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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

Man accused of threatening to shoot D.C. bar employee after making anti-gay slurs

May 24 incident took place near Black Pride events on U Street

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(Bigstock photo)

D.C. police on Sunday, May 24, at around 4:20 p.m. arrested a Maryland man for allegedly threatening to shoot an employee while using anti-gay slurs at Ben’s Next Door restaurant and bar at 1211 U St., N.W.

According to a statement released by police and a police incident report, the arrested man, identified as Delonte Fraley, 32, of Accokeek, Md., made the threats after the employee told a bartender not to serve the man alcohol.

“The suspect overheard the employee and threatened to shoot the employee and used homophobic slurs against the employee,” the police statement says. “When the employee left the restaurant for the day, the suspect was standing near the employee’s vehicle,” it says.

“The employee returned to the restaurant and called the police,” the statement continues. “The suspect was apprehended by responding officers,” it says.

The police statement says the arresting officers charged Fraley with Felony Threats (Hate/Bias).

D.C. Superior Court records show prosecutors with the Office of the U.S. Attorney for D.C., which prosecutes D.C. criminal cases, escalated the charge to Threatening to Injure or Kidnap a Person (Bias-Related Hate Crime).

The incident occurred during Memorial Day weekend when thousands of visitors and D.C. area LGBTQ advocates and supporters were attending D.C. Black Pride events held in locations across the city, including Black Pride parties hosted by LGBTQ bars in the U Street entertainment area near Ben’s Next Door.

Among the nearby LGBTQ bars hosting D.C. Black Pride events were Nellie’s Sports Bar and Thurst Lounge. Ben’s Next Door is located next to the popular longtime U Street eatery Ben’s Chili Bowl.

Court records show that Judge Robert R. Rigsby at a May 25 presentment hearing released Fraley on personal recognizance with a stay-away order — the details of which were not publicly disclosed pending a June 4 preliminary hearing.   

A more detailed arrest affidavit filed in court by D.C. police says Fraley allegedly confronted the employee at Ben’s Next Door with anti-gay slurs on the day prior to his arrest.

“The complainant told the defendant that because he used homophobic slurs towards himself previously on May 23, 2026, and his hostess, as well as making threats to the complainant and calling him a faggot, he was unable to stay in the establishment,” the affidavit states.

It adds, “The defendant became irate stating, ‘I know where your Tesla is at. See me outside faggot, I will slap your ass’ and ‘I will shoot your ass.’” The affidavit says the complainant confirmed to police the Tesla referred to by Fraley was his vehicle. It says as the victim walked toward his car after getting off work, he saw Fraley standing directly in front of the car.

“The complainant stated he felt unsafe while the defendant was standing in front of his vehicle because he felt the defendant was capable of carrying out those threats,” says the affidavit. It says the victim then decided to return to the restaurant and call police without the defendant having seen him.  

“The defendant was placed under arrest for Felony Threats Hate/Bias and was transported to the Third District Station for processing,” the affidavit concludes.

It couldn’t immediately be determined whether the victim identifies as LGBTQ or whether any of the Ben’s Next Door patrons had been involved with D.C. Black Pride.

“Established in 2008, Ben’s Next Door is a family-owned and operated restaurant and bar on U Street, Northwest in Washington, D.C.,” a statement on its website says. “As a Black-owned establishment, it’s our goal to deliver a warm, welcoming, familiar, and communal vibe to all guests,” the statement says.    

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2026 Midterm Elections

Bree Fram’s congressional campaign ends but her fight continues

Former highest-ranking trans military member steps back from Va. congressional race

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Bree Fram (Photo courtesy of Bree Fram)

After being forced to retire, Bree Fram couldn’t stop. Restless even after giving everything she had to make the United States Air Force — and later the Space Force — better in every way she could, Fram quickly turned toward a new mission: public office.

