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Post-DOMA rule proposed for hospice care, nursing homes

Administration seeks to ensure same-sex marriages recognized regardless of state of residence

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Centers for Medicare & Medicaid Services, gay news, Washington Blade

The Centers for Medicare & Medicaid has proposed a new rule for hospice care and nursing homes. (Image public domain).

The Obama administration on Thursday announced a proposed rule that aims to ensure medical care for individuals in same-sex marriages — regardless of the state in which they live — following the Supreme Court decision against the Defense of Marriage Act.

The Centers for Medicare & Medicaid proposes the rule to change conditions for medical care providers and suppliers receiving support from Medicare and Medicaid, including hospitals and hospice care, as well as the requirements for long-term care facilities, or nursing homes.

The thrust of the proposed rule is to ensure same-sex marriages are recognized nationwide, even in states without marriage equality, for programs that in some aspects are administered by the states.

“This proposed rule addresses certain regulations governing Medicare and Medicaid participating providers and suppliers where current regulations look to state law in a matter that implicates (or may implicate) a marital relationship,” the rule states. “Our goal is to provide equal treatment to spouses, regardless of their sex, whenever the marriage was valid in the jurisdiction in which it was entered into, without regard to whether the marriage is also recognized in the state of residence or the jurisdiction in which the health care provider or supplier is located, and where the Medicare program explicitly or impliedly provides for specific treatment of spouses.”

The proposed rule, which can found here, is set for publication in the Federal Register on Friday. Once it’s published, comments must be received by 60 days to be assured consideration before the rule is made final.

Karen Loewy, senior attorney and seniors program strategist for the LGBT group Lambda Legal, said the proposed rules are “a very welcome development” and would “amend references to discriminatory state laws to provide equal treatment to spouses.”

“In practical terms, these changes will mean that a patient’s same-sex spouse will have the same right to access information, make decisions, and be part of admissions processes that a different-sex has in hospitals, hospice care, surgical care centers, long term care settings, labs, and community mental health centers that receive Medicare or Medicaid dollars, even when the laws of the state would not recognize their right to do so,” Loewy said. “These rules would provide important automatic protections for same-sex spouses, ensuring that a patient’s spouse gets to be by his or her side, be informed, and make those difficult decisions in vulnerable health care situations.”

In summary, the proposed rule seeks to established a same-sex spouse should be considered a person’s representative — regardless of state law — for the purposes for care from ambulatory surgical centers, hospice care, exercising a patient’s rights, informing patients of their rights, notification for laboratory services to screen blood and blood products for potentially infectious diseases like HIV and Hepatitis C, care in long-term facilities, pre-admission screening and resident review for long-term care, findings of these evaluations, care in Community Mental Health Centers and client rights at these facilities.

Mark Daley, a spokesperson for the National LGBTQ Task Force, said changes in proposed rule are “common-sense” and would help elders in the LGBT community ensure they receive equal care in medical facilities.

“These new policies help ensure that one of the most vulnerable populations in our country, LGBTQ elders, are able to access federal programs in the same way that non-LGBTQ people access programs,” Daley said. “This means ensuring that same-sex spouses will be treated exactly the same as different-sex spouses in programs like long-term care facilities, Hospice care, and hospitals. What this really means for LGBTQ folks is that same-sex spouses will be able to visit and make medical decisions on behalf of their spouse, just like different-sex couples. It means that LGBTQ elders will have legal rights in the health care context, regardless of whether your state continues to discriminate against you by refusing to recognize your marriage.”

After the Supreme Court decision against DOMA, the Centers for Medicare & Medicaid already issued guidance — once in September 2013 and again in May 2014 — to ensure same-sex marriages are recognized in determining eligibility for Medicaid and the Children’s Health Insurance Program. But the proposed rule says it’s needed because policies it addresses “are administered by different statutes and are administered by state Medicaid agencies and CMS.”

Sarah Warbelow, legal director for the Human Rights Campaign, said the proposed rule will help individuals in same-sex marriages in the medical care situations when they need assistance the most.

“When people are at their most vulnerable, from hospitals to hospice care to nursing homes, they need to know that their spouse will be fully informed, be able to help them make decisions, and be fully regarded as their spouse,” Warbelow said. “The rule proposed by the Centers for Medicare and Medicaid will help to ensure that the marriages of same-sex couples are treated equally regardless of where the couple lives.”

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D.C.’s affirming congregations to mark Holy Week, Easter

Dignity Washington among groups holding events

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Foundry United Methodist holds two Easter Sunday services at 9 and 11:15 a.m. (Washington Blade photo by Michael Key)

LGBTQ-friendly congregations in the D.C. area this week are marking Easter and Holy Week.

The Metropolitan Community Church of Washington, D.C., located in Mount Vernon Square, holds both online and in-person services. 

