In October 1979, Graham joined Whitman-Walker Clinic's board. He helped the clinic survive its initial funding crises and in April 1981 became president of the board. Within three years, he became the executive director, leading the clinic's response to AIDS for 15 years. Under his leadership the clinic became a leading HIV/AIDS institution, with more than 1,200 volunteers, 270 full-time employees, and satellite operations in Southeast Washington, Maryland and Virginia. When Graham left Whitman-Walker in January 1999, it had become one of the most comprehensive community based medical organizations responding to HIV/AIDS in the country. In 1984, dismayed by the quality of legal support, Graham himself undertook the legal aid counseling of those with AIDS for 18 months: "I went to dying people to straighten out their legal affairs... in addition to other duties. It carried me right into the trenches; it created the whole experience. I vividly remember going to the bedsides, the horrible circumstances.... It was extremely emotional." In an oral history for the Rainbow History Project, Graham commented, "We've had one of the greatest epidemics of all time and this was the history, the history of the community banding together and helping itself. It was a phenomenal story." He says of the time: "It was the most difficult period that I've ever been through, there's no question."
Public service
Graham was first elected in 1998 and won reelection in 2002, 2006, and 2010 but was defeated in his bid for a fifth term in the Democratic primary election on April 1, 2014, by a margin of 41 percent to 59 percent for challenger Brianne Nadeau. He was the second openly gay elected official in D.C., after David Catania. He was an immigrant from Wishaw, Scotland, having become a naturalized as an American. and resided in Adams Morgan. Graham served as chairman of the Washington Metropolitan Area Transit Authority's board of directors twice—once in 2003 and again in 2009. In 1999 and 2007, Graham donated a large collection of his personal and professional papers to the George Washington University. The collection is under the care of GWU's Special Collections Research Center, located in the Estelle and Melvin Gelman Library. Committees Graham served as a member of the following committees on the D.C. Council:
In early 2005, Graham was accused of driving historically African-American businesses from the neighborhoods of Columbia Heights, Shaw, and the U Street corridor. The Washington City Paper reported on the accusation:
In early 2005, just as the Club U issue was heating up, posters portraying Graham as a reptile holding a pitchfork labeled "Grahamzilla" appeared on light poles and street signs around the ward. Another set of posters depicted Graham standing on a porch partying with young white men at the Graham "plantation." The latter included an illustration showing "Graham opponents" hanging from a gallows. The posters stretched the limits of political speech and disappeared quickly after they were put up.
On September 24, 2009, Graham's Chief of Staff, Ted Loza, was arrested by the FBI and charged with two counts of accepting bribes. The indictment alleges that Loza accepted two payments and promised to promote the legislation and policies concerning D.C. taxi cabs that the alleged briber wanted. Graham was the chairman of the committee that oversees taxi cab regulation, but he voluntarily gave up oversight of cabs after Loza's arrest. The District of Columbia Board of Ethics and Government Accountability found substantial evidence that Graham asked a developer to withdraw its bid for a real estate project so that another firm, who had donated to Graham, could win the bid. In exchange, Graham offered to support the firm's bid for a lottery contract, violating the District employees code of conduct. The District Council also reprimanded Graham for his inappropriate actions. Graham described his actions as political horsetrading rather than anything illegal or unethical.