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Medicare to examine ban on gender reassignment surgery

Rationale for policy ‘not complete and adequate’

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transgender, caduceus, medicare, gay news, Washington Blade, health
transgender, caduceus, medicare, gay news, Washington Blade, health

HHS is set to reconsider the ban on Medicare-provided gender reassignment surgery. (Image public domain)

The Obama administration is set to re-examine the ban that prohibits Medicare from covering gender reassignment surgery, according to a memorandum obtained Tuesday by the Washington Blade.

The document from the Department of Health & Human Services, dated Dec. 2, finds that the reasoning for the ban is “not complete and adequate” to support denying Medicare coverage for transgender people seeking the procedure.

The HHS Department Appeals Board states the ban — which is codified as National Coverage Determination 140.3 — “fails to account for development in the care and treatment” for transgender people over the course of the last 30 years.

The next step, the memo states, is proceeding into a “discovery” phase for the taking of evidence to determine whether the ban can be justified.

Mara Keisling, executive director of the National Center for Transgender Equality, said “there really isn’t that much to say” at this point in the process.

“This is really a preliminary step,” Keisling said. “It’s a good sign, but we have more to go on this.”

Masen Davis, executive director of the Transgender Law Center, was optimistic the ban would be lifted following the discovery process.

“Current Medicare standards are based on science from the 1960s, so it’s about time for a review,” Davis said. “Because the current scientific evidence overwhelmingly shows that sex-reassignment surgeries are effective and medically necessary treatments for some transgender individuals, we are hopeful the board will find the exclusion is not supported.”

The DAB initiated the review of the ban on Medicare-provided gender reassignment surgery in response to a request filed in March by a quartet of LGBT advocates: the National Center for Lesbian Rights, the American Civil Liberties Union, Gay & Lesbian Advocates & Defenders and civil rights attorney Mary Lou Boelcke.

The challenge was filed on behalf of Denee Mallon, a 73-year-old transgender woman in Albuquerque, N.M. A Medicare recipient, Mallon was recommended to have gender reassignment surgery by doctors to treat her gender dysphoria

In a joint statement provided to the Washington Blade in response to the HHS memorandum, the ACLU, NCLR and GLAD expressed optimism that DAB would come to the conclusion after discovery that the ban on Medicare-provided gender reassignment surgery should be lifted.

“Because the current evidence overwhelmingly shows that sex-reassignment surgeries are effective and medically necessary treatments for some individuals with gender dysphoria, we are hopeful the Board will find the exclusion is not supported,” the statement says.

According to the memorandum, the ban was put in place in 1989 as a result of a 1981 report from the National Center for Health Care Technology, an arm of HHS. The report concluded “transsexual surgery not be covered by Medicare at this time” because of the high rate of complications and questions about whether it was effective in treating gender identity disorder.

“Transsexual surgery for sex reassignment of transsexuals is controversial,” the regulation states. “Because of the lack of well controlled, long term studies of the safety and effectiveness of the surgical procedures and attendant therapies for transsexualism, the treatment is considered experimental. Moreover, there is a high rate of serious complications for these surgical procedures. For these reasons, transsexual surgery is not covered.”

Despite the institution of this policy, the American Medical Association and the American Psychological Association support gender reassignment surgery for transgender people as a means to treat gender identity disorder.

Notably, the Centers for Medicare & Medicaid didn’t put up a fight in response to the request from LGBT advocates to lift the ban. According to the memo, CMS notified the board in June that it wouldn’t submit a response to their request to lift the ban.

Neither HHS nor CMS responded to the Blade’s request for comment on the determination or why it declined to defend the ban.

It’s unclear when the discovery period for reevaluating the ban on Medicare-provided gender reassignment surgery will come to an end. Shawn Jain, a spokesperson f0r the ACLU, said his organization doesn’t know when the process will be complete.

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District of Columbia

D.C. Pride flag raising ceremony set for June 1

Mayor, council members to participate

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D.C. Mayor Muriel Bowser at the flag-raising of the Progress Pride flag at the Wilson Building in D.C. on June 1, 2023. (Washington Blade photo by Michael Key)

D.C. Mayor Muriel Bowser’s Office of LGBTQ Affairs is inviting the LGBTQ community and friends to attend the city’s annual Pride flag raising ceremony scheduled for 4 p.m. Monday, June 1, outside the John Wilson Building that serves as the D.C. City Hall.

Like in prior years, members of the D.C. Council and officials with the Office of LGBTQ Affairs were expected to join Bowser in delivering remarks on the front entrance steps at the Wilson Building before raising the Pride flag atop one of the tall flagpoles next to the building’s entrance.

Gaby Vincent, a spokesperson for the LGBTQ Affairs Office, said attendees of the flag raising ceremony will be invited to attend a reception immediately following the ceremony in the main lobby of the Wilson Building, which is located on Pennsylvania Avenue at 14th Street, N.W.

