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Blade’s Q&A with American Library Association President Emily Drabinski

Conversation comes after a week of battles over book bans on Capitol Hill

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American Library Association (ALA) President Emily Drabinski (Photo credit: ALA)

American Library Association President Emily Drabinski was in Washington for the PFLAG National “Learning with Love” Convention, whose timing and theme are particularly apposite this year given the escalating fight this week on Capitol Hill over book bans.

She connected with the Washington Blade Saturday morning to discuss matters including how best to combat efforts to pull books from library shelves and ways to help restore public faith in the these institutions along with the qualified professionals serving in them.

Drabinski on Wednesday was named to the Out 100 2023 list, which celebrates the year’s “most impactful and influential LGBTQ+ people” and has included some of the most famous and celebrated public figures.

The honor comes about 16 months after Drabinski was named ALA president and then immediately earned right-wing backlash for a celebratory tweet in which she reflected on the significance of her election as a lesbian with progressive views.

Among the first to speak out against her over the tweet was a co-founder of Moms for Liberty, the anti-LGBTQ group that promotes book bans, opposes public support and funding for libraries and other institutions, and is considered a far-right extremist group by the Southern Poverty Law Center. It was not long before elected Republican officials followed suit.

These critics often argue for their right to hold and express political opinions as they wish while claiming that others are unsuited for high profile roles because they hold or have shared views they find objectionable, those that are left-of-center, said Drabinski, who acknowledged homophobia also played a role in the outrage directed at her.

At the same time, Drabinski stressed that her focus remains on the responsibilities of leading the ALA, many of whose 49,000+ members have also been personally targeted by school boards, elected officials, and advocacy groups like Moms for Liberty.

The ALA is not alone in raising the alarm over the alignment of these parties and interests in favor of censoring certain ideas and voices, a movement which according to PEN America has led to an unprecedented number and range of titles being pulled from library shelves across the country.

“These efforts are a threat to student’s rights and freedoms,” according to a spokesperson for the U.S. Department of Education, whose Office of Civil Rights last month appointed Deputy Assistant Secretary Matt Nosanchuk whose duties include responding to book bans, taking “enforcement action when necessary.”

This interview has been edited for length and clarity.

American Library Association President Emily Drabinski
October 21, 2023 Interview with the Washington Blade’s White House correspondent, Christopher Kane.

Washington Blade: Reading about the backlash you encountered, I was reminded of Gigi Sohn’s confirmation process in the Senate and how ugly that got. I’m curious to hear how your experience with this may have impacted the way that you look at whether and how to share your political views publicly. And more broadly, as the issues that are top of mind and front and center for ALA are becoming really politically fraught, how you look at the intersection of politics with your work?

Emily Drabinski: It’s a question I think about constantly. You know, I think everybody has a political viewpoint, all of us do, and my political views inform how I think about the world and how I explain the world to myself, but the American Library Association isn’t about me. The status of American libraries is not about me. Attacks on the right to read and and libraries in general, they might have my name on them, but they’re clearly not about me.

What’s been frustrating is to see the whole entire Association — which is about what libraries are about, which is building community; it’s about collective action and collectives of people coming together. [So], to see the focus on me as an individual has been really distressing.

It’s also not lost on me which ideas you can have, which identities you can have, or which you can write — like what political viewpoint will get you this kind of blowback. And it’s not everybody, right? It’s only some of us. You know, they’re all about freedom of thought and they’re all against cancellation of individuals for their viewpoints, and yet they don’t extend that to people from across the political spectrum.

Blade: You mentioned the issue of which identities are allowed. The homophobia seems not to be lingering beneath the surface; this is really tinged with homophobia.

Drabinski: Absolutely. When the Montana Library Commission voted to not renew their membership with the American Library Association, that was about my queer identity as much as it was about anything else.

Regardless of what they said, when you listen back to the hearing, there were that someone on the call quoting Leviticus — which felt like, you know, so, so regressive, and a kind of conversation about queer identity that I had, that I remember us having in the 90s. And I thought we were in a different kind of world, but it’s like the book bans — there are obvious attacks on black people, people of color, indigenous people, and LGBTQ+ people. And so it’s no surprise that they’ve come from for me also, I suppose.

