LGBTQ Refugee

Running from the attacks and the persecution, and even to save their lives, the members of “Asociación Los Hijos del Arcoiris LGBTI” went to Costa Rica. In a meeting, around 20 young LGBT men and women from the group told their stories. With ages ranging between 18 and 30 years old, they came from different regions in Nicaragua: some from Managua (where the capital is located), Carazo and León. They have different backgrounds: a group of them are college students looking to be engineers, pharmacists and social workers; others had occupations as bakers, barbers, Zumba instructors and paramedics; there are some who are professionals like Ulises, who is a journalist, and others who are political leaders. They identify as gay, lesbian or bisexual and faced day to day discrimination for their sexual orientation, even before the crisis.

When the protests and persecutions started, most of them had to hide or  travel to another city of the country, and keep moving for months until the only option was, ultimately, to flee to Costa Rica. Some took buses and crossed the border legally, but the majority had to walk for days. “I had to cross plantation fields, under the sun and the rain, with only a backpack and very little food,” Ulises Rivas told INTO. When asked why, Rivas said: “I had to leave behind—and they took them—most of my legal papers, even my passport. I didn’t have a legal way to cross the border.” Finally, Rivas reached San José as more than 19,000 other Nicaraguans have.

Most of the LGBTQ refugees had to sleep in parks and other public places, and some were lucky enough to be received by other Nicaraguans, or by Costa Ricans that took them in. They had to walk the city seeking for help, and found the Costa Rican Immigration Office, the United Nations High Commissioner for Refugees (UNHCR), and local and Nicaraguan LGBTQ organizations and activists that helped them ask for asylum and helped them build a new life in Costa Rica.

That’s why three months ago, Rivas and 5 other young men decided to come together and start the Arcoiris organization. They started looking for other LGBTQ Nicaraguans, and collected donations that helped them rent and furnish two houses in the city—where they now house more than 30 people.

Members of the Nicaraguan refugee group Asociación Hijos del Arcoiris LGBTI at a home in Costa Rica. Photo by Jess Marquez Gaspar.
Members of the Nicaraguan refugee group Asociación Hijos del Arcoiris LGBTI at a home in Costa Rica. Photo by Jess Marquez Gaspar.

They have learned how to work the system created to receive and support refugees in Costa Rica. The Costa Rican office of the Hebrew Immigrant Aid Association (HIAS) has given them free legal advice on how to ask the Costa Rican Immigration Office for asylum; while the organization that helps refugees, RET International, offers them psychological and medical attention, and helps them find and pay for permanent housing and food. FundaMujer, an organization that works for human rights with a gender perspective, offers them education opportunities such as technical studies; and the UNHCR helps them find jobs through their corporate responsibility program “Living the Integration.” Also, the Center of Social Rights of Migrants (CENDEROS) gives temporary housing to the ones that have been victims of sexual and gender-based violence.

Right now, the situation is complicated for most of them. Of the 19,720 Nicaraguans that have asked Costa Rica for asylum since April 2018, none have received an answer. The immigration office has a year-long backlog of cases to process, according to Marcela Rodríguez from the UNHCR. Because of the delays the UNHCR has been working with the immigration office to make the system more efficient.

Over 30 percent of the Nicaraguans have applied for asylum under two types of persecution recognized by the 1951 Refugee Convention: political opinion, as they have been attacked and chased down for being against Daniel Ortega’s government; and for sexual orientation, gender identity and expression, and persecution associated with LGBTQ and human rights activism. While they wait for a resolution, they have temporary visas, which allows them to find jobs.

Only a few of them have jobs, only 10 percent have enrolled in educational programs, and most of them spend their days looking for ways to make money or find food and clothes; participating in LGBTQ activities and activism; and trying to overcome what has happened to them.

A calendar of activities for residents at one of the Hijos de Arcoirís homes in Costa Rica. Photo by Jess Marquez Gaspar.
A calendar of activities for residents at one of the Hijos de Arcoirís homes in Costa Rica. Photo by Jess Marquez Gaspar.