The same tenacity that fueled her rise from Air Force researcher to the highest-ranking openly transgender officer in the United States Armed Forces would eventually carry her onto the campaign trail in Virginia.

Now, after months of campaigning, countless conversations with voters, and abrupt shifts in Virginia’s political landscape, Fram has stepped back from her congressional run.

Fram sat down with the Blade to discuss her decision to step away, what she learned on the campaign trail, and what comes next.

Earlier this month, the Virginia Supreme Court struck down a voter-approved Democratic congressional redistricting plan that likely would have created multiple additional Democratic-leaning seats in the U.S. House. The ruling dramatically altered the district Fram had built her campaign around and left little time for candidates to adjust before voting began.

“That decision really was the end of my campaign, that there was not the chance after that ruling, particularly so late in the game, for me to meaningfully pivot back to a different district and have a conversation with voters with just five weeks to go until early voting started,” Fram said. “I do feel that the will of the people has been ignored over a technicality regarding the date of Election Day.”

For Fram, the ruling was not only politically devastating, but personally frustrating after months spent building relationships with voters and shaping a campaign around the district’s needs.

“What was incredibly disappointing about it was that none of the facts about the case had changed from the beginning of the year until when they made the ruling,” she said.

Still, Fram entered the race with a platform centered on affordability, government accountability, and protecting fundamental rights, pledging “to protect our rights, make opportunity affordable, and build a government that works for the people.”

That message focused heavily on affordability — one of the defining political issues of 2026 — and lowering costs for Virginians across ideological, geographic, and generational divides. Fram said voters responded warmly to that vision, even if it ultimately did not lead to an office in the Rayburn House Office Building on Capitol Hill.

“The experience on the trail was fantastic. As a first-time candidate, you never know what you’re really getting yourself into, but any chance I had to get out there and talk with people was amazing,” Fram said. “I had the opportunity to change folks’ minds about trans people, about people from Northern Virginia.”

One conversation with a rural Virginia voter especially stayed with her.

“I called someone who runs a rural art shop… and he started talking about Democrats messaging on trans issues being such a problem,” Fram recalled. “And I’m like, do you know that you’re talking to one?”

Throughout the campaign, Fram said she often found herself breaking down preconceived notions about both transgender people and military service. The impact of that visibility became especially clear during another interaction on the trail that still stays with her.

“I had a young person, maybe 20 years old, come up to me. I could tell there was something on their mind,” Fram said. “I preempted them by saying ‘If you were about to ask if I’m trans, the answer is yes.’”

The young person, she said, appeared visibly relieved.

“As we made small talk I could tell there was something else he wanted to ask,” Fram continued. “Eventually they got it out– that they think they might be too.”

The moment quickly turned emotional.

“And then I asked, do you need a hug, they leaned in at first and then just hung on for dear life,” she said. “So what it means to our community to have that kind of representation out there, and to hopefully inspire others, was incredibly important.”

For Fram, those moments became some of the most meaningful parts of the campaign.

“My experience, I think, helped just shape what was our strategy,” she said.

The campaign also came at a uniquely difficult moment in Fram’s life. The Human Rights Campaign honored Fram alongside four other transgender military officials during a Jan. 8 event in Washington commemorating the forced retirement of transgender service members following President Donald Trump’s Executive Order 14183, “Prioritizing Military Excellence and Readiness,” which directed the Pentagon to prohibit transgender, nonbinary, and gender-nonconforming people from serving openly in the military.

Even while navigating the fallout from the discriminatory policy that forced her retirement, Fram launched a campaign rooted heavily in direct voter engagement and personal storytelling.

Her decades in the military, she said, fundamentally shaped how she approached campaigning and leadership.

“As an officer, particularly the more senior you become, you get more and more training on ‘what does it mean to match your ends’ ways and means,’” Fram said. “My end goal was get into office … and constantly reassess what it looks like.”

Fram also said her military background informed her progressive politics more than many voters expected.

