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Medicare to examine ban on gender reassignment surgery

Rationale for policy ‘not complete and adequate’

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transgender, caduceus, medicare, gay news, Washington Blade, health
transgender, caduceus, medicare, gay news, Washington Blade, health

HHS is set to reconsider the ban on Medicare-provided gender reassignment surgery. (Image public domain)

The Obama administration is set to re-examine the ban that prohibits Medicare from covering gender reassignment surgery, according to a memorandum obtained Tuesday by the Washington Blade.

The document from the Department of Health & Human Services, dated Dec. 2, finds that the reasoning for the ban is “not complete and adequate” to support denying Medicare coverage for transgender people seeking the procedure.

The HHS Department Appeals Board states the ban — which is codified as National Coverage Determination 140.3 — “fails to account for development in the care and treatment” for transgender people over the course of the last 30 years.

The next step, the memo states, is proceeding into a “discovery” phase for the taking of evidence to determine whether the ban can be justified.

Mara Keisling, executive director of the National Center for Transgender Equality, said “there really isn’t that much to say” at this point in the process.

“This is really a preliminary step,” Keisling said. “It’s a good sign, but we have more to go on this.”

Masen Davis, executive director of the Transgender Law Center, was optimistic the ban would be lifted following the discovery process.

“Current Medicare standards are based on science from the 1960s, so it’s about time for a review,” Davis said. “Because the current scientific evidence overwhelmingly shows that sex-reassignment surgeries are effective and medically necessary treatments for some transgender individuals, we are hopeful the board will find the exclusion is not supported.”

The DAB initiated the review of the ban on Medicare-provided gender reassignment surgery in response to a request filed in March by a quartet of LGBT advocates: the National Center for Lesbian Rights, the American Civil Liberties Union, Gay & Lesbian Advocates & Defenders and civil rights attorney Mary Lou Boelcke.

The challenge was filed on behalf of Denee Mallon, a 73-year-old transgender woman in Albuquerque, N.M. A Medicare recipient, Mallon was recommended to have gender reassignment surgery by doctors to treat her gender dysphoria

In a joint statement provided to the Washington Blade in response to the HHS memorandum, the ACLU, NCLR and GLAD expressed optimism that DAB would come to the conclusion after discovery that the ban on Medicare-provided gender reassignment surgery should be lifted.

“Because the current evidence overwhelmingly shows that sex-reassignment surgeries are effective and medically necessary treatments for some individuals with gender dysphoria, we are hopeful the Board will find the exclusion is not supported,” the statement says.

According to the memorandum, the ban was put in place in 1989 as a result of a 1981 report from the National Center for Health Care Technology, an arm of HHS. The report concluded “transsexual surgery not be covered by Medicare at this time” because of the high rate of complications and questions about whether it was effective in treating gender identity disorder.

“Transsexual surgery for sex reassignment of transsexuals is controversial,” the regulation states. “Because of the lack of well controlled, long term studies of the safety and effectiveness of the surgical procedures and attendant therapies for transsexualism, the treatment is considered experimental. Moreover, there is a high rate of serious complications for these surgical procedures. For these reasons, transsexual surgery is not covered.”

Despite the institution of this policy, the American Medical Association and the American Psychological Association support gender reassignment surgery for transgender people as a means to treat gender identity disorder.

Notably, the Centers for Medicare & Medicaid didn’t put up a fight in response to the request from LGBT advocates to lift the ban. According to the memo, CMS notified the board in June that it wouldn’t submit a response to their request to lift the ban.

Neither HHS nor CMS responded to the Blade’s request for comment on the determination or why it declined to defend the ban.

It’s unclear when the discovery period for reevaluating the ban on Medicare-provided gender reassignment surgery will come to an end. Shawn Jain, a spokesperson f0r the ACLU, said his organization doesn’t know when the process will be complete.

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District of Columbia

Rush reopens after renewing suspended liquor license

Principal owner says he’s working  to resolve payroll issue for unpaid staff

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Pictured is a scene from the preview night at Rush on Nov. 28. Rush reopened on Saturday after a brief closure. (Blade file photo by Michael Key)

The D.C. LGBTQ bar and nightclub Rush reopened and was serving drinks to customers on Saturday night, Dec. 20, under a renewed liquor license three days after the city’s Alcoholic Beverage and Cannabis Board suspended the license on grounds that Rush failed to pay a required annual licensing fee.

In its Dec. 17 order suspending the Rush liquor license the ABC Board stated the “payment check was returned unpaid and alternative payment was not submitted.”

Jackson Mosley, Rush’s principal owner, says in a statement posted on the Rush website that the check did not “bounce,” as rumors circulating in the community have claimed. He said a decision was made to put a “hold” on the check so that Rush could change its initial decision to submit a payment for the license for three years and instead to pay a lower price for a one-year payment.

“Various fees and fines were added to the amount, making it necessary to replace the stop-payment check in person – a deadline that was Wednesday despite my attempts to delay it due to these circumstances,” Mosley states in his message.

