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New HHS reg seeks non-discrimination in health care as monkeypox spreads

Proposed rule bars strengthens protections for LGBTQ patients

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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.

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Federal Government

Republicans attach five anti-LGBTQ riders to State Department funding bill

Spending package would restrict Pride flags on federal buildings, trans healthcare, LGBTQ envoys

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(Washington Blade photo by Michael Key)

As Congress finalizes its funding for fiscal year 2027, Republicans are attempting to include five anti-LGBTQ riders in the National Security and Department of State Appropriations Act.

A rider is an unrelated provision tacked onto a bill that must pass — in this instance, the bill provides funding for national security policy and for the State Department.

The riders range from restricting Pride flags in federal buildings to banning transgender healthcare, but all aim to limit the visibility and rights of LGBTQ Americans.

The five riders are:

Section 7067(a) prohibits Pride flags from being flown over federal buildings.

Section 7067(c) restricts the United States’ ability to appoint special envoys, representatives, or coordinators unless expressly authorized by Congress. These roles have historically been used to promote U.S. interests in international forums — including advancing human and LGBTQ and intersex rights and other policy priorities. The change would halt what the Congressional Equality Caucus describes as providing “critical expertise to U.S. foreign policy and leadership abroad.”

Section 7067(d) reinforces multiple anti-equality executive orders signed by President Donald Trump, effectively requiring that foreign assistance funded by the United States comply with those orders. This includes rescinding federal contractor nondiscrimination protections, including for LGBTQ people.

Section 7067(e) prohibits funding for any organization that provides or promotes medically necessary healthcare for trans people or “promotes transgenderism” — effectively banning funds for organizations that recognize trans people exist. This is despite the practice of gender-affirming care being supported by nearly every major medical association.

Section 7067(g) reinforces two global gag rules put forward by the Trump-Vance administration. One is the Trans Global Gag Rule, which prohibits foreign assistance funding for organizations that acknowledge the existence of trans people or advocate for nondiscrimination protections for them, among other activities. The second is the DEI Global Gag Rule, which prohibits foreign assistance funding for organizations that engage in efforts to address the ongoing effects of racism, sexism, and other forms of bigotry outside the United States.

The global gag rule has its roots in anti-abortion policy introduced by President Ronald Reagan in 1984, when the 40th president barred foreign organizations receiving U.S. global health assistance from providing information, referrals, or services for legal abortion, or from advocating for access to abortion services in their own countries. Planned Parenthood notes that the policy also affects programs beyond abortion, including efforts to expand access to contraception, prevent and treat HIV/AIDS, combat malaria, and improve maternal and child health.

If organizations funded by the State Department engage in these activities, they could lose funding.

This anti-LGBTQ push aligns with broader actions from the Trump-Vance administration since the start of Trump’s second term, which have focused on restricting human rights — particularly those of trans Americans.

The House Appropriations Committee is responsible for drafting the appropriations legislation. U.S. Rep. Tom Cole (R-Okla.) serves as chair, with U.S. Rep. Rosa DeLauro (D-Conn.) as ranking member. The committee includes 34 Republicans and 27 Democrats.

For FY27 appropriations, Congress is supposed to pass and have the president sign the funding bills by Sept. 30, 2026.

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Noticias en Español

The university that refuses to let go

Joanna Cifredo is a trans woman participating in University of Puerto Rico strike

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Joanna Cifredo outside the University of Puerto Rico campus in Mayagüez, Puerto Rico. (Washington Blade photo by Ignacio Estrada Cepero)

Over the past days, I have been walking with a question that refuses to leave me. Not the kind of question you answer from a desk or from a distance, but one that grows out of what you witness in real time, at the gates, in the faces of those who remain there without knowing how any of this will end. What is truly happening inside the University of Puerto Rico, and why have so many students decided to risk everything at a moment when they can least afford to lose anything.

I write as someone who lives just steps away from the Río Piedras campus. These days, the silence has replaced the constant movement that once defined this space. The absence is felt in every corner where students used to pass at all hours. Since arriving in Puerto Rico three years ago, I have come to know firsthand stories that rarely make it into reports or official statements. One of the reasons I chose to stay was precisely this, to serve the university community, to help create a space where students could find something as basic as a safe meal at night and, in some way, ease burdens that are often carried in silence.

I have listened, asked questions, and tried to understand without imposing answers. What I have found is not a collective outburst or a generational whim. What exists is a fracture, a deep break between those making decisions and those living with their consequences every single day.

There has been an effort to reduce this strike to an issue of order, scheduling, or academic disruption. Conversations revolve around missed classes, delayed semesters, and students supposedly unaware of the consequences of their actions. What is rarely addressed are the conditions that lead an entire student body to pause its own future to sustain a protest that offers no guarantees.

