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Biden administration to ban discrimination against LGBTQ patients

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The Biden administration announced on Monday it would enforce civil rights protections under Obamacare to prohibit discrimination in health care against patients for being LGBTQ, reversing policy during the Trump years excluding transgender status as a protected characteristic under the law.

The Department of Health & Human Services declared it would enforce Section 1557 of the Affordable Care Act, which prohibits discrimination in health care on the basis of sex, and begin to take up cases of discrimination based on sexual orientation and gender identity.

HHS Secretary Xavier Becerra said in a statement the Supreme Court has “made clear that people have a right not to be discriminated against on the basis of sex and receive equal treatment under the law, no matter their gender identity or sexual orientation.”

“Fear of discrimination can lead individuals to forgo care, which can have serious negative health consequences,” Becerra said. “It is the position of the Department of Health and Human Services that everyone — including LGBTQ people — should be able to access health care, free from discrimination or interference, period.”

The move is consistent with the executive order President Biden signed on his first day in office directing federal agencies to implement the U.S. Supreme Court’s decision last year in Bostock v. Clayton County to the furthest extent possible. Federal agencies were directed to comply within 100 days of the executive order, which is about now and a short time after Biden’s first 100 days in office.

The announcement with respect to Section 1557 comes on the same day as the hearing took place this morning in Bagly v. HHS, a case before a federal court in Massachusetts challenging Trump’s undoing of transgender protections under the law. An attorney with the U.S. Justice Department announced a new notice of proposed rule-making is coming with respect to Section 1557.

Sharita Gruberg, vice president for the LGBTQ Research and Communications Project at the Center for American Progress, said in a statement the change “assures LGBTQ people that their rights will be upheld at the doctor’s office, vaccine sites, and everywhere else they seek health care and coverage.”

“The administration’s announcement that it will enforce these protections are a critical step toward addressing vaccine hesitancy among LGBTQ people, a population that has been disproportionately impacted by the pandemic and seriously harmed by the previous administration’s attempts to permit discrimination against LGBTQ patients, Gruberg added.

The past three administrations have instituted policy on LGBTQ protections based on their interpretation of Section 1557. Each move had varying implications and directions for LGBTQ patients.

The Obama administration issued a rule in 2016 interpreting Section 1557 to apply to cases of anti-transgender discrimination and discrimination against women who have had abortions, which was consistent with court rulings at the time. However, that move was enjoined by a nationwide court order in Texas as a result of litigation filed by Texas Attorney General Ken Paxton.

The Trump administration, shortly after the Supreme Court’s ruling in Bostock, made final a regulation proposed last year rescinding the Obama administration’s transgender protections under Section 1557. Faced with criticism, the Trump administration defended itself by saying its move was consistent with the court order in Texas, although it seemed to ignore the decision from the higher court.

The new rule from HHS goes above and the beyond the Obama administration by instituting protections based on both sexual orientation and gender identity. It wasn’t immediately clear whether the proposed rule would be a new regulation entirely, or seek to modify the changes that were made in the two previous administrations. The Blade has placed a request seeking comment with HHS.

Susan Bailey, president of the American Medical Association, said in a statement the new HHS rule is a welcome change after the Trump administration rescinded protections for transgender patients.

“It’s unfortunate that such an obvious step had to be taken; the AMA welcomes this common-sense understanding of the law,” Bailey said. “This move is a victory for health equity and ends a dismal chapter in which a federal agency sought to remove civil rights protections.”

Discrimination in health care is an experience transgender people commonly report. The U.S. Transgender Survey in 2015 found one-third of responders said they had at least one negative experience in health care related to being transgender. Further, 23 percent of responders said they didn’t seek health care because they feared being mistreated and one-third said they didn’t go to a provider because they couldn’t afford it.

A Center for American Progress survey from 2018 had similar findings with respect to transgender people and patients with being gay, lesbian and bisexual or queer. Eight percent of responders said a doctor refused to see them because of their perceived or actual sexual orientation, while 28 percent of providers said a doctor refused to see them because of their actual or perceived sexual orientation.

Hospitals, especially religiously affiliated providers, refusing to provide transition-related care, including gender assignment surgery, is another frequently reported incident for transgender patients. The American Civil Liberties Union, for example, has filed litigation against hospitals under Section 1557 for refusing to perform the procedure.

Rachel Levine, assistant secretary of health and the first openly transgender presidential appointee to obtain Senate confirmation, hailed the HHS rule change in a statement.

“The mission of our Department is to enhance the health and well-being of all Americans, no matter their gender identity or sexual orientation. All people need access to healthcare services to fix a broken bone, protect their heart health, and screen for cancer risk,” Levine said. “No one should be discriminated against when seeking medical services because of who they are.”

