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
Both sides propose revised orders in Capital Pride stalking case
Defendant Darren Pasha agreed to accept less restrictive directive
An evidentiary hearing in D.C. Superior Court on April 29 in which the Capital Pride Alliance presented three of four planned witnesses to testify in support of its civil complaint that D.C. gay activist Darren Pasha engaged in a year-long effort to harass, intimidate, and stalk its staff, board members, and volunteers ended abruptly at the direction of the judge.
Judge Robert D. Okun announced from the bench that the hearing, which was intended provide Capital Pride an opportunity to present evidence in support of its request to reinstate an anti-stalking order against Pasha that the judge temporarily rescinded on April 17, was no longer needed because Pasha stated at the hearing that he is willing to accept a revised, less restrictive temporary restraining order.
Pasha made that statement after two Capital Pride witnesses — June Crenshaw and Vincenzo Volpe — each testified in support of the stalking allegations against Pasha for over an hour under questioning from Capital Pride attorney Nick Harrison and under cross-examination from Pasha, who is representing himself without an attorney.
After Capital Pride’s third witness, Tifany Royster, testified for just a few minutes, and after the judge called a recess for lunch and to attend to an unrelated case, Pasha announced that after obtaining legal advice he determined that he was unsuited to continue cross-examining the witnesses. He said he would be willing to accept a significantly less restrictive temporary restraining order.
Okun then ruled that the evidentiary hearing was no longer needed and directed Capital Pride and Pasha to submit to him their version of a revised stay away order. He said he would use their proposed revisions to help him develop his own order, which he would issue after deliberating over the matter.
He also scheduled a mandatory remote mediation session for July 23, in which efforts would be made to resolve the case without going to trial. He then adjourned the hearing at 3:50 p.m.
The online Superior Court docket for the case stated after the hearing ended that the judge would issue “a new modified Temporary Protective Order,” but it did not say when it would be issued.
Shortly before the April 29 hearing began at 11 a.m., Harrison filed a “Draft Temporary Anti-Stalking Order” that included a list of 34 “Protected Persons” that Harrison said during the hearing were affiliated with Capital Pride Alliance as staff and board members, volunteers, and others associated with the group.
The proposed order stated, “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 communications, or any other means.”
The proposal represented a significant change from Capital Pride’s initial civil complaint against Pasha filed in February that Pasha claimed called for him to stay away at least 200 yards from all Capital pride staff, board members, and volunteers without naming them. Okun granted that stay away request in February but reduced the stay away distance to 100 feet.
Capital Pride attorney Harrison disputes Pasha’s interpretation of the order, saying the 100-foot stay-away was for events, not for individual Capital Pride staff, volunteers, or board members. He said the order prohibited Pasha from engaging in any way with the Capital Pride staffers, volunteers or board members.
But the proposed order Capital Pride at first submitted at the April 29 hearing also called for Pasha to stay away from and to not attend as many as 25 Capital Pride events scheduled to take place this year from April 30 through June 21 and for him to say away from the Capital Pride office located at 1827 Wiltberger St., N.W., which is the building in which it shares with the DC LGBTQ Community Center.
At the April 29 hearing, at Pasha’s request, Okun called on Capital Pride to consider allowing Pasha to attend at least the two largest events — the Capital Pride Parade and Festival — which draw over 500,000 participants.
Harrison said in a follow-up message to the judge following the hearing that Capital Pride would allow Pasha to attend those two events and one other as long as he stays away from “ticketed and controlled access areas.”
At an April 17 status hearing Okun rescinded the earlier stay away order at Pasha’s request, among other things, on grounds that it was too vague and didn’t provide Pasha with sufficient specific information on who to stay away from. It was at that hearing that Okun scheduled the April 29 evidentiary hearing, saying it would give Capital Pride a chance to provide sufficient evidence to justify an anti-stalking order and Pasha an opportunity to challenge the evidence.
In his own response to the initial civil complaint filed in February and in subsequent court filings, Pasha has strongly denied he engaged in stalking and has alleged that the complaint was a form of retaliation against him over a dispute he has had with Capital Pride and its former board president, Ashley Smith.
