National
Biden administration to ban discrimination against LGBTQ patients
The Biden administration announced on Monday it would enforce civil rights protections under Obamacare to prohibit discrimination in health care against patients for being LGBTQ, reversing policy during the Trump years excluding transgender status as a protected characteristic under the law.
The Department of Health & Human Services declared it would enforce Section 1557 of the Affordable Care Act, which prohibits discrimination in health care on the basis of sex, and begin to take up cases of discrimination based on sexual orientation and gender identity.
HHS Secretary Xavier Becerra said in a statement the Supreme Court has “made clear that people have a right not to be discriminated against on the basis of sex and receive equal treatment under the law, no matter their gender identity or sexual orientation.”
“Fear of discrimination can lead individuals to forgo care, which can have serious negative health consequences,” Becerra said. “It is the position of the Department of Health and Human Services that everyone — including LGBTQ people — should be able to access health care, free from discrimination or interference, period.”
The move is consistent with the executive order President Biden signed on his first day in office directing federal agencies to implement the U.S. Supreme Court’s decision last year in Bostock v. Clayton County to the furthest extent possible. Federal agencies were directed to comply within 100 days of the executive order, which is about now and a short time after Biden’s first 100 days in office.
The announcement with respect to Section 1557 comes on the same day as the hearing took place this morning in Bagly v. HHS, a case before a federal court in Massachusetts challenging Trump’s undoing of transgender protections under the law. An attorney with the U.S. Justice Department announced a new notice of proposed rule-making is coming with respect to Section 1557.
Sharita Gruberg, vice president for the LGBTQ Research and Communications Project at the Center for American Progress, said in a statement the change “assures LGBTQ people that their rights will be upheld at the doctor’s office, vaccine sites, and everywhere else they seek health care and coverage.”
“The administration’s announcement that it will enforce these protections are a critical step toward addressing vaccine hesitancy among LGBTQ people, a population that has been disproportionately impacted by the pandemic and seriously harmed by the previous administration’s attempts to permit discrimination against LGBTQ patients, Gruberg added.
The past three administrations have instituted policy on LGBTQ protections based on their interpretation of Section 1557. Each move had varying implications and directions for LGBTQ patients.
The Obama administration issued a rule in 2016 interpreting Section 1557 to apply to cases of anti-transgender discrimination and discrimination against women who have had abortions, which was consistent with court rulings at the time. However, that move was enjoined by a nationwide court order in Texas as a result of litigation filed by Texas Attorney General Ken Paxton.
The Trump administration, shortly after the Supreme Court’s ruling in Bostock, made final a regulation proposed last year rescinding the Obama administration’s transgender protections under Section 1557. Faced with criticism, the Trump administration defended itself by saying its move was consistent with the court order in Texas, although it seemed to ignore the decision from the higher court.
The new rule from HHS goes above and the beyond the Obama administration by instituting protections based on both sexual orientation and gender identity. It wasn’t immediately clear whether the proposed rule would be a new regulation entirely, or seek to modify the changes that were made in the two previous administrations. The Blade has placed a request seeking comment with HHS.
Susan Bailey, president of the American Medical Association, said in a statement the new HHS rule is a welcome change after the Trump administration rescinded protections for transgender patients.
“It’s unfortunate that such an obvious step had to be taken; the AMA welcomes this common-sense understanding of the law,” Bailey said. “This move is a victory for health equity and ends a dismal chapter in which a federal agency sought to remove civil rights protections.”
Discrimination in health care is an experience transgender people commonly report. The U.S. Transgender Survey in 2015 found one-third of responders said they had at least one negative experience in health care related to being transgender. Further, 23 percent of responders said they didn’t seek health care because they feared being mistreated and one-third said they didn’t go to a provider because they couldn’t afford it.
A Center for American Progress survey from 2018 had similar findings with respect to transgender people and patients with being gay, lesbian and bisexual or queer. Eight percent of responders said a doctor refused to see them because of their perceived or actual sexual orientation, while 28 percent of providers said a doctor refused to see them because of their actual or perceived sexual orientation.
