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.
Abigail Spanberger was sworn in as the 75th governor of Virginia at a ceremony on the grounds of the Virginia State Capitol on Saturday. Thousands of spectators watched the swearing-in ceremony and parade, despite the rain and temperatures in the low 40s.
Spanberger, a member of the Democratic Party and an LGBTQ ally, became the first woman to be Virginia’s governor.
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Newly-elected Attorney General Jay Jones, Lt. Gov. Ghazala Hashmi, and Spanberger were each administered the oath of office in the public ceremony.

Republican former Gov. Glenn Youngkin left the ceremony shortly after the oath of office was administered to Spanberger and before the inaugural address.
In her speech, the new governor made an appeal to bipartisanship and looking past division in our current moment.
“To my friends in the General Assembly — on both sides of the aisle — I look forward to working with you,” said Spanberger. “I know what it means to represent your constituents, to work hard for your district, and to pursue policies you believe in. We will not agree on everything, but I speak from personal experience when I say that we do not have to see eye-to-eye on every issue in order to stand shoulder-to-shoulder on others.”
Spanberger acknowledged Virginians’ frustrations with federal layoffs and governmental policy.
“I know many of you are worried about the recklessness coming out of Washington. You are worried about policies that are hurting our communities — cutting healthcare access, imperiling rural hospitals, and driving up costs,” said Spanberger. “You are worried about Washington policies that are closing off markets, hurting innovation and private industry, and attacking those who have devoted their lives to public service.”
Spanberger alluded to the Trump-Vance administration, through never mentioned President Donald Trump’s name in her remarks.
Spanberger said, “you are worried about an administration that is gilding buildings while schools crumble, breaking the social safety net, and sowing fear across our communities, betraying the values of who we are as Americans, the very values we celebrate here on these steps.”
The new governor then spoke of her priorities in office, pledging to tackle housing affordability by working to “cut red tape” and increase housing supply. Spanberger also spoke of forestalling an impending healthcare crisis by protecting access and cracking down on “middlemen who are driving up drug prices.”
Spanberger spoke of investments in education at every level, standing up for workers (including the large number of federal workers in Virginia), and taking action on gun violence.
Virginia married couple Mary Townley and Carol Schall witnessed the inauguration ceremony from the stands set up on the grounds of the Capitol. Schall and Townley are one of the plaintiff couples in the case that challenged the Virginia constitutional ban on same-sex marriage.
Same-sex marriage became legal in Virginia in 2014.
“We are delighted with the inauguration of Abigail Spanberger as governor of Virginia,” Schall told the Washington Blade. “The celebration of her inauguration was full of the beautiful diversity that is Virginia. The Virginia Pride contingent was included as a part of what makes Virginia a great place to live.”
“Such an honor to attend such a wonderful event in Virginia history,” Townley told the Blade. “The weather before the Inauguration was cold and rainy, but I believe it represented the end of a dreary time and it ushered in the dry and sunny weather by the end of the inaugural parade. Madam Governor brought us to the light!”
The inaugural parade following the governor’s remarks included a contingent from Diversity Richmond and Virginia Pride. Marchers in the LGBTQ contingent carried a giant Progress Pride flag and were met with loud cheers from the gathered spectators.

Spanberger after her inauguration signed 10 executive orders. One of them bans discrimination against state employees based on sexual orientation, gender identity, and other factors.
“By virtue of the authority vested in me as Governor under Article V of the Constitution of
Virginia, I hereby declare that it is the firm and unwavering policy of the Commonwealth of Virginia to ensure equal opportunity in all facets of state government,” reads the executive order. “The foundational tenet of this executive order is premised upon a steadfast commitment to foster a culture of inclusion, diversity, and mutual respect for all Virginians.
Virginia
VIDEO: LGBTQ groups march in Va. inaugural parade
Abigail Spanberger took office on Saturday
The inaugural ceremonies for Virginia Gov. Abigail Spanberger were held in Richmond, Va. on Saturday. Among the groups marching in the parade were Diversity Richmond and the Virginia Pride project of Diversity Richmond.
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Virginia
Va. Senate approves referendum to repeal marriage amendment
Outgoing state Sen. Adam Ebbin introduced SJ3
The Virginia Senate on Friday by a 26-13 vote margin approved a resolution that seeks to repeal a state constitutional amendment that defines marriage as between a man and a woman.
Outgoing state Sen. Adam Ebbin (D-Alexandria) introduced SJ3. The Senate Privileges and Elections Committee on Wednesday approved it by a 10-4 vote margin.
Same-sex couples have been able to legally marry in Virginia since 2014. Outgoing Republican Gov. Glenn Youngkin in 2024 signed a bill that codified marriage equality in state law.
A resolution that seeks to repeal the Marshall-Newman Amendment passed in the General Assembly in 2021. The resolution passed again in 2025.
Two successive legislatures must approve the resolution before it can go to the ballot. Democrats in the Virginia House of Delegates have said the resolution’s passage is among their 2026 legislative priorities.
“It’s time for Virginia’s Constitution to reflect the law of the land and the values of today,” said Ebbin after Friday’s vote. “This amendment, if approved by voters, would affirm the dignity of all committed couples and protects marriage equality for future generations.”
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