Connect with us

Federal Government

HHS official discusses agency’s proposed LGBTQ-inclusive nondiscrimination rule

Proposed regulation change published Tuesday

Published

2 years ago

on

Melanie Fontes Rainer, director of the Office of Civil Rights at the U.S. Department of Health and Human Services, during the agency's June 2023 Pride Summit (Screen capture/YouTube)

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.”

Related Topics:
Advertisement
FUND LGBTQ JOURNALISM
SIGN UP FOR E-BLAST

Federal Government

White House finds Calif. violated Title IX by allowing trans athletes in school sports

Education Department threatens ‘imminent enforcement action’

Published

4 days ago

on

June 26, 2025

By

California Gov. Gavin Newsom (D) (Washington Blade photo by Michael Key)

The Trump-Vance administration announced on Wednesday that California’s Interscholastic Federation and Department of Education violated federal Title IX rules for allowing transgender girls to compete in school sports.

In a press release, the U.S. Department of Education’s Office of Civil Rights threatened “imminent enforcement action” including “referral to the U.S. Department of Justice” and the withholding of federal education funding for the state if the parties do not “agree to change these unlawful practices within 10 days.”

The agency specified that to come into compliance; California must enforce a ban excluding transgender student athletes and reclaim any titles, records, and awards they had won.

Federal investigations of the California Interscholastic Federation and the state’s Department of Education were begun in February and April, respectively. The Justice Department sued Maine in April for allowing trans athletes to compete and refusing a similar proposal to certify compliance within 10 days.

Broadly, the Trump-Vance administration’s position is that girls who are made to compete against trans opponents or alongside trans teammates are unfairly disadvantaged, robbed of opportunities like athletics scholarships, and faced with increased risk of injury — constituting actionable claims of unlawful sex discrimination under Title IX.

This marks a major departure from how the previous administration enforced the law. For example, the Department of Education issued new Title IX guidelines in April 2024 that instructed schools and educational institutions covered by the statute to not enforce categorical bans against trans athletes, instead allowing for limited restrictions on eligibility if necessary to ensure fairness or safety at the high school or college level.

Sports aside, under former President Joe Biden the department’s Office of Civil Rights sought to protect against anti-LGBTQ discrimination in education, bringing investigations and enforcement actions in cases where school officials might, for example, require trans students to use restrooms and facilities consistent with their birth sex or fail to respond to peer harassment over their gender identity.

Much of the legal reasoning behind the Biden-Harris administration’s positions extended from the 2020 U.S. Supreme Court case Bostock v. Clayton County, which found that sex-based discrimination includes that which is based on sexual orientation or gender identity under Title VII rules covering employment practices.

A number of high profile Democrats, including California Gov. Gavin Newsom, have recently questioned or challenged the party’s position on transgender athletes, as noted in a statement by Education Secretary Linda McMahon included in Wednesday’s announcement.

“Although Gov. Gavin Newsom admitted months ago it was ‘deeply unfair’ to allow men to compete in women’s sports, both the California Department of Education and the California Interscholastic Federation continued as recently as a few weeks ago to allow men to steal female athletes’ well-deserved accolades and to subject them to the indignity of unfair and unsafe competitions.”

Continue Reading

Federal Government

Trump’s dismantling of US foreign aid derails HIV prevention effort in Africa

FDA approved breakthrough preventative drug lenacapavir earlier this month

Published

4 days ago

on

June 26, 2025

By

President Donald Trump (Washington Blade photo by Michael Key)

On June 18, the Food and Drug Administration approved a long-acting injectable for the prevention of HIV that could have a transformational impact on decades-long efforts to end the epidemic in the U.S. and abroad.

Offering robust protection with just two doses per year, lenacapavir has the potential to dramatically improve uptake and adherence compared to daily oral PrEP regimens like Truvada or Descovy, particularly for high risk populations living in places with poor health infrastructure or where stigma about HIV discourages frequent testing and clinic visits.

According to the New York Times, however, the rollout of lenacapavir for HIV prevention overseas has been stymied by the gutting of agencies, staff, programs, and funding dedicated to foreign aid and public health during President Donald Trump’s second term.

Among other moves, the administration has frozen or withdrawn nearly all U.S. foreign development assistance, dismantled the U.S. Agency for International Development and reduced the size of its workforce by more than 95 percent, and shuttered key public health units housed under the U.S. Department of Health and Human Services, the National Institutes of Health, the Centers for Disease Control and Prevention, and the FDA.