Although the Biden administration’s announcement is a welcome move for LGBTQ advocacy groups, the change is not without critics.

John Banzhaf, a law professor at George Washington University who declares himself a supporter of transgender rights, said the policy could have unintended consequences, which he said has become evident in the British health system.

“[Transgender] individuals with a penis but no vagina are being asked to have medical tests on their non-existent cervices, while [transgender] persons with a vagina and cervix will not be asked, under new guidelines which appear to place lives at risk and encourage a physically impossible medical exam on organs which simply do not exist,” Banzhaf said. “And, carrying this absurdity to its totally illogical conclusion, a patient with a penis and a full beard was offered a cervical test because, despite his clearly masculine appearance and style of dress, he registered himself as being gender neutral.”

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Comings & Goings

Ted Lewis named director of Rainbow Families

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Ted Lewis

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]

The Comings & Goings column also invites LGBTQ college students to share their successes with us. If you have been elected to a student government position, gotten an exciting internship, or are graduating and beginning your career with a great job, let us know so we can share your success. 

Congratulations to Ted Lewis M.ED. on being named executive director of Rainbow Families. On their appointment they said, “Right now, when we are facing tremendous opposition to our very existence, is the time to build up our community and our community resources. LGBTQ+ families are innovative, supportive, loving, and resilient and we will need all those tools and more in this moment. My hope as Rainbow Families’ Executive Director is to expand our membership and welcome the vast community resources, expertise, and lived experiences to support new family formation and new parents. I hope to bring education, advocacy and support to LGBTQ+ families, parents, and prospective parents when we are worried about our rights disappearing. I’m also excited to join the joyous and thriving community at Rainbow Families and expand on fun events that bring families together from our weekend camping trip, to picking pumpkins at Cox Farms, and dancing at family parties. It is within a beloved community that we can both prepare for challenges ahead and celebrate our fabulousness together.”

Prior to this, Lewis served as director of Youth Well-Being for the Human Rights Campaign Foundation. Lewis served as project manager for Project THRIVE, a multi-year campaign with 30+ national organizations committed to the thriving of LGBTQ youth resulting in industry specific resources and professional development on LGBTQ best practices. Lewis was also founder and CEO of Ted Lewis Consulting, advising K-12 school districts, Fortune 500 companies, higher education institutions, and non-profits on LGBTQ inclusive practices. They also served as assistant director for Sexual/Gender Diversity, UNC Charlotte, responsible for LGBTQ student programming as well as Men’s & Women’s programming for the institution. Lewis has presented on numerous panels including: “Othermuvas: How Black LGBTQ+ Chosen Families Provide Support to Black LGBTQ+ Youth” National Mentoring Summit, 2025; “Addressing the Issues of LGBTQ+ Cultural Competency, Parity and Inconsistency” Richmond Bench-Bar Conference, 2019; and “The Unmasking: Race & Reality in Richmond” Richmond Magazine Panel, 2017. Lewis was named in Style Weekly’s 40 Under 40, in 2018; and received the VA Pride Firework Award in 2019.

Lewis earned a bachelor’s degree in English and History, University of Mary Washington; Master of Education, University of South Carolina, and an Education Master Certificate in Women & Gender Studies, University of North Carolina, Charlotte. 

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Federal Government

Garcia writes to HHS Secretary about the dismantling of HIV programs in Trump’s second term

Out congressman was elected top Democrat on House Oversight on June 24

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Robert F. Kennedy, Jr. appears on HBO's "Real Time with Bill Maher" in April 2024. (Screen capture via YouTube)

U.S. Rep. Robert Garcia (D-Calif.), ranking member of the House Oversight Committee, sent a letter on Thursday to U.S. Health Secretary Robert F. Kennedy Jr. demanding answers about the Trump-Vance administration’s “systematic” elimination of programs to fight HIV in the U.S. and around the world.

Also signed by Democratic Congressman Raja Krishnamoorthi of Illinois, the letter requests information about cuts to federal support for HIV research, including vaccine development efforts, the shuttering of the HIV prevention division of the Centers for Disease Control and Prevention, and the defunding of programs providing HIV treatment and prevention services since President Donald Trump returned to the White House.

The lawmakers requested responses by or before the end of July.

“It is shameful that HHS Secretary RFK Jr. and the Trump Administration are working to dismantle our HIV research, care, and prevention programs aimed at eradicating the disease across the world,” Garcia said. “This decision is absolutely reckless and puts millions of lives at risk.  Oversight Democrats refuse to let Secretary Kennedy’s reliance on conspiracy theories and misinformation threaten the health and safety of our public health.” 

