News
Post-DOMA rule proposed for hospice care, nursing homes
Administration seeks to ensure same-sex marriages recognized regardless of state of residence
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.”
Honduras
Corte IDH reconoce a Thalía Rodríguez como familia social de Leonela Zelaya
Se construyeron una familia tras más de una década de convivencia
Por DORIS GONZÁLEZ * | TEGUCIGALPA, Honduras — En la sentencia del caso Leonela Zelaya y otra vs Honduras emitida por la Corte Interamericana de Derechos Humanos se estableció un hito jurisprudencial para las personas LGBTQ en Honduras, así como en la región en relación a las diversas conformaciones de familias existentes. La Corte IDH interpretó por primera vez el concepto de familia social, indicando que la construcción de familia no debe restringirse a la familia nuclear o a nociones tradicionales, bajo el entendido de que hay diferentes formas en las que se materializan los vínculos familiares.
Este análisis se trae a colación debido al contexto de discriminación, prejuicio y violencia que atravesamos las personas LGBTQ, el cual se puede manifestar incluso dentro de nuestras propias familias. Esta violencia se manifiesta a través de actos de odio como ser el desarraigo familiar, violencia física, psicológica, social, económica, expulsiones de los hogares, violaciones correctivas e incluso, culminando en muertes violentas. Esta violencia motivada por la orientación sexual, identidad y expresión de género de las personas imposibilita la convivencia familiar.
Ante esto, las personas LGBTQ construimos vínculos sociales fuera del vínculo familiar tradicional, los cuales a través de la convivencia, amistad, apoyo económico-social y construcción de vida en común constituyen familias, tal como ocurrió en este caso.
Tras el abandono de su familia biológica, Leonela Zelaya y Thalía Rodríguez construyeron una familia tras más de una década de convivencia, en los cuales se apoyaron mutuamente en diversas situaciones, viviendo como mujeres trans, portadoras de VIH, ejerciendo el trabajo sexual y en situación de pobreza, enfrentando constantes episodios de detenciones arbitrarias y violentas por parte de los órganos policiales.
Tras su asesinato, fue Thalía quien recogió el cuerpo de Leonela en la morgue de Tegucigalpa y quien gestionó el féretro a través de la Funeraria del Pueblo. Los servicios fúnebres de Leonela Zelaya fueron realizados en un bar por mujeres trans, trabajadoras sexuales, al cual no asistió ningún miembro de su familia biológica.
El asesinato de Leonela y la falta de esclarecimiento generaron a Thalía un sentimiento de inseguridad, frustración e impotencia. Por estas violaciones de derechos humanos, la Corte reconoció a Thalía Rodríguez, en calidad de familiar de Leonela, como víctima del caso, generando estándares aplicables a todas las personas LGBTQ.
A juicio de la Corte, esta situación lleva a que, en casos de muertes violentas de mujeres trans, las personas que integren las redes de apoyo de la persona fallecida puedan ser declaradas víctimas por la violación de sus derechos a la integridad psíquica o moral, siempre que se acredite la existencia de un vínculo estrecho con la víctima y una afectación a sus derechos, derivada, por ejemplo, de las gestiones realizadas para obtener justicia. Esta sentencia logra reconocer que las personas LGBTQ construimos familias sociales, familias elegidas, e indica que estas deben ser reconocidas y validadas.
* Abogada litigante del caso Leonela Zelaya y otra vs Honduras, Red Lésbica Cattrachas
District of Columbia
Eleanor Holmes Norton ends 2026 reelection campaign
Longtime LGBTQ rights supporter introduced, backed LGBTQ-supportive legislation
The reelection campaign for D.C. Congressional Delegate Eleanor Holmes Norton, who has been an outspoken supporter of LGBTQ rights since first taking office in 1991, filed a termination report on Jan. 25 with the Federal Elections Commission, indicating she will not run for a 19th term in the U.S. House of Representatives.
Norton’s decision not to run again, which was first reported by the online news publication NOTUS, comes at a time when many of her longtime supporters questioned her ability to continue in office at the age of 88.
NOTUS cited local political observers who pointed out that Norton has in the past year or two curtailed public appearances and, according to critics, has not taken sufficient action to oppose efforts by the Trump-Vance administration and Republican members of Congress to curtail D.C.’s limited home rule government.
Those same critics, however, have praised Norton for her 35-year tenure as the city’s non-voting delegate in the House and as a champion for a wide range of issues of interest to D.C. LGBTQ rights advocates have also praised her longstanding support for LGBTQ rights issues both locally and nationally.
D.C. gay Democratic Party activist Cartwright Moore, who has worked on Norton’s congressional staff from the time she first took office in 1991 until his retirement in 2021, points out that Norton’s role as a staunch LGBTQ ally dates back to the 1970s when she served as head of the New York City Commission on Human Rights.
“The congresswoman is a great person,” Moore told the Washington Blade in recounting his 30 years working on her staff, most recently as senior case worker dealing with local constituent issues.
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.
She has introduced multiple LGBTQ supportive bills, including her most recent bill introduced in June 2025, the District of Columbia Local Juror Non-Discrimination Act, which would ban D.C. residents from being disqualified from jury service in D.C. Superior Court based on their sexual orientation or gender identity.
For many years, Norton has marched in the city’s annual Pride parade.
Her decision not to run for another term in office also comes at a time when, for the first time in many years, several prominent candidates emerged to run against her in the June 2026 D.C. Democratic primary. Among them are D.C. Council members Robert White (D-At-Large) and Brooke Pinto (D-Ward 2).
