National
HHS expands hospital visitation rights for gay couples
Patients may designate visitors during hospital stay
The Department of Health & Human Services on Wednesday unveiled a new policy to enhance hospital visitation rights for same-sex couples.
The Centers for Medicare & Medicaid sent a letter on Wednesday to states building off the memorandum President Obama issued last year mandating that hospitals receiving Medicare and Medicaid funds allow patients to designate their own visitors during a hospital stay, including a same-sex partner.
In November, HHS issued the final rule implementing Obama’s proposed change. The letter sent to states on Wednesday provides the enforcement mechanism by which state survey and certification groups can ensure hospitals are abiding by the policy.
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Jesse Moore, an HHS spokesperson, said his department generally works with hospitals to bring them into compliance with rules and, at this point, HHS hasn’t heard of any problems with the guidance related to same-sex couples.
However, Moore said if a hospital doesn’t comply with the new rule and fails to fix the problem, HHS has “the power to terminate a Medicare provider agreement.”
The guidance that will be given to state survey agencies marks the last step in implementing the change that Obama proposed on hospital visitation last year.
Additionally, the letter also issues guidance mandating that hospitals recognize advance directives designating a same-sex partner as someone who can make emergency medical decisions for a patient who’s incapacitated. The department clarifies hospitals should defer to patients’ wishes concerning their representatives — whether expressed in writing, verbally or through other evidence — unless prohibited by state law.
HHS Secretary Kathleen Sebelius emphasized the importance of the policy change to LGBT couples in a statement.
“Couples take a vow to be with each other in sickness and in health and it is unacceptable that, in the past, some same-sex partners were denied the right to visit their loved ones in times of need,” Sebelius said. “We are releasing guidance for enforcing new rules that give all patients, including those with same-sex partners, the right to choose who can visit them in the hospital as well as enhancing existing guidance regarding the right to choose who will help make medical decisions on their behalf.”
The new guidance updates the conditions of participation for hospitals participating in Medicare and Medicaid, which are the health and safety standards that these hospitals must meet. The change applies to all patients of these hospitals — even if the patient isn’t on Medicare or Medicaid.
Don Berwick, the CMS administrator, said the updated guidance to states is beneficial for same-sex couples and enhances the quality of health care throughout the country.
“This announcement is another step toward equal rights for all Americans, and it is another step toward putting the patient at the center of our health care system,” Berwick said. “All patients should be afforded the same rights and privileges when they enter our health care system, and that includes the same opportunity to see their significant other.”
LGBT rights groups were quick to praise the updated policy as a means to ensure LGBT Americans are treated fairly during hospital stays.
Rea Carey, executive director of the National Gay & Lesbian Task Force, commended HHS for issuing the updated policy in a statement as she said more work is necessary.
“Ensuring that the medical wishes of [LGBT] people are respected is an example of the federal government recognizing the life of LGBT families,” Carey said. “An emergency situation in a hospital is the last place where anyone should feel unsafe. While a positive step forward, it is critical we continue to work at all levels of government to make sure our families are fully recognized and treated fairly.”
Michael Cole-Schwartz, spokesperson for the Human Rights Campaign, also said the guidance is beneficial to LGBT people seeking hospital treatment.
“This is a great step to help ensure enforcement of a common sense policy,” Cole-Schwartz said. “No one should be denied the ability to visit their loved ones in the hospital and this next step ensures that principle will be carried out.”
In addition to sending out this letter, the Health Resources & Services Administration, an agency within HHS, is set to announce a $248,000 grant to help create a national training and technical assistance center aimed at helping community health centers improve the health of LGBT populations. The grant was awarded to Fenway Health, a Boston-based center that works to provide the LGBT community access to health care, education, research and advocacy.
NOTE: This article has been updated.
CORRECTION: An earlier version of this article, quoting HHS spokesperson Jesse Moore, incorrectly stated HHS could revoke accreditation for hospitals that fail to comply with the change.
The White House
Report: Grenell wants Russian ambassadorship
Country’s anti-LGBTQ record a reported barrier
Richard Grenell, President Donald Trump’s special envoy for “special missions,” is making it known that he is interested in the Russian ambassadorship.
According to reporting by the Daily Mail, Grenell has “floated” his interest in the role to coworkers, but issues surrounding the former German ambassador’s sexuality have made securing the position more difficult.
“He had an interest in the job — or at least he floated the idea to select colleagues. But Putin’s regime is extremely anti–LGBTQ, so I’m sure they didn’t take that thought too seriously,” one source close to Grenell told the Daily Mail. “That would never happen anyway.”