Blade: Did you meet with lawmakers when you were in Washington, and can you tell me about what your advocacy work has looked like recently?

Drabinski: I did not meet with lawmakers. I was here to be at PFLAG. ALA continues to work with lawmakers, and I think it’s important to say across the political spectrum, you know, we there’s broad bipartisan support for libraries. That’s always been true. And so we work with people from all sides of the aisle around the right to read. So, you know, I don’t want it to seem like the politicization of libraries is coming from the Republican Party in general. I think we all know it’s from a minority of people that don’t represent the broad political spectrum in this country.

Blade: And those voices have become, I think, amplified on social media. You’ve certainly had experiences with Moms for Liberty. I’m curious to hear your thoughts about the group and its influence and maybe some of the ways that that that might be countered, you know, from the left.

Drabinski: I don’t follow the group very closely, you know, just because I think that their work — they want to sort of sow chaos, I think, inside of public institutions, including schools and libraries. They’re very well funded; their funding is difficult to track. They clearly aren’t local, right? You have in many libraries Moms for Liberty groups trying to ban books when they’re not even members of the community.

But I think what we can learn from them is what it means to be loud, right? They have a tiny number of people who are very, very loud and draw a lot of attention and in some cases can drown out the other side at various school and library board meetings. But what I’m seeing on the ground when I travel around the country is that once people understand what is happening in their libraries, they are quick to mobilize against it.

Even in southern Louisiana, right, near the gulf where you had St. Tammany Parish, the story of the attacks on the libraries there which have been definitely driven by these organized groups. [The state’s Attorney General] Jeff Landry [created] a tip line where you can report on your librarians and teachers for distributing, you know, inappropriate materials or whatever. He campaigns on this issue in St. Tammany, but even in St. Tammany, the community is organized to fight back and you see books now making their way back to the shelf.

So, I think that there’s something for us to learn — that we need to be as loud as they are. We know we’ve got numbers on our side. As long as we can get everybody out to the meeting when the decisions are being made, as long as we can get people who are pro-library, pro-reading and pro-freedom, frankly, in positions of authority in local government and on library boards, I think we’re gonna win because poll after poll shows that that nobody’s against children reading. You just can’t be.

Blade: I’m reminded now of your comments during last night’s panel discussion at the PFLAG conference about the importance of these library board elections. Do you think that there’s more work to be done to build out an infrastructure of grassroots organizing around these issues in the same way that Moms for Liberty has done?

Drabinski: Yeah, I think so. I think that’s the way to win, right, is to have densely organized people on the ground who have a vision of a world that’s about equality and equal access to public resources. We have the desire to have people live on our side. Most people want those things. But the one thing I would push back against is the idea that we don’t have organized entities doing that kind of work already. I think we’ve paid less attention to those movements than we should.

So, for example, in St Tammany Queer North Shore is a social group that has been organized around all the things that LGBTQ+ people do, hanging out with each other, going to potlucks, go to parties, or making a float for the Mardi Gras parade — but then they also see what’s happening in their local library and they organize quickly and got a lot of the community out to support the library.

There’s a recent story in Convergence Magazine that talks about a library in Danvers, Massachusetts where they had people organized to protest a drag queen makeup hour, where they were gonna teach you how to put on makeup, which is such a great program, right? And 350 people showed up from the organized labor community, the faith community, the other related movements like the environmental movement, in that area. They showed up en masse to protect the library and formed a human chain, a human wall around a library to keep the 11 protesters away.

So I think sometimes the stories we tell overemphasize the power that groups like Moms for Liberty have, when we have lots of examples that I think get a little less airtime, where you see organized people who care about libraries showing up and and winning.

Blade: There’s also this persistent problem of declining faith in expertise and institutional knowledge. How do you think the media could do a better job of relaying information about these topics?

Drabinski: Every time I see a profile of — you know that profile in the Post of like the 11 people who are behind the vast majority of book ban attempts? I want every one of those profiles to be matched by a profile of a school or public or academic librarian who is doing critical, community based, community focused work to make life better for people.

