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

Proposed regulation change published Tuesday

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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.”

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Federal Government

Todd Blanche’s record on LGBTQ issues comes under scrutiny as he takes over DOJ

Blanche was confirmed by the Republican controlled Senate 50-49.

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Attorney General Todd Blanche (Photo public domain)

Todd Blanche, President Trump’s former personal lawyer, was sworn in as attorney general of the United States on Monday.

Blanche secured the position as the country’s 88th chief law enforcement officer on Sunday night after a contentious Senate confirmation process, ultimately ending with a 50-49 vote in his favor. All Democrats, as well as Republican Sens. Susan Collins and Lisa Murkowski, voted against him.

The confirmation hearing — and subsequent vote — brought questions surrounding Blanche’s credibility and integrity, as well as concerns about Trump’s ethical dilemmas surrounding cronyism, to the forefront.

The attorney general acts as the head of the Department of Justice, responsible for enforcing federal laws, representing the U.S. in court, and advising the president.

Blanche has a long history in Washington, beginning when he attended American University for his undergraduate education, like fellow former Trump attorney Michael Cohen. He began his legal career as an intern in the U.S. Attorney’s Office in Washington, which eventually became a full-time position.

That job eventually led him to work as a paralegal in the U.S. Attorney’s Office for the Southern District of New York while attending Brooklyn Law School at night. Blanche graduated cum laude in 2003.

Blanche left the public sector in 2014, taking a job in the Manhattan office of the law firm WilmerHale. In September 2017, he moved to Cadwalader, Wickersham & Taft LLP, where he was a partner in the White Collar Defense and Investigations practice.

There, Blanche represented several figures associated with President Donald Trump, including former New York City Mayor Rudy Giuliani and Trump’s former campaign manager Paul Manafort.

In 2024, Blanche switched from Democrat to Republican and moved from New York City to Palm Beach, Fla., where he would be closer to Trump’s primary legal residence at Mar-a-Lago.

He then served as Trump’s personal defense attorney in the New York state case that led to Trump’s 2024 conviction on 34 felony counts of falsifying business records to cover up hush-money payments to adult film star Stormy Daniels.

While serving as acting head of the Department of Justice before his official confirmation, Blanche played a central role in overseeing the department and was involved in leadership decisions tied to several controversial actions affecting LGBTQ people.

One of the first issues was transgender rights and gender-affirming care, particularly for minors — an issue the White House and Republican Party have made a key part of their broader cultural agenda and federal policy efforts.

In a letter to New York Attorney General Letitia James, Blanche declared that the Justice Department “will not sit idly by while you attempt to use your office to force harmful procedures on our most vulnerable population.”

The letter came before NYU Langone ended its gender-affirming care at the behest of the president, forcing the hospital system to stop prescribing puberty blockers and hormones to minors.

The hospital’s change in policy came after the Trump-Vance administration threatened to pull all federal funding if it continued providing the care.

Blanche wrote that “the Justice Department believes the law is clear, and anti-discrimination laws cannot be used to force NYU Langone to perform sex-rejecting procedures on children.”

“As just one example, your office’s position would require a hospital to prescribe certain medications for certain diagnoses, regardless of the hospital’s or its doctors’ independent medical determination about the propriety of such treatment,” he continued in the letter.

In addition to his anti-transgender positions, Blanche also echoed his predecessor, Pam Bondi, in taking a public stance on limiting LGBTQ-related protections at the federal level.

He aligned with Bondi’s sentiments in June 2025 regarding the U.S. Supreme Court’s 6–3 decision that restricted LGBTQ history lessons in schools and limited lower federal courts from issuing nationwide injunctions — rulings that have often blocked Trump administration policies.

Blanche called it “another great decision that came down today,” arguing the ruling “restores parents’ rights to decide their child’s education.”

“It took the Supreme Court to set the record straight, and we thank them for that,” he said. “Now that ruling allows parents to opt out of dangerous trans ideology and make the decisions for their children that they believe is correct.”

In December 2025, a Justice Department memo stated that, “effective immediately,” prisons and jails would no longer be held responsible for violations of standards meant to protect LGBTQ people from harassment, abuse and rape under the Prison Rape Elimination Act.

The law, passed unanimously by Congress in 2003, requires that incarcerated people be screened for their risk of sexual assault, including consideration of LGBTQ status, and applies to all correctional facilities.

