News
New HHS reg seeks non-discrimination in health care as monkeypox spreads
Proposed rule bars strengthens protections for LGBTQ patients
A new regulation proposed by the Biden administration seeks to ensure non-discrimination in health care settings for women who have had abortions and LGBTQ people at a time when monkeypox cases continue to increase and fears persist after the U.S. Supreme Court overturned Roe v. Wade.
The new regulation, announced Monday by the Department of Health & Human Services, would interpret Section 1557 of the Affordable Care Act to apply more broadly to the definition of sex after the court’s earlier 2016 decision in Bostock v. Clayton County, which determined anti-LGBTQ discrimination was an illegal form of sex discrimination. The rule would enhance the prohibition discrimination on the basis of sex in health care settings and federally funded health care programs consistent with the law.
The regulation also institutes non-discrimination protections for intersex traits; and pregnancy or related conditions, including pregnancy termination; and people with limited English proficiency.
Xavier Becerra, secretary of health and human services, announced the proposed rule on Monday during a conference call with reporters and said it would ensure communities that have had barriers to accessing health care would be able to obtain it.
“Everyone in America should be able to get the care that they need from any health provider in the country, especially if they’re that provider is receiving funding from HHS,” Becerra said. “We want to make sure that Americans are free from discrimination when they try to access the care that they need. Pretty simple proposition.”
Becerra, asked by the Washington Blade how he sees the proposed rule playing out as part of the Biden administration’s approach to the monkeypox outbreak among gay and bisexual men, said the rule makes clear discrimination in health care is unacceptable and enables LGBTQ people to file a complaint with the Office of Civil Rights at the Department of Health & Human Services.
“The reality is that today, the issue of monkeypox, you should not face any discrimination when it comes to the issue of accessing the health care services you might need to address monkeypox,” Becerra said.
The new regulation doesn’t appear to be timed as a means to address monkeypox, but a follow-up to an earlier commitment from the Biden administration to make the change.
The proposed rule is similar to a regulation in the final years of the Obama administration, which interpreted the language of Section 1557 to bar discrimination based on sex stereotypes and gender identity. The rule, however, was rescinded during the Trump administration under HHS Director of the Office of Civil Rights Roger Severino, who bucked the decision in Bostock and reversed the rule pursuant to an earlier lower federal court ruling in Texas.
Melanie Fontes Rainer, now the director of the Office of Civil Rights under the Biden administration, said on the call that restoring non-discrimination protections after they were rescinded makes health care more accessible for everyone.
“The 2020 version of this rule narrowed its scope to cover fewer health programs and activities, limiting vital non-discrimination protections for so many across the country,” Rainer said. “The proposed rule proposes revisions to Section 1557 implementing regulation by restoring and strengthening provisions that protect individuals from discrimination and health programs and activities”
The Biden administration rule, however, is different from the Obama-era rule in key aspects. For starters, the Biden-era rule explicitly prohibits discrimination on the basis of sexual orientation in addition to other sex-based categories that were articulated before, using the Supreme Court’s decision in Bostock as justification.
The newer regulation also contains language that interprets Medicare Part B as federally funded assistance and includes an explicit exemption for health care providers who have objections to certain procedures, such as abortion and gender reassignment surgery. The exact breadth of the religious exemption wasn’t immediately clear.
Becerra said during the call the religious conscience provision was included as a result of stakeholder feedback and is consistent with the Biden administration’s goal to protect the rights of people in health care settings.
“That is also part of the work that we do, and we don’t believe that there’s any inconsistency in making sure that people are accessing care without discrimination,” Becerra said.
Becerra, asked during the call about the timeline for the rule, said he expects it will be made final before the end of this year and after the formal 90-day comment period.
State Department
Democracy Forward files FOIA request for State Department bathroom policy records
April 20 memo outlined anti-transgender rule
Democracy Forward on Tuesday filed a Freedom of Information Act request for records on the State Department’s new bathroom policy.
A memo titled “Updates Regarding Biological Sex and Intimate Spaces, Including Restrooms” that the State Department issued on April 20 notes employees can no longer use bathrooms that correspond with their gender identity.
“The administration affirms that there are two sexes — male and female — and that federal facilities should operate on this objective and longstanding basis to ensure consistency, privacy, and safety in shared spaces,” State Department spokesperson Tommy Piggot told the Daily Signal, a conservative news website that first reported on the memo. “In line with President Trump’s executive order this provides clear, uniform guidance to the department by grounding policy in biological sex as determined at birth.”
President Donald Trump shortly after he took office in January 2025 issued an executive order that directed the federal government to only recognize two genders: male and female. The sweeping directive also ordered federal government agencies to “effectuate this policy by taking appropriate action to ensure that intimate spaces designated for women, girls, or females (or for men, boys, or males) are designated by sex and not identity.”