He told the Washington Blade in an interview inside Rush on Saturday night, Dec. 20, that the Alcoholic Beverage and Cannabis Administration (ABCA) quickly processed Rush’s liquor license renewal following his visit to submit a new check.

He also reiterated in the interview some of the details he explained in his Rush website statement regarding a payroll problem that resulted in his employees not being paid for their first month’s work at Rush, which was scheduled to take place Dec. 15 through a direct deposit into the employees’ bank accounts.

Several employees set up a GoFundMe appeal in which they stated they “showed up, worked hard, and were left unpaid after contributing their time, labor, and professional skills to Rush, D.C.’s newest LGBTQ bar.” 

In his website statement Mosley says employees were not paid because of a “tax related mismatch between federal and District records,” which, among other things, involves the IRS. He said the IRS was using his former company legal name Green Zebra LLC while D.C. officials are using his current company legal name Rainbow Zebra LLC. 

“This discrepancy triggered a compliance hold within our payroll system,” he says in his statement. “The moment I became aware of the issue, I immediately engaged our payroll provider and began working to resolve it,” he wrote.

He added that while he is the founder and CEO of Rush’s parent and management company called Momentux, company investors play a role in making various decisions, and that the investors rather than he control a “syndicated treasury account” that funds and operates the payroll system.

He told the Blade that he and others involved with the company were working hard to resolve the payroll problem as soon as possible. 

“Every employee – past or present – will receive the pay they are owed in accordance with D.C. and federal law,” he says in his statement. “That remains my priority.” 

In a follow-up text message to the Blade on Sunday night, Dec. 21, Mosley said, “All performers, DJs, etc. have been fully paid.” 

He said Rush had 21 employees but “2 were let go for gross misconduct, 2 were let go for misconduct, 1 for moral turpitude, 2 for performance concerns.” He added that all of the remaining 14 employees have returned to work at the time of the reopening on Dec. 20. 

Rush held its grand opening on Dec. 5 on the second and third floors of a building at 2001 14th Street, N.W., with its entrance around the corner on U Street next to the existing LGBTQ dance club Bunker. 

With at least a half dozen or more LGBTQ bars located within walking distance of Rush in the U Street entertainment corridor, Mosley told the Blade he believes some of the competing LGBTQ bars, which he says believe Rush will take away their customers, may be responsible along with former employees of “rumors” disparaging him and Rush. 

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India

Few transgender people benefit from India’s low-income housing program

Pradhan Mantri Awas Yojana launched in 2015

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(Photo by Rahul Sapra via Bigstock)

The Indian government on Dec. 15 informed parliament that only one transgender person in Jammu and Kashmir has been recorded as a beneficiary under the Pradhan Mantri Awas Yojana since the housing program was launched a decade ago. 

PMAY is a federal government program aimed at expanding access to affordable housing for low- and middle-income households, including through credit-linked subsidies. The parliamentary disclosure indicates that trans beneficiaries have been virtually absent from the program’s records in the union territory, despite official guidelines listing trans people as a priority category.

In a written reply to a question in the upper house of parliament, known as the Rajya Sabha, the Housing and Urban Affairs Ministry said Jammu and Kashmir recorded zero trans beneficiaries under the program in each financial year from 2020–2021 through 2025–2026, with the cumulative total since inception remaining at one.

The Indian government launched the program on June 25, 2015, and the Housing and Urban Affairs Ministry implemented it.

The parliamentary reply came in response to a question on whether trans people are being included under the housing scheme and what steps have been taken to address barriers to access. The ministry said both PMAY and its successor, PMAY 2.0, are demand-driven programs, with responsibility for identifying and selecting beneficiaries resting with state and regional governments.

The ministry said the program lists trans people as a priority group, alongside widows, single women, people with disabilities, senior citizens, and other socially disadvantaged categories. It added that actual implementation depends on housing proposals and beneficiary lists submitted by state and regional governments.

According to figures the Indian government cited, a total of 809 trans beneficiaries have been recorded under PMAY and its successor, PMAY 2.0, since the programs were launched, with the vast majority concentrated in a small number of states. The southern state of Tamil Nadu accounts for 222 beneficiaries, followed by Andhra Pradesh with 186, and Odisha with 101. By contrast, several other states and federally administered regions, including Jammu and Kashmir, have reported either negligible or no coverage. India is administratively divided into 28 states and eight federally governed territories.

According to India’s 2011 national Census, Jammu and Kashmir recorded 4,137 trans residents. The same census counted 487,803 trans people nationwide, providing the most recent official population baseline for the community in India.

The ministry also said it has not conducted a specific survey to assess barriers faced by trans communities in accessing the scheme’s benefits. Instead, it said lessons from earlier implementation phases informed the design of the second phase of the program, launched on Sept. 1, 2024, which aims to support an additional 10 million urban beneficiaries over the next five years.