An online-only Good Friday service will take place on April 3 at 7 p.m. In person or online Resurrection Sunday services will take place on April 5 at 10:30 a.m.

Dignity Washington, an LGBTQ Catholic group, is also holding Holy Week and Easter events.

The group on March 29 held a Palm Sunday prayer event. Dignity Washington on April 5 will hold a Mass at St. Margaret’s Episcopal Church at 6 p.m. It will be livestreamed on Facebook.

Foundry United Methodist Church holds two Easter Sunday services at 9 and 11:15 a.m.

Riverside Baptist Church, located in Southwest Washington, is an “Inclusive, Multicultural, Christ-Centered” congregation that also offers Holy Week and Easter activities. 

The church on Good Friday at 3 p.m. is holding an outreach period in which they will clean up the neighborhood. Easter Sunday services will be held at 9:45 a.m., starting with a musical prelude, followed by services. 

The church offers weekly “Wednesday Witness,” a youth and safety zone drop-in, serving as a safe space for the students of Jefferson Middle School and the community. It takes place from 3-5 p.m.

The DC LGBTQ+ Community Center offers a comprehensive list of inclusive faith communities on its website. The Association of Welcoming and Affirming Baptists offers a list of churches partnered with their organization that are inclusive and mainly Baptist, but the group does feature churches of other denominations.

The 18th National Rainbow Seder took place at the Human Rights Campaign on March 29. The sold out event is the country’s largest Passover Seder for the Jewish LGBTQ community.

Organizations behind the event included Bet Mishpachah, a local D.C. LGBTQ synagogue that Rabbi Jake Singer-Beilin leads, and GLOE, an Edlavitch DC Jewish Community Center program that sponsors events for the queer Jewish community. The theme for this year’s Seder was “Liberation for All Who Journey: Remembering, Resisting, Rebuilding.” Rabbis Atara Cohen, Koach Frazier, and Avigayil Halpern led it. 

The Seder honored the late GLOE co-chair Michael Singer. Singer also served on the Edlavitch DC Jewish Community Center’s board.

“This Seder is both a celebration of how far we have come and a call to continue building a more just and inclusive world.” Bet Mishpachah Executive Director Joshua Maxey told the Washington Blade.

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Trans activists gather on National Mall for Transgender Day of Visibility

Upwards of 200 people participated in D.C. event

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"RuPaul's Drag Race" star and transgender activist speaking at the Transgender Day of Visibility rally on March 28. (Washington Blade photo ny Michael Key)

The National Mall was covered in kites on Saturday as transgender activists from around the country gathered to support the second annual Transgender Day of Visibility. The event, put on by the Christopher Street Project — whose mission to protect and support trans Americans on the ballot and in streets — brought together around 200 supporters and organizations to honor trans homicide victims and rally for the future of human rights.

Created 17 years ago by psychotherapist and trans activist Rachel Crandall-Crocker, the day was born out of a need to celebrate one of the most marginalized groups in American politics, she told The 19th in 2021.

Since then, the nation has slowly caught up. This year marked the second time the observance has expanded into a multi-day movement, with events ranging from panels and congressional lobbying to organizing efforts, culminating in a rally on the “nation’s front door” — the National Mall.

A recent survey conducted by SRSS, a national research and marketing firm, and commissioned by the Human Rights Campaign Foundation, found that 41 percent of American adults say they personally know someone who is trans. That figure is up from previous estimates of around 30 percent. The study also shows that 27 percent say they have had a regular conversation with a transgender person in the last year. For HRC, this data is confirmation that visibility efforts are working.

“Transgender people are not strangers. They are our neighbors, coworkers, family members, and friends. And this new data shows that as people get to know them, they are more likely to stand by them as allies,” said Kelley Robinson, president of HRC said in a statement. “Defending trans rights is part of defending democracy itself. The more we show up for each other, the stronger our communities and our democracy become.”

Despite this progress and growing positive sentiment, more than 80 anti-trans bills are currently pending in state legislatures across the country, according to HRC, while similar issues are being debated at the national level. Many of the bills seek to restrict trans youth from participating in sports aligned with their gender identity and limit access to gender-affirming medical care.

Tyler Hack, founder and executive director of the Christopher Street Project, who is trans and nonbinary, spoke with the Washington Blade on March 28 about the growing importance of the day.

“We saw that there was a lack of political power for the trans community. We saw that there was a lack of political power for the trans community,” Hack said. “We decided to step up and implement the demand leadership and have galvanized people all across this country for Trans Day of Visibility and our gatherings these last few days we’ve had people come from as far as Hawaii to come celebrate with us, advocate for our rights on the hill, and learn about what it means to fight for all of us.”

