Local
Md. bans gender transition exclusions in insurance
Advocates applaud state entity for changes

Patrick A. Paschall, executive director of FreeState Legal and Equality Maryland, applauded the Maryland Insurance Administration. (Photo courtesy Patrick Paschall)
FreeState Legal and Equality Maryland announced on Wednesday that the Maryland Insurance Administration has issued bulletins prohibiting individual, small-group, and student health insurance plans sold in Maryland from excluding coverage for health care for the purpose of gender transition. This announcement follows longstanding advocacy by FreeState Legal and Equality Maryland, most recently including a request to the federal Center for Consumer Information and Insurance Oversight asking federal regulators to require Maryland to prohibit transition-related care exclusions from appearing in these state-regulated insurance plans that are governed by the federal Affordable Care Act.
“We applaud the Maryland Insurance Administration for prohibiting this discriminatory exclusion that has become a fixture in health insurance plans and that does significant harm to the transgender community,” said Patrick A. Paschall, executive director of FreeState Legal and Equality Maryland.
“Transition-related care exclusions serve no other purpose than to discriminate against transgender people. To deny life-saving medical care to an entire population based solely on the fact that they identify as transgender is not only unconscionable, but we believe a violation of federal law. We are glad that the Maryland Insurance Administration agrees that transition-related care exclusions violate federal law and has taken action to ensure that the individual, small-group, and student plans it regulates no longer discriminate on the basis of gender identity.”
The Maryland Insurance Administration bulletins, issued on Dec. 7 and 10, 2015, inform health insurers that transition-related care exclusions will no longer be permitted as the agency reviews and approves individual and small-group health plans for the 2017 plan year and student health plans for the 2016-17 school year. The bulletins require carriers to update their plans, and clarify that the requirement applies to plans that are sold either through the ACA exchange or off the exchange.
The administration based its decision on an existing federal regulation, 45 CFR § 156.200(e), issued in 2012, that prohibits discrimination in qualified health plans on the basis of personal characteristics such as gender identity. In the recent bulletins, the Maryland Insurance Administration ruled that transition-related care exclusions can no longer appear in small-group, individual, and student plans because “federal guidance has determined that this type of exclusion is a discriminatory benefit design,” prohibited by the federal regulation.
“We hope this sends a clear message to insurers that denial of transition-related health care solely because the patient is transgender is unlawfully discriminatory, and that the federal regulations on which the agency based its decision are currently in effect,” said Paschall. “We believe that discrimination against transgender people in all health insurance plans is against the law, and we at FreeState Legal and Equality Maryland will continue to bring legal action against insurers that discriminate and employers that choose discriminatory plans. We will not stop until all transgender people in Maryland have full and equal access to the health care they need.”
This action has been applauded by advocates for gender identity equality. “Maryland state regulations continue to fall into line with the civil rights code from the Affordable Care Act,” Dana Beyer, executive director of Gender Rights Maryland, told the Blade. “Thanks to Free State Legal and its dogged and skillful pursuit of these benefits for Maryland residents!”
District of Columbia
D.C. Council member honored by LGBTQ homeless youth group
Doni Crawford receives inaugural Wanda Alston Legacy Award
About 100 people turned out Tuesday evening, April 7, for a presentation by D.C.’s Wanda Alston Foundation of its inaugural Wanda Alston Legacy Award to D.C. Council member Doni Crawford (I-At-Large) for her support for the foundation’s mission to support homeless LGBTQ youth.
Among those who attended the event was Japer Bowles, director of D.C. Mayor Muriel Bowser’s Office of LGBTQ Affairs, who delivered an official proclamation issued by Bowser declaring April 7, 2026 “A Day of Remembrance for Wanda Alston.”
Alston, a beloved women’s and LGBTQ rights activist, served as the city’s first director of the then newly created Office of LGBTQ Affairs under then-Mayor Anthony Williams from 2004 until her death by murder on March 16, 2005.
To the shock and dismay of fellow LGBTQ rights advocates, police and court records reported Alston, 45, was stabbed to death inside her Northeast D.C. house by a man high on crack cocaine who lived nearby and who stole her credit cards and car. The perpetrator, William Martin Parrott, 38, was arrested by D.C. police the next day and later pleaded guilty to second-degree murder. He was sentenced in July 2005 to 24 years in prison.
