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Rulemaking on Older Americans Act targets seniors who are LGBTQ, living with HIV

Monday was National HIV/AIDS and Aging Awareness Day

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U.S. Department of Health and Human Services Hubert Humphrey Building. (Public domain photo courtesy GSA)

Ahead of Monday’s National HIV/AIDS and Aging Awareness Day, the Washington Blade spoke with Aaron Tax, director of federal government relations for SAGE, to discuss what proposed updates to the Older Americans Act might mean for LGBTQ elders and older adults living with HIV.

The conversation followed the conclusion of the public comment period for a Notice of Proposed Rulemaking filed by the Administration for Community Living, a U.S. Department of Health and Human Services agency that is responsible for administering the statute.

An HHS spokesperson told the Blade a final rule is expected “early next year.”

“We’ve looked at the many challenges facing LGBT older people and older people living with HIV,” said Tax, whose organization, Services and Advocacy for GLBT Elders, is the country’s largest group focused on the needs of LGBTQ seniors.

These populations experience “higher rates of social isolation” and “higher rates of poverty” and are “less likely to be partnered, less likely to have children, [and are] more culturally and socially isolated from mainstream institutions,” he said.

Therefore, they “seem to fit the definition of greatest social need quite well,” Tax said, referring to a distinction in the legislation that SAGE has sought to effectuate for LGBTQ elders and older adults with HIV, coming “quite close” in the law’s 2020 reauthorization.

Tax explained, “what we got at the end of the day is some language that requires every state unit on aging in the country and every area agency on aging in the country — which are basically state departments of aging and local departments of aging — to do three things.

“One,” he said, “engage in outreach to LGBT older people; two, to collect data on their needs; and three, to collect data on whether they are meeting their needs.”

SAGE is now working with these state and local entities to ensure “they’re, in fact, carrying out these requirements” Tax said.

Next year, the Older Americans Act will be up for reauthorization again, so “we will once again be fighting for an explicit greatest social need designation again for LGBT older people and older people living with HIV,” he said, adding, “And we recently introduced legislation with [U.S. Rep.] Suzanne Bonamici [D-Ore.] that would try to accomplish that goal in 2024.”

The legislation, Tax explained, originally “came about in 1965 under Lyndon Johnson’s Great Society as a counterpart to Medicare and Social Security,” which respectively addressed the medical and financial needs of older Americans.

“The Older Americans Act is everything else that should enable you to age in place in your community,” Tax said — and, as such, the statute covers, among other programs, “home and congregate meals and meals at senior centers, Meals on Wheels, transportation assistance, legal assistance, caregiver support, respite, all the things that have enabled people to age in place in their community.”

SAGE’s legislative efforts are coupled with advocacy around the administration and enforcement of the statute by ACL, which prior to the forthcoming rulemaking has not issued new regulations on the Older Americans Act since 1988, Tax said.

“Part of that,” he said, “is because there have been so many legislative changes since the law came about in 1988, so, their goal now is to modernize those regs and recognize the changes to the OAA and also maybe put some additional information in there or some additional guidance in there that might not be captured in the statute.”

SAGE wants the ACL “to be as explicit as possible, as proscriptive as possible, about ensuring that the aging network is meeting the needs of both LGBT older people and older people living with HIV,” Tax said, which informed the organization’s public comment to the agency.

This work is important because there are state-by-state differences in how older LGBTQ adults and seniors with HIV are treated, Tax said.

For instance, the “New York State Office for the Aging is extremely aware of the needs of LGBT older people and older people living with HIV,” he said. “They acknowledge that in the work that they do; they’re very intentional in the work that they do to meet the needs of LGBT folks and older people living with HIV.”

Tax said, “we are working hard at SAGE to make sure that other states first acknowledge that this population, or these populations, even exist, and secondly, [that they] are doing more to make sure that LGBT older people and older people living with HIV have access to the same aging services and supports other older people have access to.”

Politics, unfortunately, can play a role, Tax told the Blade.

“When anti equality forces are in control in the White House, of course, that does have an impact on the types of rules and regulations you see coming out of the administration and its agencies” he said.

By contrast, “it’s pretty clear now with the Biden administration’s focus on equity and its interest in making sure that LGBT folks are treated like everybody else, that we’re seeing regulations or proposed regulations that incorporate those important themes.”

“There are good people in state agencies across the country who want to do the right thing,” Tax said, but “Sometimes they bump up against the political realities of their states.”

“We are working hard at SAGE to make sure people who want to do the right thing regardless of what state they live in have the resources and the information and the tools that they need to take care of all of the older people in their states,” Tax said.

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Federal Government

Senate Democrats press DOJ over anti-trans prison directives

Markey joins other lawmakers in demanding reversal of policies

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(Photo by Andrushko Galyna/Bigstock)

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.

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DOE investigates Smith College’s trans-inclusive policy

Mass. college accused of violating Title IX

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The Department of Education building in Washington, D.C.

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.

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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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