As the director of the RET International Office in Costa Rica, Christine Eppelin Ugarte reveals that the LGBTQ refugees to whom they provided psychological attention all suffer from post-traumatic stress from the sexual and gender-based violence they have received for being LGBTQ in Nicaragua, but also in Costa Rica. Their symptoms are usually anxiety, low self-esteem, depression, insomnia, eating and sleeping disorders, and a state of constant alert.

LGBTQ Nicaraguans go through a “migratory mourning” that comes from multiple struggles.

Eppelin Ugarte explains what those struggles are: “First, the impact of having to leave their country by force; the difficulties of coming to Costa Rica and being attacked or robbed; second, once they get to Costa Rica, the disappointment they suffer when they realize being an immigrant doesn’t match the high expectations they had about the life they imagined in their new home; and third, the difficulties and unrooted feeling that comes from losing their homeland as a concept and as a place, and having to integrate in a society they don’t know or understand.”

The young women and men of “Asociación Los Hijos del Arcoíris LGBTI” say they feel frustrated, angry, and sad. At the Ya Ni Sé event, Nicaraguan artist Eyla Sinvergüenza explained the feeling: “I feel lost, without a country, hurting, as the place I called my homeland is dead, it no longer exists.”

José David Moya, coordinator of case management at RET, explains that most refugees come with wounds and dehydration from the trip to Costa Rica, malnutrition because of the crisis, and multiple diseases and conditions—such as HIV, anxiety, depression, and STIs.

Also, Moya thinks “Xenophobia and LGBTQ-phobia has increased in Costa Rica during 2018 like never before.” While the Costa Rican government took steps to protect LGBTQ immigrants—including the Global Migratory Pact, pushing an executive order to prevent and sanction LGBTQ-phobic discrimination among public workers, and two other executive orders— a demonstration against Nicaraguans took over the streets of San José in August, resulting in 44 detentions for xenophobic attacks, and there were 25 verbal and physical assaults against LGBTQ people, according to the Frente por los Derechos Igualitarios (Front for Equalitarian Rights), a coalition of nonprofit organizations.

The members of the “Asociación Los Hijos del Arcoíris LGBTI” have felt this. One of them, a young woman named Ángeles, says, “It’s been hard, we don’t receive much acceptance because we are Nicaraguans and because we are refugees. But also, Costa Ricans, and even other Nicaraguans, discriminate [against] us because we are LGBTQ.”

That is why, in the middle of this hard situation, the work they have done is inspirational, and so is their attitude.  “We have hope,” said Andrey, one of the young men.

“We see this as an opportunity to grow, to learn from the things the LGBTQ movement has conquered here and [in] the Costa Rican democracy, and then come back to our country to make a change,” says Dave, another member of the group.

Rossi, one of the young women, states: “We are not alone. We have each other and we are united by one cause.” When asked what that cause is, at least 10 of them yell at the same time: “¡Nicaragua Libre!”

These New Apps Rate Businesses Based on Size, Gender, Disability, and POC Accessibility

In Portland, Oregon where I live, I often work from a local laundromat and cafe. I love the place, but am always anxious to grab a specific spot at the sole bench against the wall as to avoid the inevitable bruises that come from the only other seating options: chairs that cut into my thighs, leaving indentations for a couple hours. Sitting in those uncomfortable chairs is a reminder of how I’ve failed to conform to the thinness that society requires of me in order to sit comfortably. I avoid them at all costs.

When I saw those very same chairs around my own dining table, brought in by my well-meaning but thin housemate, I didn’t know what to say. It’s hard to know what to say about fatphobia, and it’s terrifying when it sneaks its way into your own home.

As people with bigger bodies navigate a world designed for thin people, apps that aim to tell you which places have actually considered their needs helps mitigate fear and anxiety. Both Ample and AllGo, two Portland-based apps with the purpose of identifying and rating businesses on their inclusivity of marginalized bodies, were founded due to personal anxiety and experiences like my own.