She said the reception will feature a DJ, dancing, and refreshments provided by the D.C. LGBTQ bar and café Spark Social House.  

Vincent said the flag raising event will also mark the 20th anniversary of the opening of the D.C. Mayor’s Office of LGBTQ Affairs.

In its official announcement of the flag raising event the LGBTQ Affairs Office also announced it is hosting the 7th annual District of Pride Showcase event to be held Friday, June 17, at 7 p.m. at the Lincoln Theater.

The announcement says LGBTQ community members, families, and allies are also invited to walk with Bowser in the Capital Pride Parade scheduled for Saturday, June 20. It says the mayor’s parade contingent will assemble at 2 p.m. at the parade’s starting location at 14th and U Streets, N.W.

“As we also celebrate the 20th anniversary of the Mayor’s Office of LGBTQ Affairs, we invite residents, community members, families and allies to join us throughout June for moments of pride, connection, visibility, and joy,” the announcement says.  

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Still marching: Rev. Troy Perry and the ongoing fight for liberation

MCC founder reflects on Pride’s beginning, ongoing power of radical representation

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Rev. Troy Perry (Photo courtesy of Founders MCC)

Long before tone-deaf Target swag and rainbow-scented hashtags lit up the very queer month of June, Rev. Troy Perry was helping the LGBTQ community create space where it did not yet exist, and he did so with little more than faith and perseverance. This Pride season, as communities around the world fight once again with rising attacks on LGBTQ rights and democratic freedoms, Perry returns to the movement he helped build for a conversation rooted not only in history but in survival. The unveiling of Steps to Liberation at Founders Metropolitan Community Church serves as an uplifting reminder that Pride is not just a parade but also serves as a commitment to continue to advocate for our community.

Joined by original rainbow flag co-creator Lynn Segerblom, Perry looks back on the legacy of the first Pride marches, the spiritual and political power of real representation, and why the rainbow flag still matters nearly fifty years after its creation. As Founders MCC transforms its front steps into a vibrant rainbow pathway, the symbolism feels especially timely — freedom is not a destination, it’s something communities continuously build together, step by step. In our interview, Perry speaks candidly on activism, faith, and his continued belief that even in difficult times, hope remains an unwavering act of resistance.

You’ve been at the forefront of LGBTQ history for decades. What does this moment, unveiling Steps to Liberation, mean for you?  You’ve often spoken about visibility as an act of courage. Why is that still not only true but also essential today?

I will be 86 years old in another month. Not in the best of health and in a wheelchair, but still a LGBTQ activist at heart. I tell my husband, Phillip De Blieck, that I never thought I would live this long. He and I will be celebrating our 41st anniversary this year.

In the early days of our struggle for our liberation, I used to cut up and tell people there’s just nothing like a good demonstration to get my heart pumping. This is what I feel as we dedicate the Steps of Liberation! Another symbol of our freedom. We’re here, we’re queer, and we’re gonna fight to our last breath, to win all the rights that the colors on the steps represent.

When you think back to organizing the first Pride march in Los Angeles, what emotions or memories visit you?

Having the guts to follow through on our vow to hold a pride parade, no matter what! We did follow through and sued the city of Los Angeles for the right to hold that parade. We won! Thank God for the ACLU. The next thing I thought was, my God, look at all the people who have come out to be in the parade, and to watch it. I was also thankful that no one was hurt that day, and the pride I had of being a part of that demonstration.

How does this new installation reflect the spirit of those early days of activism?

The steps of liberation tell all who see it that we are still here and not afraid after 56 years have passed since our first Pride parade.

The theme of IDAHOBIT 2026 is “The Heart of Democracy.” In your view, how has the LGBTQ movement played its part in influencing our country’s democracy?

I think that most of us have played by the rules and use the cards dealt to us to make a difference in our democracy here in the USA. The LGBTQ community has changed so much in 56 years. Today, members of our community are serving in every political office in our country. We have gay and bisexual city council members, lesbian governors, and trans state legislators. We have a gay man who has run for president of the United States. The heart of democracy is a right given to all of us to work to change our country so that all of us are treated the same. Nothing more, nothing less!

You’ve often spoken about visibility as an act of courage. Why is that still not only true but also essential today?

I tell groups of young LGBTQ people to be yourself. Flaunt it! Coming out of the closet is the best thing you can do. Whether you come out fast or slow, just come out. If you are going to do it, now is the time. I am so proud of young people who are using the Internet, TikTok, and YouTube to make a difference for us. Your siblings are looking for you!

What do you hope someone feels the first time they walk up the Rainbow Steps?

God, does this feel good! Why didn’t I do this a long time ago?

How has faith intersected with activism in your life?

