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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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Netherlands

Rob Jetten becomes first gay Dutch prime minister

38-year-old head of government sworn in on Monday

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Rob Jetten (Photo via @RobJetten/X)

Rob Jetten on Monday became the Netherland’s first openly gay prime minister.

Jetten’s centrist D66 party won the country’s elections last October, narrowly defeating Geert Wilders’ far-right Party for Freedom.

King Willem-Alexander on Monday swore in Jetten, who is also the country’s youngest-ever prime minister. The Associated Press notes Jetten’s coalition government includes the center-right Christian Democrats and the center-right People’s Party for Freedom and Democracy.

“Proud to be able to do this together,” said Jetten in an X post before Willem-Alexander swore him in.

COC Nederland, a Dutch LGBTQ advocacy group, in a statement said Jetten “becoming prime minister shows that your sexual orientation doesn’t have to matter.”

“You can become a construction worker, a doctor, a lawyer, and even prime minister,” said COC Nederland.

The advocacy group noted Jetten has said his government will implement its “Rainbow Agreement” that include calls for strengthening nondiscrimination laws “to better protect transgender and intersex people,” appointing more “discrimination investigators … to address violence against LGBTQ+ people and other minorities,” and introducing measures “to promote acceptance in schools.”

“COC will hold the Cabinet to that promise,” said COC Nederland.

Jetten’s fiancé is Nicolás Keenen, an Argentine field hockey player who competed in the 2024 Summer Olympics in Paris.

Jetten is one of two openly gay heads of government: Andorran Prime Minister Xavier Espot Zamora came out in 2023. Gay Latvian President Edgars Rinkēvičs, who is the country’s head of state, took office in 2023.

Leo Varadkar, who was Ireland’s prime minister from 2017-2020 and from 2022-2024, and Xavier Bettel, who was Luxembourg’s prime minister from 2013-2023, are gay. Ana Brnabić, who was Serbia’s prime minister from 2017-2024, is a lesbian.

Former Icelandic Prime Minister Jóhanna Sigurðardóttir in 2009 became the world’s first openly lesbian head of government. Former Belgian Prime Minister Elio Di Rupo, former San Marino Captain Regent Paolo Rondelli, and former French Prime Minister Gabriel Attal are also openly gay.

Colombian presidential candidate Claudia López, who is the former mayor of Bogotá, the Colombian capital, would become her country’s first female and first lesbian president if she wins the country’s presidential election that is taking place later this year.

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District of Columbia

D.C. police arrest man for burglary at gay bar Spark Social House  

Suspect ID’d from images captured by Spark Social House security cameras

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Spark Social House (Washington Blade photo by Michael Key)

D.C. police on Feb. 18 arrested a 63-year-old man “of no fixed address” for allegedly stealing cash from the registers at the gay bar Spark Social House after unlawfully entering the bar at 2009 14th St., N.W., around 12:04 a.m. after it had closed for business, according to a police incident report.

“Later that day officers canvassing for the suspect located him nearby,” a separate police statement says. “63-year-old Tony Jones of no fixed address was arrested and charged with Burglary II,” the statement says.

The police incident report states that the bar’s owner, Nick Tsusaki, told police investigators that the bar’s security cameras captured the image of a man who has frequently visited the bar and was believed to be homeless.

“Once inside, the defendant was observed via the establishment’s security cameras opening the cash register, removing U.S. currency, and placing the currency into the left front pocket of his jacket,” the report says.

Tsusaki told the Washington Blade that he and Spark’s employees have allowed Jones to enter the bar many times since it opened last year to use the bathroom in a gesture of compassion knowing he was homeless. Tsusaki said he is not aware of Jones ever having purchased anything during his visits.

According to Tsusaki, Spark closed for business at around 10:30 p.m. on the night of the incident at which time an employee did not properly lock the front entrance door. He said no employees or customers were present when the security cameras show Jones entering Spark through the front door around 12:04 a.m. 

Tsusaki said the security camera images show Jones had been inside Spark for about three hours on the night of the burglary and show him taking cash out of two cash registers. He took a total of $300, Tsusaki said.

When Tsusaki and Spark employees arrived at the bar later in the day and discovered the cash was missing from the registers they immediately called police, Tsusaki told the Blade. Knowing that Jones often hung out along the 2000 block of 14th Street where Spark is located, Tsusaki said he went outside to look for him and saw him across the street and pointed Jones out to police, who then placed him under arrest.