For Ample’s Alissa Sobo, it was being fat-shamed at her doctor’s office in a small California town while she was pregnant. “I had one particularly terrible experience that was traumatic for me. I lived in a small town and didn’t have any way of finding a less fatphobic doctor,” said Sobo, now based in Portland.

Ample founder Alissa Sobo (L) with Ample graphic designer Gus Cannon (R)
Ample founder Alissa Sobo (L) with Ample graphic designer Gus Cannon (R)

AllGo’s Rebecca Alexander, a fat, queer fundraiser, said she was tired of   searching the background of pictures on Yelp to see if the restaurant she was taking a new client to had chairs big enough for her.

“I’ve spent the last 10 years raising money for nonprofits,” Alexander told INTO. “Involved in that job was meeting people I’d never met before who had lots of money [to contribute to my causes]. The anxiety I had on a daily basis meeting these people in new places was traumatic.”

During Alexander’s entire senior year of college, the only chairs available in her own apartment left indentations in her outer thighs for almost six hours every time she sat in them.

“Ninety-five percent of self-identified fat respondents [to AllGo’s initial user surveys] reported anxiety about going places with friends. For people who didn’t identify as fat, they felt excited. It didn’t even register,” Alexander told INTO. “So much of the world is just not designed with human diversity in mind.”

AllGo founder Rebecca Alexander. Image via
AllGo founder Rebecca Alexander. Image via

So when Alexander shared her anxieties and desire for a solution with Michele Amar, a tech and design strategist in the Fall of 2017, the two decided to collaborate on an app (Amar has since stepped away from the project). Businesses that appear in the app are given a green checkmark or a red X for having or not having things such as armless chairs or moveable tables, allowing potential visitors to decide if their whole party will feel comfortable at an establishment prior to going there physically. There is also space for users to submit a more extended review.

AllGo’s initial Kickstarter campaign was supported by some famous names in the fat and body positive communities, such as the queer writer Roxane Gay, who donated five signed copies of her critically acclaimed book on the emotional and psychological struggles around food and body image, Hunger, to their fundraiser (a pledge that sold out the first day). Tess Holliday, a plus-sized model who has graced the cover of Cosmo, posted to Facebook, “This app is going to make it easier for people like my mom to visit new places.” The campaign raised over $55k, allowing Alexander to hire some coders.

I'm so excited that AllGo – An App For People of Size is making the world accessible to fat and plus size people! This…

Posted by Tess Holliday on Saturday, March 24, 2018

Portland is a fertile and ideal testing ground. Despite the aforementioned cafe with the terrible chairs, Portland is the home base of many fat activists and organizations such as queer fat femme blogger Bevin Branlandingham, as well as body-positive hiking groups Fat Girls Hiking and Unlikely Hikers. Portland hosted the Association for Size Diversity and Health conference in August 2018, and hosts an annual plus-sized fashion show called Knockout. The city is also home to indie plus-sized clothing shop Fat Fancy; and Chunky Dunk, an outdoor pool party that celebrates the natural diversity of human bodies, and offers fat-inclusive swimming every summer. (It was the setting for a significant pool party scene in the upcoming TV adaptation of Lindy West’s Shrill, starring SNL’s Aidy Bryant).

“Queer people understand what it means to be excluded from public conversation,” Alexander said. “So many queer women and men have contributed to [fat activism]. There’s a lot of queer people doing the work. They want to see a queer entrepreneur [like myself] succeed.”

The amount of fat acceptance and celebration in Portland is one reason this big bottom has remained planted here. So it’s not surprising that another app dedicated to promoting accessible businesses, Ample, also began its journey in Oregon’s biggest city.

For founder Alissa Sobo, it was discussing her idea for a “fat Yelp” with Virgie Tovar, the creator of Babecamp, a 4-week online course designed to hold your hand through finally breaking up with diet culture, that gave her the final push to start Ample. “[Tovar] loved the idea, and initially she was the impetus for me for taking it from just reviewing doctors and healthcare providers to including restaurants, hair salons — everything we now include,” Sobo told INTO.

