Politics
EXCLUSIVE: Annise Parker, Lori Lightfoot outline path to victory for Harris
Former Houston and Chicago mayors emphasize importance of big cities
Former Houston Mayor Annise Parker and former Chicago Mayor Lori Lightfoot spoke exclusively with the Washington Blade last week in Chicago during the Democratic National Convention.
Among other topics, they discussed their impressions of the convention, Vice President Kamala Harris and Minnesota Gov. Tim Walz’s path to victory in November, the Democratic campaign’s efforts to mobilize voters in key battleground states, the candidates’ proven track records of fighting for LGBTQ rights, and the ways in which their administration would build on this work of expanding freedoms and protections for the community.
This year’s DNC was the last Parker will attend as president and CEO of the LGBTQ Victory Fund, which works to elect LGBTQ candidates to public office, and the LGBTQ Victory Institute, which coordinates placement of LGBTQ federal employees and administers training and networking events.
“It’s not my first convention, but I have to say it is the most exciting and energetic convention,” she said. “There’s an energy around Kamala — the surprise, the sense of change and possibility that I’m not used to, and it feels really great.”
Prior to President Joe Biden’s announcement on July 21 that he would step aside to clear the path for Harris’s nomination, Parker said that “respectfully, some of us were slogging through” because “we knew he was the better candidate than Donald Trump, and we were going to support him because of that reason.”
“Now we’re excited because we have somebody new and different,” she said, “a shift in personality and also a shift in energy, and that works its way through the campaign.”
Lightfoot agreed that “there is a tremendous amount of energy and excitement,” but hedged that “if that doesn’t translate to butts at the polls, it doesn’t matter.”
“So, everywhere I’m going and talking to folks, it’s like, this is great; step one, get the base reunified, because it was very fractured, I think, even a month ago,” she said. “The level of excitement, consolidating the votes for the nomination, positive press, the amount of money that’s being raised — that’s all good stuff, but it’s got to have a significant ground game, because people need to show up.”
Lightfoot noted that folks from Chicago and elsewhere in Illinois, a deep blue city in a largely blue state, are traveling to Wisconsin, Michigan, and Minnesota because “no one wins in November unless they win the Midwest, so we’re reaching out to our friends, our neighbors, and saying, ‘you got to plug in; you got to pay attention, educate yourself and get to the polls.'”
Parker echoed those remarks. “Our job is to bring in those who are not the regular Democratic rank and file,” she said, “the independents, and even disaffected Republicans, and there are a lot of those out there.”
The former mayors agreed that Trump’s narrow electoral college win in 2016 was made possible in part by the decision of many voters to stay home because they believed Hillary Clinton’s victory was not just likely — but certain.
The 2024 presidential election will be very close. Harris’s emergence as the nominee has put some states in play for the Democrats that were out of reach when Biden was leading the ticket, but even as she pulls ahead, recent polls in key battlegrounds show the candidates are in a near-dead heat.
In this race, Parker is counting on the “push-up” effect. Down-ballot candidates can expect a boost from Harris, she said, but likewise “we’re going to turn people out to vote for their school board candidates,” or in city council and statehouse races “and they’re going to vote at the top of the ticket as well.”
Lightfoot said that part of the task before the Harris-Walz campaign will be to engage a “broad cross section of Americans who, frankly, are still disengaged, disenchanted, angry, frustrated, scared” and otherwise struggling as they recover from the “traumatic shocks” of COVID.
The pandemic worsened preexisting skepticism toward the government, she said, so the candidates must “talk about why they are the solution to a lot of the concerns that the average voter has” particularly by “speaking to those incredibly important swing voters in the seven or eight states that are in play.”
First they must win
As Democrats, Lightfoot said, “we have a great propensity, sometimes,” of “trying to make the perfect be the enemy of the good” but “we need to win first, right?”
“This is one of those Bill Clinton-Al Gore moments back in the ’90s,” she said. “It’s like, I get it, I get it, but let me get there first, let me win, and then we can accomplish great things together.”
Parker and Lightfoot, both out lesbians, agreed that LGBTQ issues are not necessarily what Harris and Walz need to be talking about on the campaign trail with little more than two months until the election.
Rather, the focus must be on “the issues [that are] top of mind for the American voter,” Parker said, because the candidates “need to be talking to that great middle America out there that needs to show up to vote.”
Of course, she and Lightfoot said, it is important for LGBTQ folks, especially those who have a seat at the table, to make sure the community’s policy agenda is understood by the candidates, and likewise for the campaign to remind voters of Harris and Walz’s pro-LGBTQ backgrounds — even if, as Parker said, “that’s not how she’s going to win this election, talking about that.”
With respect to their commitments to advancing LGBTQ rights, the former mayors repeatedly stressed that the vice president and the governor have nothing to prove. “They don’t have to promise anything,” Parker said. “They’ve already done it.”