Additionally, when the Justice Department, under Blanche’s deputy leadership and at Trump’s behest, attempted to force Children’s National Hospital in D.C. to turn over medical records related to gender-affirming care, U.S. District Judge Julie R. Rubin ruled that the effort “appears to have no purpose other than to intimidate and harass.”

Blanche also faced scrutiny over a slew of other issues surrounding his leadership during his tenure as acting AG.

The Justice Connection, a watchdog organization that works to protect current and former civil servants working in the U.S. Department of Justice, called his work so far “devastating.”

The organization said Blanche “harmed the department’s workforce, advanced the politicization of the department, undermined the rule of law, and threatened public safety.”

The group cited several issues, including what it described as Blanche minimizing the violent reality of the January 6 insurrection led by Trump supporters; investigating and attempting to prosecute President Trump’s perceived political enemies; the botched release of the Epstein Files to Congress and the public, including the release of victim and witness details and censorship surrounding the scope of Trump’s relationship with the convicted sex trafficker and pedophile; and the expansion of federal immigration enforcement in Minnesota which lead to the death of two U.S. citizens by federal officials.

Sharon McGowan, senior vice president of Policy & Litigation at the Human Rights Campaign, the largest LGBTQ advocacy group in the country, provided a statement to the Blade about Blanche’s confirmation calling it “chilling.”

“The last thing Todd Blanche deserves is a promotion,” McGowan said via email. “For months, Blanche has used his position as Acting Attorney General to advance President Trump’s personal and financial interests and to weaponize the Justice Department against the President’s enemies, whether they be transgender kids or civil rights organizations trying to help people vote. His notion of justice is warped and dangerous, and LGBTQ+ Americans deserve better.”

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Federal Government

Trump holds housing bill hostage to anti-trans SAVE Act

President’s SAVE Act failed in the Senate

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People protesting the restrictive and anti-trans SAVE Act in March. (Washington Blade photo by Michael Key)

President Donald Trump is refusing to sign a new bipartisan housing bill unless his SAVE Act is approved by the legislative branch.

The bill being prevented from being enacted into law is the “21st Century ROAD to Housing Act.” The legislation is an attempt by Congress to make buying a home in the U.S. Senate more affordable in response to various factors — including housing shortages and regulatory constraints — that have made homeownership increasingly difficult. The total number of homeowners has nearly stopped growing, with high interest rates and surging home prices pushing more Americans toward renting.

The housing bill was considered highly bipartisan, something that is rare in this Congress. The House voted to pass the bill 358-32 on Tuesday after the Senate approved the measure 85-5 a day earlier. The legislation was led by U.S. Sens. Elizabeth Warren (D-Mass.) and Tim Scott (R-S.C.) in the Senate and U.S. Reps. Maxine Waters (D-Calif.) and French Hill (R-Ark.) in the U.S. House of Representatives.

Some of the highlights of the legislation are aimed at increasing the supply of affordable housing while making homeownership more accessible. The bill would streamline environmental reviews and direct the U.S. Department of Housing and Urban Development to provide guidance to communities on reforming zoning and land-use policies that can create barriers to housing development.

The legislation would also expand the definition of “manufactured housing,” making it cheaper and easier to mass-produce homes built in factories before being transported to their sites. To encourage additional development, the bill would provide grants and loans for the construction of new housing, the rehabilitation of aging properties, and the conversion of vacant buildings into residential units. It would also increase certain banks’ Public Welfare Investment cap, allowing them to direct more capital toward low-income and affordable housing projects.

In an effort to help more Americans purchase homes, the legislation would create a program to expand access to small-dollar mortgages, which are often used to finance lower-cost homes, while also seeking to improve housing opportunities for veterans. The bill would further promote homeownership by limiting the number of single-family homes that large institutional investors can own and requiring them to disclose how many such properties they control, a measure intended to prioritize American families over corporate buyers.

The bill the president wants enacted — the SAVE Act — is a restrictive and anti-transgender piece of proposed legislation.

The bill would impose a number of new limitations on voter registration across the country by amending the National Voter Registration Act of 1993 to require in-person proof of citizenship for anyone seeking to vote in U.S. elections. The bill would also limit acceptable forms of identification to documents such as a birth certificate or passport — records that the Brennan Center for Justice estimates more than 21 million Americans do not possess — effectively restricting access to the ballot. It would also ban online voter registration, DMV voter registration efforts, and mail-in voter registration.