Sobo uses Google to gather businesses so almost anything is available to review. If it isn’t already in Ample, users can add any business they like, upload pictures, and continue the review process in addition to choosing a rating of one to four stars on size, disability, trans, and BIPOC (Black and Indigenous People of Color) inclusivity (the latter two coming at various points in the initial design process). It became her goal to take conversations that were happening on Facebook, Twitter or other personal groups, and make it accessible and searchable to anyone.

“I think, particularly in fat community, the information gets ‘trapped’ in our small, often geographically specific social media groups,” Sobo said. “And there isn’t one central trove of data that everyone could access for everywhere in the world.”

Image via Ample
Image via Ample

Because Sobo is a coder, she was able to take a more DIY approach and just created an initial prototype herself, but even she couldn’t do it alone. When she moved to Portland, her best friend and graphic artist Gus Cannon joined the team in charge of design. As a trans man, Cannon saw a lot of overlap in the hurdles trans people and fat people face in public spaces, such as gendered restrooms or use of incorrectly gendered language.

“So we expanded the project then,” Sobo explained, “We thought it made sense to allow people to review a place from an intersectional perspective.”

The app added ratings for trans inclusivity alongside the ones they already had for size and disability. Initially, they decided not to include a BIPOC rating on the advice of a POC friend, because none of the contributors were people of color, but after some feedback at launch, ultimately decided it was important to include.

“Shauna McDavis-Conway, the president of [fat activist organization] NOLOSE called us in on the POC perspective being discounted, and as soon as we realized that the community wanted it, and as soon as we realized the error of our ways, educated ourselves a bit more, we worked frantically to include it,” Sobo said. “I worked a solid few days to add it in, practically without stopping, because I wanted to show the community that we cared. We deployed the feature [adding star ratings for this new group] just a few days after it was called to our attention.”

With such a broad target audience, Ample has had to scale back in some other ways. Initially written as an iOS app, Sobo decided to launch Ample as a website first. “Eighty-five percent of all apps are only opened once,” Sobo said. “Our volunteer UX designer, who is a fat babe activist and total badass at her job, also felt that it doesn’t make sense to build a mobile app until you have a reliable and dependable user base. If people opened the app and there wasn’t anything yet in their area, would they ever open it again?”

Sobo hopes to grow the user base organically and has done so in a few different ways. By plotting all the places with reviews on a map, she has a visually engaging way to see what places are rated well in your area. She has also corralled a team of “Amplifiers,” members of the community who have volunteered to identify accessible businesses.

“Businesses are ‘amplified’ when a business or provider are recommended outside of the Ample platform,” Sobo explained.  “This can be from a face-to-face conversation or from a discussion they see on social media. Amplified businesses will show up on the Ample map and in the top search results, alongside businesses that already have reviews. A badge will appear on the pages of Amplified businesses, letting users know that this place or provider is being recommended even if there are not yet firsthand user reviews.”

Businesses can also participate by “claiming” their Ample entry. They only have about 75 claimed listings so far but, “Most of them take our inclusivity pledge,” Sobo said, which consists of a promise to, “treat people of all genders, body sizes, races, and abilities equally.” Business owners pledge to: “keep an open and eager mind towards learning how [they] might improve accessibility on an ongoing basis.”

Sobo emphasized that they’ve had positive feedback from businesses as well as users. “This isn’t a business-bashing tool. We hope its an educational tool and an awareness-raising tool.”

Alexander also hopes businesses will see her project, AllGo, as an opportunity to grow and change, as well as a marketing tool. “One-third of the population is considered overweight or obese,” she said. “If potentially one-third of their customer base can’t fit into the seats at a new restaurant, with an industry with that slim of a profit margin they can’t afford [to alienate them]. We can help them out.”

Both Ample and AllGo continue to grow. Alexander expects betas to launch in up to 10 other cities this year but is looking to angel investors to help make that happen. She also has some other projects directed at plus-sized consumers that should become public in the coming year.

Sobo hopes more programmers and Amplifiers will want to participate. I have personally already used both apps when deciding what coffee shop to work from. It’s good to know that I can quickly glance at either Ample or AllGo to check if I will be comfortable at a meeting spot suggested by a friend.