We’re very activated around the book banners, but we don’t pay enough attention to the parts and places where we’re winning. And so I think a better understanding of what librarians do every day, and what library workers contribute to their community…I see all of this attention being paid to us around the books and stuff. And I want to use this moment to tell the stories of American libraries that are bigger and better and greater than that.

When I go around to libraries and talk to library workers, and they show what they’re doing — everything from a library in Ames, Iowa, [where] you can borrow a pair of reading glasses in the library in case you forgot yours. Like, a little example of the library solving a problem for people and every every library will have like in that same library. And in that library in Ames, there were like 15 other things that were evidence that librarians were solving problems for the community. So I think it’s really important to tell those kinds of stories and they’re a little less sexy, I think, than the meanness, but I think they’re also really important.

That expertise piece, you know, I heard this like stat many years ago about Flickr, the old photo site, the most popular tag on on Flickr was “me,” the word “me,” because people wanted to be able to click on the word and find pictures of themselves. People, right? We curate worlds for ourselves, which is [not shameful]; we all do it.

But what library workers do is they think about everybody at once. They think about the public and think about meeting the needs of the public. So even the “parent’s rights” thing, like I’m a parent. I have rights. I have a child that I want to protect and the idea that by giving my child access to a diverse range of reading materials, which is absolutely a priority in my household, that that would somehow be an attack on someone else’s children. It’s like my librarians know and understand and appreciate publics in a way that nobody else does.

If we could talk more about that public and the service that libraries provide, it would be good for all of us to be thinking about other people rather than so much about our individual solitary worldviews.

I find that when I tell stories about what’s happening in public libraries to people, they’re blown away. Like, there’s a library where you can check out a cotton candy machine in Donnelly Idaho — rural Donnelly, Idaho, a town of like, I don’t know, 4000 people, the vast majority of whom are living below the poverty line.

The library is a public entity that makes it possible for everybody to have a birthday party. And, once a month, they get queer kids together for like after=hours hangout time and they’ve got three or four kids who show up and it’s the only place in the community where they can use the names that they have for themselves and the pronouns that they use for themselves without fear of reprisal. And that’s the work of the library, making that possible.

I think if we could tell more of those stories, of what libraries really do — which is absolutely not distribute pornography — that is not what any library is doing, I absolutely promise you that. It’s not happening.

Blade: For me, the question of who ought to decide things like which materials should be made available to young people and of which ages is settled just with the knowledge that librarians are required to have master’s degrees. But there are many people who refuse to defer to the expertise of medical doctors. Is the kind of storytelling you were describing a way to get around this problem?

Drabinski: Yeah, but you erode trust in public institutions, and you defund them over 40 years of organized disinvestment in the public sector, and then you find that they are weakened. And then you say, this institution is weak and failing, and then you attack it. And we’ve seen this again and again, libraries aren’t the first and we won’t be the last. I think we have a lot to learn from public education, because they came for the teachers at schools first, and now they’ve come for us.

Blade: Absolutely, and in the arts more broadly. I’m thinking of Jesse Helms’s crusade against the National Endowment for the Arts in the 80s.

Drabinski: Totally. we’ve been here before, you know, but I think for a lot of us — I was talking to a couple of other PFLAG-ers this morning, and we can’t believe we’re here again.

Blade: The word “unprecedented” is cropping up a lot lately…

Drabinski: Who doesn’t love a library? Everybody loves the library, right? This attack on a much beloved public institution and the people who steward that institution, that feels unprecedented to me. I had no idea that the world would turn against us in this way; it’s been challenging.

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Politics

Log Cabin Republicans remove transgender rights from mission

Decision made after ‘significant discussion’ with members, board

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From left, former U.S. Ambassador to Germany Richard Grenell and then-Log Cabin Republicans President Charles Moran attend the Log Cabin Republicans Big Tent Event at the 2024 Republican National Convention in Milwaukee. (Washington Blade photo by Michael Key)

Log Cabin Republicans, an organization that formerly represented LGBTQ conservatives, has removed advocating for transgender and queer rights from its “renewed” national advocacy focus.