Because that is the reality. These are students who fully understand what they are risking, and yet they remain. When someone reaches that point, the least they deserve is not judgment, but to be heard.

From the outside, there have also been attempts to discredit what is happening. Familiar narratives are repeated, legitimacy is questioned, and doubt is cast over intentions. It is easier to do that than to acknowledge that this did not begin at the gates, but long before, in decisions made without building trust.

And something must be said clearly. This is not limited to the gates of Río Piedras. What we are witnessing extends across every unit of the University of Puerto Rico system. Mayagüez, Ponce, Arecibo, Bayamón, Cayey, Humacao, Carolina, Aguadilla, Utuado, and the Medical Sciences Campus. This is not an isolated reaction. It is a movement that runs through the entire institution. Río Piedras may be more visible, but it is not alone. What is happening there reflects a broader unrest felt across the system.

Within that context, one demand has grown increasingly present, the call for the resignation of University of Puerto Rico President Zayira Jordán Conde. This is not the voice of a small group. It reflects a deeper level of mistrust that has spread across multiple campuses.

The Puerto Rican Association of University Professors has also made it clear that this is not solely a student issue. There is real concern among faculty, and a shared recognition of the conditions currently shaping the university. When students and professors arrive at the same conclusion, the problem can no longer be minimized.

Meanwhile, the administration continues to speak in the language of dialogue. But dialogue is not a word, it is a practice. And when trust has been broken, it cannot be restored through statements alone, but through decisions that prove a willingness to truly listen.

In the midst of all of this, there are voices that cannot be ignored. Voices grounded not in theory, but in lived experience. One of them is Joanna Cifredo, a student at the Mayagüez campus, a young Puerto Rican trans woman, and someone widely recognized for her advocacy.

I spoke with her in recent days. What follows is her voice, exactly as it is.

How would you describe what is happening inside the University of Puerto Rico right now, beyond what people see from the outside?

Estamos viviendo momentos muy difíciles, en el sentido de que hay mucha incertidumbre y una presión constante por parte de la administración para reabrir el recinto, pero, entre todo el caos e inestabilidad provocado por las decisiones de esta administración, también hemos vivido momentos muy poderosos. Esta lucha ha sacado lo mejor de nuestra comunidad.

Lo vimos en las asambleas y plenos, donde 1,500, 1,700, hasta 1,800 estudiantes llegaron —bajo lluvia, bajo advertencias de inundaciones— y aun así se quedaron, participaron y votaron a favor de una manifestación indefinida hasta que se atiendan nuestros reclamos.

He conocido a tantas personas en los diferentes portones, estudiantes graduados, aletas, estudiantes de intercambio, estudiantes de todo tipo de concentraciones y se unieron para apoyar el movimiento estudiantil. Estudiantes que vienen a los portones después del trabajo o antes de trabajar. Estudiantes que vienen a dejar agua y suministros entre turnos de trabajo. Viejitos que vienen a los portones con desayuno, almuerzo o cena.

Más allá de lo que se ve desde afuera, lo que estamos viviendo es una mezcla de tensión y resistencia, pero también de comunidad, solidaridad y compromiso colectivo.

Much of what is discussed remains at the level of headlines or social media. From your direct experience, what specific decisions or actions from the administration have led to this level of mobilization?

Desde el inicio, la designación de la Dra. Zayira Jordán Conde careció de respaldo dentro de la comunidad universitaria. No contaba con experiencia administrativa en la UPR ni con un conocimiento básico de nuestros procesos, cultura y reglamentos. Por eso, en asamblea, el estudiantado votó para solicitarle a la Junta de Gobierno que no considerara su candidatura, y múltiples organizaciones docentes hicieron lo mismo. Existía un consenso amplio de que no tenía la experiencia necesaria para liderar una institución como la nuestra.

A pesar de ese rechazo claro, la Junta de Gobierno decidió ignorar los reclamos de la comunidad universitaria e imponer su nombramiento.

Una vez en el cargo, su estilo de gobernanza ha sido poco transparente y poco colaborativo. Sin embargo, el detonante principal de la movilización en el Recinto Universitario de Mayagüez fue su decisión de destituir, de manera unilateral y en medio del semestre, a cinco rectores, incluyendo al nuestro, el Dr. Agustín Rullán Toro, para reemplazarlo por un rector interino, el Dr. Miguel Muñoz Muñoz.

Esta acción, tomada de forma abrupta, provocó de inmediato un clima de caos e inestabilidad dentro de la institución. Y deja una pregunta inevitable: ¿no anticipó el impacto de esa decisión, lo que evidenciaría una falta de experiencia? ¿O lo anticipó y aun así decidió proceder? No está claro cuál de las dos es más preocupante.