“[AllGo] would save me and people like me so much anxiety,” tweeted Roxane Gay. It also gives thin people a chance to learn how to be allies. Maybe then our new knowledge will make our options feel ample, and ensure that we can all go to places we feel comfortable and welcome.

This Man Sued Mutual of Omaha for Denying Him Insurance Because He Takes Truvada — and Won

What if your insurance denied you coverage because you responsibly took a drug to prevent you from getting HIV? Unfortunately, this is an all-too common practice, but a legal victory today could make it a thing of the past.

A settlement was reached today in the Massachusetts lawsuit Doe v. Mutual of Omaha which challenged an insurance company’s policy on denying applicants’ various forms of coverage for taking Truvada, a medication taken for HIV prevention.

The lawsuit, which GLAD (GLBTQ Advocates and Defenders) filed against Mutual of Omaha, has resulted in the insurance company revising their underwriting guidelines that previously dictated that applicants who take Truvada, a pre-exposure prophylaxis for HIV commonly known as PrEP, were automatically declined for long-term care insurance. Long-term care insurance generally covers things like home care, assisted living, adult daycare, respite care, hospice care, or nursing homes; types of care that aren’t always covered by health insurance or Medicare.

As a result of the outcome of the suit, the plaintiff in the case, known only as John Doe, will receive the long-term care policy he applied for.

“We are pleased that Mutual no longer declines insurance coverage based on the use of HIV pre-exposure prophylaxis, and we call upon other providers of life, disability, and long-term care insurance to do the same,” said Bennett Klein, AIDS Law Project Director for GLAD, in a press release Tuesday. Klein also represented Doe in the lawsuit.

Mutual of Omaha told INTO on Tuesday that it is revising their underwriting guidelines and that they were no longer “[declining] long-term care insurance applications solely on the basis that an applicant takes Truvada as PrEP for HIV prevention.”

Truvada, which was approved for use by the Food and Drug Administration (FDA) in 2012, reduces the risk of users contracting HIV by more than 90 percent, according to the Center for Disease Control and Prevention. The health protection agency openly sanctioned the use of PrEP for reducing risk of contracting HIV in 2014.

The CDC also reported that 90,000 PrEP prescriptions were filled in 2018, with a total of 1.1 million Americans at risk for HIV nationwide.

Generally, the Affordable Care Act bars discrimination against applicants on the basis of their sexual orientation for health insurance, but allows states to determine applicant eligibility for other types of insurance, such as life insurance or disability insurance.

Unfortunately, Mutual is hardly the first insurance company to reject applicants for taking PrEP. In February 2018, the New York Times reported on a similar circumstance in which Dr. Philip J. Cheng, an openly gay Massachusetts doctor, was only offered coverage for five years on a disability insurance plan because of his PrEP use.

The article also highlighted how insurance applicants who take PrEP are indirectly penalized for taking a preventative medication by insurance companies, while those who do not are much more likely to receive coverage.

“I was really shocked,” Dr. Cheng told NYT at the time. “PrEP is the responsible thing to do. It’s the closest thing we have to an HIV vaccine.”

Following the NYT report, New York state financial regulators stated publicly that they would investigate reports of gay men who had been denied various forms of insurance, including disability and long-term care, because of taking PrEP.

“Denying insurance to people who take steps to prevent HIV makes no sense, undermines public health, and contributes to HIV stigma,” said Gabriel Arkles, senior staff attorney at the ACLU, in an email to INTO Tuesday. “We are pleased that Mutual of Omaha will no longer discriminate against people who take advantage of this form of preventive medicine.”

This Japanese Lesbian Couple Is Getting Married in 26 Countries to Prove a Good Point

A young Japanese couple, both students at Utsunomiya University, are crowdfunding their wedding online. But not just one wedding; the couple wants to travel around the world getting married in every single country where same-sex marriage is legal.