Grenell has long been one of Trump’s closest allies and was the first openly gay person to hold a Cabinet-level position. He was ousted last month as acting director of the Kennedy Center, a position he had held since Trump reestablished the board to be composed of his political supporters in 2025.
In addition to leading the nation’s cultural arts center, Grenell previously served as the U.S. ambassador to Germany from 2018 to 2020, and as the special presidential envoy for Serbia and Kosovo peace negotiations from 2019 to 2021. He was also a State Department spokesperson to the U.N. under the George W. Bush administration and a Fox News contributor.
Russia has a longstanding history of being anti-LGBTQ.
In 2013, the country passed a law banning any public endorsement of “nontraditional sexual relations” among minors. In December 2022, Putin signed legislation expanding the ban, making it illegal to promote same-sex relationships or suggest that non-heterosexual orientations are “normal” for people of any age, widening censorship across media and public life.
The Russian courts have also supported the restriction of LGBTQ identity in the country. In November 2023, Russia’s Supreme Court granted a request from the Justice Ministry to outlaw the “international LGBT movement” as “extremist,” allowing authorities to criminalize advocacy and potentially prosecute individuals for expressions of LGBTQ+ identity or support.
In addition to LGBTQ rights issues, the war between Russia and Ukraine has become a global concern. Ukraine, which was part of the former Soviet Union, includes the territory known as Crimea, which Russia annexed in 2014. The annexation remains a major point of international dispute over sovereignty. Since 2022, Russia’s large-scale invasion of Ukraine has escalated the conflict, drawing global attention and sanctions while straining U.S.-Russia relations.
The U.S. has spent $188 billion in total related to the war in Ukraine since the Russian invasion in February 2022, according to the Council on Foreign Relations.
The Russian ambassadorship seems to be a difficult role to fill, according to additional information presented by the Daily Mail. With Trump already being seen as relatively positive by Russian President Vladimir Putin, and with close ties to members of his Cabinet and family — like son-in-law Jared Kushner — the ambassadorship is complicated and viewed as less critical than in previous administrations.
“There is no rush to fill that role because it has now been deemed unnecessary,” another source told the U.K.-based publication.
Bob Foresman, a seasoned businessman with decades-long ties to the Kremlin, was reportedly once the frontrunner, according to the Daily Mail. Foresman served as vice chair of UBS Investment Bank and Deputy Chairman of Renaissance Capital between 2006 and 2009, and earlier led investment banking for Russia at Dresdner Kleinwort Wasserstein from 1997 to 2000.
“This is a pattern, especially in the Trump administration — special envoys big–footing the ambassadors,” a source told the Daily Mail. “It is shocking that we are already in April and we don’t have an ambassador to one of the most important countries in the world.”
Tennessee
Tenn. lawmakers pass transgender “watch list” bill
State Senate to consider measure on Wednesday
The Tennessee House of Representatives passed a bill last week to create a transgender “watch list” that also pushes detransition medical treatment. The state Senate will consider it on Wednesday.
House Bill 754/State Bill 676 has been deemed “ugly” by LGBTQ advocates and criticized by healthcare information litigators as a major privacy concern.
The bill would require “gender clinics accepting funds from this state to perform gender transition procedures to also perform detransition procedures; requires insurance entities providing coverage of gender transition procedures to also cover detransition procedures; requires certain gender clinics and insurance entities to report information regarding detransition procedures to the department of health.”
It would require that any gender-affirming care-providing clinics share the date, age, and sex of patients; any drugs prescribed (dosage, frequency, duration, and method administered); the state and county; the name, contact information, and medical specialty of the healthcare professional who prescribed the treatment; and any past medical history related to “neurological, behavioral, or mental health conditions.” It would also mandate additional information if surgical intervention is prescribed, including details on which healthcare professional made a referral and when.
HB 0754 would also require the state to produce a “comprehensive annual statistical report,” with all collected data shared with the heads of the legislature and the legislative librarian, and eventually published online for public access.
The bill also reframes detransitioning as a major focus of gender-affirming healthcare — despite studies showing that the number of trans people who detransition is statistically quite low, around 13 percent, and is often the result of external pressures (such as discrimination or family) rather than an issue with their gender identity.
This legislation stands in sharp contrast to federal protections restricting what healthcare information can be shared. In 1996, Congress passed the Health Insurance Portability and Accountability Act, or HIPAA, requiring protections for all “individually identifiable health information,” including medical records, conversations, billing information, and other patient data.
