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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.
District of Columbia
HIV/AIDS activists block intersection near White House
World AIDS Day provided backdrop for calls to fully fund PEPFAR
Upwards of 100 HIV/AIDS activists on Monday blocked an intersection near the White House and demanded the Trump-Vance administration fully fund PEPFAR.
Housing Works, Health GAP, Treatment Action Group, AIDS United, ACT UP Philadelphia, and the National Minority AIDS Council organized the protest that took place at the intersection of 16th and I Streets, N.W. The activists then marched to Lafayette Park.
(Washington Blade video by Michael K. Lavers)
(Washington Blade video by Michael K. Lavers)
Activists since the Trump-Vance administration took office in January have demanded full PEPFAR funding.
Secretary of State Marco Rubio Jan. 28 issued a waiver that allowed PEPFAR and other “life-saving humanitarian assistance” programs to continue to operate during the freeze on nearly all U.S. foreign aid spending. HIV/AIDS service providers around the world with whom the Washington Blade has spoken say PEPFAR cuts and the loss of funding from the U.S. Agency for International Development, which officially closed on July 1, has severely impacted their work.
The State Department in September announced PEPFAR will distribute lenacapavir in countries with high prevalence rates. The first doses of the breakthrough HIV prevention drug arrived in Eswatini and Zambia last month.
The New York Times in August reported Office of Management and Budget Director Russell Vought “apportioned” only $2.9 billion of $6 billion that Congress set aside for PEPFAR for fiscal year 2025. (PEPFAR in the coming fiscal year will use funds allocated in fiscal year 2024.)
Bipartisan opposition in the U.S. Senate prompted the Trump-Vance administration in July withdraw a proposal to cut $400 million from PEPFAR’s budget. Vought on Aug. 29 said he would use a “pocket rescission” to cancel $4.9 billion for HIV/AIDS prevention and global health programs and other foreign aid assistance initiatives that Congress had already approved.
“Russell Vought, director of the Office of Management and Budget, has defied the appropriations authority of Congress, slashing the budget for the program despite full funding enacted by lawmakers, stealing $1.6 billion despite the direction of Congress that PEPFAR be fully funded,” notes a press release that detailed Monday’s protest. “As a result, lifesaving treatment and prevention programs have closed across dozens of sub-Saharan African countries, while Vought has refused to release money ringfenced by Congress to save lives.”
Monday’s protest coincided with World AIDS Day.
The White House has not publicly acknowledged World AIDS Day. A State Department directive the New York Times obtained last week mandated employees and grantees “to refrain from messaging on any commemorative days, including World AIDS Day.”
“Trump thinks by banning commemoration of World AIDS Day, he can hide from the death and destruction that he’s causing around the world,” said Health GAP Executive Director Asia Russell in Lafayette Square. “But we’re here to say, we can see him. We see him stealing medicine, stealing support services, stealing HIV testing, stealing life-saving care from communities all around the world suffering and dying without access.”
The Clinton Health Access Initiative in a report it published last month said more people with HIV or are at risk of contracting the virus because of “HIV treatment and prevention cascades” during the first half of 2025. Specific figures include:
• 3.4 million fewer adults tested for HIV
• 24,000 fewer infants tested for HIV
• A 22 percent decline in new HIV diagnoses due to a reduction in testing among the most vulnerable, highest-risk people
• An 8 percent decline in people living with HIV receiving CD4 tests to diagnose advanced HIV disease
• 2,000 fewer infants and children with HIV started on life-saving medication
• A 37 percent reduction in PrEP initiations for people at risk for HIV
• 26,000 fewer infants and children on antiretroviral medications
• A 5 percent reduction in adults starting antiretroviral medications
• A 10 percent increase in people living with HIV disengaging from treatment
The Clinton Health Access Initiative also said more children around the world will die “due to undiagnosed and un- or under-treated HIV infection” if “these trends persist.”
The Human Rights Campaign Foundation in its 2025 Annual LGBTQ+ Community Survey notes more than 20 percent of adults said “policies the federal government have made accessing HIV prevention and treatment care more difficult in the last year.” The report indicates 30 percent of respondents identify as LGBTQ.
The Comings & Goings column is about sharing the professional successes of our community. We want to recognize those landing new jobs, new clients for their business, joining boards of organizations and other achievements. Please share your successes with us at [email protected].
Congratulations to RODRIGO HENG-LEHTINEN on his new role as Trevor Project Senior Vice President of Public Engagement Campaigns. On accepting the position, he said, “My mission has long been to stop LGBTQ, and especially trans, people from being perceived as political footballs and start getting us seen as real people – your friends, your families, your neighbors. Now I get to focus on that 100% at The Trevor Project.”
Prior to this, he was executive director, Advocates for Trans Equality (A4TE), where he co-led the merger of two national transgender rights organizations, NCTE and TDLEF, to create the new organization. He had served as executive director of the National Center for Transgender Equality, leading that organization through a period of growth, restoring organizational size and stability. He had served as deputy executive director prior to that. Previously he served as vice president of Public Education, Freedom for All Americans, where he led a successful campaign for transgender nondiscrimination protections in New Hampshire. He oversaw a full range of legislative lobbying, field organizing, and communications strategies and oganized a leadership coalition, established structure, and divided roles for key committees of 17 state and national partner organizations and local activists.