In an opinion piece written by Log Cabin Republicans President Ross Hemminger for the conservative media outlet Town Hall, he announced that trans rights would no longer be part of what the organization advocates for through conservative leadership and candidates.

In his piece, Hemminger wrote that after “significant discussion” with members and Log Cabin Republicans’ board of directors, the organization’s leadership voted to “refine Log Cabin Republicans’ national advocacy focus to concentrate specifically on issues of sexual orientation and conservative values,” a focus that does not include trans people.

“We have fought for the right to legally marry who we love, serve our country and our communities openly and proudly, and to enjoy the same inalienable rights afforded to all law-abiding Americans — and we succeeded,” Hemminger wrote. “However, the new era of gender identity politics is not the movement we supported and fought for. Gay men and women are losing public support across the country, and support for gay marriage and other once-widely accepted rights is eroding. Why? Because many voters today weren’t alive or cognizant of the politics of gay marriage winding its way through the courts and gaining ground in public opinion. Their view of the gay community is based on today’s radical transgender activists with their unnecessary and discomfiting focus on America’s youth.”

Hemminger then went on to argue that trans advocacy has shifted to focusing primarily on minors — a characterization that does not reflect the breadth of issues trans advocates address.

“They push schools to teach radical gender ideology; they want biological men in women’s sports regardless of the consequences; perhaps most offensively, they support gender reassignment treatments for minors, often without the knowledge or consent of the parents, knowing full well these treatments are mostly irreversible,” he wrote.

Hemminger and many right-wing political leaders have continued to assert this false reality as fact.

A Harvard-affiliated study found approximately 2.1 gender-affirming surgeries occur per 100,000 trans and gender-diverse minors diagnosed with gender dysphoria, underscoring how uncommon these procedures are among minors. In addition to the option of surgery for those who think it’s right for them, there is an array of other medically sound options to treat gender dysphoria, which according to KFF, an independent source for health policy research and polling, includes “medical, surgical, mental health, and non-medical services for transgender and nonbinary people.”

Additionally trans advocacy is not as narrow as Hemminger makes it seem in his opinion piece.

There are a slew of issues the trans community faces — and fights for — on a daily basis that have nothing to do with healthcare. Those include obtaining government documents that accurately reflect one’s gender identity, multiple elements of family law that include the right to marry and adopt children as straight couples can, protections from violence, hate crime protections, the right to serve in the military, access to bathrooms corresponding with their gender, and the right to education.

Despite the overwhelming number of issues trans people — regardless of political affiliation — have to struggle with as a result of systemic gaps in protections that are supposed to be afforded to everyone under the law, they remain vulnerable to unequal treatment.

Despite this shift, Log Cabin Republicans has committed to standing with the Republican Party rather than LGBTQ people as a whole. The organization was initially founded as a loosely connected network of local California social clubs made up of LGBTQ conservatives in the late 1970s before eventually emerging as a national political organization in the early 1990s under its founding executive director, Rich Tafel.

As the organization continued to gain momentum, it endorsed a handful of Republicans who voted against the Respect for Marriage Act, the 2022 law that federally recognized marriage equality for same-sex couples.

The Washington Blade reached out to Log Cabin Republicans for comment but did not hear back by the time of publication.

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Trump-Vance administration’s LGBTQ brain drain: what you need to know

Several high profile figures have left government since January 2025

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Demetre Daskalakis resigned from the Centers for Disease Control and Prevention months after the Trump-Vance administration took office in January 2025. (Screen capture via Zoom)

Uncloseted Media published this article on Aug. 21.

By SPENCER MACNAUGHTON and HOPE PISONI | Since President Donald Trump regained office in January 2025, he and his administration have waged an all-out war against the LGBTQ community.

This has led queer Americans to move to other countries at unprecedented rates — Rainbow Railroad, a Canadian nonprofit that supports LGBTQ asylum seekers, reported receiving a huge increase in inquiries from the U.S. last year.

