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D.C. requires insurers to cover gender reassignment

Mayor bans insurance discrimination against trans residents

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Vincent Gray, transgender, gay news, Washington Blade
Vincent Gray, transgender, gay news, Washington Blade, gender reassignment

‘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, NCTE, National Center for Transgender Equality, gay news, Washington Blade

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.

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District of Columbia

How Pepper the courthouse dog helps victims of abuse

Reshaping how the legal system balances compassion with procedure

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Abby Stavitsky and Pepper (Courtesy photo)

Deborah Kelly’s blind husband, Alton, was dragged for blocks to his death by a hit-and-run driver who had already plowed into her on Alabama Ave., S.E., in June 2024. 

But her trauma had only just begun. It took 10 months before the driver, Kenneth Trice, Jr., was arrested, and another six months before he was sentenced to just six months behind bars.  

As she heaved and sobbed in the courtroom in November, Kelly had a steady four-legged presence by her side: Pepper the Courthouse Dog, as the black Labrador retriever is known in D.C. Superior Court.

Abby Stavitsky, a former federal prosecutor who now serves as a victims’ advocate, is the owner and handler of nine-year-old Pepper. She says that one of the things that has made Pepper such a great asset in the court in the past six years is the emotional support and comfort she provides to victims.  

“She absorbs all of the feelings and the emotions around her, but she’s very good at handling it,” Stavitsky said. 

Pepper and Stavitsky started working in Magistrate Judge Mary Grace Rook’s courtroom — and now works in Magistrate Judge Janet Albert’s — to provide support for youth who suffer trauma, especially young survivors of commercial sexual exploitation.

These specially trained dogs offer emotional support to trauma victims of all ages. Courthouse dogs can reduce victims’ and witnesses’ anxiety and stress, making it easier for them to provide clear statements in the courtroom, according to a 2019 report in the Criminal Justice Review. 

“Having something to pet and interact with is a distraction that results in victims being calmer when testifying in court,” says Stavitsky. “This gives them an extra level of comfort.” 

What brought Stavitsky and Pepper together

Stavitsky, who spent 25 years as an assistant U.S attorney, handled a lot of victim-based crimes, mostly domestic violence and sex offenses. She was also a dog lover, and once she learned about courthouse dogs and their use, she was inspired.

In 2019, Pepper was given to Stavitsky by a Massachusetts-based organization, NEADS, formerly known as the National Education for Assistance Dog Services. Although Pepper was originally trained to be a service dog, evaluators determined her character was best suited for a courthouse dog.

Pepper now works regularly in various treatment court cases involving juveniles, many of whom have experienced trauma or are involved in the child welfare system. She also sits with victims while they are testifying in a trial.

“She loves people, especially children,” Stavitsky said. “She loves that interaction.”

Courthouse dogs have a long history 

In courthouses across the U.S. specially trained “facility dogs” are becoming an important part of how the justice system supports vulnerable victims and witnesses.

Since the late 1980s, these dogs were used to help trauma survivors and anxious children during testimonies and interviews. The first dog to make an appearance in a courtroom was Sheba, a German shepherd who assisted child sexual abuse victims in the Queens (N.Y.) District Attorney’s Office. Courthouse dogs help them communicate more clearly, especially in these settings that make them anxious and stressed.

Unlike service dogs, courthouse facility dogs are professionally trained through accredited assistance dog organizations and work daily alongside prosecutors, victim advocates, and forensic interviewers. For example, courthouse dogs can have more social interaction, unlike service dogs.

Courthouse dogs’ growing use has prompted state laws and professional guidelines to recognize the dogs as a trauma-informed tool that helps victims participate in the justice process without compromising courtroom fairness.

As more jurisdictions adopt these programs, courthouse dogs are reshaping how the legal system balances compassion with procedure, ensuring that victims’ voices can be heard in environments that might otherwise silence them.

Pepper makes it easy to see why. 

“I really love people, especially kids, and can provide emotional support and comfort during all stages of the court process,” reads the business card Stavitsky hands out with Pepper’s picture. “I’m calm, quiet and can stay in place for several hours.” 

(This article was written by a student in the journalism program at Bard High School Early College DC. This work is part of a partnership between the Washington Blade Foundation and Youthcast Media Group, funded through the FY26 Community Development Grant from the Office of D.C. Mayor Muriel Bowser.)

