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HHS clarifies gay couples have nursing home visitation rights

Guidance was among Sebelius’ goals for improving LGBT health

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Secretary of Health & Human Services Kathleen Sebelius speaks before the AIDS 2012 International Conference

Secretary of Health & Human Services Kathleen Sebelius had sought to expand the hospital visitation rights memo to include nursing homes. (Blade file photo by Michael Key)

Gay people living in nursing homes will have the same guaranteed access to their partners and spouses as gay patients in hospitals receiving Medicare and Medicaid, according to new guidance obtained Friday by the Washington Blade.

In guidance dated June 28 to state survey agency directors, the Centers for Medicare & Medicaid clarifies that President Obama’s 2010 memorandum guaranteeing that patients can have a same-sex partner visit them in the hospital also means residents in long-term care facilities, or nursing homes, must “be given full and equal visitation privileges.”

“Residents must be notified of their rights to have visitors on a 24-hour basis, who could include, but are not limited to, spouses (including same-sex spouses), domestic partners (including same-sex domestic partners), other family members, or friends,” the guidance states.

The guidance, signed by CMS Director of Survey & Certification Thomas Hamilton, says the guidance takes effect immediately and should be communicated within 30 days toĀ all survey and certification staff, their managers and state or regional office training coordinators.

Clarifying that the hospital visitation rights memo for gay couples also applies to nursing homes was among the goals that Secretary of Health & Human Services Kathleen Sebelius identified in her 2012 report on objectives to improve LGBT health.

Brian Cook, a CMS spokesperson, said the new guidance will help ensure that gay residents living in nursing homes will have access to their partners or spouses while in long-term care.

ā€œToday, as the Department of Health & Human Services celebrates Pride Month, we have clarified regulations for federally regulated nursing facilities, to protect visitation rights for residents in same-sex relationships,” Cook said. “This new guidance furthers the administration’s commitment to equality for same-sex couples and will help to guarantee that spouses or domestic partners of nursing home residents have every opportunity to be with their loved ones.ā€

In April 2010, President Obama issued a memorandum mandating that hospitals receiving Medicare and Medicaid funds ā€” or most facilities ā€” permit patients to allow their same-sex partners and spouses to visit them. The guidance issued on Friday clarifies that memorandum also applies to nursing homes, which also receives funds from Medicare and Medicaid.

An estimated 1.5 million people are currently living in nursing homes. Given that the William Institute estimates 3.5 percent of the adult population identifies as gay, lesbian or bisexual, those numbers would indicate 52,500 LGB people live in nursing homes and would be covered under the new guidance.

Michael Cole-Schwartz, spokesperson for the Human Rights Campaign, praised HHS for clarifying these protections for gay people living in nursing homes.

ā€œAs weā€™ve urged HHS, weā€™re grateful they have made clear that the visitation rights of individuals in long-term care facilities, such as nursing homes, include the ability to receive visits from same-sex spouses and partners,” Cole-Schwartz said. “Too many older members of the LGBT community are forced back into the closet when they enter nursing facilities. Todayā€™s guidance will help ensure that they and their families are respected.ā€

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Congress

House Republican misgenders Sarah McBride in transphobic attack

Comment derailed subcommittee hearing

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U.S. Rep. Sarah McBride (D-Del.) attends the joint session of Congress on March 4, 2025. (Washington Blade photo by Michael Key)

U.S. Rep. Keith Self (R-Texas) deliberately and repeatedly used the honorific “Mr.” for U.S. Rep. Sarah McBride (D-Del.), the first and only transgender member of Congress, sparking a confrontation that derailed a House subcommittee hearing on Tuesday.

After Self, who leads the House Foreign Affairs Committee’s Europe Subcommittee, misgendered the congresswoman from Delaware, she replied “Thank you, Madam Chair.”

The top Democrat in the room, Massachusetts Congressman Bill Keating, then spoke up to request that the chair repeat his introduction, which he did, again referring to McBride as “Mr.”

“You are out of order. Mr. Chairman,” Keating said, raising his voice. “Have you no decency? I mean, I have come to know you a little bit, but this is not decent.”

Self then started to adjourn the hearing, telling colleagues “we will continue this” before he was interrupted by the ranking member, who told him, “You will not continue it with me unless you introduce a duly elected representative the right way.”

McBride addressed the matter in a post on X Tuesday night, writing, “No matter how I’m treated by some colleagues, nothing diminishes my awe and gratitude at getting to represent Delaware in Congress. It is truly the honor and privilege of a lifetime. I simply want to serve and to try to make this world a better place.”

Self doubled down again, writing on social media “it is the policy of the United States to recognize two sexes, male and female,ā€ citing President Donald Trump’s day-one executive order mandating that the federal government treat gender as a binary that cannot and does not deviate from one’s birth sex.

The policy is out of step with mainstream science and medicine, which recognizes that human biology is complex and one’s gender identity is often but not always linked to one’s sex at birth. Critics of the order have also noted that its narrow definitions for sex and gender exclude people who are born intersex, with a combination of male and female biological traits (genitals, chromosomes, hormones.)