This is my testimony. Most of my relatives would tell you that I have been deeply spiritual all my life. I have had the opportunity to live a very interesting life. I started preaching when I was 13 years old. I was licensed to preach in the Southern Baptist church at age 15. I married heterosexually at age 18. I started pastoring my first church at age 19. I am the father of two children. I am a Vietnam-era veteran. I was divorced at age 26 and founded Metropolitan Community Church at age 28. I have been slapped in the face, spat on, had some people try to murder me, and cursed by some throughout my life, all because I dare call myself a clergyman as a gay man. Has it been worth it? Absolutely. I would not change my life for anything. I try to always keep my faith intact.

In moments when progress feels uncertain or under threat, what keeps your hopes up?

I have my husband, Phillip, and friends that I can talk to. I also have a favorite scripture that keeps me going: though God slay me, I will trust in God. Job 13:15

How do you see younger folks carrying forward the legacy you helped build?

Don’t give up the fight. Organize, organize, organize!

The launch of Flag50 looks ahead to the 50th anniversary of the rainbow flag. What do you think folks should be reflecting on as that milestone approaches?

I love the Pride flag! It gives us hope that there can be a tomorrow. I love the colors and what they represent. Hopefully, we will be able to teach this in our schools one day, along with the American flag and how each of those colors is meant to give us dignity, as well as hope.

How do art and public installations like this one shape cultural change in ways that perhaps policy can’t?

Laws are important because they protect us, but art touches the heart first. A public installation like the Steps of Liberation tells our story without anyone having to say a word. A young person can walk up those steps and realize they are not alone. Families can see our colors and remember that LGBTQ people are part of every community in America. Art creates visibility, and visibility changes hearts and minds. Sometimes culture changes before politics catches up. I believe symbols matter. The rainbow flag matters. These steps matter. They remind us that liberation is not just something you read about in history books. It is something we continue to live every day.

What threats facing our LGBTQ community today concern you more than others?

I worry when people try to erase us, especially our transgender brothers and sisters and LGBTQ young people. I have lived long enough to know that fear and hatred can grow when people stop seeing each other as human beings. We cannot go backward. I also worry when people become discouraged and think their voice no longer matters. That is exactly when we must organize, vote, speak out, and stand together. We have survived attacks before, and we will survive them again, but only if we refuse to be silent. Silence has never protected our community. Courage and love have.

What does it mean to you to take that next step, and how would you advise our readers to take it?

Every generation has its own next step to take. For some, it means coming out. For others, it means speaking up when someone is being mistreated. It may mean marching, voting, creating art, serving your community, or simply learning to love yourself exactly as God made you. The important thing is not to stand still. Keep moving forward. Keep believing that change is possible. I have spent my whole life taking one step after another with people who dreamed of a better world. My advice is simple: do not wait for someone else to do the work. Take the next step yourself, and bring somebody with you.

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District of Columbia

‘Queer Love’ campaign launched to address domestic violence

D.C. event set for LGBTQ+ Domestic Violence Awareness Day on May 28

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‘Domestic and family violence in LGBTQ+ communities is real and too often invisible,’ said Cesar Toledo, the Alston Foundation’s executive director. (Photo courtesy of Toledo)

The D.C.-based Wanda Alston Foundation, which provides housing and support services for homeless LGBTQ youth, announced earlier this month that it has joined partner organizations to launch a Queer Love Shouldn’t Hurt campaign aimed at addressing domestic violence within the LGBTQ community.

 In a May 18 statement, the Alston Foundation said the campaign involves a public awareness initiative leading up to LGBTQ+ Domestic Violence Awareness Day scheduled for May 28. 

“Domestic and family violence in LGBTQ+ communities is real and too often invisible,” Cesar Toledo, the Alston Foundation’s executive director, said in the statement. “As a community, we do not talk about it enough, and that silence can leave survivors feeling isolated and alone,” he said. “We must break that silence.”

He added that culturally competent care for those impacted by domestic violence is available through a newly launched website, queerlove.org, “where people can safely access vital resources, educational toolkits, and support networks they need on their healing journey.”

The website announces one of the project’s first events, a Queer Love Community Social, was scheduled for Thursday, May 28,  from 6-8 p.m. at the D.C. LGBTQ+ Community Center at 1827 Wiltberger St., N.W.

“Join us this LGBT+ Domestic Violence Awareness Day for a community social dedicated to visibility and survivor resilience,” the website statement says. “Let’s gather to strengthen our bonds, honor the path to healing, and share free resources,” it says of the May 28 event. 

The website also announces a June 1 workshop called Empowering Survivors of LGBTQ+ Intimate Partner Violence, which it says will be presented by Jesse Wedell, an official with the D.C. LGBT+ Counseling Collaborative. The website provides an online form to register for the workshop upon which its location would be disclosed.        

It identifies the partner organizations working with the Alston Foundation on the Queer Love Public Awareness Campaign as the LGBT+ Counseling Collaborative, Whitman-Walker Health, the D.C. LGBTQ+ Community Center, and Equality Chamber.

 The resources and information provided by the project can be accessed at www.queerlove.org.

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