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Md. bans gender transition exclusions in insurance

Advocates applaud state entity for changes

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Patrick Paschall, gay news, Washington Blade
Patrick Paschall, gay news, Washington Blade

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!”

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Maryland

4th Circuit dismisses lawsuit against Montgomery County schools’ pronoun policy

Substitute teacher Kimberly Polk challenged regulation in 2024

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(Photo by Sergei Gnatuk via Bigstock)

A federal appeals court has ruled Montgomery County Public Schools did not violate a substitute teacher’s constitutional rights when it required her to use students’ preferred pronouns in the classroom.

The 4th U.S. Circuit Court of Appeals in a 2-1 decision it released on Jan. 28 ruled against Kimberly Polk.

The policy states that “all students have the right to be referred to by their identified name and/or pronoun.”

“School staff members should address students by the name and pronoun corresponding to the gender identity that is consistently asserted at school,” it reads. “Students are not required to change their permanent student records as described in the next section (e.g., obtain a court-ordered name and/or new birth certificate) as a prerequisite to being addressed by the name and pronoun that corresponds to their identified name. To the extent possible, and consistent with these guidelines, school personnel will make efforts to maintain the confidentiality of the student’s transgender status.”

The Washington Post reported Polk, who became a substitute teacher in Montgomery County in 2021, in November 2022 requested a “religious accommodation, claiming that the policy went against her ‘sincerely held religious beliefs,’ which are ‘based on her understanding of her Christian religion and the Holy Bible.’”

U.S. District Judge Deborah Boardman in January 2025 dismissed Polk’s lawsuit that she filed in federal court in Beltsville. Polk appealed the decision to the 4th Circuit.

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District of Columbia

Norton hailed as champion of LGBTQ rights

D.C. congressional delegate to retire after 36 years in U.S. House

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Del. Eleanor Holmes Norton announced she will not seek re-election; her term ends January 2027. (Washington Blade file photo by Drew Brown)

LGBTQ rights advocates reflected on D.C. Congressional Del. Eleanor Holmes Norton’s longstanding advocacy and support for LGBTQ rights in Congress following her decision last month not to run for re-election this year. 

Upon completing her current term in office in January 2027, Norton, a Democrat, will have served 18 two-year terms and 36 years in her role as the city’s non-voting delegate to the U.S. House.

LGBTQ advocates have joined city officials and community leaders in describing Norton as a highly effective advocate for D.C. under the city’s limited representation in Congress where she could not vote on the House floor but stood out in her work on House committees and moving, powerful speeches on the House floor.

 “During her more than three decades in Congress, Eleanor Holmes Norton has been a champion for the District of Columbia and the LGBTQ+ community,” said David Stacy, vice president of government affairs for the Human Rights Campaign, the D.C.-based national LGBTQ advocacy organization.

“When Congress blocked implementation of D.C.’s domestic partnership registry, Norton led the fight to allow it to go into effect,” Stacey said. “When President Bush tried to ban marriage equality in every state and the District, Norton again stood up in opposition. And when Congress blocked HIV prevention efforts, Norton worked to end that interference in local control,” he said.

Del. Eleanor Holmes Norton (D-D.C.) (Washington Blade photo by Jeff Surprenant)

In reflecting the sentiment of many local and national LGBTQ advocates familiar with Norton’s work, Stacy added, “We have been lucky to have such an incredible champion. As her time in Congress comes to an end, we honor her extraordinary impact in the nation’s capital and beyond by standing together in pride and gratitude.”

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. 

Activists familiar with Norton’s work also point out that she has played a lead role in opposing and helping to defeat anti-LGBTQ legislation. In 2018, Norton helped lead an effort to defeat a bill called the First Amendment Defense Act introduced by U.S. Sen. Mike Lee (R-Utah), which Norton said included language that could “gut” D.C.’s Human Rights Act’s provisions banning LGBTQ discrimination.

Norton pointed to a provision in the bill not immediately noticed by LGBTQ rights organizations that would define D.C.’s local government as a federal government entity and allow potential discrimination against LGBTQ people based on a “sincerely held religious belief.”

“This bill is the latest outrageous Republican attack on the District, focusing particularly on our LGBT community and the District’s right to self-government,” Norton said shortly after the bill was introduced. “We will not allow Republicans to discriminate against the LGBT community under the guise of religious liberty,” she said. Records show supporters have not secured the votes to pass it in several congressional sessions.

