News
Medicare to examine ban on gender reassignment surgery
Rationale for policy ‘not complete and adequate’

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.
District of Columbia
Judge issues revised order in Capital Pride stalking case
Defendant Darren Pasha agreed to accept less restrictive directive
A D.C. Superior Court judge on April 30 reinstated an anti-stalking order requested by the Capital Pride Alliance against local gay activist Darren Pasha based on allegations that Pasha engaged in a year-long effort to harass, intimidate, and stalk the organization’s staff, board members, and volunteers.
The reinstated order by Judge Robert D. Okun followed an April 17 court hearing in which he rescinded a similar order he initially approved in February on grounds that more evidence was needed to substantiate the need for the order.
At the time he rescinded the earlier order he scheduled an evidentiary hearing for April 29 at which three Capital Pride staff members testified in support of the anti-stalking order. But Okun discontinued the hearing after Pasha, who was representing himself without an attorney, announced he was willing to accept a revised, less restrictive temporary restraining order.
The judge said Pasha’s decision to accept a restraining order made it no longer necessary to continue the evidentiary hearing. He then asked Capital Pride and Pasha to submit their suggested revisions for the order which they submitted a short time later.
The case began when Capital Pride Alliance, the D.C.-based LGBTQ group that organizes the city’s annual Pride events, filed a civil complaint on Oct. 27, 2025, against Pasha, accusing him of engaging in a year-long effort to harass, intimidate, and stalk Capital Pride staff, board members, and volunteers. It includes a 167-page addendum of “supporting exhibits” that includes multiple statements by unidentified witnesses.
Pasha, who has represented himself without an attorney, has argued in multiple court filings and motions that the stalking allegations are untrue. In his initial court response to the complaint, he said it appears to be a form of retaliation against him for a dispute he has had with Capital Pride and its former board president, Ashley Smith, who has since resigned from the board.
Similar to his earlier anti-stalking order against Pasha, Okun’s reissued order on April 30 states, a “Temporary Anti-Stalking Order is GRANTED, effective immediately and remaining in effect until further order of the Court or final disposition of this matter.”
It adds, “The defendant shall not contact, attempt to contact, harass, threaten, or otherwise communicate with any protected person, directly or indirectly, including through third parties, social media, electronic communication, or any other means.”
Unlike the earlier order, which did not identify the “protected persons” by name, the latest order includes a list of 34 people, 13 of whom are Capital Pride staff members or volunteers, including CEO Ryan Bos and Chief Operating Officer June Crenshaw. The other 21 people listed are identified as Capital Pride board members, including board chair Anna Jinkerson.
Possibly because Pasha addressed this in his suggested version of the order, the judge’s revised order says Pasha is allowed to visit the D.C. LGBTQ+ Community Center, where the Capital Pride office is located, if he gives the community center a 24 hour advance notice that he will be visiting the center, which hosts many events unrelated to Capital Pride. The earlier order required him to stay at least 100 feet away from the Capital Pride office.
The new order also prohibits Pasha from attending 21 named events that Capital Pride Alliance either organizes itself or with partner organizations that were scheduled to take place from April 30 through June 21. The order says he is allowed to attend the two largest events, the June 20 Pride Parade and the June 21 Pride Festival and Concert, in which 500,000 or more people are expected to attend.
It says Pasha is also allowed to attend the June 15 Pride At The Pier event organized by the Washington Blade.
But for those three events the order says he is restricted from entering “ticketed and controlled access areas.”
At the April 29 court hearing, Okun also scheduled a mandatory remote mediation session for July 23, in which efforts would be made to resolve the civil complaint case brought by Capital Pride without going to trial.
New Zealand
New Zealand blood donation rules shift
One-size-fits-all assumptions about gay, bi, and takatāpui men to end
More gay, bi, and takatāpui men in Aotearoa may soon be able to donate blood, with New Zealand Blood Service changing its sexual activity screening rules in a move that shifts the focus away from sexuality and on to specific recent behavior.
For many queer people, the change represents a move away from treating all men who have sex with men as a single risk category. Instead, all donors will be asked the same questions about new or multiple sexual partners in the past three months, and whether they have had anal sex with those partners.
Under the new approach, donors who have had anal sex with a new or multiple partners in the past three months will still face a three-month deferral. But those who have not — and who meet all other eligibility criteria — will be able to donate. Donors will also be asked whether they have had gonorrhea or any other sexually transmitted infection in the past three months, with a three-month wait applying after treatment and recovery.
That change could open the door for some gay, bisexual, takatāpui and other men who have sex with men who were previously excluded from giving blood. In particular, men who have had anal sex with only one partner in the past three months, where that sexual contact has been ongoing for longer than three months, may now be eligible to donate, including those in long-term single-partner relationships.
For years, blood donation rules have been experienced not just as a public health measure, but as a blunt and often stigmatizing signal that queer men were viewed differently from everyone else. This change suggests a more nuanced approach, one that looks at what people do, rather than who they are, based on findings from the Sex and Prevention of Transmission Study (SPOTS) and international evidence supporting behavior-based screening.
New Zealand Blood Service says the new model will maintain the safety of the blood supply while making donation more inclusive.
Still, the new rules are not a complete removal of the restrictions, and some will see them as progress rather than full equity. The three-month deferral remains in place for donors who have had anal sex with a new or multiple partners, even if they are taking PrEP or using condoms. New Zealand Blood Service says that while PrEP is highly effective for HIV prevention, it can mask low levels of HIV during testing, and condoms are not considered completely fail-safe.
Congress
Bill seeks to block global gag rule expansion
Policy now bans US foreign aid to groups promoting ‘gender ideology’
Lawmakers on Wednesday introduced a bill that would block the expansion of the global gag rule.
President Ronald Reagan in 1985 implemented the global gag rule, also known as the “Mexico City” policy, which bans U.S. foreign aid for groups that support abortion and/or offer abortion-related services.
Trump reinstated the rule during his first administration. The Biden-Harris administration shortly after it took office in 2021 rescinded it.
The Trump-Vance administration earlier this year expanded the global gag rule to ban U.S. foreign aid for groups that promote “gender ideology.” The expansion took effect on Feb. 26.
U.S. Sens. Jeanne Shaheen (D-N.H.) and Jacky Rosen (D-Nev.) introduced the Protecting Human Rights and Public Health in Foreign Assistance Act in the U.S. Senate. U.S. Reps. Grace Meng (D-N.Y.), Lois Frankel (D-Fla.), Diana DeGette (D-Colo.), Pramila Jayapal (D-Wash.), Sara Jacobs (D-Calif.), and Gregory Meeks (D-N.Y.) introduced it in the U.S. House of Representatives.
“Using taxpayer money to export the Trump administration’s anti-trans, anti-science, and anti-abortion ideological agenda isn’t just immoral — it’s antithetical to efficient, effective, and rights-based foreign assistance,” said Council for Global Equality Senior Policy Fellow Beirne Roose-Snyder on Wednesday in a press release.
Meng in a Congressional Equality Caucus press release added the Trump-Vance administration’s “crusade against healthcare and global aid is putting millions of lives at risk worldwide.”
“No one will flourish under the new expanded global gag rule,” said the New York Democrat. “These policies weaponize foreign aid and will result in greater harm, particularly for women and girls, marginalized communities, and LGBTQI+ individuals.”
“They should never have been implemented at all, let alone without even a basic public comment process,” she added. “This legislation will reverse these dangerous policies.”
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