Junior researchers’ chances of sustaining the rest of their PhD degrees seemed to evaporate overnight—simply due to their affiliation with the LGBTQ Mental Health Initiative
In the spring of 2019, a group of twenty-one queer Black and Latino men gathered in the Fair Haven Community Health Care. At night, they slipped into a building near New Haven’s Mill River, spending ninety-minute sessions sharing their experiences of homophobic and racist discrimination.
Led by two clinical psychologists under Yale’s ESTEEM lab, the meetings were trial sessions for a new form of LGBTQ-affirmative group therapy. After ten weeks, these sessions became an important space for the participants. The men reported feeling less alone. Many spoke with a new sense of pride.
“I came out to my mom. I came out to a lot more friends, and now I’m not ‘in the closet,” the participant said in his exit interview three months after the sessions. “I’m just living my best life.”
As a graduate research assistant at ESTEEM, Tyler Harvey helped recruit participants for the group therapy program. Harvey, who spoke with me between cram study sessions for their first medical licensing exams, had wrestled with the invisibility of non-binary gender identities in the healthcare system.
Witnessing therapy sessions that successfully foregrounded their participants’ marginalized sexual and racial identities catalyzed the rest of Harvey’s academic trajectory. Despite writing their master’s thesis on mass incarceration, they began to consider becoming a scholar-physician in the field of LGBTQ+ public health research.
In 2023, Harvey returned to Yale to pursue an MD-PhD degree, seeking training under Dr. John Edward Pachankis, the David R. Kessler, M.D. ’55 Professor of Public Health and ESTEEM’s founder. Pachankis grew up in Louisiana and received his undergraduate degree from Loyola University in 2002, before training as a clinical psychologist at Stony Brook University. During his undergraduate years, he came out to his grandfather, who advised him to take a “conscientious approach to the task of being gay.”
Pachankis has been a key figure in LGBTQ+ mental health research from its outset in the early 2000s, when federal funding for the field was virtually nonexistent. Over the past decade or so, funding from the NIH has allowed Pachankis to expand ESTEEM into the Yale LGBTQ Mental Health Initiative, now a high-profile program within the Yale School of Public Health (YSPH). One YSPH press release describes Pachankis’s lab as “one of the world’s leading academic centers on LGBTQ+ mental health research.”
But on March 21st, 2025, the financial infrastructure supporting the LGBTQ Mental Health Initiative collapsed. The Trump administration launched a nationwide attack against NIH-funded scientific research in categories that did not support “agency priorities,” targeting projects relating to DEI, vaccines, and gender.
As part of the first wave of cuts to Yale-affiliated NIH projects, the federal government terminated every one of the LGBTQ Mental Health Initiative’s grants, amounting to a total loss of $5 million.
Heading into their third year of the MD-PhD program, Harvey had spent the previous summer writing an NIH diversity supplement grant application, which would cover the tuition costs of their PhD. Since 1989, the grant has been a standard source of financial support for underrepresented students. But since the diversity supplement Harvey sought was tied to Pachankis’s project, the NIH automatically deemed his application ineligible for review and funding. Without reliable funding and a PhD advisor, Harvey wasn’t sure they would be able to finish their MD-PhD degree—due merely to their affiliation with the LGBTQ Mental Health Initiative. With little over a month to find another advisor, Harvey was in crisis. At one point, they seriously considered dropping out of the PhD program altogether. For many early career researchers in the field of LGBTQ+ public health, their research is inseparable from their identities as queer people. They’ve invested years of training to serve queer communities, and the nascent field’s future hinges on their generation. Now, faced with NIH funding cuts, they’re being pushed to avoid any association with the LGBTQ community in their research. They’re questioning whether they can stay in the field at all.
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in the Psychological Bulletin on the psychological impacts of concealing one’s sexuality. He noted that queer people developed higher rates of depression and anxiety when concealing their sexual orientations, even when they did not face open discrimination. This corresponds with the American Psychiatric Association’s finding that members of the LGBTQ+ community are 2.5 times more likely than heterosexual people to struggle with depression, anxiety, and substance misuse.