Además, esta decisión tuvo consecuencias concretas para el estudiantado, incluyendo el retiro de becas educativas para nuevos integrantes del RUM por parte de la Fundación Ceiba, que calificó la movida como “sorprendente” y “preocupante”. Decisiones impulsivas como la que tomó la presidenta ponen en peligro la estabilidad de nuestra institución y la acreditación de la universidad.

As a trans woman within this movement, how does your identity intersect with what is happening, and why does this also shape the future of people like you?

Soy una de varias chicas trans que formamos parte activa de este movimiento estudiantil.

For those outside the UPR who believe this does not affect them, what are the real consequences of this crisis?

La Universidad de Puerto Rico se fundó para servir al pueblo.

It is impossible to overstate the role the University of Puerto Rico and its students have played in shaping the social, cultural, and economic life of this country. Its impact extends into science, medicine, and every profession that has sustained Puerto Rico over time. No other educational institution has contributed more.

After listening to her, one thing becomes undeniable. This is not just another protest, but a generation refusing to let go of what little remains within its reach. And when a generation reaches that point, the issue is no longer the strike, the issue becomes the country itself.

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District of Columbia

Judge issues revised order in Capital Pride stalking case

Defendant Darren Pasha agreed to accept less restrictive directive

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Darren Pasha (Washington Blade photo by Lou Chibbaro, Jr.)

A D.C. Superior Court judge on April 30 reinstated an anti-stalking order requested by the Capital Pride Alliance against local gay activist Darren Pasha based on allegations that Pasha engaged in a year-long effort to harass, intimidate, and stalk the organization’s staff, board members, and volunteers.

The reinstated order by Judge Robert D. Okun followed an April 17 court hearing in which he rescinded a similar order he initially approved in February on grounds that more evidence was needed to substantiate the need for the order.   

At the time he rescinded the earlier order he scheduled an evidentiary hearing for April 29 at which three Capital Pride staff members testified in support of the anti-stalking order. But Okun discontinued the hearing after Pasha, who was representing himself without an attorney, announced he was willing to accept a revised, less restrictive temporary restraining order.

The judge said Pasha’s decision to accept a restraining order made it no longer necessary to continue the evidentiary hearing. He then asked Capital Pride and Pasha to submit their suggested revisions for the order which they submitted a short time later.

The case began when Capital Pride Alliance, the D.C.-based LGBTQ group that organizes the city’s annual Pride events, filed a civil complaint on Oct. 27, 2025, against Pasha, accusing him of engaging in a year-long effort to harass, intimidate, and stalk Capital Pride staff, board members, and volunteers. It includes a 167-page addendum of “supporting exhibits” that includes multiple statements by unidentified witnesses.

Pasha, who has represented himself without an attorney, has argued in multiple court filings and motions that the stalking allegations are untrue. In his initial court response to the complaint, he said it appears to be a form of retaliation against him for a dispute he has had with Capital Pride and its former board president, Ashley Smith, who has since resigned from the board.

Similar to his earlier anti-stalking order against Pasha, Okun’s reissued order on April 30 states, a “Temporary Anti-Stalking Order is GRANTED, effective immediately and remaining in effect until further order of the Court or final disposition of this matter.”

It adds, “The defendant shall not contact, attempt to contact, harass, threaten, or otherwise communicate with any protected person, directly or indirectly, including through third parties, social media, electronic communication, or any other means.”

Unlike the earlier order, which did not identify the “protected persons” by name, the latest order includes a list of 34 people, 13 of whom are Capital Pride staff members or volunteers, including CEO Ryan Bos and Chief Operating Officer June Crenshaw. The other 21 people listed are identified as Capital Pride board members, including board chair Anna Jinkerson.

Possibly because Pasha addressed this in his suggested version of the order, the judge’s revised order says Pasha is allowed to visit the D.C. LGBTQ+ Community Center, where the Capital Pride office is located, if he gives the community center a 24 hour advance notice that he will be visiting the center, which hosts many events unrelated to Capital Pride. The earlier order required him to stay at least 100 feet away from the Capital Pride office.

The new order also prohibits Pasha from attending 21 named events that Capital Pride Alliance either organizes itself or with partner organizations that were scheduled to take place from April 30 through June 21. The order says he is allowed to attend the two largest events, the June 20 Pride Parade and the June 21 Pride Festival and Concert, in which 500,000 or more people are expected to attend.

It says Pasha is also allowed to attend the June 15 Pride At The Pier event organized by the Washington Blade.

But for those three events the order says he is restricted from entering “ticketed and controlled access areas.”

At the April 29 court hearing, Okun also scheduled a mandatory remote mediation session for July 23, in which efforts would be made to resolve the civil complaint case brought by Capital Pride without going to trial. 

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