Like its initial complaint filed in February, Capital Pride filed a multipage document at the start of the April 29 hearing with written testimony from staff members and volunteers who allege that Pasha did engage in stalking, harassment, and intimidating behavior toward them and others.
Like Capital Pride, Pasha following the April 29 hearing, filed his own proposed version of the stay away order with significantly less restrictions than the Capital Pride proposal. Among other things, it calls for him to restrict his contact with Capital Pride CEO Ryan Bos and Crenshaw but says it “does not by its terms restrict the defendant’s communications with any other person, entity, governmental body, or media outlet.”
“Darren Pasha sent multiple messages to us and to the court after the proceedings asking for further modifications — which we are not accepting or responding to,” Harrison told the Blade in response to a request for further comment on Judge’s request for each side to submit proposed revisions of the stay away order.
“We appreciate the court’s time and careful attention to the evidence presented today,” Harrison told the Washington Blade in a written statement after the hearing. “This process was about bringing forward the experiences of individuals who reported a pattern of conduct that caused fear, serious alarm, and emotional distress,” he said.
“Capital Pride Alliance remains committed to ensuring that our events and community spaces are safe, welcoming, and free from harassment and we will continue to take appropriate steps to support and protect our community,” his statement says.
“I am happy with what we have accomplished so far,” Pasha told the Blade after the hearing. “I’m just waiting to see what will happen next. But I want to reiterate this goes back to when someone treats you wrong you speak up,” he said. “Even if I lose this case, I am glad that I spoke up and raised concerns.”
He added, “I will just be confident that in the next couple of months the truth will come out. But for now, I am happy with the progress that we have made regarding this.”
This story will be updated when the judge issues his revised stay away order.
European Union
European Parliament backs EU-wide conversion therapy ban
More than 1.2 million people backed campaign
The European Parliament on Wednesday voted in favor of banning so-called conversion therapy across the European Union.
ACT (Against Conversion Therapy) LGBT in 2024 launched a campaign in support of the ban through the EU’s European Citizens Initiative framework. More than 1.2 million people ultimately signed it.
The proposed ban had the support of 405 MEPs. The European Commission is expected to formally respond to it by May 18.
Seven EU countries — Belgium, Cyprus, France, Malta, Norway, Portugal, and Spain — have banned conversion therapy outright.
Greece in 2022 banned the practice for minors. German lawmakers in 2020 passed a law that prohibits conversion therapy for minors and for adults who have not consented to undergoing the widely discredited practice.
National
Advocacy groups issue US travel advisory ahead of World Cup
Renee Good’s death in Minneapolis among incidents cited
More than 100 organizations have issued a travel advisory for the U.S. ahead of the 2026 World Cup.
The World Cup will take place in the U.S., Canada, and Mexico from June 11-July 19.
“In light of the deteriorating human rights situation in the United States and in the absence of meaningful action and concrete guarantees from FIFA, host cities, or the U.S. government, the undersigned organizations are issuing this travel advisory for fans, players, journalists, and other visitors traveling to and within the United States for the June 2026 FIFA Men’s World Cup. World Cup games will be played in 11 different cities across the United States, which, like many localities, have already been the target of the Trump administration’s violent and abusive immigration crackdown,” reads the advisory that the Council for Global Equality and other groups that include the American Civil Liberties Union issued on April 23. “The impacts of these policies vary by locality.”
“While the Trump administration’s rising authoritarianism and increasing violence pose serious risks to all, those from immigrant communities, racial and ethnic minority groups, and LGBTQ+ individuals have been and continue to be disproportionately targeted and affected by the administration’s policies and, as such, are most vulnerable to serious harm when traveling to and/or within the United States,” it adds. “This travel advisory calls on fans, players, journalists, and other visitors to exercise caution.”
The advisory specifically mentions Renee Good.
A U.S. Immigration and Customs Enforcement agent on Jan. 7 shot and killed her in Minneapolis. Good, 37, left behind her wife and three children.
The full advisory can be read here.
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