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In the early 2000s, population-based mental health surveys had just started to recognize LGBTQ+ identities. But Pachankis’s 2007 paper set the rest of his work in motion. In 2013, he began Project ESTEEM, which offered cognitive behavioral therapy (CBT) geared towards queer men. He founded the LGBTQ Mental Health Initiative six years later, expanding the lab’s scope to encompass a wider range of sexual and gender minorities.
In 2016, fresh out of Pennsylvania State University, TJ Sullivan joined ESTEEM as a postbaccalaureate research assistant. Sullivan spoke softly but deliberately as he recounted his undergraduate trajectory. At the time, he had just come out and wanted to apply his experience in researching relationship stress to the queer community.
Sullivan entered the field of queer psychotherapy at a time when the tides of federal funding were rapidly shifting in favor of LGBTQ+ issues. In 2014, transgender health had first entered the NIH’s radar. Professional organizations focused on LGBTQ+ research were starting to sprout nationwide, gathering in small conference rooms from Northwestern to Stanford. At ESTEEM, Sullivan helped Pachankis launch the first evidence-based trial of an LGBTQ-affirmative form of CBT in 2016, which would eventually become the group therapy trial at the Fair Haven Community Health Care.
ESTEEM turned one-off case studies on LGBTQ-affirmative therapy into clinical trials, aiming to create a standardized set of principles and techniques: validating painful adolescent experiences, undoing internalized homophobia, and encouraging self-expression.
While the American Psychological Association had first sketched guidelines on conducting LGBTQ-affirmative therapy in 2000, their techniques had lacked rigorous, evidence-based implementation. The community clinicians hired for Pachankis’s trial followed a ten-module plan that directly addressed queer needs, such as information about HIV prevention and intimacy in relationships.
“If found to be efficacious,” Pachankis wrote in his 2014 proposal for the pilot trial of ESTEEM, “the psychosocial intervention described here would be one of the first to improve the mental health of gay and bisexual men by targeting minority stress.”
Sullivan oversaw the protocol’s implementation, watching clients break lifelong patterns of emotional avoidance. Many of the clients spoke about needing to shut down and ignore their queerness in order to survive, he said. “It’s kind of hard not to come out unscathed in that environment.”
In 2023, Pachankis won a $4 million grant from the NIH to implement his novel CBT methods in over ninety low-resource community health centers, training other clinicians across the country in their techniques. A year later, Sullivan returned to the project, now with a PhD in clinical psychology under his belt.
Meanwhile, investment in LGBTQ+ public health research grew: the scattered thirty-person gatherings where Sullivan started his career became packed hotel ballrooms. In 2024, the Hetrick-Martin Institute, a New Yorkbased LGBTQ+ nonprofit, awarded the LGBTQ Mental Health Initiative with the Emery Award, an honor shared by stars Dominique Jackson, an actress on the TV show Pose and Leiomy Maldonado, a judge on HBO’s Legendary. Sullivan attended the ceremony in a black sequined blazer, posing for photos alongside Pachankis.
But three months into Trump’s second term, five projects under the LGBTQ Mental Health Initiative received termination notices from the NIH’s extramural research program. This included the $4 million CBT-implementation project and Project EQuIP, a version of ESTEEM originally intended to stay for a second year of postdoctoral training, but the funds to extend his contract vanished.
The NIH’s cuts explicitly targeted grants containing keywords such as “AIDS,” “transgender” and “LGBTQ,” halting many operations mid-trial. The termination notices came from the NIH’s director of external funding. This overrode the typical chain of communication between the NIH’s program officers and university principal investigators, according to Jeffrey Wickersham, a Yale researcher.
“Research programs based on gender identity are often unscientific, have little identifiable return on investment, and do nothing to enhance the health of many Americans,” the termination notices declared. “No corrective action is possible here.” Never, in the history of the NIH, have grants been terminated without the option to appeal.