“My military background was interesting, because I was running as the progressive candidate,” she said. “People think you were in the military, how can you possibly be the progressive person?”

Her answer, she said, often surprised people.

“Well, where did you think I learned this stuff?” Fram said. “No matter who we were at the same rank, no matter what our job was, we all got paid the same. We all had government-provided health care where we never needed to worry about a medical bill.”

For Fram, and those who talked with her on the trail, military service reinforced the idea that good governance allows people to thrive.

“You actually learn a lot about progressive policies and good governance that lets people be their best self in the military,” she said. “We understand that military officers’ oaths don’t expire when their time in uniform does, and I think that resonated with a lot of people, that veterans can be part of the solution in getting us out of the situation that we are in today.”

Before launching her campaign, Fram built one of the most extensive careers of any openly transgender military officer in U.S. history, serving in senior leadership roles across the Air Force, Space Force, and intelligence community.

Most recently, she served as chief of the Requirements Integration Division at Headquarters, Space Force, after previously leading acquisition policy for the Air Force’s space programs. Earlier in her career, she oversaw advanced weapons and cyberspace programs at the Air Force Research Laboratory, managed billions in foreign military sales and intelligence-related operations, worked on Capitol Hill as a legislative fellow, and directed major engineering and national security programs at the National Reconnaissance Office.

Fram also co-led the Department of the Air Force’s LGBTQ+ Initiatives Team and deployed in support of Operation Iraqi Freedom. She holds a master’s degree from the Air Force Institute of Technology and is a distinguished graduate of the Naval War College.

Despite stepping away from the race, Fram said she remains optimistic about the future.

“When I look at the big picture of what we did and how we ran a campaign, that is what I’m most proud of,” she said. “It really is the strategy that my team and I were able to craft, the messaging that we were able to share, that was all about connecting our personal story, the story of America to something that says we need a vision of what can be.”

Fram rejected the idea that ending her congressional campaign means ending her public life altogether.

“I can absolutely guarantee that I will not get off the stage. It is just a question of what stage or stages do I jump to,” she said.

She also encouraged LGBTQ people — especially transgender Americans — to stay politically engaged despite increasingly hostile rhetoric and legislation nationwide.

“Just do it,” Fram said. “It is incredibly important to show at every level that people can engage with the political process and make a meaningful difference.”

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Obituary

Rev. Peter Leland DeGroote dies at 86

Trailblazing gay United Methodist pastor once worked at Blade

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Rev. Peter Leland DeGroote

(The following statement was prepared by friends of Rev. Peter Leland DeGroote.)

Peter Leland DeGroote, a trailblazing gay United Methodist pastor, was born on January 19, 1940, to Leland Peter and Lea (Sitnik) DeGroote in Rochester, New York. The family moved to Syracuse during Peter’s early years. Peter had an older stepbrother, Robert, and brother, Joseph, and was followed by three sisters—Mary, Martha and Margaret. Lea, their mother, had been Roman Catholic but was ostracized from her parish after marrying a Protestant. So she took the children to Lafayette Street Methodist Church every Sunday for worship and Christian education.

Peter attended West Virginia Wesleyan University, graduating with a bachelor’s degree in psychology in 1961. While he considered a career in pastoral ministry—his brother Joseph was a long-time United Methodist clergy—Peter thought that his same-sex orientation would hinder his career in the church. He enlisted in the U.S. Army in October 1961 and served a three-year term, spending one year in Heidelberg, Germany. This provided the opportunity to explore Europe. In August 1964, he was granted early release and honorable discharge to go to school.

He began graduate studies in public administration at American University in Washington, D.C. Peter met Tom McKain in January 1967 and they began a five-year relationship and remained best friends thereafter. One of Peter’s professors was an executive with the International City Management Association (ICMA) who recognized Peter’s talents and arranged for him to help with some projects there. During summers Peter directed camping programs at the YMCA’s Camp Letts in Edgewater, Md. While he worked on a Ph.D. and did some teaching at American University, he did not complete his dissertation and so received an M.A. degree in 1971.