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Rehoboth Beach

Women’s FEST returns to Rehoboth Beach next week

Golf tournament, mini-concerts, meetups planned for silver anniversary festival

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(Washington Blade file photo by Daniel Truitt)

Women’s+ FEST 2026 will begin on Thursday, April 9 at CAMP Rehoboth Community Center.

The festival will celebrate a remarkable milestone in 2026: its silver anniversary. For 25 years, Women’s+ FEST has brought fun and entertainment for all those on the spectrum of the feminine spirit. There will be a variety of events including a golf tournament, mini-concerts and happy hour meetups.

For more information, visit Camp Rehoboth’s website.

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District of Columbia

How new barriers to health care coverage are hitting D.C.

Federally qualified health centers bracing for influx of newly uninsured patients

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Erin Loubier, vice president for access and strategic initiatives at Whitman-Walker Health. (Courtesy photo)

Washington, D.C. has the second-lowest rate of people who lack health insurance in the country, but many residents are facing new barriers to health care due to provisions of the sweeping federal law passed in July, which threatens access for thousands. 

Changes to insurance eligibility and the rising cost of premiums, which kicked in for some in October and others more recently, are expected to leave many more patients uninsured or unable to afford medical care. Federally qualified health centers, including D.C.’s Whitman-Walker Health, where 10 to 12 percent of patients are uninsured, are bracing for an influx of newly uninsured patients while facing their own financial challenges. 

Even in D.C., where uninsured rates have been among the lowest in the country, changes brought on by the passage of the Republican mega bill (known as the “Big Beautiful Bill”) will have major effects. 

The changes from the bill affect Medicaid, which is free to low-income patients, and subsidies for insurance that people buy on the health insurance exchanges that were started under the Affordable Care Act, which were allowed to expire on Dec. 31. 

Erin Loubier, vice president for access and strategic initiatives at Whitman-Walker Health, says some Whitman-Walker Health patients have received notices about premium increases, including several who say the increases are up to 1,000 percent more than they were paying. 

“That is like paying rent,” she says. “We live in an expensive city, so any increases are going to be really, really hard on people.”

Whitman-Walker Health and other healthcare providers are expecting the changes to have multiple effects — some patients may not be able to afford coverage or may avoid going to the doctor and allow health conditions to worsen because they can’t afford care, and many more will be seeking care who don’t have insurance. 

“I’m worried that we’re going to not just have people who can’t get care, but that they delay care until they’re really sick, and then the care is not as effective because they might have waited too long, and then we may have a less healthy population,” Loubier says.

Loubier says delaying care, and serving more people without insurance has major implications for Whitman-Walker Health and other health centers serving the community.

“There’s going to be a lot of pressure on us to try to find and raise more money, and that’s going to be harder, because I think all organizations who provide health care are going to be facing this,” she says. 

The U.S. health care system is the most expensive in the world, and has much higher out-of-pocket costs for individuals. But in other countries like the United Kingdom, Australia, Canada, and many others, health care is much less expensive — or even free.

Even though the U.S. has a high-priced healthcare system, critics say there are still ways to bring down costs by forcing insurance and pharmaceutical companies to absorb more of the costs, rather than transferring the costs to patients.

“In the U.S., they end up trying to cut costs at the person’s level, not at the level of the different corporations or structures that are making a lot of money in healthcare,” said Loubier. “Our system is so complicated and there is probably waste in it, but I don’t think that that cost and waste is at the ‘people’ level. I think it’s higher up at the system level, but that is much, much harder to get people to try to make cuts at that end.”

Ultimately at Whitman-Walker Health, healthcare providers and insurance navigators are planning to help with everyday necessities when it comes to healthcare coverage and striving to provide healthcare in partnership with patients, said Loubier.

“The key here is we’re going to have a lot of people who may lose insurance, and they’re going to rely on places like Whitman-Walker Health and other community health centers, so we have to figure out how we keep providing that care,” she said. 

(This article was written by a student in the journalism program at Bard High School Early College DC. This work is part of a partnership between the Washington Blade Foundation and Youthcast Media Group, funded through the FY26 Community Development Grant from the Office of D.C. Mayor Muriel Bowser.)

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