“We are working with folks who have a proven track record of understanding the importance of our community,” Lightfoot said. “They’ve hired, they’ve appointed, they get it.”
Expanding freedoms and protections for LGBTQ people has been a through line of Harris’s career in public service. For example, well before it would have been politically advantageous, she fought for same-sex marriage when serving as district attorney of San Francisco and attorney general of California, defying legal restrictions to perform some of the country’s first gay and lesbian weddings.
Additionally, the past four years have cemented the Biden-Harris administration’s legacy as the most pro-LGBTQ presidency in American history, in no small part thanks to the work of the vice president.
And for his part, practically from the moment he was chosen as Harris’s running mate, Walz has been attacked by Trump and his conservative allies over his pro-trans record as governor. Before he entered public life, Walz was a high school teacher and football coach who served as faculty adviser to the student-led gay-straight alliance club in the 1990s, an anecdote that was shared by Harris when she appeared with him for the first time on stage at a rally on Aug. 6.
The campaign has also made outreach to and engagement with LGBTQ constituents a major priority. During an Aug. 21 meeting of the LGBTQ Caucus at the DNC, Harris for President National LGBTQ+ Engagement Director Sam Alleman outlined plans for additional activity and investment in Out for Harris, the LGBTQ national organizing push.
Putting aside the looming election, when asked whether there are specific LGBTQ policies she would like to see in a Harris-Walz administration, Parker said those conversations will be possible in earnest only if Democrats are able to win not just the White House but also flip control of the House and hold onto their majority in the Senate.
Then, she said, “we’re going to want to make sure” that LGBTQ appointees are picked to serve in key positions throughout the federal government, noting that historic numbers — 15 percent — were nominated and confirmed under the Biden-Harris administration.
“I expect that to continue,” Parker said.
Congress will play a critically important role in effectuating the Harris-Walz agenda, including on LGBTQ issues, she said, but policy is implemented “in the departments and in the bowels of government” which is why representation in these spaces matters, too.
The Democratic candidates’ support for LGBTQ rights is of a piece with the positive and inclusive spirit of their bid for the White House, which stands in stark contrast with the approach seen from their opponents.
“There is a joy, truly, about Kamala Harris’s campaign,” Parker said, and while it is unclear whether and to what extent the good vibes will be sustained until Election Day, “you get the sense that she’s really, emotionally, she’s all in it.”
Lightfoot agreed. “What happened within the next 24 hours,” after Biden endorsed his vice president to run in his stead, “no one could have predicted it. No one could have scripted it. It was this organic movement and coalescing around her with really genuine enthusiasm.”
The former Chicago mayor also praised Harris’s digital team. “Their social media game is off the charts,” she said. “They are hitting home runs every single day,” maintaining the vice president’s positive message while trolling Trump and his running mate, U.S. Sen. J.D. Vance of Ohio.
Meanwhile, as he has done in previous campaigns, Trump “hurls insults and slurs,” deploying a strategy of “constant attack — disrespecting, vilifying people on the other side,” Parker said. “It’s negative, negative, negative.”
Harris “doesn’t have to do that,” she said. Moreover, “people don’t want her to do that.”
Lightfoot agreed. “It would be easy” for the vice president “to roll in the mud with with Trump, and my money’s on her, but she hasn’t done that — what she’s done is addressed the criticism to some extent, but then immediately pivoted to a more positive, forward thinking message.”
The approach is “clearly throwing off the Trump world,” Lightfoot said. “I love it. I think it’s exactly what people want to hear. They don’t want to see, you know, WWE in their presidential candidates.”
Voters “want somebody who is strong, who is ready and up for the task,” but — at least just as importantly — they want a leader sho is “always making sure that they are tuning in with those people who work hard every day,” she said.
Parker said Harris made “a great choice” picking Walz as her running mate, adding,” I’ve met him before, and he’s the real deal.”
Nodding in agreement, Lightfoot said, “I grew up in one of those small towns where football was everything” and “it’s unimaginable, unimaginable, that the football coach” would have publicly embraced the high school’s LGBTQ students as Walz did, including by chairing the GSA club.
Tapping into the power of cities and mayors
Conservatives are fond of characterizing Democrats from progressive coastal cities, especially those from San Francisco, as out of touch elitists whose values do not align with those held by the overwhelming majority of American voters.
Nancy Pelosi, the longtime Democratic leader whose congressional district includes most of the city, balked when Vance sought to smear not only Harris but also Walz, her former House colleague, as a “San Francisco-style liberal,” a label that the former speaker has co-opted for herself and worn as a badge of honor.