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While Pachankis’s faculty position at Yale remains secure, early career researchers—whose salaries and future career prospects depend on grants—are most vulnerable to the NIH’s haphazard terminations.
“It feels treacherous,” Sullivan said. “If funding gets cut in any way, so does your job.”
In contrast to academic departments within Yale’s Faculty of Arts and Sciences, the LGBTQ Mental Health Initiative operates under the Yale School of Medicine and the YSPH. The two schools rely on a soft funding structure: rather than receiving money from Yale’s annual budget, researchers are expected to apply for extramural funding from one of the NIH’s twenty-seven research institutes to round out their salaries. Almost all faculty members receive 70 percent or more of their salary from grants. In 2023, YSPH faculty won $70 million in grants. Two thirds of that funding came from the NIH.
Postdoctoral positions rely even more on a steady influx of NIH funding: some positions are entirely funded by external grants, while others receive funding from a mix of grants and university funds. The funding for Sullivan’s postdoctoral position was pieced together from grants awarded to the Initiative, including Project EQuIP, the CBT-implementation project, and a program supporting parents of LGBTQ children. Sullivan divided his time among these programs, pivoting from clinical supervision and therapeutic treatment for the women under Project EQuIP to mental health screenings and participant recruitment.
When the grants were terminated, all of Sullivan’s funding sources collapsed. In the absence of active projects, he feared that his postdoctoral training goals—gaining experience in clinical work and supervision—were now completely off the table.
Yale intially agreed to extend $102,000 to Pachankis to cover lab members’ salaries. But Pachankis notes this amount only compensated 120 days of work, ending in late July—a month shorter than their annual contracts. Lab members had no promise of pay beyond that point. Sullivan was uncertain if he would still have a job come August.
Ultimately, Yale only covered about 4.4 percent of the original $5 million the Initiative had received in NIH funding, intended to last over three years of research. Yale’s temporary contribution could not sustain the Initiative in the long term.
In February, before the LGBTQ Mental Health Initiative’s termination, Yale had announced a bridge funding policy for projects impacted by federal funding cuts. According to an informational webpage for Yale faculty, the policy claims to cover the salaries of impacted research staff.
“Bridge funding requests should articulate a compelling rationale for support (for example: that without support Yale might lose talent and skills that took significant time and investment to build),” stated the Dean of Yale’s Faculty of Arts and Sciences in an internal memo to Yale faculty.
Pachankis requested $275,000 of bridge funding to retain members of his staff for another year. That request was denied.
According to Pachankis, Yale School of Public Health administrators implied in private conversations that he should deplete all his non-federal research accounts before requesting additional institutional funding, because he had received prior funds from private donors. “However, these other accounts would only cover a small fraction of the lost NIH funding and would therefore be depleted quickly,” Pachankis said
When asked to comment, the YSPH’s office emphasized their commitment to supporting faculty and students affected by the terminations. “We have worked diligently to secure bridge funding that covers salaries, protects ongoing data collection, and sustains scholarship during this period,” YSPH’s chief of staff wrote. “While such support cannot fully offset the scale of lost federal research dollars, we are prioritizing early-career researchers, including PhD students, as well as protecting patients in clinical trials.”
The YSPH did not directly respond to the claim that Pachankis’s bridge funding was denied, nor that he was asked to deplete all his research accounts before requesting additional funding.
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Without the $5 million in NIH grants, Pachankis and the rest of the Initiative got creative. After the terminations, the Initiative received
$70,000 in funding from the YSPH’s Department of Social and Behavioral Sciences’s director. Combined with private donations, the money allowed Pachankis’s team to complete the guaranteed ten-session therapy treatments and perform safe closeouts for the rest of the Initiative’s studies.
The women under Sullivan’s care in Project EQuIP had been chosen specifically for their histories of depression, anxiety, suicidality, and substance abuse. They wanted help. They wanted treatment.