Crawford was among those attending the award event who reflected on Alston’s legacy and outspoken advocacy for LGBTQ and feminist causes.
“I am deeply humbled and honored to receive this inaugural award,” Crawford told the Washington Blade at the conclusion of the event. “I think the world of Wanda Alston. She has set such a great foundation for me and other Council members to build on,” she said.
“Her focus on inclusivity and intersectionality is really important as we approach this work,” Crawford added. “And it’s going to guide my work at the Council every day.”
Crawford was appointed to the D.C. Council in January of this year to replace then Council member Kenyan McDuffie (I-At-Large), who resigned to run for D.C. mayor as a Democrat. She is being challenged by four other independent candidates in a June 16 special election for the Council seat.
Under the city’s Home Rule Charter written and approved by Congress, the seat is one of two D.C. Council at-large seats that cannot be held by a “majority party” candidate, meaning a Democrat.
A statement released by the Alston Foundation last month announcing Crawford’s selection for the Wanda Alston Legacy Award praised Crawford’s record of support for its work on behalf of LGBTQ youth.
“From behind the scenes to now serving as an At-Large Council member, she has fought fearlessly for affordable housing, LGBTQ+ funding priorities, and racial justice,” the statement says. “Council member Crawford’s leadership reflects the same courage and conviction that defined Wanda’s legacy.”
Organizers of the event noted that it was held on what would have been Wanda Alston’s 67th birthday.
“Today’s legacy reception was a smashing success,” said Cesar Toledo, the Alston Foundation’s executive director. “Not only did we come together to celebrate Wanda Alston on her birthday, but we also were able to raise over $10,000 for our homeless LGBTQ youth here in D.C.,” Toledo told the Blade.
“In addition to that, we celebrated and we acknowledged a rising star in our community,” he said. “And that is At-Large Council member Doni Crawford, who we named the inaugural Wanda Alston Legacy Award recipient.”
At the request of D.C. Council Chair Phil Mendelson (D-At-Large) the Council voted unanimously on Jan. 20, 2026, to appoint Crawford to the Council seat being vacated by McDuffie.
Council records show she joined McDuffie’s Council staff in 2022 as a policy adviser and later became his legislative director before McDuffie appointed her as staff director for the Council’s Committee on Business and Economic Development for which McDuffie served as chair.
District of Columbia
Police mental health struggles gain growing attention
‘My body begins to manifest physically, through depression, stress’
When Scott Silverii began his career as a police officer, he faced daily exposure to traumatic incidents with little guidance or support, particularly in distressed neighborhoods where officers were expected to respond decisively under pressure.
“When I started, the only thing they offered was to suck it up and get over it,” Silverii said. “Any indication that you were hurt meant that you were weak, and if you were weak, it meant you could not be trusted.”
Years later, when Silverii became a police chief, he chose a different approach. Rather than reinforcing silence around trauma, he made mental health support a visible part of his leadership.
“In every critical incident that we had, I would bring the critical incident stress debriefing team in — and I would participate in it,” Silverii said. “I wanted to promote it from the top. That’s what it’s going to continue to take to change the culture.”
Silverii’s experience reflects a broader reality in law enforcement. Across the country, police officers face ongoing mental health challenges linked to repeated exposure to violent crime scenes, fatal accidents, and human suffering — experiences that most civilians never encounter. Long shifts and the responsibility of protecting the public have long been documented to further intensify emotional strain, particularly when officers fear making mistakes with serious consequences.
Silverii, former Thibodaux, La., chief of police and current National Law Enforcement Initiative Manager at Mothers Against Drunk Driving (MADD), said coping mechanisms in the past were often unhealthy.
“A lot of officers, they would drink — sometimes prescription drug use, just different ways,” of coping, he said. Today, he said, the trauma can linger long after an incident: “…you become affected by the trauma. It doesn’t have to happen to you. But when officers respond to a crash, you’re involved… You carry this trauma.”
In some cases, he says, the impact resurfaces every year. “My body begins to manifest physically, through depression, through stress… once I realize it’s the anniversary, I can start dealing with it,” he said.