The same pattern is playing out within the government. And it’s leading to a brain drain of competent queer employees and allies who are either resigning or being fired, often because of their LGBTQ identity or their belief that queer people deserve basic human rights.

Here are six examples of federal workers who had a messy exit from Trump 2.0:

Demetre Daskalakis

  1. WHAT HE DID: Dr. Daskalakis is one of the foremost LGBTQ health professionals in the U.S. Under Trump’s first term, he was appointed director of the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention. Under Biden, he also served as the deputy response coordinator for mpox at the White House.
  2. WHAT HAPPENED: While he continued a lot of this work under Trump 2.0, he didn’t last long. In August 2025, he resigned from the CDC, writing in his resignation letter that he was “unable to serve in an environment that treats CDC as a tool to generate policies and materials that do not reflect scientific reality and are designed to hurt rather than to improve the public’s health.”
  3. BOTTOM LINE: I recently interviewed Daskalakis, where he told me that leadership from RFK Jr.’s Health and Human Services Department justified HIV cuts by saying the virus is “just too woke.”

Julia Curlee

  1. WHAT SHE DID: Julia Curlee worked in intelligence for nearly two decades between the CIA and the National Security Council. Earlier this week, she wrote an article in The Atlantic explaining how she had served as Mike Pence’s daily briefer and the NSC’s director for intelligence programs. During Trump 1.0, she briefed the president on Air Force One.
  2. WHAT HAPPENED: Curlee told CNN this week that in Trump’s second term, her treatment by the federal government transformed. She was no longer allowed to use the women’s bathroom on federal property and had to leave her workplace to relieve herself. Her passport was also reissued to read “male,” which led to complications when traveling abroad. In March 2025, less than 70 days into Trump’s second term, Curlee says she received a call while at a rib joint in Virginia with her family informing her that her White House tour was over and that they couldn’t tell her why. She continued to work for the CIA for some months, but she later resigned.
  3. BOTTOM LINE: Curlee wrote that moments after she learned she was fired from the White House, she saw a post from right-wing political activist Laura Loomer that read “A transgender, Biden holdover who hates President Trump is still working in the NSC intel office. I’m told there are several NSC staffers who have complained that this trans Biden holdover hasn’t been fired yet, but nothing is being done about it.”

Marc Seawright

  1. WHAT HE DID: Marc Seawright worked for more than eight years at the U.S. Equal Employment Opportunity Commission. Most recently, he served as the EEOC’s director of information governance and strategy, where he oversaw tech policy to help combat workplace harassment and discrimination.
  2. WHAT HAPPENED: During Trump 2.0, Seawright was ordered to develop technology that would erase any mention of LGBTQ identities from EEOC outreach materials. “[My expertise] was being leveraged to perpetuate discrimination against people like me,” he told the Associated Press. In that article, Seawright and other transgender and gender nonconforming federal employees described their “fear, grief, frustration, and distress working for the federal government at a time when it rejects them — often with no clear path for recourse or support.”
  3. BOTTOM LINE: Seawright quit in June, citing a hostile work environment. “It became overwhelming. It felt insurmountable,” he told the AP. He has now hired lawyers at Katz Banks Kumin and has filed a discrimination complaint.

David Maltinsky

  1. WHAT HE DID: Until 2025, Maltinsky worked for more than 16 years at the FBI as an intelligence specialist. In 2025, he was training to become a special agent, but three weeks ahead of graduation, he was fired.
  2. WHAT HAPPENED: On Oct. 1, he was delivered a letter from FBI Director Kash Patel informing him that he was being fired for an “inappropriate display of political signage.” The signage in question, according to Maltinsky, was a Pride flag displayed in his work station at a previous post in Los Angeles. The flag had been given to him by the FBI’s LA Field Office, and Maltinsky says he had been told by multiple supervisors that displaying it would not be a violation.
  3. BOTTOM LINE: Maltinsky is currently suing the FBI and the Department of Justice, arguing that his firing constituted unlawful discrimination.