Democracy Forward’s FOIA request that the Washington Blade exclusively obtained on Tuesday is specifically seeking a copy of the memo that details the State Department’s new bathroom policy. Democracy Forward has also requested “all” memo-specific communications between the State Department’s Bureau of Global Public Affairs and the Daily Signal from April 1-21.
Federal Government
House Republicans push nationwide ‘Don’t Say Gay’ bill
Measures would restrict federal funding for LGBTQ-affirming schools
Republicans have been gaining ground in reshaping education policy to be less inclusive toward LGBTQ students at the state level, and now they are turning their focus to Capitol Hill.
Some GOP lawmakers are pushing for a nationwide “Don’t Say Gay” bill, doubling down on their commitment to being the party of “traditional family values” by excluding anyone who does not identify with their sex at birth.
The largest anti-LGBTQ education legislation to reach the House chamber is House Bill 2616 — the Parental Rights Over the Education and Care of Their Kids Act, or the PROTECT Kids Act. The PROTECT Kids Act, proposed by U.S. Rep. Tim Walberg (R-Mich.), and co-sponsored by U.S. Reps. Burgess Owens (R-Utah), Mary Miller (R-Ill.), Robert Onder (R-Mo.), and Kevin Kiley (R-Calif.), would require any public elementary and middle schools that receive federal funding to require parental consent to change a child’s gender expression in school.
The bill, which was discussed during Tuesday’s House Rules Committee hearing, would specifically require any schools that get federal money from the Elementary and Secondary Education Act of 1965 — which was created to minimize financial discrepancies in education for low-income students — to get parental approval before identifying any child’s gender identity as anything other than what was provided to the school initially. This includes getting approval before allowing children to use their preferred locker room or bathroom.
It reads that any school receiving this funding “shall obtain parental consent before changing a covered student’s (1) gender markers, pronouns, or preferred name on any school form; or (2) sex-based accommodations, including locker rooms or bathrooms.”
LGBTQ rights advocates have criticized both national and state efforts to require parental permission to use a child’s preferred gender identity, as it raises issues of at-home safety — especially if the home is not LGBTQ-affirming — and could lead to the outing of transgender or gender-curious students.
A follow-up bill, HB 2617, proposed by Owens, one of the bill’s co-sponsors, prevents the use of federal funding to “advance concepts related to gender ideology,” using the definition from President Donald Trump’s 2025 Executive Order 14168, making that an enshrined definition in law of sex rather than just by executive order. There is also a bill making its way through the senate with the same text— Senate Bill 2251.
Advocates have also criticized this follow-up legislation, as it would restrict school staff — including teachers and counselors — from acknowledging trans students’ identities or providing any support. They have said that this kind of isolation can worsen mental health outcomes for LGBTQ youth and allows for education to be politicized rather than being based in reality.
David Stacy, the Human Rights Campaign’s vice president of government affairs, called this legislation out for using LGBTQ children as political pawns in an ideology fight — one that could greatly harm the safety of these children if passed.
“Trans kids are not a political agenda — they are students who deserve safety and affirmation at school like anyone else,” Stacy said in a statement. “Despite the many pressing issues facing our nation, House Republicans continue their bizarre obsession with trans people. H.R. 2616 does not protect children. It targets them. This bill is cruel, and we’re prepared to fight it.”
This is similar to Florida House Bills 1557 and 1069, referred to as the “Don’t Say Gay” bill and “Don’t Say They” bill, respectively, restricting classroom discussions on sexual orientation and gender identity, prohibiting the use of pronouns consistent with one’s gender identity, expanding book banning procedures, and censoring health curriculum.
The American Civil Liberties Union is tracking 233 bills related to restricting student and educator rights in the U.S.
Botswana’s government has repealed a provision of its colonial-era penal code that criminalized consensual same-sex sexual relations.
The country’s High Court in 2019 struck down the provision. The Batswana government in 2022 said it would abide by the ruling after country’s Court of Appeals upheld it.
The government on March 26 announced the repeal of the penal code’s “unnatural offenses” section that specifically referenced any person who “has carnal knowledge of any person against the order of nature” and “permits any other person to have carnal knowledge of him or her against the order of nature.”
Lesbians, Gays and Bisexuals of Botswana, a Batswana advocacy group known by the acronym LEGABIBO, challenged the criminalization law with the support of the Southern Africa Litigation Center. LEGABIBO in a statement it posted to its Facebook on April 25 welcomed the repeal.
“For many, these provisions were not just words on paper — they were lived realities,” said LEGABIBO. “They affected access to healthcare, safety, employment, and the freedom to love and exist openly.”
“LEGABIBO believes that the deletion of these sections is a necessary and long-overdue step toward restoring dignity and aligning our legal framework with constitutional values of equality and human rights,” it added. “It is a clear message that LGBTIQ+ persons are not criminals, and that their lives and relationships deserve protection, not punishment.”
LEGABIBO further stressed that “while this does not erase the harm of the past, it creates space for healing, inclusion, and continued progress toward full equality.”
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Botswana repeals colonial-era sodomy law
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