Heng-Lehtinen conducted English-language interviews with outlets such as The New York Times, CNN, MSNBC, and Politico. He planned a Transgender Leadership Summit for the Transgender Law Center and served as Development & Donor Services Assistant, Liberty Hill Foundation. He earned his bachelor’s degree in Latin American Studies from Brown University.
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D.C., Va., Md. to commemorate World AIDS Day
Cathedral of St. Matthew the Apostle will hold a Mass, candlelight prayer vigil
The D.C. area will observe World AIDS Day on Dec. 1 through a variety of community events.
Established by the World Health Organization in 1988, World AIDS Day aims to raise awareness about HIV/AIDS and honor the individuals affected by the epidemic. The global theme for 2025 is “overcoming disruption, transforming the AIDS response.”
Washington
DC Health will host a World AIDS Day event at the Martin Luther King, Jr. Library from noon to 9 p.m on Dec. 1. Attendees can expect live performances, free food and free HIV testing.
The all-day event will also feature community resources from DC Health, DC Public Library, DC Health Link, Serve DC, and the Mayor’s Office of LGBTQ Affairs.
The Lily and Earle M. Pilgrim Art Foundation is partnering with Visual AIDS, a New York-based non-profit that uses art to fight AIDS, to reflect on World AIDS Day with a film screening on Dec. 1.
The David Bethuel Jamieson Studio House at Walbridge in Mount Pleasant will premiere “Meet Us Where We’re At,” an hour-long collection of six videos. The free screening highlights the complexity of drug use in intersection with the global HIV epidemic.
The videos, commissioned by artists in Brazil, Germany, Nigeria, Puerto Rico and Vietnam, showcase the firsthand experience of drug users, harm reduction programs, and personal narratives. The program intends to showcase drug users as key individuals in the global response to HIV.
In addition to streaming the videos, the event will include an evening potluck and conversation led by Peter Stebbins from 6-8 p.m.
The Cathedral of St. Matthew the Apostle will hold a 5:30 p.m. Mass and candlelight prayer vigil at 6 p.m. in honor of World AIDS Day on Dec. 1. The event is open to all and includes a subsequent reception at 6:30 p.m.
The Capital Jewish Museum is hosting a speaker series on Dec. 2 from 6:30-8 p.m. that explores the response to AIDS within the Jewish community. Speakers include LGBTQ psychiatrist Jeffrey Akman, physician assistant Barbara Lewis and Larry Neff, lay service leader at Bet Mishpachah, a synagogue founded by LGBTQ Washingtonians. Heather Alt, deputy director of nursing at Whitman-Walker Health, will moderate the event.
The program is free for museum members. General admission is $10 and Chai tickets, which help subsidize the cost of general admission, are $18. Tickets include access to LGBT Jews in the Federal City, a temporary exhibition that collectively explores Washington, Judaism, and LGBTQ history. The exhibition is on view through Jan. 4, 2026.
Virginia
Alexandria Mayor Alyia Gaskins and local residents will commemorate World AIDS Day on Dec. 1 at the Lee Center.
The event, which is free to attend, will include music, choir performances, educational moments and more. The commemoration will be held from 6:30-8:30 p.m.
Maryland
The Frederick Center will host talks, tabling and a raffle in honor of World AIDS Day. The Frederick County Health Department will conduct free HIV testing.
The event, which is free to attend, will be held on Nov. 30 from 1-4 p.m. The Frederick County Health Department always offers free, walk-in HIV testing on Tuesdays and Fridays from 9 a.m. to 3 p.m.
The Prince George’s County Alumnae Chapter of Delta Sigma Theta Sorority will host a community day of awareness in honor of World AIDS Day on Dec. 6 from 1 a.m. to 2 p.m. The free event will feature free, confidential HIV testing, private talks with medical professionals and health workshops.
The event will be held at Suitland Community Center in Forestville and will include breakfast and snacks.
Damien Ministries is commemorating World AIDS Day on Dec. 1 through the grand opening of the We the People Community & Wellness Collaborative. The event, held at 11:30 a.m. at 4061 Minnesota Avenue, N.E., is free to attend.
Damien Ministries is a faith-based non-profit committed to supporting those with HIV/AIDS.
Begin Anew, a Baltimore non-profit that provides education, outreach and resources to improve public health, wellness and economic stability, is hosting its 4th Annual World AIDS Day Community Celebration on Dec. 1 alongside community partners.
Hosted at the University of Maryland BioPark from noon to 3 p.m., the program will feature keynote speaker Jason E. Farley of the Johns Hopkins School of Medicine. The celebration will also dedicate awards to local heroes focused on fighting HIV/AIDS and promoting health equity.
The free event includes lunch, live entertainment and networking opportunities with health advocates and partners.
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Comings & Goings
Impulse Group DC to host fundraiser
Calendar: November 28-December 4
India’s Jharkhand state works to improve trans people’s access to health care