Margaret Riley, professor of law, public health sciences, and public policy at the University of Virginia, has written about similar efforts at the federal level, noting the Trump-Vance administration’s push to subpoena multiple hospitals’ records of gender-affirming care for trans patients despite no claims — or proof — that a crime was committed.
It has “sown fear and concern, both among people whose information is sought and among the doctors and other providers who offer such care. Some health providers have reportedly decided to no longer provide gender-affirming care to minors as a result of the inquiries, even in states where that care is legal.” She wrote in an article on the Conversation, where she goes further, pointing out that the push, mostly from conservative members of the government, are pushing extracting this private information “while giving no inkling of any alleged crimes that may have been committed.”
State Rep. Jeremy Faison (R-Cosby), the bill’s sponsor, said in a press conference two weeks ago that he has met dozens of individuals who sought to transition genders and ultimately detransitioned. In committee, an individual testified in support of the bill, claiming that while insurance paid for gender-affirming care, detransition care was not covered.
“I believe that we as a society are going to look back on this time that really burst out in 2014 and think, ‘Dear God, What were we thinking? This was as dumb as frontal lobotomies,’” Faison said of gender-affirming care. “I think we’re going to look back on society one day and think that.”
Jennifer Levi, GLAD Law’s senior director of Transgender and Queer Rights, shared with PBS last year that legislation like this changes the entire concept of HIPAA rights for trans Americans in ways that are invasive and unnecessary.
“It turns doctor-patient confidentiality into government surveillance,” Levi said, later emphasizing this will cause fewer people to seek out the care that they need. “It’s chilling.”
The Washington Blade reached out to the American Civil Liberties Union of Tennessee, which shared this statement from Executive Director Miriam Nemeth:
“HB 754/SB 676 continues the ugly legacy of Tennessee legislators’ attacks on the lives of transgender Tennesseans. Most Tennesseans, regardless of political views, oppose government databases tracking medical decisions made between patients and their doctors. The same should be true here. The state does not threaten to end the livelihood of doctors and fine them $150,000 for safeguarding the sensitive information of people with diabetes, depression, cancer, or other conditions. Trans people and intersex people deserve the same safety, privacy, and equal treatment under the law as everyone else.”
Iran
LGBTQ groups condemn Trump’s threat to destroy Iranian civilization
Ceasefire announced less than two hours before Tuesday deadline
The Council for Global Equality is among the groups that condemned President Donald Trump on Tuesday over his latest threats against Iran.
Trump in a Truth Social post said “a whole civilization will die tonight” if Tehran did not reach an agreement with the U.S. by 8 p.m. ET on Tuesday.
Iran is among the handful of countries in which consensual same-sex sexual relations remain punishable by death.
Israel and the U.S. on Feb. 28 launched airstrikes against Iran.
One of them killed Supreme Leader Ayatollah Ali Khamenei. Iran in response launched missiles and drones against Israel and other countries that include Kuwait, Bahrain, Qatar, the United Arab Emirates, Jordan, Saudi Arabia, Azerbaijan, and Cyprus.
Gas prices in the U.S. and around the world continue to increase because the war has essentially closed the Strait of Hormuz, a strategic waterway that connects the Persian Gulf and the Gulf of Oman through which roughly 20 percent of the world’s crude oil passes.
Trump less than 90 minutes before his deadline announced a two-week ceasefire with Iran that Pakistan helped broker.
“We the undersigned human rights, humanitarian, civil liberties, faith-based and environmental organizations, think tanks and experts are deeply alarmed by President Trump’s threat regarding Iran that ‘a whole civilization will die tonight’ if his demands are not met. Such language describes a grave atrocity if carried out,” reads the statement that the Council for Global Equality more than 200 other organizations and human rights experts signed. “A threat to wipe out ‘a whole civilization’ may amount to a threat of genocide. Genocide is a crime defined by the Genocide Convention and by the Rome Statute of the International Criminal Court as committing one or more of several acts ‘with intent to destroy in whole or in part a national, racial or religious groups as such.'”
The statement states “the law is clear that civilians must not be targeted, and they must also be protected from indiscriminate or disproportionate attacks.”
“Strikes on civilian infrastructure — such as the recent attack on a bridge and the attacks President Trump is repeatedly threatening to carry out to destroy power plants — have devastating consequences for the civilian population and environment,” it reads.
“We urge all parties to respect international law,” adds the statement. “Those responsible for atrocities, including crimes against humanity and war crimes, can and must be held accountable.”
The Alliance for Diplomacy and Justice, Amnesty International USA, Human Rights Watch, the American Civil Liberties Union, the NAACP, MADRE, and the Robert and Ethel Kennedy Human Rights Center are among the other groups that signed the letter.