Hospitals, especially religiously affiliated providers, refusing to provide transition-related care, including gender assignment surgery, is another frequently reported incident for transgender patients. The American Civil Liberties Union, for example, has filed litigation against hospitals under Section 1557 for refusing to perform the procedure.
Rachel Levine, assistant secretary of health and the first openly transgender presidential appointee to obtain Senate confirmation, hailed the HHS rule change in a statement.
“The mission of our Department is to enhance the health and well-being of all Americans, no matter their gender identity or sexual orientation. All people need access to healthcare services to fix a broken bone, protect their heart health, and screen for cancer risk,” Levine said. “No one should be discriminated against when seeking medical services because of who they are.”
Although the Biden administration’s announcement is a welcome move for LGBTQ advocacy groups, the change is not without critics.
John Banzhaf, a law professor at George Washington University who declares himself a supporter of transgender rights, said the policy could have unintended consequences, which he said has become evident in the British health system.
“[Transgender] individuals with a penis but no vagina are being asked to have medical tests on their non-existent cervices, while [transgender] persons with a vagina and cervix will not be asked, under new guidelines which appear to place lives at risk and encourage a physically impossible medical exam on organs which simply do not exist,” Banzhaf said. “And, carrying this absurdity to its totally illogical conclusion, a patient with a penis and a full beard was offered a cervical test because, despite his clearly masculine appearance and style of dress, he registered himself as being gender neutral.”
Vice President JD Vance and his wife, second lady Usha Vance, will visit Hungary next week.
An announcement the White House released on Thursday said the Vances will be in Budapest, the Hungarian capital, from April 7-8.
JD Vance “will hold bilateral meetings with” Hungarian Prime Minister Viktor Orbán. The announcement further indicates the vice president “will also deliver remarks on the rich partnership between the United States and Hungary.”
The Vances will travel to Hungary less than a week before the country’s parliamentary elections take place on April 12.
Orbán, who has been in office since 2010, and his Fidesz-KDNP coalition government have faced widespread criticism over its anti-LGBTQ crackdown.
The Associated Press notes polls indicate Orbán is trailing Péter Magyar and his center-right Tisza party.
President Donald Trump removed Attorney General Pam Bondi from her post Thursday, following growing criticism over how she and the Department of Justice handled a range of issues, including matters related to sex offender and Trump ally Jeffrey Epstein.
Trump announced Bondi’s removal on Truth Social, where he also said Todd Blanche will serve as acting head of the Justice Department.
“Pam Bondi is a great American patriot and a loyal friend, who faithfully served as my attorney general over the past year,” Trump wrote on the platform. “Pam did a tremendous job overseeing a massive crackdown on crime across our country, with murders plummeting to their lowest level since 1900.”
Trump was seen as recently as Wednesday with the now-former attorney general at a Supreme Court hearing on citizenship.
The decision contrasts with Trump’s previous public praise of Bondi, the 87th U.S. attorney general and former 37th attorney general of Florida, who served in that role from 2011-2019 before joining the Trump-Vance administration. He has frequently lauded her loyalty and said he speaks with her often. Bondi was also one of president’s defense lawyers during his first impeachment trial.
Privately, however, Trump had grown frustrated that Bondi was not “moving quickly enough” to prosecute critics and political adversaries he wanted to face criminal charges, according to multiple sources. The New York Times reported that her inability to charge former FBI Director James B. Comey and New York Attorney General Letitia James with any crimes is a large factor in the president’s choice to fire her from the government’s primary law enforcement agency.
The move comes as Trump has sought to minimize public turmoil within his administration, avoiding the perception of a revolving-door Cabinet that defined his first term.
Lee Zeldin, a former Republican congressman from New York who unsuccessfully ran for governor, has emerged as a leading contender to lead the Justice Department. He has been one of Trump’s most reliable allies.
“He’s our secret weapon,” Trump said of Zeldin in February during a White House event promoting the coal industry, adding, “He’s getting those approvals done in record-setting time.”
Bondi has also growing faced scrutiny from Congress.
The House Oversight Committee recently subpoenaed her to testify about the department’s handling of certain files, where she declined to answer key questions during a contentious House Judiciary Committee hearing in February.