By completing the ten sessions, Sullivan helped equip each woman with emotional coping strategies and relapse prevention techniques. When some of his clients voiced suicidal ideation or displayed serious depressive symptoms, Sullivan conducted mental health assessments to ensure their safety.
One of the private donors who helped support the LGBTQ Mental Health Initiative’s closeouts was Jamie Marks ’83, a Yale alum who had previously partnered with the Initiative to help recruit participants for studies. The YSPH’s press publicized the move as a bona-fide miracle. “His gift saved the study,” the headline proclaimed. It allowed Pachankis’s core team to continue a project on building family support for LGBTQ+ youth.
Marks’s donation signaled a shift toward an alternative to the NIH’s base of federal funding: private philanthropy. As a research assistant for the Initiative, Meredith McGee MPH ’25 has contributed to grant writing for Pachankis since 2024, after spending her undergraduate summers working in queer advocacy at LGBTQ+ community centers. In 2022, McGee had helped write a grant proposal for a family story hour event that congressional representative Marjorie Taylor Greene criticized as “left-wing Marxist indoctrination.” McGee saw this backlash as part of a broader conservative shift in philanthropic funding. Over time, she started writing grant applications without explicitly mentioning projects’ connections to the LGBTQ+ community.
“Before we were the LGBT community center, and now it’s more a community center where we serve these people to the best of our ability,” she said. “The language that we once relied on as a gold standard is now words that we have to try and stay away from.”
After the funding cuts, McGee helped draft the LGBTQ Mental Health Initiative’s applications to philanthropic donors. Pachankis’s team highlighted the impact on community rather than science, and pivoted to training other clinicians rather than developing new clinical trials.
“Typical philanthropy doesn’t fund research,” McGee explained.
In all his email communications and press releases, Pachankis emphasizes the applications of the Initiative’s research to “all people.”
“Our work to implement mental health care in 90 LGBT community centers across the U.S.,” he said, “informs how to implement mental health care in other low-resource community settings for other populations nationally.”
By rephrasing their primary research objectives, the Initiative risks conceding to the federal government’s thesis that DEI-related projects are “antithetical to the scientific inquiry.”
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In July 9, six months after the initial terminations, the LGBTQ Mental Health Initiative’s grants were abruptly reinstated.
The NIH did not provide specific reasons for their decision. For one of Pachankis’s projects, he received a half-apology “This award was inadvertently misidentified and does not support DEI activities.”
A week later, the reason for the reinstatements became clearer: they were a result of a lawsuit filed by the American Public Health Association (APHA) and a coalition of state attorneys against the NIH. The judge ruled that the abrupt cuts were “void and illegal.” Pachankis would now receive all the money originally awarded to his projects, restoring funding for the entire Initiative.
Despite these reinstatements, Pachankis’s team has already begun to shrink. At least three members of the LGBTQ Mental Health Initiative’s team have departed for different fields. McGee is considering cannabis research, while another student is working on VR-assisted mental health interventions. Without its base of MPH research assistants, the Initiative has been operating only at partial capacity, focusing mostly on undoing the damage of the funding cuts. Over the summer, Pachankis’s already-reduced team has been overwhelmed by administrative tasks: drafting overdue progress reports, updating ethics approvals, and reconvening data safety review boards.
Pachankis is currently in the process of rebuilding entire research teams for the various projects gutted by the funding cuts. In August, he uploaded a job posting for a postgraduate associate for the 2025-2026 school year. But the process of rehiring and retraining incoming research associates will take months at best, and delay the Initiative’s ability to relaunch clinical trials.
Now, the Initiative’s active projects have yet to restart their recruitment phases. “Recruiting starting in Fall 2025!” reads the “Project Status” section on Project EQuIP’s webpage. As of late September, recruitment had not begun.
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Having already invested their postgraduate years in LGBTQ+ public health research, Sullivan and Harvey are determined to stay in academia. Through the generosity of another professor,Sulliva joined another department at the Yale School of Medicine, allowing him one more year of training.