Fighting for “all of us,” Hack noted, means showing up where political power is concentrated — in the nation’s capital. The National Mall, a hub for both protest and tourism, draws a wide range of visitors, from political activists brandishing MAGA hats or “You did it, Joe” t-shirts to everyday sightseers.

“I literally just saw a guy in a Trump shirt [at the rally], but we’re not going anywhere,” they said. “Visablity is really important, alongside needing to be an active parts of society, being having public life, and we need to demonstrate that we’re not going anywhere. I mean, we had people from the hill, Congress members come who weren’t even planning to come and did … We are now learning about what it means to fight for and stand up for our rights.”

Hack then looked toward the Capitol after being asked why they believe there are so many negative — and false — statements coming from congressional legislators about trans people. After a pause, they emphasized that the fight for trans rights is often deliberately mischaracterized by Republican opponents try to turn Americans against the community. That, they pointed out, is not what is happening outside the halls of the Hill.

“We are fighting for an America that works for all of us, and we know that,” Hack said. “We know that fighting for all of us is not unpopular. What’s unpopular is genital inspections in schools for girls as young as four years old — who some of our leaders want to transvestigate for not looking feminine enough. What’s unpopular are subpoenas of hospitals so the government can go through your records and decide what they like and don’t like. It is about power.”

That framing — that trans people simply want to live freely and equally under the law — has become central to the movement’s messaging, even as conservative media organizations and political leaders continue to shape public perception in opposing ways.

“We can’t cede any ground because we don’t need to. We are not fighting for a cause that’s inherently unpopular. People know that we shouldn’t throw anyone under the bus, and that’s what we’re here to say to our leaders: we’re paying attention.”

This year’s TDoV was noticeably larger in production than last year’s event, with a bigger stage, more high-profile speakers, increased security, and expanded programming across multiple days.

“We also planned three days of programming. We had dozen panels and workshops on Thursday, and we had over 75 Hill meetings on Friday,” they said. “Now we have this rally, and our capacity hasn’t grown that much — a lot of this was done by two people, but I think it just has come to fruition in a way. I’m happy with it, but I would love to see people with crazy budgets and includes expanded capacity, also we can continue to step out and do the work.”

One moment that stood out to Hack was seeing a parent advocate for her trans child — highlighting what they described as the deeply human nature of these stories.

“The first person to come up to me today was a mom of a trans kid and a nonbinary kid who said she came to our whole convening, going to the Hill to advocate yesterday — for the first time, because we inspired her to act, and that she was too scared to be a part of something,” they said. “She knew that her kids’ lives had been criminalized and that she needed to act and –that really hit me. I also know most of the people who educated our lawmakers, were people who have never been to the Hill before. These people who were also telling their stories, were also fighting for reproductive freedom for all. I mean, we had people from Hawaii, Washington State, California, people who some of them hadn’t been to D.C. Those are the people that we are here to mobilize because they haven’t been galvanized by any project before. I’m just grateful we gave them something that they’re willing to get behind.”

Speakers throughout the rally echoed similar themes of urgency, visibility, and collective action.

Rayceen Pendarvis, a local D.C. trans activist, spoke at the event, emphasizing the history behind the current fight — especially the exclusion of trans people from broader LGBTQ movements — and the need to push back against current political attacks on the most marginalized.

“Trans people in D.C. had to fight for their seat at the table. Trans people were either an afterthought — or left out completely. Now, trans people have become the scapegoat. Ignorance about trans people has been weaponized.”

The lifelong Washingtonian, who had a popular show that ran for 10 seasons with a range of programming covering local and national LGBTQ topics from 2012–2021, continued on the need to stay aware and vocal during the increasingly difficult Trump-Vance administration.

“We have to push back — be as relentless as they are. If your vote was not important, they wouldn’t spend so much time trying to stop you from using it. Voting is not enough — we all must get involved. Let us make our ancestors proud by unifying, organizing, and fighting back.”

She ended her speech with advice to not only strategically spend time advocating, but also build relationships within and around the transgender community.

“Support each other, encourage each other, and help each other. Spend time with your trans elders while you can and learn from them. Give them their flowers, but also give the old dolls some money to pay their bills,” she said to cheers from the crowd. “Allies need to put their money where their mouth is!”

“RuPaul’s Drag Race” contestant, singer-songwriter, and trans activist Peppermint spoke about the mixed feelings the day brings, allowing her to recognize both pride and frustration with the slow-moving progress for the transgender community.

“I love being trans, and it’s inspiring to see more people feel comfortable expressing who they are,” Peppermint said to the crowd. “But I’m disappointed that we have to march for our rights. I’m disappointed that we have to convince people who we are, while we’ve been here supporting them all along. I’m disappointed that not enough people show up when the trans community is under attack.”