Not only was the governor beloved by colleagues when he represented Minnesota’s 1st Congressional District, but he was also widely seen as a moderate, she said. “I can say this with some authority: He’s not on the left,” Pelosi told NBC News. “He was right down the middle, right down the middle in his values and leverage in the debate in the Congress.” (As it happens, Walz had never set foot in San Francisco before last month.)
Parker and Lightfoot agreed the matter strikes at an issue that is deeper than misleading political rhetoric targeting the 2024 Democratic candidates.
“Americans live in the big cities across the country,” the former Houston mayor said. “We are a powerful voting bloc, but we’re also where people’s lives happen. Trump has built this mythology — there’s tires burning in the streets, barricades and riots everywhere, there’s armed camps.”
“He’s been attacking cities,” she said, and we need to reclaim them.
Together, America’s largest metropolises are “like 80 percent of the GDP,” Lightfoot added. “So, why are you attacking the economic engine of our country? Why are you attacking the places where innovation happens? Of all the good things that come in America, a huge percentage of that comes from big cities.”
Not only has Trump characterized D.C. as a crime-ridden hellscape, but he has also pledged to “take over” the district — potentially exercising the authority he would have, if elected, to put the police force under his control and arrogate powers that are exercised by the D.C. Council and the mayor.
“I think Mayor [Muriel] Bowser has done a yeoman job under difficult circumstances where she doesn’t get to make her own calls, because she’s got to worry about folks in the federal government, and particularly in Congress, second guessing everything that the good citizens of D.C. do,” said Lightfoot, who noted that Bowser is a close personal friend.
Cities “are the heartbeat of this country, and I think a leader who says, ‘I want to bring everybody together, I want to be the leader of the free world,’ — well, you got to start with being a leader of cities and recognizing our importance on every single issue domestically,” she said.
Parker and Lightfoot agreed that the Harris-Walz campaign would be well served in the election by reclaiming cities.
“All things local,” Lightfoot said. The chief executives of municipalities are some of “the best surrogates to get the message out, particularly mayors of the towns like those that we represented.”
“If the [Harris-Walz] campaign is smart, and it’s getting there, it’s going to galvanize mayors all across the country to be those surrogates,” she said. “Mayors like me who governed under Trump, governed under Biden and Harris, and [can speak to] the sea change and the difference in how cities in particular were helped and recognized and respected in a way that we didn’t see in the previous four years in the previous administration.”
Parker agreed. “Mayors can talk about their cities. Mayors are the public face and the voice of their cities.”
This does not mean one should avoid talking about the challenges facing places like D.C. or Chicago, but there must be an understanding that “cities have to be strong and healthy, or America’s not strong and healthy,” she said.
Next up for Victory
Parker announced her planned departure from Victory at the beginning of February, though she will continue leading the organizations past the election and through the end of 2024 or “until I find my successor.”
She told the Blade that “the goal” is to choose a new president and CEO in September.
“I’m sure that they’re going to find somebody amazing to step in,” Parker said, but in the meantime, “I’m going to leave it in good shape, I can tell you that.”
Over Parker’s six-year tenure, annual budgets were doubled, contributions to candidates served by the Victory Fund were increased fourfold, and the Victory Institute’s David Mixner Political Appointments Program was relaunched to advocate for LGBTQ representation in government.
Strikingly, during this time the number of LGBTQ officials served by Victory swelled from 450 to more than 1,300. “I would love to take credit for that, but some of it is truly the Trump effect,” she said. “The more we are attacked as a community, the more people want to stand up and say, ‘no, I’m not going to put up with this.'”
“The work of Victory has continued for more than 30 years,” Parker said. “The work is still there, it’s still important, representation still matters.”
“We need to elect tens of thousands more [LGBTQ] people to achieve parity,” she said, because even though the number of out elected officials has more than doubled in six years, 1,300 is only 0.25 percent of the “hundreds of thousands of open positions.”
Lightfoot added, “her leadership has been phenomenal. Phenomenal. I mean, really, the organization is stronger now than when she found it. It’s going to be stronger when she leaves it. The amount of things that we’ve been able to accomplish — the programmatic gains, the financial gains, these would not have happened without Mayor Parker.”
Politics
Log Cabin Republicans remove transgender rights from mission
Decision made after ‘significant discussion’ with members, board
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.
White House
Trump-Vance administration’s LGBTQ brain drain: what you need to know
Several high profile figures have left government since January 2025
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
- 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.
- 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.”
- 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
- 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.
- 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.
- 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
- 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.
- 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.”
- 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
- 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.
- 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.
- BOTTOM LINE: Maltinsky is currently suing the FBI and the Department of Justice, arguing that his firing constituted unlawful discrimination.
Mary Brinkmeyer
- 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.
- 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.
- 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
- 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.
- 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.
- 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.”
White House
White House targets gender-affirming care funding, states fight back
Attorneys general from Md. and elsewhere are fighting directives
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.”