In 2011, Norton was credited with lining up sufficient opposition to plans by some Republican lawmakers to attempt to overturn D.C.’s same-sex marriage law, that the Council passed and the mayor signed in 2010.   

In 2015, Norton also played a lead role opposing attempts by GOP members of  Congress to overturn another D.C. law protecting LGBTQ students at religious schools, including the city’s Catholic University, from discrimination such as the denial of providing meeting space for an LGBTQ organization.

More recently, in 2024 Norton again led efforts to defeat an attempt by Republican House members to amend the D.C. budget bill that Congress must pass to eliminate funding for the Mayor’s Office of LGBTQ Affairs and to prohibit the city from using its funds to enforce the D.C. Human Rights Act in cases of discrimination against transgender people.

“The Republican amendment that would prohibit funds from being used to enforce anti-LGBTQ+ discrimination regulations and the amendment to defund the Mayor’s Office of LGBTQ+ Affairs are disgraceful attempts, in themselves, to discriminate against D.C.’s LGBTQ+ community while denying D.C. residents the limited governance over their local affairs to which they are entitled,” Norton told the Washington Blade.

In addition to pushing for LGBTQ supportive laws and opposing anti-LGBTQ measures Norton has spoken out against anti-LGBTQ hate crimes and called on the office of the U.S. Attorney for D.C. in 2020 to more aggressively prosecute anti-LGBTQ hate crimes.

Del. Eleanor Holmes Norton marches in the 1995 AIDS Walk. (Washington Blade archive photo by Clint Steib)

“There is so much to be thankful for Eleanor Holmes Norton’s many years of service to all the citizens and residents of the District of Columbia,” said John Klenert, a member of the board of the LGBTQ Victory Fund. “Whether it was supporting its LGBTQ+ people for equal rights, HIV health issues, home rule protection, statehood for all 700,000 people, we could depend on her,” he said.

Ryan Bos, executive director of Capital Pride Alliance, the group that organizes D.C.’s annual LGBTQ Pride events, called Norton a “staunch” LGBTQ community ally and champion for LGBTQ supportive legislation in Congress.

“For decades, Congresswoman Norton has marched in the annual Capital Pride Parade, showing her pride and using her platform to bring voice and visibility in our fight to advance civil rights, end discrimination, and affirm the dignity of all LGBTQ+ people” Bos said. “We will be forever grateful for her ongoing advocacy and contributions to the LGBTQ+ movement.”

Howard Garrett, president of D.C.’s Capital Stonewall Democrats, called Norton a “consistent and principled advocate” for equality throughout her career. “She supported LGBTQ rights long before it was politically popular, advancing nondiscrimination protections and equal protection under the law,” he said.

“Eleanor was smart, tough, and did not suffer fools gladly,” said Rick Rosendall, former president of the D.C. Gay and Lesbian Activists Alliance. “But unlike many Democratic politicians a few decades ago who were not reliable on LGBTQ issues, she was always right there with us,” he said. “We didn’t have to explain our cause to her.”

Longtime D.C. gay Democratic activist Peter Rosenstein said he first met Norton when she served as chair of the New York City Human Rights Commission. “She got her start in the civil rights movement and has always been a brilliant advocate for equality,” Rosenstein said.

“She fought for women and for the LGBTQ community,” he said. “She always stood strong with us in all the battles the LGBTQ community had to fight in Congress. I have been honored to know her, thank her for her lifetime of service, and wish her only the best in a hard-earned retirement.”

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Virginia

Hashmi speaks at Equality Virginia Lobby Day

Lt. gov. is a vocal LGBTQ ally

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Virginia Lt. Gov. Ghazala Hashmi (YouTube screenshot)

Lieutenant Gov. Ghazala Hashmi on Monday opened Equality Virginia’s annual Lobby Day in Richmond.

The Lobby Day was held at Virginia’s Capitol and was open to the public by RSVP. The annual event is one of the ways that Equality Virginia urges its supporters to get involved. It also offers informational sessions and calls to action through social media.

Hashmi, a former state senator, has been open about her support for the LGBTQ community and other marginalized groups. Her current advisor is Equality Virginia Executive Director Narissa Rahaman, and the group endorsed her for lieutenant governor. 

Hashmi historically opposes anti-transgender legislation.

She opposed a 2022 bill that sought to take away opportunities from trans athletes.

One of the focuses of this year’s Lobby Day was protecting LGBTQ students. Another was protecting trans youth’s access to gender-affirming care.

Advocates spent their day in meetings and dialogues with state legislators and lawmakers about legislative priorities and concerns. 

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