For decades, police culture discouraged officers from seeking mental health support, often treating emotional distress as a weakness rather than an occupational hazard. In recent years, however, departments have begun expanding access to counseling, peer-support programs, and crisis-intervention training.
In Baltimore, a shift in police culture is tackling the long-standing “shrug it off” mentality toward officer mental health. The Baltimore Police Department’s Officer Safety and Wellness Section, started in 2018, changed how the agency handles trauma, depression, and substance abuse by treating these issues as medical needs rather than disciplinary failures.
A core component of the program is its confidential alcohol addiction treatment, which has seen more than 250 officers voluntarily sign themselves in without fear of termination. This proactive approach has led to a dramatic drop in internal interventions — falling from 250 in 2018 to 48 in 2024 — alongside a decrease in citizen complaints and use-of-force incidents.
The need for such programs is underscored by national data from the Police1 2024 State of the Industry report, which found that 76% of officers cite a lack of time due to heavy workloads as the primary barrier to maintaining their health. More than 50% of respondents report that a significant stigma still surrounds seeking mental health services. Perhaps most telling — 12% of officers nationwide report having no access to mental health resources at all, and 33% have considered calling themselves out of service due to emotional distress or exhaustion.
Chris Asplen, executive director of the National Criminal Justice Association, is a former Washington prosecutor who handled child abuse and other high-stakes cases. He said the emotional weight of the work eventually led him to step away after becoming a parent.
“It became too mentally and emotionally difficult after I had my own child,” Asplen said.
Asplen said his understanding of trauma was also shaped in part by his upbringing. Raised by a parent who struggled with mental illness, he described growing up feeling overlooked. “My father’s mental health issues made me essentially invisible to him,” he said — an experience that later informed how he approached victims in the justice system.
Asplen also pointed to disparities in how mental health crises are handled. His family’s middle-class background, he said, afforded protections and support not available to many others. “Mental health issues for people who are not white and middle class are often treated as criminal matters,” he said.
Experts warn that when mental health challenges go unaddressed, they can affect officers’ judgment, job performance, and interactions with the public. In response, lawmakers and communities have begun exploring preventive approaches. In 2023, Congress passed the De-escalation Act, providing funding for training focused on crisis response, de-escalation, and officer wellness.
In addition to legislative efforts, some communities are turning to violence intervention programs aimed at reducing harm before police are required to respond. One such organization, Roca, was founded in Massachusetts in 1988 and has operated in Baltimore since 2018. According to the organization’s impact data, 87% of its participants have had no new incarcerations after entering the program for at least 24 months.
Police officers in Baltimore and several other cities have been trained by Roca’s nonprofit coaching arm, the Roca Impact Institute, to use cognitive behavioral therapy (CBT) to regulate their emotions and understand the impact of trauma on officers and community members. The training reduced stress, loss of temper and use of force incidents, according to the institute.
A 2024 report by the D.C. Office of the Attorney General showed the city’s violence intervention program’s efforts contributed to an 18% decrease in shootings and a 26% decrease in gun homicides across its target neighborhoods in 2023. Based on the national Cure Violence Global model, the programs treat violence as a public health epidemic through the use of what it calls “credible messengers” to de-escalate conflicts.
But a Washington Post investigation published Feb. 3 found excessive spending that City Administrator Kevin Donahue called a “completely inappropriate use of public money.” A week later, the publication reported that two DC violence interrupters were charged with murder in the death of a Baltimore man in a DC nightclub in 2023.
When done correctly, these programs can offer a secondary benefit by reducing the volume of high-stress calls handled by law enforcement. Advocates say such approaches can lessen the emotional toll on officers by preventing traumatic encounters altogether.
“If we can reduce the amount of trauma that occurs at the scene,” Asplen said, “then we’re a lot further along.”
(Carl Barbett is a senior at Bard High School Early College DC, one of Youthcast Media Group’s journalism class partners. This story was produced under the mentorship of Edith Mwangi, a Kenyan multimedia journalist based in D.C. with a background in international reporting and politics.)