Last year, a record number of anti-trans policies passed through state and federal legislatures — many originating from Republican lawmakers who argue such measures are necessary for safety. Idaho voted to make it a criminal offense to use the bathroom aligned with one’s gender identity if it does not match sex assigned at birth, setting up a bounty-style enforcement system. Twenty-seven states have banned sports participation for transgender children, primarily targeting transgender girls, citing fairness and safety — claims that research has shown are not supported by evidence. Last month, Kansas’s state Senate voted to invalidate driver’s licenses and birth certificates of trans residents who had updated their gender markers, while also defining sex strictly as assigned at birth.

Peppermint highlighted the specific cruelty of these policies and echoed the rally’s broader message.

“People are being asked to make an agreement to throw us under the bus. You’re watching our civil rights be stripped away like it’s entertainment. When you empower a government to take rights from some, you empower it to take rights from everyone,” the Broadway performer added. “That’s the reality we’re facing.”

She finished by affirming those present and pointing toward the future of the fight for equal treatment under the law.

“Trans people are women, men, nonbinary, immigrants, disabled — every kind of person. We are here, and we are inevitable. I’m disappointed — but I’m hopeful. I’m grateful — and you should be too,” Peppermint said. “I love you, I’m in awe of you, and I am grateful for you. I’m proud to stand with this diverse trans community. We have always shown up for others, year after year. And we’re still here.”

Rabbi Abby Stein framed the moment through a spiritual and historical lens, offering an alternative to narratives often pushed by conservative lawmakers and commentators.

“They’ve moved past trying to erase us — they’re using us. We have become the rock they’re using to hit the people they want to oppress,” Stein said. “We are visible, but we’ve been forced into a narrow place. That’s the reality of this moment.”

She continued, explaining that, despite what some have said, her trans identity reaffirms her religion and strengthens her Jewish faith.

“For generations, we’ve told stories about leaving narrow places. Those narrow places exist today — in closets, in systems, in the ways people try to restrict us. But we have always found a way out. That is our history and our power.”

“Coming out and being who you are isn’t just okay — it’s a spiritual obligation. It is powerful, and it is necessary. If you try to take away our visibility, our rights, and our joy, you will fail. We are going to win because we will keep fighting together.”

Other activists that spoke included military members who had been forced out of their jobs and benefits following the Trump-Vance administration’s return to banning transgender military members, including SPARTA Pride Executive Director and US Army Major Kara Corcoran and Air Force Master Sgt. Logan Ireland, both focusing their time on stage on sharing how they gave their country their lives, yet the president couldn’t accept their gender identity.

Others who spoke/performed included the queer cheerleading group Cheer DC, local trans DJ and organizer Samson, and Chastity Bowick, Executive Director of Marsha P. Johnson Institute also spoke.

Precious Brady-Davis at the Trans Day of Visibility rally on the National Mall. (Photo by Michael Key)

Hack closed with a message centered on their belief in collective action to create a better world for everyone and the resilience of the community.

“We’ve been fighting in the halls of power, and I’m proud of how far we’ve come. This week is about educating, advocating, and rallying. There isn’t one strategy to take back our country. It takes all of us … This is not just about trans people — this is about whether the government gets to decide who is acceptable. When one group is targeted, it never stops there. That’s what history shows us. That’s why this moment matters.”

“We’re being scapegoated and forced out of public life. There are efforts to legislate us out of existence. Our freedoms are intertwined — we can’t leave anyone out. They think we’re small, but they’re wrong.”

“The days of respectability politics are over,” Hack said, with rainbow kites lying overhead, signaling a welcome and powerful reflection of the day’s movement — one that echoed the sentiments of those gathered. “Our movement has never needed permission to exist — and we’re not asking for it now. There is something inevitable about a people who refuse to disappear. It is inevitable that we win.”

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Senegalese president signs bill that further criminalizes homosexuality

Measure passed in National Assembly with near unanimous support

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Bassirou Diomaye Faye (Screen capture via Reuters/YouTube)

Senegalese President Bassirou Diomaye Faye on Tuesday signed into law a bill that further criminalizes consensual same-sex sexual relations in the country.

Lawmakers in the African country on March 11 nearly unanimously passed the measure that increases the penalty for anyone convicted of engaging in consensual same-sex sexual relations from one to five years in prison to five to 10 years. The bill that Prime Minister Ousmane Sonko introduced also prohibits the “promotion” or “financing” of homosexuality in Senegal.

Reuters on March 16 reported MassResistance, an anti-LGBTQ group based in the U.S., worked with Senegalese groups that support the bill. Volker Türk, the U.N. high commissioner for human rights, is among those who urged Faye not to sign it.

The Senegalese National Assembly in 2021 rejected a bill that would have further criminalized homosexuality in the country.

Police in February arrested a dozen men and charged them with committing “unnatural acts.”

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