Misato Kawasaki, 21, and Mayu Otaki, 22,  cannot legally marry in their native country of Japan. So they’re hoping to challenge the Japanese government to change the law by getting married elsewhere — at least 26 times. For now, that’s the number of nations where same-sex marriage is legal. But the couple said on their fundraising page that they aim to marry everywhere they legally can.

“I want to show through our wedding photos that being lesbian, gay, bisexual and transgender (LGBT) is normal so that those who are troubled by their sexual status can harbor hope,” Kawasaki told the English-language Japanese newspaper Asahi Shimbun on Thursday.

The couple has been dating for a little over a year, and are collecting money for the trip on the Japanese crowdfunding platform Faavo. At press time, they had raised 334,000 Yen (about $3,000). According to Asahi Shimbun, they estimate it will take just over 4 million Yen (about $38,000) to cover the cost of the entire trip with transportation and lodging.

In exchange for funding, Kawasaki and Otaki are offering benefits ranging from attendance at some of the weddings and parties, to framed wedding photos and handwritten thank-you letters.

The couple plans to start the journey this March in Britain, with weddings in Europe, Africa, North America, and South America to follow into September. Kawasaki and Otaki will post about the weddings, and their travels, on an Instagram account they started for the project (@loveislove.japan).

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私たちは #同性婚 が認められた国で #ウェディングフォト を撮る #世界一周 の #旅 を計画しています。 . スーツののみさとです👔 . 2018年9月の始まりの日。 私とマユは別々の場所に。 9月は、お互いの時間を大切に、 それぞれ成長する月と決めました。 . 彼女はインドで、私は日本で🏃‍♂️ . ブログ等も書いていく予定なので是非読んでみてください! . ちなみに、 先日タイに行ってきました! 久々の海外、たくさんの刺激を受けて帰ってきました🇹🇭 とても楽しかった💁‍♂️ . てことで、 9月、走り抜けます🏃‍♀️🏃‍♂️🏃‍♀️🏃‍♂️ . カメラマン: @d.i.k.m.s.a スーツ: @aoyama__official ドレス: @watabewedding . . Hello! We are planning to go on a round trip journey to take #weddingphotos within countries which are recognized #samesexmarriage #26timeswedding . . Before starting our trip, we decided to share our wedding photos from Japan. . #LGBT#lgbtrights#lgbtyouth#weddingphotography #samesexcouple#lgbt💛💙💙🏳️‍🌈🇨🇴💗 #lgbt🌈 #lgbtlove#loveislove

A post shared by 26回結婚式💐26TimesWedding (@loveislove.japan) on

The pair also plan to visit Taiwan, they said on the fundraising page. As INTO reported in-depth from Taiwan in November, Taiwanese citizens voted to ban same-sex marriage in a surprise upset. But because such policies can’t be decided by public referendum in Taiwan, it’s unclear what the future holds for marriage rights there. In the meantime, the Taiwanese government is allowing same-sex couples to register as domestic partners.

If the marriage eventually ends, it could present a serious problem for the young couple — who would likely need to return to all 26 nations to file for divorce in each one.

Report: The Trump Administration Is Considering Broad Rollbacks to Civil Rights Laws

The Washington Post on Thursday reported it had obtained internal memos and source material about the Trump administration’s plans to weaken federal civil rights protections.

According to the Post, an internal Justice Department memo instructs the agency’s civil rights officials to investigate “disparate impact” regulations with the intent to change or revoke them. “Disparate impact” is essentially the legal theory that allows anti-discrimination laws like the Civil Rights Act and the Fair Housing Act to be applied in cases of secondary or less-than-overt discrimination. For example, one 2005 lawsuit brought by a group of Black police sergeants in Memphis, Tennessee alleged that a new written test required for promotion had a discriminatory impact on Black applicants.

A more recent “disparate impact” case in 2016 found that in one California school district, Black students were disciplined at much higher rates than white students. The U.S. Department of Education’s Office of Civil Rights found the school district guilty of disparate impact discrimination and negotiated an agreement to retrain employees and other remedies.