The parliamentary reply reveals an even more severe gap in Ladakh, India’s northernmost federally governed territory bordering China and Pakistan-administered areas and considered strategically critical to national security. 

Official records show that Ladakh has not reported a single trans beneficiary under the housing scheme, either in recent years or cumulatively since the program began, with zero coverage recorded across all financial years listed in the Annexure. By comparison, Ladakh’s trans population stands at six, according to a written submission made to the High Court of Jammu and Kashmir in 2024.

Despite trans people being listed as a priority group in the scheme’s guidelines, the federal government said that as of November 2025 it had sanctioned more than 12.2 million homes nationwide under both versions of the program, with over 9.6 million homes completed and delivered. At the same time, data from Jammu and Kashmir, Ladakh, and several other regions show little to no recorded housing uptake by trans beneficiaries.

Speaking with the Washington Blade, Meera Parida, a trans activist, former member of the National Council for Transgender Persons in India’s eastern zone, and a former state advisor under the housing and urban development department, said the 2011 Census does not reflect the full size of India’s trans population, noting that public recognition and self-identification were far more limited at the time. She pointed to later government data collection efforts, including the National Portal for Transgender Persons that the Social Justice and Empowerment Ministry launched in 2020, as evidence that official counts have expanded beyond what was captured in the last Census.

“I am surprised that around the country only over 800 people benefited from the scheme, because most of the transgender population is from socially backward classes,” said Parida. “So they do not have a house and no family. Five years have passed since the NALSA judgment and the Transgender Protection Act; even after all these, if only over 800 transgender persons got home, that is a sad situation.”

Parida said that Prime Minister Narendra Modi has publicly positioned trans people’s welfare as a priority, but argued that the issue requires greater attention at the administrative level. She said the prime minister’s office should issue clear directions to all relevant departments to ensure trans people receive housing support and that implementation moves more quickly.

“There is still widespread discrimination and stigma against the community. Many transgender people are afraid to speak openly, which is why this issue continues to persist,” Parida said. “If stigma and discrimination are not addressed seriously, the marginalized community will remain invisible and reluctant to come forward. In that situation, the government will also be limited in what it can do. State governments should work with activists and community organizations to build accurate data. The government has decided to resume the Census in 2026, but the enumerators who go door to door must be sensitized to engage respectfully with the transgender community. The government should also improve awareness of housing schemes, because many people simply do not know they exist. A single-window system is needed.”

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Israel

A Wider Bridge to close

LGBTQ Jewish group said financial challenges prompted decision

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U.S. Rep. Debbie Wasserman Schultz (D-Fla.) speaks at the Capital Jewish Museum in D.C. on June 5, 2025, after A Wider Bridge honored her at its Pride event. A Wider Bridge has announced it will shut down. (Washington Blade photo by Michael K. Lavers)

A Wider Bridge on Friday announced it will shut down at the end of the month.

The group that “mobilizes the LGBTQ community to fight antisemitism and support Israel and its LGBTQ community” in a letter to supporters said financial challenges prompted the decision.

“After 15 years of building bridges between LGBTQ communities in North America and Israel, A Wider Bridge has made the difficult decision to wind down operations as of Dec. 31, 2025,” it reads.

“This decision comes after challenging financial realities despite our best efforts to secure sustainable funding. We deeply appreciate our supporters and partners who made this work possible.”

Arthur Slepian founded A Wider Bridge in 2010.

The organization in 2016 organized a reception at the National LGBTQ Task Force’s Creating Change Conference in Chicago that was to have featured to Israeli activists. More than 200 people who protested against A Wider Bridge forced the event’s cancellation.

A Wider Bridge in 2024 urged the Capital Pride Alliance and other Pride organizers to ensure Jewish people can safely participate in their events in response to an increase in antisemitic attacks after Hamas militants attacked Israel on Oct. 7, 2023.  

The Jewish Telegraphic Agency reported authorities in Vermont late last year charged Ethan Felson, who was A Wider Bridge’s then-executive director, with lewd and lascivious conduct after alleged sexual misconduct against a museum employee. Rabbi Denise Eger succeeded Felson as A Wider Bridge’s interim executive director.

A Wider Bridge in June honored U.S. Rep. Debbie Wasserman Schultz (D-Fla.) at its Pride event that took place at the Capital Jewish Museum in D.C. The event took place 15 days after a gunman killed two Israeli Embassy employees — Yaron Lischinsky and Sarah Milgrim — as they were leaving an event at the museum.

“Though we are winding down, this is not a time to back down. We recognize the deep importance of our mission and work amid attacks on Jewish people and LGBTQ people – and LGBTQ Jews at the intersection,” said A Wider Bridge in its letter. “Our board members remain committed to showing up in their individual capacities to represent queer Jews across diverse spaces — and we know our partners and supporters will continue to do the same.”

Editor’s note: Washington Blade International News Editor Michael K. Lavers traveled to Israel and Palestine with A Wider Bridge in 2016.

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