Federal Government
HHS official discusses agency’s proposed LGBTQ-inclusive nondiscrimination rule
Proposed regulation change published Tuesday
The U.S. Department of Health and Human Services published a Notice of Proposed Rulemaking on Tuesday for a new regulation that clarifies nondiscrimination rules on the basis of sexual orientation and gender identity.
“The department is doing all that it can to protect access to health and human services,” Melanie Fontes Rainer, director of HHS’s Office of Civil Rights, told the Washington Blade by phone on Tuesday.
“This proposed rule is a step in that effort,” she said.
Health programs administered by the agency are covered by the nondiscrimination rules in Section 1557 of the Affordable Care Act, Fontes Rainer said, so, “This rule is meant to get to that other slice of the pie that encompasses really important work at the Department of Human Services.”
Nondiscrimination, here, is a priority, “specifically nondiscrimination on the basis of sexual orientation and gender identity,” she said.
If finalized pursuant to the 60-day public comment period, HHS’s rule will apply to such programs as those administered by the “Administration for Children and Families, SAMHSA, and some other organizations within HHS that have grants,” Fontes Rainer said.
Examples include Head Start, which provides educational, health, nutritional and other services to low income children and their families.
The agency’s legal authority to enforce inclusive nondiscrimination rules was statutorily ordained by Congress, but clarified with the U.S. Supreme Court’s 2020 ruling in Bostock v. Clayton County, which “made clear that sexual orientation and gender identity were part of this protected sex based discrimination class,” Fontes Rainer said.
The decision helped to accelerate the Biden-Harris administration’s coordination of efforts across the federal government to shore up protections for LGBTQ Americans, she noted, beginning with the Justice Department and then the U.S. Department of Education and HHS.
Those agencies and federal courts have since made clear the law applies not just in the Title VII context — which covers nondiscrimination in employment, the legal question at issue in Bostock — but also “to other federal programs like Title IX,” Fontes Rainer said.
HHS is coordinating efforts with the White House, which last month unveiled a series of new actions to better protect LGBTQ Americans, including through programs administered by HHS, such as those targeting queer youth and their families.
Last June, Fontes Rainer noted, the administration announced that the department’s Administration for Children and Families would pursue a new rule making to “clarify that state child welfare agencies must ensure LGBTQI youth are treated in a safe and appropriate manner.”
The agency’s rule “is inclusive of some grants and services that are inclusive of homelessness services for LGBTQI youth,” Fontes Rainer said. “That’s certainly a part of it. And this grants rule is certainly a part of that effort in the Human Services context.”
“It’s really important right now to have the federal government be strong in the LGBTQI space, whether it’s healthcare, human services or some other service that the federal government provides and [also to] be very clear about what non discrimination means,” she said. “Because, you know, there there is a tsunami of these [anti-trans] healthcare bans across the country.”
According to the Human Rights Campaign, almost 30 percent of transgender youth in the U.S. live in places that have passed bans on gender affirming care, criminalizing healthcare interventions that are backed by every mainstream scientific and medical society.
“We’re seeing a shift right now, where there are a lot of healthcare bans,” Fontes Rainer said. “And, I think, ultimately, these are decisions that are going to be taken into litigation in various contexts, which we’re already seeing across the country.”
Meanwhile, on the federal level, Congressional Republicans are moving to add riders restricting access to healthcare for trans youth into must-pass appropriations bills. Asked to respond to these efforts, Fontes Rainer was quick to note that, “my job is not on the legislative front, here.”
At the same time, she said, when it comes to HHS’s proposed regulation, for “every single program and service we’ve identified, these [nondiscrimination] protections already exist in the law,” so the agency is therefore confident that “we are on good authority and legal footing here.”
While the regulation and its implementation would be new, Fontes Rainer said, HHS is acting under its statutory authority as established long ago by the legislature.
Policy carries real impact on people, families
Last month, HHS hosted a Pride Summit, where officials at the agency from Fontes Rainer to Assistant Secretary Adm. Rachel Levine and Secretary Xavier Becerra, along with other high ranking members of the Biden-Harris administration like White House Press Secretary Karine Jean-Pierre, spoke about the government’s work advancing rights and protections for the LGBTQ community.
At the event, Becerra dedicated a portion of his remarks to recounting discussions he had with LGBTQ families about how his agency can better serve their needs across the various health and human services programs that comprise its book of business.
Fontes Rainer told the Blade she has participated in many of these conversations, with and without the secretary. “I have made a point to visit with providers, advocates, parents and kids, in many of the states that either have passed or are seeking to pass bans on healthcare for trans youth,” she said.