The Trump administration wants to do away with this kind of civil rights case, and not just at the federal criminal justice agency; according to the Post, similar measures are underway at the Department of Housing and Urban Development and the Department of Education.

Changes to civil rights law could greatly impact LGBTQ Americans. Even though the Civil Rights Act does not expressly include sexual orientation and gender identity as protected classes alongside race, religion, and other such groups, the prohibition against ‘sex’ discrimination has been extended to include LGBTQ people in previous legal verdicts.

Doing away with disparate impact regulations could make civil rights protections a lot harder to enforce, and suggests that the Trump administration wants to see civil rights laws applied only in the most purely literal sense — to avoid their protections being extended to anyone not explicitly protected. And, to argue that any unintended or secondary discrimination is not really discrimination at all.

Sarah Kate Ellis, the CEO of GLAAD, said the proposals to roll back federal anti-discrimination laws are just the latest example of Trump’s chipping away at the rights of marginalized Americans.

“Either the Trump Administration is blissfully ignorant or just simply unwilling to understand the depth of discrimination that exists in the United States. But one thing is certain: if you are a part of a marginalized community, President Trump wants nothing to do with you,” said Ellis in a statement Thursday. “These attacks on LGBTQ and other marginalized people must stop.”

There is a glimmer of hope for LGBTQ people in the face of Trump considering changes to anti-discrimination law. With Congress flipped to the Democrats and Nancy Pelosi re-taking the title of Speaker of the House, it’s likely that the Equality Act will be reintroduced in 2019. The bill would add sexual orientation and gender identity language to the Civil Rights Act, and would become the only federal nondiscrimination protection ever offered to LGBTQ Americans.

Image via Getty

Queering Congress: 10 LGBTQ Senators and Representatives are Being Sworn In Today

On Thursday, the 116th U.S. Congress opens for business, and a historic number of newly-elected and reelected LGBTQ officials are about to be sworn in. With two senators and eight congressional representatives starting work today, neither chamber has ever been this queer.

All 10 of the new queer Congress members are Democrats, hailing from all over the country. Coming to the Senate are Wisconsin’s Tammy Baldwin and Arizona’s Kyrsten Sinema. Four congressional freshmen are coming aboard for the first time: Minnesota’s Angie Craig, Kansas’ Sharice Davids, California’s Katie Hill, and New Hampshire’s Chris Pappas.

The newbies will join four gay incumbents who were reelected to Congress this year: Rhode Island’s David Cicilline, New York’s Sean Patrick Maloney, Wisconsin’s Mark Pocan, and California’s Mark Takano.

With Congress flipped to a Democratic majority, and Nancy Pelosi returning to her reign as Speaker of the House, 2019 is setting up to be a banner year for LGBTQ equality legislation.

“Speaker Pelosi will have eight LGBTQ Representatives to consult about how various healthcare or criminal justice reform policies uniquely affect our community,” said Annise Parker, President & CEO of LGBTQ Victory Institute, in a statement on Thursday. “The relationships these LGBTQ lawmakers will build with their colleagues on Capitol Hill are transformative, and with an unprecedented number of women and people of color also joining the 116th Congress, equality issues will finally receive the attention they deserve.”

Parker, who became the first openly gay mayor of a major metropolitan U.S. city when she was elected mayor of Houston, Texas in 2009, noted that even though the Senate chamber remains under Republican control, the presence of lesbian (Baldwin) and bisexual (Sinema) senators can only help increase LGBTQ visibility there.

“In the U.S. Senate, those opposed to the Equality Act will now need to look two openly LGBTQ Senators in the eyes and tell them their lives are not worth protecting,” said Parker.

The Equality Act is a bill previously introduced twice by Cicilline that would add sexual orientation and gender identity to the Civil Rights Act of 1964. If passed, it would offer LGBTQ Americans the first federal antidiscrimination protections in history — and the only protections for those living in states that have no local antidiscrimination laws inclusive of LGBTQ people.

The new LGBTQ members of Congress are already making their voices heard. In a letter to the House chief administrative officer on Thursday, Pappas said he plans to refuse his first congressional paycheck — saying he doesn’t want to get paid until the government shutdown ends. During the shutdown, around 800,000 federal government workers are under furlough and not being paid.

