Local
D.C. requires insurers to cover gender reassignment
Mayor bans insurance discrimination against trans residents

‘Treatment of individuals diagnosed with gender dysphoria is a covered benefit in all individual and group insurance plans in the District of Columbia, including Medicaid,’ said Mayor Vincent Gray. (Washington Blade photo by Michael Key)
D.C. Mayor Vincent Gray announced on Thursday that health insurance companies doing business in the District must provide full coverage for medically recognized treatments to help transgender people change their gender, including gender reassignment surgery.
At a news conference in a meeting room outside his office, Gray said the city’s Department of Insurance, Securities, and Banking issued a bulletin directing insurers to recognize a condition known as gender dysphoria, or gender identity disorder, as a medical condition to be covered by insurance plans.
Transgender advocates note that the American Medical Association and the American Psychiatric Association recognize gender dysphoria as a diagnosable condition through which physicians and other health care professional provide a wide range of approved medical treatments to assist people in transitioning from one gender to another.
“Today, the District takes a major step toward leveling the playing field for individuals diagnosed with gender dysphoria,” Gray said. “These residents should not have to pay exorbitant out-of-pocket expenses for medically necessary treatment when those without gender dysphoria do not,” he said.
“I’m clarifying today that treatment of individuals diagnosed with gender dysphoria is a covered benefit in all individual and group insurance plans in the District of Columbia, including Medicaid,” Gray said.
Gray’s remark drew a prolonged, standing ovation from LGBT activists, including transgender advocates, who gathered in the mayor’s ceremonial bill-signing room where Gray held his news conference.
“Those who know me know how proud I am that the District continues to be on the cutting edge and on the forefront when it relates to equality and fairness for its LGBTQ residents,” Gray said.
The bulletin, which the city sent to insurance companies on the day of Gray’s announcement, cites the D.C. Human Rights Act as among the legal grounds being used to require insurers to cover transgender related treatments. The Human Rights Act, among other categories, bans discrimination based on gender identity and expression as well as sexual orientation.
The bulletin cites the D.C. Unfair Insurance Trade Practices Act of 2001 as further grounds for not allowing insurers to exclude coverage of trans-related treatments from their insurance plans.
Among those speaking at the news conference was Mara Keisling, executive director of the D.C.-based National Center for Transgender Equality, which worked with the mayor’s office and insurance department officials to help draft the four-page bulletin.
Keisling said Gray’s action places D.C. among just five states that have adopted similar policies requiring insurers to cover treatments such as gender reassignment surgery and hormone therapy to assist an individual’s transition to another gender.
Those states are California, Oregon, Colorado, Vermont and Connecticut.
“This is really significant,” Keisling told the Blade after the news conference. “It means that transgender people in D.C. now can make their health care decisions with their doctor rather than with their insurance companies,” she said.

Mara Keisling, executive director of the National Center for Transgender Equality. (Washington Blade photo by Michael Key)
Asked what treatments are involved in a gender transition, Keisling said experts with the World Professional Association for Transgender Health Standards of Care (WPATH) have developed a wide range of treatments that may vary from person to person depending on individual needs.
“It’s a whole range of transition-related care — everything from diagnostic visits to experts in the field,” Keisling said. “It can mean hormone treatments. It can mean lab tests to make sure your hormones are working correctly and not causing any harm. There are various kinds of surgeries that transgender people may need. So it covers a whole range of things.”
D.C. transgender activist Andy Bowen, who recently joined the staff of the NCTE as a policy associate, called the D.C. initiative announced by Gray the most comprehensive among the states that have adopted similar policies.
“If you look at some of the other states they say they’re not going to cover some treatments,” Bowen said. “D.C. has not done that. It just said that if it’s one of the WPATH treatments we’re going to cover it. And that’s amazing to hear a government be that unequivocal about it.”
Philip Barlow, the city’s Associate Commissioner of Insurance, said after the news conference that requiring health insurance companies to cover the medical treatments for transgender people would likely result in a small increase in premiums over a period of time.
“It will just be incorporated into the general cost and utilization that insurers use in coming up with future rate increases,” he said. “But we don’t really anticipate it to have a significant impact on the rates.”
Michael Silverman, executive director of the New York-based Transgender Legal Defense and Education Fund, praised Gray for taking action that he said would “end health care discrimination against transgender residents of Washington, D.C.”