“While there are some areas of active debate, scientists are in wide agreement that biological sex in humans as well as the rest of life on earth is much more complicated than a simple binary,” a biology professor said in a report published by the Washington Post last month.

ā€œItā€™s trying to explain away people,ā€ a health law professor told the paper, referring to the executive order. The administration, he added, wants “to try to present it as this extremely simple issue ā€” as if itā€™s really just one or the other, youā€™re male or youā€™re female.ā€

McBride’s historic election last year came as Trump and other Republicans were running on promises to enact increasingly extreme anti-trans legislation or policies, with GOP campaigns, spending $21.5 million on anti-trans ads, with much of that spend coming at the tail end o the 2024 cycle.

Transphobic attacks against the congresswoman, including from House Republicans, began before she was even seated. U.S. Reps. Nancy Mace of South Carolina and Marjorie Taylor Greene of Georgia both misgendered her repeatedly while touting Mace’s proposal to prohibit trans women from using sex-segregated women’s bathrooms at the Capitol, publicly acknowledging that the move was intended to target McBride. More recently, U.S. Rep. Mary Miller of West Virginia misgendered her in February on the House floor.

When serving in the Delaware Senate, McBride was recognized for her successful sponsorship of a bill providing 12-week paid family and medical leave for workers, an issue that was central to her congressional campaign along with her focus on healthcare reform and is a key piece of her focus on reforming care infrastructure in Congress.

In cases where she has elected to address the cruel and bigoted attacks against her from GOP colleagues and others, McBride, has consistently tried to redirect attention towards her work on behalf of the constituents she serves, as seen in her post on Tuesday.

In January, McBride partnered with U.S. Rep. Young Kim (R-Calif.) on the first bill she introduced in Washington, which aims to protect consumers from scams in the credit repair industry.

Last week, the congresswoman joined her colleagues in reintroducing the bipartisan Protecting the Right to Organize Act, and together with other Democrats introduced the John Lewis Voting Rights Advancement Act which, per a press release, would “restore and modernize the protections of the Voting Rights Act of 1965 and prevent states with a history of voter discrimination from erecting new barriers to the ballot box.”

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Congress

Republican lawmakers demand IOC ban transgender athletes from women’s events

2028 Summer Olympics to take place in Los Angeles

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U.S. Rep. Lauren Boebert (R-Colo.) is among the Republican lawmakers who have demanded the International Olympic Committee ban transgender athletes from women's events. (Washington Blade photo by Michael Key)

A group of Republican lawmakers have demanded the International Olympic Committee ban transgender athletes from women’s athletic competitions.

The lawmakers ā€” U.S. Sens. Jim Risch (R-Idaho), Mike Crapo (R-Idaho), Jim Banks (R-Ind.), Marsha Blackburn (R-Tenn.), Steve Daines (R-Mont.), Lindsey Graham (R-S.C.), Josh Hawley (R-Mo.), Jim Justice (R-W.Va.), James Lankford (R-Okla.), Tim Sheehy (R-Mont.), and Tommy Tuberville (R-Ala.) and U.S. Reps. Burgess Owens (R-Utah), Lauren Boebert (R-Colo.), Vern Buchanan (R-Fla.), Tim Burchett (R-Tenn.), Dan Crenshaw (R-Texas), Brad Finstad (R-Minn.), Craig Goldman (R-Texas), Mark Green (R-Tenn.), Ashley Hinson (R-Iowa), Mike Kennedy (R-Utah), Nick LaLota (R-N.Y.), Blake Moore (R-Utah), Riley Moore (R-W.Va.), Austin Pfluger (R-Texas), John Rose (R-Tenn.), and Claudia Tenney (R-N.Y.) ā€” made the demand in a letter they sent to IOC President Thomas Bach on Tuesday.

“In the United States, we honor our female Olympians. These athletes, and so many others, have inspired generations of young women around the world to compete and excel. Their legacy underscores the vital importance of fairness in womenā€™s sports at every level of competition,” reads the letter. “Future Olympians are counting on the IOC to protect the opportunities of women and girls to contribute to this proud tradition.”

“To do so, the IOC must base eligibility for womenā€™s athletic competitions on biological sex,” it adds. “Allowing biological males to compete in womenā€™s categories undermines competitive opportunities, safety, and respect for female athletes.”

The IOC in 2021 adopted its “Framework on Fairness, Inclusion and Nondiscrimination on the Basis of Gender Identity and Sex Variations” that includes the following provisions:

ā€¢ 3.1 Eligibility criteria should be established and implemented fairly and in a manner that does not systematically exclude athletes from competition based upon their gender identity, physical appearance and/or sex variations.

ā€¢ 3.2 Provided they meet eligibility criteria that are consistent with principle 4 (“Fairness”, athletes should be allowed to compete in the category that best aligns with their self-determined gender identity.

ā€¢ 3.3 Criteria to determine disproportionate competitive advantage may, at times, require testing of an athlete’s performance and physical capacity. However, no athlete should be subject to targeted testing because of, or aimed at determining, their sex, gender identity and/or sex variations.

The 2028 Summer Olympics will take place in Los Angeles.