As a result, the Times reports, HIV programs across the African continent have been “scrambling to procure drugs that the United States once supplied, replace lost nurses and lab technicians, and restart shuttered programs to prevent new infections.”

Experts fear HIV infection rates are climbing in some of the hardest-hit countries, but since the U.S. pulled funding for data collection and monitoring, there is no way to know for sure.

Historically, the U.S. has provided about 75 percent of all global spending on efforts to fight the epidemic, a reflection of the extent to which there was broad bipartisan support for the allocation of resources for this purpose through programs like the President’s Emergency Plan for AIDS Relief. Trump continued this legacy in his first term, launching the ambitious Ending the HIV Epidemic initiative that was continued under former President Joe Biden.

After returning to the White House, however, the president and his administration have justified their slash-and-burn cuts to the federal government’s work in international development and public health by arguing that funds and resources sent to overseas nations are too often pilfered by corrupt foreign state actors or wasted on ineffectual programs.

Trump and his allies also believe the U.S. should no longer be expected to shoulder such a disproportionate share of the responsibility for foreign aid, and that other countries are likelier to step up and contribute more in response to America’s retreat.

Continue Reading

Federal Government

So far, virtually no acknowledgement of Pride month by federal gov’t

Trump-Vance administration proclaimed ‘no more drag shows’ at Kennedy Center

Published

1 month ago

on

May 28, 2025

By

President Donald Trump (Washington Blade photo by Michael Key)

Just a few days from the start of June, there has been virtually no acknowledgment of Pride month by federal government agencies this year, a striking departure from recent policy and practice under the Biden-Harris administration and even under President Donald Trump’s first term.

Some limited and more localized observances have been preserved or renewed in 2025, for example by the U.S. courts’ webpage celebrating history-making LGBTQ jurists like Judges Deborah A. Batts and J. Paul Oetken of the U.S. District Court for the Southern District of New York, and by the Metropolitan Washington Airports Authority, which notes on its website plans to actively participate in WorldPride 2025.

The paltriness of Pride this year comes pursuant to several policy changes under Trump 2.0 such as executive orders narrowing the definition of gender to exclude trans and nonbinary people and banning activities related to diversity, equity, and inclusion, which have led to agency-wide changes including the removal of LGBTQ focused website content and dissolution of “affinity groups.”

Many of these actions came to light in the first few months of Trump’s second term. For example, in January the Associated Press reported a memo from the U.S. Defense Intelligence Agency indicating that observances related to Martin Luther King Jr. Day, Pride Month, Holocaust Days of Remembrance, and other cultural or historical annual events would be paused.

While it remains to be seen whether and to what extent the White House, federal government, and Congress will acknowledge Pride month in 2025, in 2024:

  • • At the end of May, President Joe Biden issued a proclamation declaring June LGBTQ Pride Month, as he had done for the previous three years of his administration
  • • The U.S. Senate, then under Democratic control, introduced a resolution recognizing June 2024 as LGBTQ Pride Month
  • • Federal agencies across the whole of government participated in Pride activities, and at a high level — for instance, then-U.S. Secretary of State Antony Blinken hosted a Pride month convening focused on U.S. foreign policy, national security, inclusive development, and human rights
  • • Actions in June, which in many cases were coordinated via LGBTQ employee resource groups or affinity groups, included celebrations of LGBTQ individuals — for example, the U.S. Department of Commerce’s Economic Development Administration toasted those who made significant contributions to economic growth, while the U.S. Patent and Trademark Office hosted a “Proud Innovation 2024” event, highlighting the accomplishments of LGBTQ innovators, entrepreneurs, and small business owners who utilize intellectual property to grow their businesses and mentor others in their communities.
  • Agencies also provided support indirectly — for example, the U.S. Federal Trade Commission sponsored attorneys who wished to represent the FTC at LGBTQ Pride events organized by various bar associations

The Washington Post pointed to some of the challenges facing organizers of WorldPride as they plan festivities in D.C. throughout early June: “This year, the LGBTQ+ celebration is being held in the backyard of a government that has targeted transgender rights and made major cuts to HIV prevention programs. At the Kennedy Center, President Donald Trump has promised “NO MORE DRAG SHOWS, OR OTHER ANTI-AMERICAN PROPAGANDA.”

On June 14, Trump is set to preside over a military parade in Washington commemorating the 250th anniversary of the U.S. Army, his 79th birthday, and Flag Day, in a celebration that will feature 6,600 soldiers from at least 11 corps and divisions nationwide and 150 military vehicles, including 28 M1 Abrams tanks.

Continue Reading

Popular