A police arrest affidavit filed in court states that at the time they arrested him police found the stolen cash inside the pocket of the jacket Jones was wearing. It says after taking him into police custody officers found a powdered substance in a Ziploc bag also in Jones’s possession that tested positive for cocaine, resulting in him being charged with cocaine possession in addition to the burglary charge.

D.C. Superior Court records show a judge ordered Jones held in preventive detention at a Feb. 19 presentment hearing. The judge then scheduled a preliminary hearing for the case on Feb. 20, the outcome of which couldn’t immediately be obtained. 

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District of Columbia

Judge rescinds order against activist in Capital Pride lawsuit

Darren Pasha accused of stalking organization staff, board members, volunteers

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Darren Pasha (Washington Blade photo by Michael Key)

A D.C. Superior Court judge on Feb.18 agreed to rescind his earlier ruling declaring local gay activist Darren Pasha in default for failing to attend a virtual court hearing regarding an anti-stalking lawsuit brought against him by the Capital Pride Alliance, the group that organizes D.C.’s annual Pride events.

The Capital Pride lawsuit, initially filed on Oct. 27, 2025, accuses Pasha of engaging in a year-long “course of conduct” of “harassment, intimidation, threats, manipulation, and coercive behavior” targeting Capital Pride staff, board members, and volunteers.

In his own court filings without retaining an attorney, Pasha has strongly denied the stalking related allegations against him, saying “no credible or admissible evidence has been provided” to show he engaged in any wrongdoing. 

Judge Robert D. Okum nevertheless on Feb. 6 approved a temporary stay-away order requiring Pasha to stay at least 100 feet away from Capital Pride’s staff, volunteers, and board members until the time of a follow-up court hearing scheduled for April 17. He reduced the stay-away distance from 200 yards as requested by Capital Pride.

In his two-page order issued on Feb. 18, Okun stated that Pasha explained that he was involved in a scooter accident in which he was injured and his phone was damaged, preventing him from joining the Feb. 6 court hearing.

“Therefore, the court finds there is a good cause for vacating the default,” Okun states in his order.

At the time he initially approved the default order at the Feb. 6 hearing that Pasha didn’t attend, Okun scheduled an April 17 ex parte proof hearing in which Capital Pride could have requested a ruling in its favor seeking a permanent anti-stalking order against Pasha.

In his Feb. 18 ruling rescinding the default order Okun changed the April 17 ex parte proof hearing to an initial scheduling conference hearing in which a decision on the outcome of the case is not likely to happen.

In addition, he agreed to consider Pasha’s call for a jury trial and gave Capital Pride 14 days to contest that request. The Capital Pride lawsuit initially called for a non-jury trial by judge.

One request by Pasha that Okum denied was a call for him to order Capital Pride to stop its staff or volunteers from posting information about the lawsuit on social media. Pasha has said the D.C.-based online blog called DC Homos, which Pasha claims is operated by someone associated with Capital Pride, has been posting articles portraying him in a negative light and subjecting him to highly negative publicity.

“The defendant has not set forth a sufficient basis for the court to restrict the plaintiff’s social media postings, and the court therefore will deny the defendant’s request in his social media praecipe,” Okun states in his order. 

A praecipe is a formal written document requesting action by a court.

Pasha called the order a positive development in his favor. He said he plans to file another motion with more information about what he calls the unfair and defamatory reports about him related to the lawsuit by DC Homos, with a call for the judge to reverse his decision not to order Capital Pride to stop social media postings about the lawsuit.    

Pasha points to a video interview on the LGBTQ Team Rayceen broadcast, a link to which he sent to the Washington Blade, in which DC Homos operator Jose Romero acknowledged his association with Capital Pride Alliance.

Capital Pride Executive Director Ryan Bos didn’t immediately respond to a message from the Blade asking whether Romero was a volunteer or employee with Capital Pride. 

Pasha also said he believes the latest order has the effect of rescinding the temporary stay away order against him approved by Okun in his earlier ruling, even though Okun makes no mention of the stay away order in his latest ruling. Capital Pride attorney Nick Harrison told the Blade the stay away order “remains in full force and effect.”

Harrison said Capital Pride has no further comment on the lawsuit.

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