President Donald Trump on Feb. 5 issued an executive orderĀ that bans trans women and girls from female sports teams in the U.S. The Human Rights Campaign and other advocacy groups criticized Democratic California Gov. Gavin Newsom last week after he said it is “deeply unfair” to allow trans athletes to compete in women’s sports.

The Guardian on Feb. 25 reported the State Department has ordered consular officials “to deny visas to transgender athletes attempting to come to the U.S. for sports competitions, and to issue permanent visa bans against those who are deemed to misrepresent their birth sex on visa applications.” A travel advisory for trans and nonbinary people who are planning to visit the U.S. that the German government issued last week specifically notes the Trump-Vance administration has banned the State Department from issuing passports with “X” gender markers.

The letter notes Trump’s Feb. 5 executive order, and indicates the signatories “stand united with Secretary of State Marco Rubio and President Trump in calling on the IOC to amend its standards and safeguard the opportunities of female athletes on the Olympic stage.”

“We urge you to reaffirm the IOCā€™s commitment to upholding the integrity of womenā€™s Olympic competitions and ensure that only biological women and girls are allowed to compete in female sports categories,” reads the letter. “The Olympic Games should be a model for integrity in sports, and the next IOC president must firmly defend the rights of dedicated female athletes.”

The Washington Blade has reached out to the IOC for comment.

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Maine targeted with federal probes, threats after guv spars with Trump

Just two trans students are competing on girls’ teams in Maine this school year

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Attorney General Pam Bondi (Washington Blade file photo by Michael Key)

Less than three weeks after Maine Gov. Janet Mills (D) sparred with President Donald Trump over his executive order prohibiting trans students from competing on school sports teams that align with their gender identity, the state has been hit with sudden cuts to funding and grants along with multiple investigations led by federal agencies and threats of more to come.

The dustup, which came during a Feb. 21 White House convening of the National Governors Association, kicked off when Mills declined to say she would enforce the policy, committing only to abiding by “state and federal law.” The president then threatened to withhold funding for Maine, and the exchange ended with both parties vowing to fight it out in court.

Shortly after Trump’s order was issued, the governing body responsible for overseeing high school sports in Maine said trans athletes would still be allowed to compete because the ban conflicted with provisions of the Maine state Human Rights Act. The Maine Principalsā€™ Association has said only two trans Mainers are competing in girls’ sports this school year.

Hours after that contentious meeting at the White House, the Maine Department of Education, the Maine School Administrative District #51, and the state’s public university system had become targets of inquiries by the U.S. Department of Education, the U.S. Department of Health and Human Services, and ā€” the following day ā€” an investigation by the U.S. Department of Agriculture.

These actions were followed on Feb. 25 by a letter to Mills from Attorney General Pam Bondi providing notice that the Justice Department was likely to soon file a lawsuit because “requiring girls to compete against boys,” or transgender girls, “in sports and athletic events violates Title IX of the Educational Amendments Act of 1972.”

Next came a decision in early March by the National Oceanic and Atmospheric Administration to pull the $4.5 million Maine Sea Grant for marine research ā€” with ProPublica noting the agency “didnā€™t touch the 33 other grantees who get similar funding” ā€” and most recently, last week’s cancellation and subsequent reinstatement of Social Security Administration contracts used by hospitals and nursing homes in the state to automatically report births and deaths.

Noting the concurrent probes led by the federal Education and Health Departments, Bondi warned that, “If these or other federal investigations show that the relevant Maine entities are indeed denying girls an equal opportunity to participate in sports and athletic events by requiring them to compete against boys, the Department of Justice stands ready to take all appropriate action to enforce federal law.”

Moreover, she wrote, because federal law passed by the U.S. Congress supersedes state statutes, it “does not matter if Maine state law allows, or even requires, state athletic associations or other similar entities to require girls to compete against boys in sports and athletic events.”

At the same time, however, Title IX has been interpreted by some courts as protecting the right of trans and gender diverse students to participate in educational programs and activities consistent with their identities, per the statutory anti-discrimination rules established under the Education Amendments of 1972.

In 2020, the U.S. Supreme Court ruled that sex-based discrimination as defined under Title VII of the Civil Rights Act of 1964, which applies to conduct by public and private sector employees with more than 15 workers, also covers acts that are motivated by the employee’s real or perceived sexual orientation or gender identity.

The decision was cited in the Biden-Harris administration’s updates to the Education Department’s Title IX guidance, which made explicit the argument that trans students in publicly funded schools are covered by explicit protections against discrimination, that the expanded definition of discrimination based on sex applies in the context of public education as well as in employment.

ProPublica, which published a comprehensive report on Tuesday chronicling the Trump administration’s “barrage of investigations and threats” that have come in the wake of the president’s tussle with Mills, notes that the DOJ also recently sent letters to Minnesota and California warning that they would face lawsuits for refusing to comply with or enforce the executive action banning trans students from competitive athletics.

The investigative news outlet also highlighted how unusual it is for an agency like HHS to enforce civil rights laws in a way that falls so far beyond its normal remit, which has primarily and historically centered on issues of health care access, and for the federal government to appear to reach conclusions with “unprecedented speed” in matters whose investigation typically takes months or even years.

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