The bulletin issued by the city’s Department of Insurance that directs insurers to provide full coverage for medically approved treatments to transgender individuals in D.C. can be obtained here.
Maryland
4th Circuit dismisses lawsuit against Montgomery County schools’ pronoun policy
Substitute teacher Kimberly Polk challenged regulation in 2024
A federal appeals court has ruled Montgomery County Public Schools did not violate a substitute teacher’s constitutional rights when it required her to use students’ preferred pronouns in the classroom.
The 4th U.S. Circuit Court of Appeals in a 2-1 decision it released on Jan. 28 ruled against Kimberly Polk.
The policy states that “all students have the right to be referred to by their identified name and/or pronoun.”
“School staff members should address students by the name and pronoun corresponding to the gender identity that is consistently asserted at school,” it reads. “Students are not required to change their permanent student records as described in the next section (e.g., obtain a court-ordered name and/or new birth certificate) as a prerequisite to being addressed by the name and pronoun that corresponds to their identified name. To the extent possible, and consistent with these guidelines, school personnel will make efforts to maintain the confidentiality of the student’s transgender status.”
The Washington Post reported Polk, who became a substitute teacher in Montgomery County in 2021, in November 2022 requested a “religious accommodation, claiming that the policy went against her ‘sincerely held religious beliefs,’ which are ‘based on her understanding of her Christian religion and the Holy Bible.’”
U.S. District Judge Deborah Boardman in January 2025 dismissed Polk’s lawsuit that she filed in federal court in Beltsville. Polk appealed the decision to the 4th Circuit.
District of Columbia
Norton hailed as champion of LGBTQ rights
D.C. congressional delegate to retire after 36 years in U.S. House
LGBTQ rights advocates reflected on D.C. Congressional Del. Eleanor Holmes Norton’s longstanding advocacy and support for LGBTQ rights in Congress following her decision last month not to run for re-election this year.
Upon completing her current term in office in January 2027, Norton, a Democrat, will have served 18 two-year terms and 36 years in her role as the city’s non-voting delegate to the U.S. House.
LGBTQ advocates have joined city officials and community leaders in describing Norton as a highly effective advocate for D.C. under the city’s limited representation in Congress where she could not vote on the House floor but stood out in her work on House committees and moving, powerful speeches on the House floor.
“During her more than three decades in Congress, Eleanor Holmes Norton has been a champion for the District of Columbia and the LGBTQ+ community,” said David Stacy, vice president of government affairs for the Human Rights Campaign, the D.C.-based national LGBTQ advocacy organization.
“When Congress blocked implementation of D.C.’s domestic partnership registry, Norton led the fight to allow it to go into effect,” Stacey said. “When President Bush tried to ban marriage equality in every state and the District, Norton again stood up in opposition. And when Congress blocked HIV prevention efforts, Norton worked to end that interference in local control,” he said.

In reflecting the sentiment of many local and national LGBTQ advocates familiar with Norton’s work, Stacy added, “We have been lucky to have such an incredible champion. As her time in Congress comes to an end, we honor her extraordinary impact in the nation’s capital and beyond by standing together in pride and gratitude.”
Norton has been among the lead co-sponsors and outspoken supporters of LGBTQ rights legislation introduced in Congress since first taking office, including the currently pending Equality Act, which would ban employment discrimination based on sexual orientation and gender identity.
Activists familiar with Norton’s work also point out that she has played a lead role in opposing and helping to defeat anti-LGBTQ legislation. In 2018, Norton helped lead an effort to defeat a bill called the First Amendment Defense Act introduced by U.S. Sen. Mike Lee (R-Utah), which Norton said included language that could “gut” D.C.’s Human Rights Act’s provisions banning LGBTQ discrimination.
Norton pointed to a provision in the bill not immediately noticed by LGBTQ rights organizations that would define D.C.’s local government as a federal government entity and allow potential discrimination against LGBTQ people based on a “sincerely held religious belief.”
“This bill is the latest outrageous Republican attack on the District, focusing particularly on our LGBT community and the District’s right to self-government,” Norton said shortly after the bill was introduced. “We will not allow Republicans to discriminate against the LGBT community under the guise of religious liberty,” she said. Records show supporters have not secured the votes to pass it in several congressional sessions.