“As someone who has run a small business, I could not imagine receiving a paycheck while any of my employees are working without pay,” Pappas told Manchester, New Hampshire’s WMUR on Thursday. “For this reason, I write today to request that my pay be withheld until the current shutdown has ended and the entire federal government is reopened.”

New Report By Group of European Nations Confirms Anti-LGBTQ Crusade in Chechnya

In a report released on Friday, the intergovernmental Organization for Security and Co-operation in Europe (OSCE)—which counts 57 participating nations among its ranks—documents a horrifying, ongoing crusade against LGBTQ people in Chechnya.

While Chechen and Russian authorities have repeatedly denied the anti-LGBTQ ‘purge’ that was first revealed by human rights groups and news reports in the spring of 2017, the report compiled by the OSCE Rapporteur is damning.

Citing a campaign targeting primarily gay and bisexual men, the report finds Chechen law enforcement kidnapped, tortured, and murdered LGBTQ people in “purges” that would take place over the course of a couple months at a time. According to the report, the attacks have not ceased despite international outcry—with the most recent anti-LGBTQ Chechen purges taking place as recently as September and October 2018.

“They were taken to interrogation rooms and beaten with police sticks, plastic tubes and cables, which resulted in severe injuries like broken ribs, jaws, and bruises,” reads the OSCE report. “Some were also treated with electric shocks, usually at the fingers. The purpose was to make them confess that they were gay and to give names of other gays.”

The victims who were not killed, the report says, were often released to their families under the instruction that the family should kill them instead.

For the first time, the report also cites Chechen authorities’ attacks on lesbian and bisexual women, saying several had been “unlawfully detained and underwent beatings and pressures to produce confessions. In extreme cases, they were raped and killed.”

In a statement on Thursday, Human Rights Campaign global director Ty Cobb said the evidence of barbaric human rights violations in Chechnya was such that “the Russian government can no longer deny the existence.”

“World leaders, including the Trump-Pence administration, must take action to hold Russia and those responsible for the crimes accountable and to ensure these atrocious crimes have been stopped and never happen again,” said Cobb. “It’s crucial that Russia follow the report’s recommendations and launch a serious investigation, and that the world community—and especially the United States—welcome refugees escaping these gross human rights abuses.”

The OSCE report notes the Russian delegation refused to participate in the examination of Chechen abuses, despite being ordered to by a coalition of 16 member nations that called for it in November.

The 16 countries that requested the report on Chechnya’s anti-LGBTQ purges are Belgium, Canada, Denmark, Estonia, Finland, France, Germany, Iceland, Ireland, Latvia, Lithuania, the Netherlands, Norway, Sweden, the United Kingdom, and the United States.

The U.S. was among the first nations to speak out about Chechnya’s LGBTQ purges, after news reports at home and abroad revealed the horrific violence taking place. In an April 2017 statement shortly after the news began to break, then-ambassador to the United Nations Nikki Haley suggested that the U.S. should investigate.

“We continue to be disturbed by reports of kidnapping, torture, and murder of people in Chechnya based on their sexual orientation and those persecuted by association,” said Haley. “If true, this violation of human rights cannot be ignored–Chechen authorities must immediately investigate these allegations, hold anyone involved accountable, and take steps to prevent future abuses.”

And on Thursday, a State Department spokesperson addressed the new OSCE report, calling Russia’s continued denials of the Chechnya violence a “particularly serious threat” to its commitments and membership in the intergovernmental group.

“This expert report concluded that Chechen authorities committed torture and other appalling human rights violations and abuses, including extrajudicial killings of LGBTI persons and others, and describes a worsening ‘climate of intimidation’ against journalists and civil society activists,” said State Department deputy spokesperson Robert Palladino in a press release. “The report observes that the Russian government ‘appears to support the perpetrators rather than the victims’ and has ‘not lived up to its responsibilities’ to address the ‘grave situation’ in Chechnya.”