Mary Brinkmeyer

  1. WHAT SHE DID: Brinkmeyer had been working as a psychologist for the Department of Veterans Affairs since 2008. She held multiple leadership roles, including the LGBTQ veteran care coordinator at the Hampton VA Medical Center. She established the first military support group for trans servicemembers and was awarded Navy Psychology Civilian Psychologist of the Year in 2016.
  2. WHAT HAPPENED: Following an early Trump executive order directing the federal government to purge any practices promoting “gender ideology,” Brinkmeyer says staff at her workplace were told to remove all LGBTQ-affirming materials from both public and private areas, as well as to identify “anything in medical records, training materials, or patient resources that could be considered ‘gender ideology.’” When she refused to comply and confronted her supervisor, she says her concerns were dismissed.
  3. BOTTOM LINE: Brinkmeyer resigned in February 2025, stating that she “didn’t want to be complicit in something that I knew was wrong.”

Amy Paris

  1. WHAT SHE DID: Paris was the second-highest ranking trans woman in the federal government, serving as a deputy digital services lead in the HHS Department, where she oversaw the safety of organ donations. Prior to that, she worked in a number of tech-related roles across the federal government since the Bush administration. She helped create cross-agency spending trackers, streamlined unemployment insurance during the pandemic and implemented trans-inclusive policies like gender-neutral passports.
  2. WHAT HAPPENED: Paris was fired as part of a string of mass layoffs across the federal government in February 2025. While the HHS did not publicly comment on why she was fired, Paris says she was told it was because of her performance, despite the fact that she got a 4.75 out of five on her last performance review and was praised for her work by multiple Biden administration officials.
  3. BOTTOM LINE: Paris told the 19th she suspected her firing was politically motivated, saying the Trump administration is “trying to sow discord and disrupt confidence in the workings of the federal government.”
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White House targets gender-affirming care funding, states fight back

Attorneys general from Md. and elsewhere are fighting directives

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Activists participate in the Transgender Unity Rally and March in D.C. earlier this year. (Washington Blade photo by Michael Key)

The Centers for Medicare and Medicaid Services announced last week that federal funding could no longer be used to pay for gender-affirming care through Medicaid or the Children’s Health Insurance Program.

The rule prohibits federal Medicaid dollars from covering puberty blockers, hormone therapy, and rare instances of surgery for enrollees under the age of 18 in the Medicaid program and under the age of 19 in CHIP. It does not prohibit coverage of counseling or psychotherapy as part of gender-affirming care.

The decision to restrict what healthcare is covered by federal dollars is part of a longer, more aggressive stance the Trump-Vance administration is taking toward LGBTQ healthcare.

Since taking the White House back for his second term, Trump has signed three executive orders that directly target transgender Americans. They include Executive Order 14168, “Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government” that requires the federal government to recognize only a person’s sex at birth, not their gender identity; Executive Order 14183, “Prioritizing Military Excellence and Readiness,” which attempts to remove transgender service members from the military and prevent them from enrolling; and an executive order that helped spur this change by restricting gender-affirming care.

The administration’s choice to villainize gender-affirming care, despite it being considered a best medical practice recommended by nearly every major medical group for gender dysphoria or gender incongruence, including the American Medical Association, American Academy of Pediatrics, and American Psychological Association, comes as KFF, a source for health policy research and polling data, estimates about 130,000 young trans people with Medicaid or CHIP coverage could be impacted by the policy.

“Today, we are ending federal taxpayer funding for sex-rejecting procedures on children,” U.S. Department of Health and Human Services Secretary Robert F. Kennedy, Jr., said last week when announcing the change. “These interventions carry serious risks and can cause irreversible harm. The federal government will no longer use Medicaid and CHIP dollars to fund procedures that fail to meet the evidentiary standard our children deserve.”

“Children deserve our protection, not experimental interventions that pose serious risks and convey no proven benefits,” said CMS Administrator Mehmet Oz. “By cutting off federal funds for these sex-rejecting procedures, we’re following the science, saving taxpayer dollars, and, most importantly, protecting children from potentially irreversible harm so they can truly flourish.”

The administration’s push is having a chilling effect on state healthcare legislation — more states now prohibit gender-affirming care than ever before. States with gender-affirming care restrictions jumped from four in 2023 to 27 states today.

