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.
Rehoboth Beach
BLUF leather social set for April 10 in Rehoboth
Attendees encouraged to wear appropriate gear
Diego’s in Rehoboth Beach hosts a monthly leather happy hour. April’s edition is scheduled for Friday, April 10, 5-7 p.m. Attendees are encouraged to wear appropriate gear. The event is billed as an official event of BLUF, the free community group for men interested in leather. After happy hour, the attendees are encouraged to reconvene at Local Bootlegging Company for dinner, which allows cigar smoking. There’s no cover charge for either event.
District of Columbia
Celebrations of life planned for Sean Bartel
Two memorial events scheduled in D.C.
Two celebrations of life are planned for Sean Christopher Bartel, 48, who was found deceased on a hiking trail in Argentina on or around March 15. Bartel began his career as a television news reporter and news anchor at stations in Louisville, Ky., and Evansville, Ind., before serving as Senior Video Producer for the D.C.-based International Brotherhood of Electrical Workers union from 2013 to 2024.
A memorial gathering is planned for Friday, April 10, 11:30 a.m.-1:30 p.m. at the IBEW International Office (900 7th St., N.W.), according to a statement by the DC Gay Flag Football League, where Bartel was a longtime member. A celebration of life is planned that same evening, 6-8 p.m. at Trade (1410 14th St., N.W.).
Puerto Rico
The ‘X’ returns to court
1st Circuit hears case over legal recognition of nonbinary Puerto Ricans
Eight months ago, I wrote about this issue at a time when it had not yet reached the judicial level it faces today. Back then, the conversation moved through administrative decisions, public debate, and political resistance. It was unresolved, but it had not yet reached this point.
That has now changed.
Lambda Legal appeared before the 1st U.S. Court of Appeals in Boston, urging the court to uphold a lower court ruling that requires the government of Puerto Rico to issue birth certificates that accurately reflect the identities of nonbinary individuals. The appeal follows a district court decision that found the denial of such recognition to be a violation of the U.S. Constitution.
This marks a turning point. The issue is no longer theoretical. A court has already determined that unequal treatment exists.
The argument presented by the plaintiffs is grounded in Puerto Rico’s own legal framework. Identity birth certificates are not static historical records. They are functional documents used in everyday life. They are required to access employment, education, and essential services. Their purpose is practical, not symbolic.
Within that framework, the exclusion of nonbinary individuals does not stem from a legal limitation. Puerto Rico already allows gender marker corrections on birth certificates for transgender individuals under the precedent established in Arroyo Gonzalez v. Rosselló Nevares. In addition, the current Civil Code recognizes the existence of identity documents that reflect a person’s lived identity beyond the original birth record.
The issue lies in how the law is applied.
Recognition is granted within specific categories, while those who do not identify within that binary structure remain excluded. That exclusion is now at the center of this case.
Lambda Legal’s position is straightforward. Requiring individuals to carry documents that do not reflect who they are forces them into misrepresentation in essential aspects of daily life. This creates practical barriers, exposes them to scrutiny, and places them in a constant state of vulnerability.
The plaintiffs, who were born in Puerto Rico, have made clear that access to accurate identification is not symbolic. It is a basic condition for moving through the world without contradiction imposed by the state.
The fact that this case is now being addressed in the federal court system adds another layer of significance. This is not a pending policy discussion or a legislative proposal. It is a constitutional question. The analysis is not about political preference, but about rights and equal protection under the law.
This case does not exist in isolation.
It unfolds within a broader context in which debates over identity and rights have increasingly been shaped by the growing influence of conservative perspectives in public policy, both in the United States and in Puerto Rico. At the local level, this influence has been reflected in legislative discussions where religious arguments have begun to intersect with decisions that should be grounded in constitutional principles. That intersection creates tension around the separation of church and state and has direct consequences for access to rights.
Recognizing this context is not an attack on faith or religious practice. It is an acknowledgment that when certain perspectives move into the realm of public authority, they can shape outcomes that affect specific communities.
From within Puerto Rico, this is not a distant debate. It is a lived reality. It is present in the difficulty of presenting identification that does not match one’s identity, and in the consequences that follow in workplaces, schools, and government spaces.
The progression of this case introduces the possibility of change within the applicable legal framework. Not because it resolves every tension surrounding the issue, but because it establishes a legal examination of a practice that has long operated under exclusion.
Eight months ago, the conversation centered on ongoing developments. Today, there is already a judicial finding that identifies a violation of rights. What remains is whether that finding will be upheld on appeal.
That process does not guarantee an immediate outcome, but it shifts the ground.
The debate is no longer theoretical.
It is now before the courts.
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