District of Columbia
Key lifestyle changes can help patients cope with diabetes
Small daily choices make a big difference in one’s health
One Tuesday evening after my family finished dinner, I noticed my grandmother sitting on the couch, sweating more than usual. The family room wasn’t hot, and she hadn’t eaten a lot of salty food that day, so seeing her like that made me worry.
My grandmother, Shirley Mitchell, is a 72-year-old who lives with Type 2 diabetes, and moments like this, when her blood sugar gets dangerously low, can happen without warning. Watching her reach for her glucose tablets reminded me how serious her condition is.
Each day, millions of people living with diabetes face a choice that can either play a role in protecting their health or putting it at risk– namely, what they eat. Nationally, 12 percent of the population lives with diabetes, according to the Centers for Disease Control. In D.C., nine percent of residents are known to have diabetes, with likely many more undiagnosed, said Dr. Marcy Oppenheimer, a family medicine doctor who practices in Northeast D.C.
“It’s super common, especially as you get older,” she said, estimating that 15 to 20 percent of her patients have diabetes, and another 20 percent have pre-diabetes, where blood sugar is higher than normal but not yet at the level to trigger a diabetes diagnosis.
What is diabetes?
Diabetes is a long-term condition that affects how the body controls blood sugar. When blood sugar levels are not managed properly, they can rise too high and cause serious damage to the body. This happens when the body does not make enough insulin or cannot use insulin correctly, which means sugar stays in the blood instead of being moved into the body’s cells where it’s needed for energy.
Having high levels of sugar in the blood over long periods of time causes damage to just about every body system, said Oppenheimer. “It can pretty much cause any part of your body to start failing over the long term, if you have high sugar for a long time.”
While food isn’t the only factor that affects diabetes — genetics play an even bigger role — certain foods can worsen diabetes by spiking the amount of sugar in the blood.
What foods should you eat if you have diabetes?
Healthy food choices play a major role in helping people with diabetes manage their condition. Foods such as vegetables, whole grains, lean proteins like fish and chicken, beans, nuts, and healthy fats digest slowly and provide steady energy. These foods help prevent sudden spikes in blood sugar, which are dangerous for people with diabetes.
Many people with diabetes learn that planning meals, watching portion sizes, and choosing healthier options can make a big difference in how they feel each day.
“I had to slow down and pay attention to what I ate because everything affected my sugar levels,” says Mitchell.
Even small choices, like drinking a lot of soda or eating too much white bread, can cause blood sugar levels to rise quickly, said Oppenheimer.
Which foods can increase the risk or harm of diabetes?
Unhealthy food choices like these can seriously harm those with diabetes. Sugary foods such as candies, cake, cookies, and sweetened drinks cause blood sugar to spike quickly. Processed foods, white bread, and fast food are also harmful because they can be high in unhealthy saturated fats and refined carbohydrates.
When these foods are eaten often, they can lead to weight gain and they make diabetes harder to control and increase the risk of long-term health problems, said Oppenheimer.
Over time, poor eating habits that lead to prolonged high blood sugar can lead to heart disease, nerve damage, kidney problems, and even vision loss.
“Basically, diabetes is an all-body condition or disease, and it just varies from person to person in how it affects you,” said Oppenheimer. “If you have uncontrolled diabetes, it definitely has a negative impact on both your daily life and your long-term health.”
Anyone with diabetes can develop serious complications like blindness — or diabetic retinopathy — and the risk factors are higher for Black, Latino and American Indian or Alaska Native groups, according to the CDC.
What you or a loved one can do to manage diabetes
Mitchell warns others not to ignore the impact of food on their health. “Don’t ignore your health,” she says. “Fix your problems early before they get worse.”
Making lifestyle changes is key because, after all, diabetes changes your entire lifestyle, says Mitchell. “Walking throughout the day has helped me feel better.”
Daniel Dow, a middle school coach at Friendship Blow Pierce Elementary & Middle School in Northeast D.C. who also has diabetes agreed with Mitchell.
“Don’t wait to change your habits, start right away,” he says. “I learned that what I eat before practice affects my sugar for the whole day.”
Mitchell’s and Dow’s experiences show that small daily choices can make a big difference in one’s health. By paying attention to what you eat and how your body responds, you can prevent problems before they get worse. Starting healthy habits early can help you stay strong, focused, and in control of your well-being.
(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.)