Others who have announced their candidacy for Norton’s seat include Jacque Patterson, president of the D.C. State Board of Education; Kinney Zalesne, a local Democratic party activist; and Trent Holbrook, who until recently served as Norton’s senior legislative counsel.
“For more than three decades, Congresswoman Norton has been Washington, D.C.’s steadfast warrior on Capitol Hill, a relentless advocate for our city’s right to self-determination, full democracy, and statehood,” said Oye Owolewa, the city’s elected U.S. shadow representative in a statement. “At every pivotal moment, she has stood firm on behalf of D.C. residents, never wavering in her pursuit of justice, equity, and meaningful representation for a city too often denied its rightful voice,” he said.
Sharon Nichols, who serves as press spokesperson for Norton’s congressional office, couldn’t immediately be reached for a comment by Norton on her decision not to seek another term in office.
Uganda
LGBTQ Ugandans targeted ahead of country’s elections
President Yoweri Museveni won 7th term in disputed Jan. 15 vote
Barely a week after Ugandan President Yoweri Museveni secured a 7th term in an election marred by state violence, intimidation, and allegations of fraud, the country’s queer community spoke about how the election environment impacted it.
The LGBTQ lobby groups who spoke with the Washington Blade noted that, besides government institutions’ failure to create a safe and inclusive environment for civic participation by all Ugandans, authorities weaponized the Anti-Homosexuality Act to silence dissent and discourage queer voter engagement.
The rights groups note that candidates aligned with Museveni’s ruling National Resistance Movement — including Parliament Speaker Anita Among — during the campaigns accused their rivals of “promoting homosexuality” to discredit them while wooing conservative voters.
Queer people and LGBTQ rights organizations as a result were largely excluded from the formal political processes for the election as voters, mobilizers, or civic actors due to fear of exposure, stigma, violence, and legal reprisals.
“This homophobic rhetoric fueled public hostility and emboldened vigilante violence, forcing many queer Ugandans into deeper hiding during the election period,” Uganda Minority Shelters Consortium Coordinator John Grace stated.
Some queer people had expressed an interest in running for local council seats, but none of them formally registered as candidates or campaigned openly because of safety concerns and local electoral bodies’ discriminatory vetting of candidates.
“UMSC documented at least three incidents of election-related violence or intimidation targeting LGBTQ+ individuals and activists,” Grace noted. “These included harassment, arbitrary detentions, extortions by state and non-state actors, digital cat-fishing, and threats of outing.”
Amid such a militarized and repressive election environment, Let’s Walk Uganda Executive Director Edward Mutebi noted queer-led and allied organizations engaged in the election process through restricted informal voter education, community discussions, and documenting human rights violations.
“Fear of backlash limited visibility and direct participation throughout the election cycle,” Mutebi said. “But despite the hostile environment of work, Let’s Walk Uganda was able to organize a successful transgender and gender diverse youth training on electoral security and safety.”
Museveni’s government escalated its repressive actions during the Jan. 15 elections by shutting down the internet and suspending nine civil society organizations, including Chapter Four Uganda and the National Coalition of Human Rights Defenders, for allegedly engaging in activities that are prejudicial to the security and laws of the country.
The suspension of the rights organizations remains in force, an action both Mutebi and Grace condemn. They say it prevents queer Ugandans from accessing urgent services from the affected groups.
“For the LGBTQ community, the impact has been immediate and deeply harmful. Many of the suspended organizations, like Chapter Four Uganda, were critical partners in providing legal representation, emergency response, and documentation of rights violations,” Grace said.
This has compelled UMSC and its other partners to handle increased caseloads with limited resources, while navigating heightened scrutiny and operational risk.
“The suspension has disrupted referral pathways, delayed urgent interventions, and weakened collective advocacy for marginalized groups and minority rights defenders, which calls for urgent international solidarity, flexible funding, and protection mechanisms to safeguard the work of grassroots organizations operating under threat,” Grace stated.
Mutebi warned that such repressive actions are tyrannical and are indicative of shrinking civic space, which undermines democratic accountability as the promotion and protection of human rights is ignored.
With Museveni, 81, extending his tenure at State House from a landslide win of 72 percent, UMSC and LWU consider a bleak future in the protection of rights for queer Ugandans and other minority groups.
“Without significant political and legal shifts, LGBTQ persons will face continued criminalization, reduced civic space, and heightened insecurity, making sustained advocacy and international solidarity more critical than ever,” Mutebi said. “ It is unimaginable how it feels to live in a country with no hope.”
Grace, however, affirmed the resistance by local queer lobby groups will continue through underground networks, regional solidarity, and digital organizing.
The duo noted that a win by Museveni’s main challenger and rapper, Bobi Wine, who only managed 24 percent of the total votes cast, could have enabled the opening up of civil space and human rights protections in Uganda.
Wine, for his part, spoke in favor of the respect for the rule of law and human rights during his campaign.
“While Bobi Wine’s past stance on LGBTQ rights was inconsistent, his recent shift toward more inclusive rhetoric and international engagement suggested a potential opening for dialogue,” Grace said. “A win might have created space for policy reform or at least reduced state-sponsored homophobia, though structural change would still require sustained pressure and coalition-building.”
Mutebi stated that a change in Uganda’s leadership to a youthful leader like Wine could have offered an opening, but not a guarantee for progress on inclusion and human rights. Mutebi added existing institutionalized and societal homophobia remain in place.
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