Ultimately, Sullivan’s future in academia is subject to the whims of the NIH’s current research priorities. He has built an entire career around aiding the LGBTQ+ community—an area that the NIH has explicitly deemed “unscientific” and “ignorant of biological realities” in its internal memos.
While some university administrators have advised researchers to modify the language of their grant applications to pass the NIH’s filters, the solution is not as simple as excising all mentions of queerness.
If Sullivan concentrated his future grant applications solely on his other research interests, his CV would still be littered with evidence of his background in LGBTQ+ mental health. Ten out of his fourteen publications directly concern queer issues, containing vulnerable keywords such as “sexual minority” and “gender identity.”
And in an academic job market as competitive as today’s, Sullivan cannot afford to equivocate.
“We spend our careers developing expertise in this particular area and being able to showcase that you are someone who has the background to carry out this research,” he said. “If you suddenly pivot to something that is still related but you don’t have direct experience in [that field], it makes it automatically more difficult for you to make a convincing case to reviewers.”
“The language that we once relied on as a gold standard is now words that we have to try and stay away from.”
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This is not the future Harvey had imagined seven years ago when they first started working at ESTEEM as a research assistant.
Harvey had started carving out a new niche in public health. In 2021, they published a paper on the psychosocial health of incarcerated gay and bisexual men, bridging their experience of queerness and parental incarceration. Harvey had hoped their rigorous training in LGBTQ+ public health would help them develop this subfield.
After the cuts, Harvey needed to find a new PhD advisor within a month and a half, or risk taking on more debt for tuition. Although they tried to remain connected to Pachankis and carry out their PhD research as originally intended, the YSPH’s administrators suggested that they simply find a different advisor in a different area of research. The YSPH did not directly respond to a request for comment.
Harvey managed to find a different mentor associated with Yale’s SEICHE Center for Health and Justice, which focuses on the public health impacts of mass incarceration. They have pivoted to a research area that is less controversial than DEI-related fields.
On the surface, Harvey’s choice to join SEICHE seems like a seamless transition. As a student still drafting their PhD dissertation proposal, they’re able to reframe the narrative of their research, distancing themself from LGBTQ+ work far more easily than Sullivan can. One could write a moving profile of Harvey’s academic trajectory that completely omits any mention of the words “queer” or “LGBTQ.”
In fact, such a profile exists. In a February 2024 interview for KidsMates, a national nonprofit organization that supports children struggling with parental incarceration, Harvey frames their path towards medicine as primarily motivated by their childhood exposure to the criminal legal system. They trace an alternative timeline of their career that highlights their master’s research on the health impacts of family member incarceration and their three years working at the SEICHE Center as stepping stones towards their current work.
“So, what I’m doing now is training to be a physician-scientist who does research on the health impacts of mass incarceration,” Harvey concluded in the KidsMates interview.
But this statement diverges widely from Harvey’s original intentions for their degree—to become a leading scholar-physician in LGBTQ+ research. It glosses over their experiences as a graduate teaching fellow for Pachankis’ class titled “LGBTQ Population Health,” their publication in LGBT Health, and their presentation on queer adolescent health at the APHA’s conference.
“Hopefully one day I’ll still be in a position to do that type of work,” Harvey said. “But it won’t happen while I’m at Yale.”
Their voice was resigned. A year before the LGBTQ Mental Health Initiative’s terminations, they published an op-ed in the American Journal of Public Health calling for more LGBTQ-inclusive language in public health research.
“I present two arguments regarding the implications around the lack of LGBTQ+-inclusive language in public health: (1) it is an injustice, and (2) it is bad for science,” Harvey wrote. “If the language of public health does not even present options that appropriately and fully include us, how can we ever be truly represented? It is a moral failure of the field.”∎
Ashley Wang is a junior in Jonathan Edwards College.
This piece was supported by the Henry Koerner Center for Emeritus Faculty.