The funding change has been met with fierce pushback from LGBTQ advocates, health experts, and government officials across the country before the rule goes into effect.

Some of the first actions against this policy began in July 2025.

Twenty-one states have attempted to restrict this effort in some fashion from going through as the White House intends. They include Arizona, California, Colorado, Connecticut, Delaware, Illinois, Maryland, Massachusetts, Maine, Michigan, Minnesota, Nevada, New Mexico, New Jersey, New York, Oregon, Rhode Island, Vermont, Washington, and Wisconsin, as well as Pennsylvania Gov. Josh Shapiro on behalf of his state.

The coalition of attorneys general filed lawsuits challenging nine separate provisions of the final rule, arguing that they would make it harder for consumers to get coverage through the ACA, increase costs for states, and weaken key ACA protections.

The U.S. District Court for the District of Massachusetts on Aug. 15 struck down a key provision of a Trump-Vance administration final rule that would have excluded coverage of certain types of gender-affirming care as essential health benefits under the Affordable Care Act. Essential health benefits are subject to the ACA’s financial protections, including limits on out-of-pocket costs.

“Everyone deserves access to health coverage,” said California Attorney General Rob Bonta. “The Trump administration tried to exclude gender-affirming care from qualifying as an essential health benefit. We fought back, and the court’s ruling means this care can — and in many states must — qualify for the ACA’s financial protections, ensuring transgender people have an equal opportunity to benefit from the ACA.”

“The Trump administration tried to make essential care unaffordable for transgender Marylanders by stripping it out of the ACA’s cost protections,” said Maryland Attorney General Anthony Brown. “We fought to keep that care covered, and we won. My Office will always defend Marylanders’ right to the care they need.”

The final rule at issue — the “Marketplace Integrity and Affordability” rule — was proposed by the Trump-Vance administration in March 2025, purportedly to “curb ACA enrollment fraud” and reduce federal spending on subsidies that help consumers afford ACA coverage. Among other changes, the rule would have removed certain types of gender-affirming care from the ACA’s 10 essential health benefit categories.

“This president would rather target young people than lower costs or expand access to health care. It is reprehensible that our federal government is intent on hurting and isolating the adolescents it is supposed to protect. I will use every tool at my disposal to fight this proposal and protect transgender Americans and their families,” said New York Attorney General Letitia James in December after the policy was announced.

In addition to state government resistance to the change, multiple LGBTQ advocates have committed to protecting the right to healthcare for LGBTQ children.

Rocky Mountain Equality CEO Mardi Moore affirmed those in Colorado would continue to help people most at risk if the change goes through.

“First, to the families impacted by this news: you will not be cut off immediately. The rule takes effect Oct. 13, 2026, and providers can continue to bill Medicaid and CHIP for youth already receiving gender-affirming care for up to six months after that. Rocky Mountain Equality is here, and we can help you understand your options to continue your child’s care.

“This is discrimination dressed up as rule-making. Government healthcare policy should expand what people can access, not strip away care that families and doctors have already determined is medically necessary,” Moore added. “We’ve seen this pattern before with other kinds of essential care, and it rarely stops with just one restriction. Any effort to ban or limit care opens the door for more restrictions on more kinds of care.”

The Human Rights Campaign, the largest LGBTQ lobbying group in the U.S., issued multiple statements following the announcement, and has filed a similar lawsuit against the federal government for prohibiting gender-affirming care to federal employees using federal health plans.

HRC President Kelley Robinson said taking a hard stance against what the administration is presenting as a win for the American people that will ultimately restrict healthcare options for thousands of Americans.

“Every young person is entitled to the health care that they, their parents, and their medical providers agree that they need, without politicians interfering with these important and highly personal decisions. And yet, rather than working to make healthcare more affordable and accessible, the Trump administration continues to obsess over the healthcare needs of trans youth, this time by cutting off health insurance coverage for those who rely on Medicaid and CHIP to access that care,” Robinson said. “The Trump administration is terrorizing trans youth and their families with these kinds of actions, and it has to stop.”

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