Travis Gayles, MD, CEO of Howard Brown Health, took the helm of the organization during a moment of both celebration and crisis.
As the Chicago-based LGBTQ+ health center marks its 50th anniversary, it is also facing some of the most serious threats to queer health care in decades: sweeping federal funding cuts, political attacks on gender-affirming care and a hostile sociopolitical climate.
Gayles, who became CEO earlier this year, said his first months in the role have been shaped by honoring Howard Brown Health’s legacy while preparing for what’s next.
“I think the most important thing as part of the 50th celebration is to celebrate the mission upon which Howard Brown was founded,” Gayles told Windy City Times. “Howard Brown was founded as a place of creating meaningful access for folks who did not have any other options to help them address their health care needs.”
Meeting this moment means staying laser-focused on patient care while preparing for financial and political uncertainty, Gayles said. Even as LGBTQ+ communities face targeted attacks and health care access becomes more fragile, Gayles said his goal is to make sure Howard Brown remains a dependable, affirming place for care.
“Our biggest goal is to make sure that we are nailing the health care delivery process and providing our patients with a high-quality, highly efficient, smooth process that meets their needs but is also a pleasant health care experience for them,” Gayles said. “That takes on added significance right now in an environment where there’s lots of sociopolitical things going on, particularly as it relates to LGBTQ+ care.”
Honoring Howard Brown’s legacy while improving patient care
Gayles said Howard Brown’s 50th anniversary is a chance to reflect on the health care access gaps that led to its founding, as well as the organization’s continued role in filling them. Today, Howard Brown remains focused on providing access to care for communities most affected by health care discrimination and political attacks, Gayles said.
“It means [serving] folks who are living in zip codes that we serve throughout the city that … have historically been medical deserts, and also places where … life expectancy lags significantly behind other parts of the city, and health outcomes lag significantly compared to other parts of the city,” Gayles said.
Gayles also emphasized that Howard Brown should be a long-term medical home for patients.
“We really want to be an access point where folks can get the full continuum of care that they need to meet their primary care needs,” Gayles said.
But he acknowledged that Howard Brown’s history is complicated.
“In that 50 years of existence … Howard Brown hasn’t done everything right,” he said. “There are some … partnerships or parts of our larger community that haven’t had great experiences with Howard Brown. And I want to be intentional … about extending the opportunity to have conversations with those groups and with those individuals, so that we can learn from that past and course correct.”
Looking ahead, Gayles outlined his top priorities: improving patient outcomes, expanding services citywide, and protecting the health center’s mission from political and financial threats.
“We remain firmly committed to everything that we have historically provided … and are looking at ways to not only maintain those service but looking at ways where we can grow opportunities to expand access again for all of the communities we serve across the city,” Gayles said. “I firmly believe that if we stay true to those priorities and do those right, we’ll be able to increase our patient volume, increase the services we provide … and be in a position to not have to compromise any of the services that we’ve historically provided.”
Preparing for political attacks and building community partnerships
Federal cuts, including those in the so-called “Big Beautiful Bill,” have already begun to reshape the health care landscape. Gayles said one of the most concerning provisions is the reduction in Medicaid funding.
“We know that from that perspective, there are folks who may lose their coverage. And we want to make sure they understand that our team will continue to work to make sure that we’re identifying resources that those folks may be eligible for in terms of coverage, as well as maintaining as we can our sliding fee scale for those individuals who are uninsured and have difficulty making payments otherwise,” Gayles said.
Howard Brown is also bracing for potential cuts to HIV prevention and public health funding.
“We’ve been looking at ways how we can expand our staff, our resources and our organizational chart to be able to absorb that volume … so that folks in the Chicago community don’t experience … an interruption in terms of access to care,” Gayles said.
Although some anti-LGBTQ+ and anti-diversity provisions were stripped from the final budget bill, Gayles warned similar attacks are surfacing elsewhere, but Howard Brown is “continuing to be very mindful and pay attention to those executive orders and other types of mechanisms that could potentially impact the work that we do.”
In the face of these rising threats, Gayles said it’s important that LGBTQ+ organizations continue to work together.
“It really is going to take collective partnership and collaboration on behalf of all our organizations to support each other,” Gayles said. “I’m bullish that with good partnership and strategic partnership, we’ll be able to as best as we can, blunt some of the impact from a funding perspective and make sure our communities we serve have the resources they need.”