Restrictions on the use of federal funds for gender-affirming care will be stripped from the Republican-led Senate reconciliation bill, following a ruling by the Senate parliamentarian on Tuesday that struck down a number of health related provisions.

The legislation banned coverage for transgender medical care through Medicaid and the Children’s Health Insurance Program, language that was also included in the House version of the bill passed on May 22 with a vote of 215-214.

The parliamentarian’s decision also rejected Republican proposals for a Medicaid provider tax framework, which allows states to charge health care providers and use the funds to support their programs, along with broader cuts to Medicaid.

Amid calls to override Tuesday’s ruling from Republicans like U.S. Rep. Greg Steube (Fla.), GOP Senate Majority Leader John Thune (S.D.) told reporters “That would not be a good outcome for getting a bill done.”

He also acknowledged that the timing and schedule might have to be adjusted. Senate Republicans had hoped to pass the reconciliation bill by the end of this week, though this was not a legal or procedural deadline.

Dubbed the “one big, beautiful bill” by President Donald Trump, the legislation would extend tax breaks from 2017 that overwhelmingly benefit the wealthiest Americans and corporations. To cover the cost, which is estimated to exceed $4 trillion over 10 years, the bill would make drastic cuts to social welfare programs, particularly Medicaid.

Democrats are not in a position to negotiate across the aisle with Republicans holding majorities in both chambers of Congress, but for months they have been calling attention to the effort by their GOP colleagues to strip Americans of their health insurance to pay for the tax breaks.

The Congressional Budget Office estimates that 10.9 million people would lose their coverage, either through Medicaid or the Affordable Care Act marketplaces. Some Republicans like U.S. Sen. Josh Hawley (Mo.) are pushing back against the deep cuts to Medicaid, arguing they would be devastating for many of their constituents and also to hospitals, nursing homes, and community health care providers in rural areas.

U.S. Rep. Mark Takano (D-Calif.), who is gay and chairs the Congressional Equality Caucus, shared a statement with the Washington Blade addressing the parliamentarian’s ruling:

“This ruling by the Senate Parliamentarian is a win for the transgender people who rely on Medicaid and CHIP to access the healthcare they need to live fuller, happier, and healthier lives—but the fight is not over yet,” the congressman said.

 “Republican Senators must abide by her ruling and remove the ban from the final version of Trump’s Big Ugly Bill,” he said. “Yet, even with this provision removed, this bill is terrible for the American people, including trans Americans. Every Equality Caucus member voted against it in the House and we’re ready to do so again if the Senate sends it back to the House.”

David Stacy, vice president for government affairs at the Human Rights Campaign, also issued a statement on Tuesday:

“The fact remains that this bill belongs in the trash. It continues to include devastating cuts to health care programs — including Medicaid — that would disproportionately harm the LGBTQ+ community, all so the already rich can receive huge tax cuts,” Stacy said.

“While it comes as a relief that the Senate parliamentarian concluded that one provision in the nightmarish reconciliation bill that would have denied essential, best practice health care to transgender adults does not belong, we aren’t done fighting,” Stacy said. “With attacks on our community coming from many directions, including the Supreme Court, we will work to defeat this bill with everything we’ve got.”

U.S. Sens. Lisa Murkowski (R-Alaska) and Jeanne Shaheen (D-N.H.) on Wednesday once again introduced a bill that would sanction foreign nationals who carry out human rights abuses against LGBTQ and intersex people.

The two senators have previously introduced the Global Respect Act. Co-sponsors include U.S. Sens. Chris Van Hollen (D-Md.), Chris Murphy (D-Conn.), Jeff Merkley (D-Ore.), Cory Booker (D-N.J.), Peter Welch (D-Vt.), Brian Schatz (D-Hawaii), Edward Markey (D-Mass.), Tammy Baldwin (D-Wis.), and Ron Wyden (D-Ore.)

“Around the world, individuals who are part of the LGBTQ+ community are in danger for simply existing,” said Murkowski in a press release. “Hate and violence cannot and should not be tolerated. I’m hopeful that this legislation will establish actionable consequences for these inexcusable human rights violations, and create a safer world for all people — regardless of who they are or who they love.” 

Shaheen in the press release notes “the risk of personal harm for LGBTQI individuals for publicly identifying who they are or expressing who they love has tragically increased in recent years.”

“Human rights, as defined by the Universal Declaration of Human rights, recognizes that global freedom, justice, and peace depend on ‘the inherent dignity’ and ‘the equal and inalienable rights of all members of the human family,” said the New Hampshire Democrat. “LBGTQI human rights are universal human rights. We must ensure that we hold all violators of those rights accountable.” 

