UNLV professor Jason Flatt’s research into Alzheimer’s and its effect on the LGBTQ+ community was inspired by his grandmother’s social isolation and struggle with the disease.

But his dreams of improving the lives of caregivers and elderly LGBTQ+ people were dashed earlier this year when the federal government canceled all federal funding toward his work — nearly $5 million in grants — on the basis that the projects dealt with transgender issues.

In a March 3 letter informing him of the cancellation, the National Institutes of Health (NIH) wrote that his research “no longer effectuates agency priorities. NIH is obligated to carefully steward grants to ensure taxpayer dollars are used in ways that benefit the American people and improve their quality of life. Your project does not satisfy these criteria.” 

It came as a gut punch for Flatt and his team of seven graduate assistants, who are now preparing for layoffs. Flatt said the current research project — which he once described as “THE grant I’ve been training for my entire career” — is vital to help better understand the unexplored nexus between an aging LGBTQ+ population and dementia diseases.

It’s estimated that there are 1 million caregivers who are LGBTQ+, but little study has been done on how to meet the needs of those caregivers. Flatt notes most federal and state services for caregivers are designed for biological family members, but members of the LGBTQ+ community often have “chosen family,” meaning they create their own family of people who aren’t biologically related but who don’t have the same level of services or resources that traditional caregivers have. 

It’s just one example of how the Trump administration’s budget cuts are rippling through Nevada and the higher education system. Last month, 20 people were laid off from the UNLV School of Public Health because of cuts to vaccination programs that were supported by pandemic-era grants. 

On Friday, Democratic Attorney General Aaron Ford joined a multistate lawsuit challenging the NIH grant cancellations, citing the canceled grants to UNLV in a press release, saying they are “illegal and will damage scientists’ ability to begin vital public health research or, in some cases, conclude research which has already begun.”

Andre Wade, president of Silver State Equality, Nevada’s statewide LGBTQ+ civil rights organization, said it’s “crazy” for the NIH to claim Flatt’s research no longer serves Americans.

“LGBTQ+ Americans are Americans, and we need to be served just like everybody else,” he said.

The research

Flatt’s work in brain health and Alzheimer’s began in 2015, after he had received his Ph.D. in public health and behavioral community health sciences. 

Hired at the University of California, San Francisco, he interviewed 20 senior citizens in the LGBTQ+ community, asking about their life history, concerns about dementia, if they have unique risks to the disease, and if they had plans for a diagnosis.

Flatt learned that those seniors — who fought for LGBTQ+ rights and marriage equality and lived through the AIDS epidemic — had lost up to 90 percent of their friend circles to the disease. 

“I left after doing that study, both with energy and a sort of sense of responsibility that these are my people,” Flatt said. “These are my people and we don’t know how to make sure that they know about their unique concerns around dementia.”

What are the unique concerns the LGBTQ+ community has around dementia? The population has historically lacked protections against discrimination in housing, employment and health care while many have also faced a lifetime of exposure to discrimination and trauma. 

LGBTQ+ individuals — who are less likely to get married or have children — are also two to three times more likely to live alone with little to no caregiver support, highlighting their higher rate of susceptibility to diseases such as Alzheimer’s and dementia.  

Flatt expected his career to slow down during the COVID-19 pandemic, but instead found new grant opportunities and a lot of interest in making sure LGBTQ+ people were supported. He ended up receiving a federal grant focused on ensuring LGBTQ+ people could participate in services and research, such as clinical trials for new drugs coming out. 

“We created advisory boards to guide all the work, different steps to generate ideas of how we include representation of all community members in it, and think about strategies how we reach people,” Flatt explained. “That is the work and that was one that was terminated.” 

Wade said it’s not surprising that the funding is being pulled, but he said that Nevadans will feel the detrimental effects.

“With the funding going away, it’s going to decrease our ability to know how well LGBTQ+ Nevadans are doing with health outcomes,” Wade told The Nevada Independent. “And the representation in that research means that we're not going to know some of the impacts of medications and interventions on our population.”

Since President Donald Trump took office, the NIH announced it would cut “indirect expenses” in grant funding, which affects academic institutions conducting research.

Many of Flatt’s colleagues from around the country who were focused on LGBTQ+ research also had their grants terminated last month. That includes grants supporting cancer and HIV research. 

Flatt also disputes the NIH’s assertion that his work is unscientific. He was initially rejected for one of the now-terminated grants, before revising and resubmitting the proposal and earning a perfect score on it. 

“That means every [scientist] gave it a perfect score, so while they’re [NIH] is saying it’s unscientific, other scientists must have saw a value in it,” he said.

One terminated grant was supposed to fund five years of research for $3.5 million; the project was nearing the end of year two. 

“It’s focused on LGBTQ+ caregivers and looking at those who are caring for someone with Alzheimer’s disease [so] that we can accurately measure their experiences,” Flatt said. “Think about chosen family, people that are caregiving from a distance. Many of us don’t live in the same city or state as a family member that’s being impacted by Alzheimer’s disease. How does that look?” 

Another grant focused on LGBTQ+ veterans with dementia. The Department of Defense awarded him $1.4 million for research that was supposed to start in January, and it was pulled right before final approval. 

“Usually a grant is terminated because you’re not delivering on what you promise to do, you’re not fulfilling the contract,” Flatt said. “And people think … you have $3.5 million in a bank account that we could just use. It doesn’t work like that.” 

The NIH doesn’t send the full $3.5 million once the research has been approved. Instead, it’s a reimbursement sent in installments. Once the grant is terminated, researchers no longer have access to receive those reimbursements. 

What’s ahead

UNLV promised to support Flatt’s graduate research assistants by funding their stipends for the rest of the spring semester. However, those graduate students could be in limbo unless they receive an assistantship elsewhere at the university. 

Flatt suspects that with federal funding being cut, assistantships will become more competitive and graduate students will lack the safety net of being employed by the university like they have been before. 

Wade believes it will take years to recover from the federal cuts. In order for LGBTQ+ health research to continue, private foundations and individual donors will need to step up. 

“[It] is a heavy lift because we're talking about millions of dollars,” Wade said. “But we have to figure out how to do the work without federal funding.”

Flatt acknowledged that during election season, he hadn’t considered the possibility that his own research would be directly affected by the Trump administration. 

However, Wade said the signs were there during the 2024 election. 

“Project 2025 outlines really the playbook, and so we knew that there was going to be an effort to literally erase representation and gender identity from all departments in the U.S. government,” Wade said. “It's not surprising. It's terribly unfortunate and disheartening.”

Flatt’s team of seven is now preparing for layoffs, and he is grappling with the loss not only of funding, but of years of effort poured into his work. 

“People don’t realize I spent years building the work and progress for this money,” Flatt said. “The grant I lost from the Department of Defense? Two years I spent on moving, demonstrating that I could do the work, and building the team and building relationships.”