In 1972, Peter was hired to initiate the ICMA Retirement Corporation (now MissionSquare Retirement) in order to develop a portable retirement plan for local government administrators. During his 16 years directing the ICMA-RC, the plan grew to over $1 billion in assets and over 100,000 participants. At his retirement in 1988, Peter was heralded as having “done a remarkable job in helping create one of the most outstanding retirement corporations in the country and is probably the most knowledgeable person in this field.” 

In the 1970s Peter volunteered with the production of a gay newspaper in Washington, D.C., serving as news editor of the Washington Blade for three months in 1975. Peter met Leslie Lugo in Fort Lauderdale in 1977. Leslie moved to D.C. the next year and they were in a seven- year relationship and remained good friends in the years following.

In 1984, Peter joined Foundry U.M. Church, where his college friend Rev. Don Stewart was on the staff. Stewart told Peter about a local group of LGBT United Methodists. Peter began attending weekly worship and social gatherings with Mid-Atlantic Affirmation and became deeply involved in providing leadership and hospitality for the group.

Peter proposed that Foundry sponsor an Affirmation Bible Study group as part of its neighborhood Bible study program. He asked Ralph Williams to host the group and Peter led it at the onset. The Bible study group met for several years and played a significant role in the process of Foundry becoming a Reconciling Congregation in 1995, a public affirmation that LGBTQ persons were full participants in the life of the church.

In November 1988, Peter made a radical life change as he retired from ICMA-RC and began an international romantic adventure, moving to Caracas, Venezuela. However, in a tragic turn of events, Peter was abducted and later found abandoned in a rural area, badly injured. Peter recounted that, as he lay suffering and awaiting rescue, he prayed that if he recovered he would commit to entering the ministry. After returning to Washington, D.C., and spending time in healing and recovery, Peter enrolled at Wesley Theological Seminary, graduating with honors and an M.Div. degree in 1994.

Peter resolved to challenge the United Methodist Church’s ban on the ordination of LGBTQ clergy. He began the ordination candidacy process at Foundry, stating publicly that he was gay and willing to be celibate. He steadily moved forward through the process and was eventually approved by the Baltimore-Washington Conference in a close vote. He was ordained deacon on June 13, 1993, and elder on June 16, 1996.

Peter served in active ministry for 16 years serving these congregations: Shady Side (1993-1996); Centenary Baltimore (1996-1998); Back River Essex (1998-2003); College Park (2003-2004); Foundry as associate (2004-2006) and The United Church (2006-2009). Peter retired from ministry in 2009. One of Peter’s noteworthy achievements during these years was the formation of BWARM (Baltimore-Washington Area Reconciling United Methodists). When Bishop John Schol arrived in Baltimore-Washington in 2004, he announced his intention to meet with various ethnic and gender groups in the conference. Peter challenged the bishop to also meet with LGBTQ members. The bishop asked Peter to arrange such a meeting. Peter invited a cross-section of LGBTQ persons and allies from around the conference to converse with the bishop. As a result of that meeting, this network of persons began to organize what has become a strong, influential BWARM group.

In retirement, Peter continued annual summer excursions to Rehoboth Beach with friends, involvement at Foundry U.M. Church and enjoying reading and writing. On May 13, 2025, the Baltimore-Washington Chapter of the Methodist Federation for Social Action honored Peter with its God’s Foolish One Award. After a period of declining health, he died on May 9, 2026.

He is survived by his sister, Martha Straub; her son, James Oliver, and his husband; long-time companion Luis Herrera; caregivers Michael Thompson and Ralph Williams and numerous dear friends. A memorial service, followed by a luncheon, will be held at 10 a.m. on Saturday, June 27, 2026, at Foundry U.M. Church, 1500 16th St., N.W., Washington, D.C.

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