The promotion of LGBTQ and intersex rights abroad was a cornerstone of the Biden-Harris administration’s foreign policy.

The current White House has suspended most foreign aid. The elimination of these funds has left the global LGBTQ and intersex rights movement reeling.

It was 10 years ago this week — on June 26 — when gay marriage became the law of the land with the landmark Supreme Court decision Obergefell v. Hodges. Both Jim Obergefell and Freedom to Marry founder Evan Wolfson contributed to the foreword of a new coffee table book, “LOVE: The Heroic Stories of Marriage Equality,” curated by photographer Frankie Frankeny and writer John Casey.

With the current political climate, many fear that marriage equality could be overturned. In my last interview with Evan Wolfson back in 2017, Trump had just started his first term. I asked him then, “Is gay marriage safe?”

Here’s what he said:

“Look, anything can happen. So I don’t think we should ever be complacent or give up or stop working. Even though the election was a catastrophe and our country is very much on the wrong path, I actually think there are other communities, values, and causes we care about that are more in danger. If we stand in solidarity with others and keep moving forward, we will also secure our own gains.

“I’m not really worried they’re going to take away the freedom to marry. That’s a very hard thing to do. Even former or current opponents are mostly focused on other things.

“We won the freedom to marry not just in court, but by shifting public opinion—growing support from 27% when I argued the first trial in Hawaii to 63% in 2015 when the Supreme Court ruled. That didn’t go away on Election Day. More than a million gay people have gotten legally married in the U.S.—and each of those marriages represents family, friends, and allies who support them. That didn’t go away either.

“We won over a hundred court rulings before the final one, and that legal foundation didn’t disappear. We built ‘facts on the ground,’ shifted opinion, mobilized allies. We have to keep doing that work.

“And Gallup just reported record-high support for marriage equality—up to 47% even among Republicans. So yes, we need vigilance, but I don’t think losing marriage equality is the biggest threat we face.”

I recently asked Wolfson if he still stands by that statement.

“So far, I stand by everything I said,” Wolfson responded. In our new conversation, Wolfson elaborated:

“There are other communities and values in more immediate danger. If we stand in solidarity and keep moving forward, we’ll secure our own rights too.

“I’m not worried they’re going to take away the freedom to marry. That’s extremely difficult to undo. Even our opponents have moved on to other battles.

“Let’s remember how we got here: by winning over public opinion through years—decades—of organizing, storytelling, and showing up. When we stood before the court in 2015, public support had climbed from 27% to 63%. That was no accident. And it hasn’t gone backward.

“Of course people are worried now. There’s a lot to worry about. But sitting around cataloging 100 possible future disasters won’t help. If you’re worried—about marriage, about immigrants, about anti-Semitism, the economy, women’s rights, trans rights, democracy—then the answer is to get to work. Worry doesn’t protect us. Action does.”

He added:

“It’s hard to undo a right. It can happen—look at Dobbs overturning Roe v. Wade—but it’s rare. And even if the Supreme Court were to roll back Obergefell, we put a fallback in place: The Respect for Marriage Act.

“Thanks to that bipartisan legislation—signed by President Biden on the White House lawn—any marriage performed legally in one state must be recognized in all 50 states and by the federal government. Even if Obergefell fell, couples could still marry in states where it remains protected and be recognized nationally.

“That act passed with support from Republicans, including some who once voted for the so-called Defense of Marriage Act.

“So yes, I understand the fear. But fear alone won’t protect us. We all need to do the work—each in our own way.”

Wolfson also reflected on the broader threats to democracy:

“None of us is 100% safe from the assaults and corruption of this current regime. That’s why we must reclaim political power—by electing better lawmakers, reforming the courts, and reaffirming the rule of law, democracy, and pluralism.

That’s not just an LGBT issue—it affects everyone. But queer people, especially trans people, are among those most targeted. And we’ve seen how divide-and-conquer politics and demonization are weaponized to climb to power.

“The trans conversation is at an earlier stage than that for gay people, which makes it more vulnerable. Republicans are exploiting that. And yes, some missteps in our activism have made things harder. But we can course-correct.

“Books like Frankie’s remind us of what we’ve already overcome: the AIDS crisis, Reagan-era discrimination, legal persecution. We rose to those challenges, and we can rise to this one.”

As Wolfson puts it:

“This is our generation’s call to action. We have to respond. And if we do it together—with solidarity and purpose—we will protect the people and values we love.”

“LOVE: The Heroic Stories of Marriage Equality” includes more than 360 pages of wedding photos and stories that are inspiring to read. The book is available everywhere.