“The Trump Administration’s reckless decision to gut HIV prevention and research programs is not only scientifically indefensible—it’s morally unconscionable. These cuts jeopardize the health of millions, both at home and abroad, and reverse decades of bipartisan progress in the fight against HIV/AIDS,” Krishnamoorthi said. “We’re demanding answers because the American people, and the global community, deserve better than politically motivated neglect of public health.”

Echoing warnings from HIV and public health experts, the congressmen in their letter stressed that backsliding in efforts to fight the disease at home and abroad come just as advancements in treatment and prevention have finally put some of the most ambitious goals to end the epidemic within reach.

The letter suggests that Kennedy’s embrace of misinformation about HIV might explain, to some extent, his dismantling of programs to end the epidemic at home and abroad, specifically, pointing to the secretary’s history of challenging the overwhelming and longstanding scientific and medical consensus about the causal relationship between HIV and AIDS.

The congressmen also detailed many of the real-world consequences of health policy concerning HIV in Trump’s second term. For example, they note experts anticipate there will be millions of excess new HIV infections and hundreds of thousands of excess HIV-related deaths in Sub-Saharan Africa in just one year.

The letter also warns that “President Trump’s Fiscal Year 2026 budget request for domestic HIV program calls for a $1.5 billion reduction in funding,” which “could lead to more than 143,000 additional HIV cases in the United States within five years and about 127,000 additional deaths from HIV and AIDS-related causes.”

Garcia’s leadership of Oversight Dems will be closely watched

If Democrats recapture a majority of seats in the House next year, Garcia becomes chair of the committee and has access to far more powerful tools to exercise oversight — like the authority to issue subpoenas (unilaterally or by majority vote) compelling witnesses to testify or requiring officials to turn over documents.

Leadership positions, especially coveted spots leading the most powerful committees in Congress, are typically awarded based on seniority. When the House Democratic caucus elected Garcia on June 24, it marked the first first time in more than a century that a second-term member was selected for the role.

During his brief time in Washington, the congressman, who is openly gay and formerly served as mayor of Long Beach, has emerged as arguably one of the strongest communicators in the House Democratic caucus and one of his party’s most vocal critics of the second Trump administration.

Thursday’s letter, which comes less than a month after his election as ranking member, may signal how Garcia will approach fact finding missions and investigations, or where he will focus the committee’s work, under the vastly expanded powers that might be available to him after the midterms.

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National

Trump threatens Rosie O’Donnell’s citizenship

Comedian responds with post linking him to Epstein

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Rosie O'Donnell (Screen capture via The Late Late Show/YouTube)

Donald Trump threatened to revoke Rosie O’Donnell’s U.S. citizenship last weekend amid his administration’s pattern of targeting people with whom he has publicly disagreed.

The actress and comedian, known for her roles in major motion pictures like “A League of Their Own” and “Harriet the Spy,” was singled out by the president on his social media app Truth Social, where he called the lesbian entertainer a “Threat to Humanity.”

“Because of the fact that Rosie O’Donnell is not in the best interests of our Great Country, I am giving serious consideration to taking away her Citizenship,” Trump also posted. “[She] should remain in the wonderful Country of Ireland, if they want her. GOD BLESS AMERICA!”

In response to the post—which reignites a decade-old feud between the two—O’Donnell shared a collage of photos from her time in Ireland, along with an old photo of Trump with convicted child sex offender Jeffrey Epstein.

“The president of the usa has always hated the fact that i see him for who he is – a criminal con man sexual abusing liar out to harm our nation to serve himself,” the former talk show host posted on Instagram. She continued, “this is why i moved to ireland – he is a dangerous old soulless man with dementia who lacks empathy compassion and basic humanity – i stand in direct opposition [to] all he represents – so do millions of others – u gonna deport all who stand against ur evil tendencies – ur a bad joke who cant form a coherent sentence.”

Trump’s threat is both irregular and constitutionally unsound. The Supreme Court has ruled over multiple decades that stripping someone of their citizenship violates the Constitution—and the 14th Amendment.

Three Supreme Court cases in particular—Trop v. Dulles (1958), Afroyim v. Rusk (1967), and Brandenburg v. Ohio (1969)—have all affirmed that once legally obtained, citizenship is not something that can simply be revoked, even if the president disagrees with what a person says or does. In Afroyim v. Rusk, the Supreme Court wrote: “In our country the people are sovereign and the Government cannot sever its relationship to the people by taking away their citizenship.”

This authoritarian threat echoes Trump’s broader efforts to undermine birthright citizenship, which has been a foundational part of the U.S. Constitution since the ratification of the 14th amendment.

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