In 2011, Norton was credited with lining up sufficient opposition to plans by some Republican lawmakers to attempt to overturn D.C.’s same-sex marriage law, that the Council passed and the mayor signed in 2010.
In 2015, Norton also played a lead role opposing attempts by GOP members of Congress to overturn another D.C. law protecting LGBTQ students at religious schools, including the city’s Catholic University, from discrimination such as the denial of providing meeting space for an LGBTQ organization.
More recently, in 2024 Norton again led efforts to defeat an attempt by Republican House members to amend the D.C. budget bill that Congress must pass to eliminate funding for the Mayor’s Office of LGBTQ Affairs and to prohibit the city from using its funds to enforce the D.C. Human Rights Act in cases of discrimination against transgender people.
“The Republican amendment that would prohibit funds from being used to enforce anti-LGBTQ+ discrimination regulations and the amendment to defund the Mayor’s Office of LGBTQ+ Affairs are disgraceful attempts, in themselves, to discriminate against D.C.’s LGBTQ+ community while denying D.C. residents the limited governance over their local affairs to which they are entitled,” Norton told the Washington Blade.
In addition to pushing for LGBTQ supportive laws and opposing anti-LGBTQ measures Norton has spoken out against anti-LGBTQ hate crimes and called on the office of the U.S. Attorney for D.C. in 2020 to more aggressively prosecute anti-LGBTQ hate crimes.

“There is so much to be thankful for Eleanor Holmes Norton’s many years of service to all the citizens and residents of the District of Columbia,” said John Klenert, a member of the board of the LGBTQ Victory Fund. “Whether it was supporting its LGBTQ+ people for equal rights, HIV health issues, home rule protection, statehood for all 700,000 people, we could depend on her,” he said.
Ryan Bos, executive director of Capital Pride Alliance, the group that organizes D.C.’s annual LGBTQ Pride events, called Norton a “staunch” LGBTQ community ally and champion for LGBTQ supportive legislation in Congress.
“For decades, Congresswoman Norton has marched in the annual Capital Pride Parade, showing her pride and using her platform to bring voice and visibility in our fight to advance civil rights, end discrimination, and affirm the dignity of all LGBTQ+ people” Bos said. “We will be forever grateful for her ongoing advocacy and contributions to the LGBTQ+ movement.”
Howard Garrett, president of D.C.’s Capital Stonewall Democrats, called Norton a “consistent and principled advocate” for equality throughout her career. “She supported LGBTQ rights long before it was politically popular, advancing nondiscrimination protections and equal protection under the law,” he said.
“Eleanor was smart, tough, and did not suffer fools gladly,” said Rick Rosendall, former president of the D.C. Gay and Lesbian Activists Alliance. “But unlike many Democratic politicians a few decades ago who were not reliable on LGBTQ issues, she was always right there with us,” he said. “We didn’t have to explain our cause to her.”
Longtime D.C. gay Democratic activist Peter Rosenstein said he first met Norton when she served as chair of the New York City Human Rights Commission. “She got her start in the civil rights movement and has always been a brilliant advocate for equality,” Rosenstein said.
“She fought for women and for the LGBTQ community,” he said. “She always stood strong with us in all the battles the LGBTQ community had to fight in Congress. I have been honored to know her, thank her for her lifetime of service, and wish her only the best in a hard-earned retirement.”
Lieutenant Gov. Ghazala Hashmi on Monday opened Equality Virginia’s annual Lobby Day in Richmond.
The Lobby Day was held at Virginia’s Capitol and was open to the public by RSVP. The annual event is one of the ways that Equality Virginia urges its supporters to get involved. It also offers informational sessions and calls to action through social media.
Hashmi, a former state senator, has been open about her support for the LGBTQ community and other marginalized groups. Her current advisor is Equality Virginia Executive Director Narissa Rahaman, and the group endorsed her for lieutenant governor.
Hashmi historically opposes anti-transgender legislation.
She opposed a 2022 bill that sought to take away opportunities from trans athletes.
One of the focuses of this year’s Lobby Day was protecting LGBTQ students. Another was protecting trans youth’s access to gender-affirming care.
Advocates spent their day in meetings and dialogues with state legislators and lawmakers about legislative priorities and concerns.
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