Trump pushed for the SAVE Act to include a provision that would ban gender-affirming medical care for trans minors, even with parental consent, and prohibit trans people from participating in school or professional sports consistent with their gender identity rather than their sex assigned at birth.

Trump also pressed Senate Majority Leader John Thune (R-S.D.) to eliminate the filibuster so the Republican-controlled Congress could pass the SAVE Act, saying Republicans will never win another election without it.

It is expected that Congress will override the president’s veto and pass the 21st Century ROAD to Housing Act, as it requires a two-thirds supermajority vote in both the House of Representatives and the Senate — a threshold the legislation currently exceeds.

It is not expected that the SAVE Act will pass the Senate in its current form. It passed the House, but every Democrat and four Republicans voted against it in the Senate.

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Advocates push back on proposed FCC warning labels

New rating system public notice seeking comments issued on April 22

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(Photo by REDPIXEL.PL/Bigstock)

The Federal Communications Commission is considering a new rating system that would require a warning label to appear before any television content that includes LGBTQ characters.

On April 22, the FCC issued a public notice asking Americans to submit comments on whether the TV Oversight Management Board should create new TV ratings to alert viewers to “transgender and gender nonbinary programming” and “the discussion or promotion of gender identity themes.”

This proposed warning would appear before content, similar to warnings that explain a program contains sexual content, drug use, or violence — categories that Congress explicitly included in the Telecommunications Act of 1996 on the grounds of obscenity and violence that some parents “believe is harmful to their children.”

The public notice says that “recently, parents have raised concerns that controversial gender identity issues are being included or promoted in children’s programs without providing any disclosure or transparency to parents.”

It goes on to say that not having a warning for trans and nonbinary people is “undermining the ability of parents to make informed choices for their families.”

LGBT Tech is an organization that works to provide LGBTQ representation in mainstream media or entertainment. The group notes 81 percent of trans respondents it surveyed said these representations had a positive impact on them discovering or learning about their identity.

“These numbers reflect a basic truth: for many people, and especially young people, seeing LGBTQ+ lives represented in ordinary media is not harmful. It is formative, affirming, and often lifesaving.”

Since the public notice’s publication, more than 40 organizations have come out against the proposed alert.

GLAAD President Sarah Kate Ellis issued a statement in May on the proposal, highlighting what she described as a concerted effort by the Trump-Vance administration to other trans and nonbinary people.

“The FCC does not set TV ratings, but under this administration the FCC has repeatedly tried to control what Americans can see on their own televisions. This government overreach is dangerous and a threat to our community and our democracy,” Ellis said.

“LGBTQ+ people and their families deserve to see their lives represented in the media they watch. And media companies must have the freedom to create programming that appeals to their viewers and subscribers without interference from a government pursuing its own anti-LGBTQ+ political agenda.”

Human Rights Campaign President Kelley Robinson pointed out that this is an act of politically motivated policy, not one based on any rhyme or reason.

“LGBTQ+ stories matter and deserve to be told, seen, and heard,” Robinson said. “The Trump administration does not get to use the FCC to try and erase us simply because they want to pretend to live in a world where we don’t exist. This is a brazen form of political interference that will hurt the ability of all people to appreciate, understand, and learn about the world and people around them.”

Brian Dittmeier, director of LGBTQI+ equality at the National Women’s Law Center Action Fund, echoed Robinson’s concerns that this is attempted censorship for the sake of political gain.

“The FCC is cloaking itself in purported concern for parents in an attempt to censor content, intimidate industry, and silence depictions of our trans siblings and neighbors,” Dittmeier wrote. “The FCC is overstepping its authority to undermine the existing ratings system, which is well understood by parents and enjoys broad public support. The FCC’s presumption that it knows better does not reflect parents’ priorities and reeks of government overreach.”

PFLAG National Vice President of Policy and Government Affairs Diego Sanchez said this is federal government overreach into censorship — something the First Amendment protects against.

“The FCC has given us yet another example of what ‘small government’ means: small enough to fit in your living room; to interrupt family movie night; small enough to make home feel unsafe,” Sanchez said. “Parents and families with transgender loved ones in particular know too well how big government actions impact their families directly, because they feel those impacts before everyone else.”

This proposed warning follows a slew of other federal actions targeting trans people in America, including Executive Order 14168, “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” which mandated that only sex assigned at birth be used on federal government documents regardless of gender identity, as well as broad-based restrictions on gender-affirming care, particularly for trans minors.

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