As they had last year, federal health officials initially agreed to underwrite this year's "Healing Works" conference on lesbian health issues, promising $75,000 for the two-day session this fall.
But early this summer, federal officials notified conference organizers that the promise to underwrite the conference had been rescinded.
Officials at the Department of Health and Human Services blamed the decision on technical problems in the grant application. But conference organizers and other activists say they are skeptical, and believe the decision was part of a series of moves by the Bush administration that have been hostile to issues important to gays and lesbians.
"Lesbians have been left out of research; they don't have equal access to care," said Kathleen DeBold, executive director of the Mautner Project, the nation's leading lesbian health advocacy group. "This could have killed the conference."
DeBold said two high-ranking staffers told her a "conference on lesbian health did not fit with Secretary [Tommy G.] Thompson's vision."
DeBold scrambled for private donations, increased the registration fee from $75 to $300 and managed to hold the conference last weekend in the District.
But the incident has fueled growing concerns by activists.
"The big problem with the Bush administration is not that they are blatantly attacking lesbian and gay populations," said Patricia Dunn, policy director of the Gay and Lesbian Medical Association. "It's just that they've been completely silent."
Winnie Stachelberg, political director for the Human Rights Campaign, said there have been other instances in the past year when the administration has rescinded a promise of financial support, transferred people serving as gay liaisons to federal agencies and distanced itself from supporters of comprehensive sex education such as Secretary of State Colin L. Powell.
"Any one or two or three of these things would be merely policy changes or the natural course of a new administration, but taken together they are of real concern to us," Stachelberg said. "While we hope that anti-gay bias is not going on at the department, it's hard to look at the totality of these things and not wonder what is going on."
HHS spokesman Bill Pierce said he could not respond to specific charges but overall, "if you look at the record of the administration's commitment in these areas, you'll find it is stronger than any other administration."
In a 10-year report titled "Healthy People 2010," HHS identified sexual orientation as one of six factors that cause health disparities. The document was written by Surgeon General David Satcher, who was appointed by President Bill Clinton and served for the first year of the Bush administration.
But current HHS initiatives on closing inequities in the health care system never mention sexual orientation, Dunn said.
And despite a promise to distribute the "Healthy People" recommendations on sexual orientation at a cost of about $20,000, Stachelberg said HHS reversed its position.
The idea for a conference on lesbian health issues came out of a 1999 Institute of Medicine report that found "significant barriers to conducting research on lesbian health."
The panel of experts recommended eight steps for improving the situation, including increased research funding, better data collection, education campaigns and regular conferences.
In response, HHS hosted the first scientific workshop on the issue in 2000, and last year the department spent about $50,000 on the first National Lesbian Health Conference in San Francisco.
Early data suggests lesbians often face difficulties getting adequate care because of anti-gay bias, poorly informed physicians and cultural differences, said Judy Bradford, an Institute of Medicine panelist and senior researcher at Virginia Commonwealth University.
Lesbians also have higher rates of tobacco use, heavy drinking and certain cancers in which early detection is critical, such as breast and ovarian cancers, she said.
"That's why there is a need to do more research and have these conferences," said Gloria E. Sarto, co-director of the Center for Women's Health and Women's Health Research at the University of Wisconsin.
Sarto said she sent numerous e-mails to contacts in the department asking why it had withdrawn support for the conference and even mentioned it in passing to Thompson's wife, who works in women's health.
"I didn't get a response," she said. "But it sends a message, whether it's meant to be or not, the perception is this is not on their agenda."
© 2002 The Washington Post Company