“Every time I have these conversations, I feel emotional afterwards,” she said. “For a lot of these kids and families, you know, they’re not asking for much. They’re asking to go to the doctor. They’re asking to be treated with respect. They’re asking to have the appropriate pronouns used — things that are very basic.”
The circumstances vary, Fontes Rainer said. Some families have the resources to travel or even relocate to states that are committed to protecting their transgender residents’ access to healthcare.
Others, however, do not. Parents, she said, often “don’t know what they’re gonna do as their child is [forcibly] tapered off of medication, mid treatment” and many are unsure how to respond to the resulting impacts on their child’s mental health.
Fontes Rainer said she has also seen the impacts of legislative restrictions on the healthcare system. “I’ve talked to providers who tell me that they provide gender affirming care in a state where it’s not banned and it’s impossible to get appointments now, because they have so many people traveling there,” she said.
“These efforts by the Biden administration, while they don’t solve everything, they’re really important — both in being strong on the policy and what the law means, but also in being very clear to parents and families and doctors that we have your back,” Fontes Rainer said.
“I’ve been in rooms with the secretary where people, providers, you know, hug him and cry,” she said, “because they feel like it’s really important to have somebody that understands the law in this moment, and they feel like it’s important that, you know, from the secretary on up to the president of the United States, they have support from the Biden administration.”
Fontes Rainer told the Blade she is proud of HHS’s legacy of leadership on LGBTQ rights. With a ceremony last year, the agency became the first to raise the Progress Pride flag, which includes colors to represent Black and brown LGBTQ communities and incorporates the stripes of the transgender Pride flag.
“Now, this year, almost every single agency did that,” she said, adding that last month, “my husband and I put up a Pride Unity flag in our yard” too.
“Right now is not the time to be shy,” Fontes Rainer said. “Now is not the time to like go hide in a hole. Now is the time to be loud and vocal and use your power for good.”
Federal Government
Senate Democrats press DOJ over anti-trans prison directives
Markey joins other lawmakers in demanding reversal of policies
U.S. Sen. Edward Markey (D-Mass.) is urging acting Attorney General Todd Blanche and William Marshall III, director of the Federal Bureau of Prisons, to reverse a policy affecting transgender inmates that lawmakers say is “endangering” their “health and safety.”
Markey, along with U.S. Sens. Jeffrey A. Merkley (D-Ore.) and Mazie K. Hirono (D-Hawaii), sent the letter that the Washington Blade verified on Monday.
The letter is a direct response to a change in prison policy that went into effect in February 2025, rolling back Biden-era protections for trans inmates. The senators described how President Trump’s Executive Order 14168, titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” forced a policy shift they argue is rooted more in political rhetoric than in medical research or evidence-based correctional practices.
In the letter, the lawmakers wrote “On Feb. 21, 2025, the BOP issued a memo to implement President Trump’s EO, requiring BOP staff to ‘refer to individuals by their legal name or pronouns corresponding to their biological sex,’ banning the use of funds for any ‘items that align with transgender ideology,’ and suspending clothing accommodations, pat search accommodations, and support programs offered to transgender individuals.”
“In a second memo, issued one week later, the BOP banned the use of federal funds for ‘any medical procedure, treatment, or drug for the purpose of conforming an inmate’s appearance to that of the opposite sex.’ These changes have resulted in the denial — or threatened denial — of hormone treatment and gender-affirming accommodations for transgender individuals in BOP custody.”
“On Feb. 19, 2026, the BOP escalated its attacks, issuing a program statement titled, ‘Management of Inmates with Gender Dysphoria.’ It prohibits incarcerated people from receiving gender-affirming care, even if paid for with private funds. This practice forces incarcerated people to discontinue care, regardless of medical recommendations.”
The senators continued, “The agency has repeatedly enacted policies that strip transgender individuals of their gender identity and dignity. This includes requiring staff to refer to transgender individuals by pronouns that ‘align with their biological sex’ rather than gender identity and to confiscate gender-affirming items, such as undergarments, clothing, cosmetics, and wigs.”
“These policies risk triggering mental health crises, including increased suicidality, among incarcerated people with gender dysphoria. The BOP’s repeated guidance to roll back gender-affirming protections — despite a federal court order finding that the BOP’s actions to discontinue gender-affirming care are likely unlawful — generate confusion about the current state of regulations and convey the BOP’s indifference to court orders and the rule of law.”
“By stripping away appropriate medical and psychiatric care, safety protections, and measures to provide dignity, the BOP is exposing transgender individuals to significant harm.”
The Marshall Project, a nonprofit newsroom focused on the U.S. criminal justice system and immigration enforcement through data-driven reporting, also reported on the policy change. The outlet spoke with Shana Knizhnik, an attorney with the American Civil Liberties Union, about the impact of the changes.
“It’s clear that this new policy is a ban on gender affirming healthcare,” Knizhnik, who works for the nationwide chapter of the ACLU said. “This is a policy that disregards the medical needs of our plaintiffs.”
The letter also asked the BOP and the DOJ specific questions regarding why the policy went into effect, as lawmakers suggested the changes appear politically motivated rather than based on new medical evidence regarding treatment for trans inmates.
The senators requested answers to these trans policy-specific questions by May 21, including:
“Does the BOP plan to monitor and assess the impacts of recent policies that eliminate gender-affirming medical and psychiatric care?”
“Since January 20, 2025, how many transgender, nonbinary, intersex, and gender-diverse individuals have been transferred to a different facility to meet the EO’s goal of housing individuals ‘according to their biological sex?’”
“Given that the BOP has stopped enforcing Prison Rape Elimination Act regulations related to gender identity and collecting data on gender identity, how will the BOP protect the physical and emotional health and safety of incarcerated transgender individuals?”
“How does the BOP plan to monitor and assess the impact of eliminating protections against sexual violence for this population?”
“Does the BOP plan to institute a specific process by which transgender individuals may seek assistance or lodge complaints regarding harms they experience from the recent BOP policies and actions implementing President Trump’s EO?”
“Describe the specific criteria the BOP intends to use to determine whether it will allow a ‘social accommodation’ for gender dysphoria.”
Markey also included a personal statement to the Blade explaining why he is using his position on Capitol Hill to push for more information and advocate for reversing the policy.
“This administration continuously shows their contempt for trans people and a total disregard for their rights and humanity. As part of this cruel campaign, the Bureau of Prisons has systematically stripped health care access and basic protections from trans people, abandoning its duty to the people in its custody. I won’t stop fighting until this administration’s hateful anti-trans policies are reversed and trans people’s rights are secured.”
The Blade reached out to the DOJ and the BOP for comment but had not received a response at press time.
Federal Government
DOE investigates Smith College’s trans-inclusive policy
Mass. college accused of violating Title IX
The U.S. Department of Education announced on Monday that it opened an investigation into Smith College for admitting transgender women.
Smith College, a private and famously all-women’s college in Northampton, Mass., established in 1871 and opened in 1875, has a long list of women who make up its historic alumni — including first ladies, influential political figures, and cultural leaders.
The DOE released a statement about the investigation into the institution through the Department’s Office for Civil Rights, saying it was looking into the possibility that Title IX of the Education Amendments of 1972 was violated by allowing trans women, referred to in the statement as “biological males,” into women’s intimate spaces protected by IX.
The statement explicitly highlighted that this stems from trans women being granted “access to women-only spaces, including dormitories, bathrooms, locker rooms, and athletic teams” while also allowing their audience into the school itself.
This is the first time the Trump-Vance administration has taken a step into admissions processes, a stark jump past investigating policies that allowed trans women to participate in women’s sports and use women’s bathrooms, and allows for the administration to go more after trans acceptance policy as a whole.
Smith’s admission policy allows for “any applicants who self-identify as women,” including “cis, trans, and nonbinary women,” according to the college’s website, and has since 2015, when it updated its policy.
“The college is fully committed to its institutional values, including compliance with civil rights laws,” Smith’s statement in response to the DOE’s investigation said. “The college does not comment on pending government investigations.”
“An all-women’s college loses all meaning if it is admitting biological males,” said Assistant Secretary for Civil Rights Kimberly Richey. “Allowing biological males into spaces designed for women raises serious concerns about privacy, fairness, and compliance under federal law. The Trump administration will continue to uphold the law and fight to restore common sense.”
This move continues to align with actions the Trump-Vance administration has taken to curtail LGBTQ — and specifically trans — rights in America, as members of the administration attempt to break down safeguards and protections that have long been used to protect marginalized communities.
Since Trump took office in his second term, there have been significant legal challenges. According to the National LGBTQ+ Bar Association, there are over 35 court cases that have emerged since his second swearing-in that directly relate to the administration’s attempts to minimize the rights and protections of trans Americans — from medical care and educational protections to military policy.
Much of this anti-trans policy direction was outlined beginning in 2022 with the Project 2025 playbook, which Trump officials have used as a guide to scale back protections for LGBTQ people, Black Americans, poor and Indigenous communities, while also increasing costs for lower-income Americans and providing tax cuts to the wealthy and ultra-wealthy. The plans also “erode” Americans’ freedoms and remove crucial checks and balances that have allowed the executive branch to remain in line with the Constitution without becoming too powerful over either the courts or the legislative branch.
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
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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