The Tampa native has a long history of opposing LGBTQ rights through her roles in government. As Florida attorney general, she fought against the legalization of same-sex marriage, arguing it would cause “serious public harm,” pushing forward a legal battle that cost taxpayers nearly half a million dollars. She also asked the Florida Supreme Court to overturn a lower court ruling that found the state’s same-sex marriage ban unconstitutional.
More recently, Bondi established a “Title IX Special Investigations Team” within the Justice Department focused on restricting transgender women and girls from participating in women’s and girls’ sports teams and accessing facilities aligned with their gender identity. She also told Children’s Hospital of Philadelphia to turn over the medical records of anyone under 19 who received gender-affirming care.
Her removal follows Trump’s decision last month to oust another controversial female Cabinet figure, Kristi Noem.
The White House
VIDEO: Gay journalist detained for booing Trumps at ‘Chicago’ opening night
Eugene Ramirez booed first family at Kennedy Center
President Donald Trump and first lady Melania Trump attended the opening night of “Chicago” at the John F. Kennedy Center for the Performing Arts on Tuesday. They were greeted by a mix of cheers, applause, and some audible boos.
Among them was Eugene Ramirez, a gay Washington resident, who later shared his account of the night after being briefly detained by security for booing the president and giving a thumbs-down gesture — an expression of what many would call a textbook definition of constitutionally protected speech to criticize the government.
Ramirez attended the opening night performance with a group of friends, hoping to catch a final show before the center undergoes two years of major changes under Trump oversight. The musical, based on a 1926 play of the same name, has become synonymous with Broadway success.
With music by John Kander, lyrics by Fred Ebb, and a book by Ebb and Bob Fosse, “Chicago” has cemented itself as a cultural staple — known for its signature Fosse choreography, stripped-down staging, and sleek, campy aesthetic. The story follows Roxie Hart and Velma Kelly, women who murder their husbands but — with the help of the manipulative, charismatic, and narcissistic attorney Billy Flynn — walk away scot-free.
It remains the longest-running American musical in Broadway history, and its 2002 film adaptation famously won the Academy Award for Best Picture. On this night, however, the production also became the backdrop for a very modern moment of political protest.
“I accompanied five friends to opening night of ‘Chicago’, as a way to enjoy a final performance in the Kennedy Center as we know it,” Ramirez began to recount to the Washington Blade, describing the moment his group settled into their seats inside the ornate Opera House theater.
Just before the performance began, the twice impeached president and first lady appeared in the balcony box, drawing immediate attention from the audience below. Theatergoers stood, cheered, clapped, and waved, while Ramirez made a different choice.
While accounts of the crowd’s reaction have varied, Ramirez said his response was intentional, immediate, and within his rights. Moments after booing and giving a thumbs-down while recording on his iPhone, security intervened.
The video of Ramirez booing the Trump’s is here:
“Within moments, the director [of security] and another guard approached and escorted me to a side area where several other security guards were waiting,” he said. “I was detained until everyone was seated and the lights dimmed.”
As he was escorted away, Ramirez said his instincts as a journalist kicked in. A former lead anchor for Sinclair’s national evening news broadcast, he said the situation immediately felt off — or more aptly put — as if he could see the strings being pulled from someone attempting to control the narrative.
“Journalism is a vocation, not just a job. I immediately knew there wasn’t just an uncomfortable interaction with security,” he said. “The Kennedy Center is a federally funded cultural institution, and being questioned about speech related to the president in that setting felt like something the public should know about.”
Ramirez explained the difference between a standard visit by a public official and this performance: the president’s appearance wasn’t just ceremonial; it was very clearly a media moment.
“The White House press pool was there, and it was clear this was an effort to manage the president’s image in the media,” Ramirez continued. “The irony was not lost on me that this was happening on opening night of ‘Chicago’, a musical about manipulating the press to shape public perception.”
According to Ramirez, the explanation he received from Kennedy Center Director of Safety and Security Karles C. Jackson Sr., was brief, but illuminating.
“He said, ‘they don’t want booing,’ and even called out my thumbs-down gesture. He never clarified who ‘they’ were, but whether it was the administration or the Kennedy Center, the distinction felt meaningless,” he explained. “Mr. Jackson ultimately told me he was just trying to do his job, shook my hand, and allowed me to return to my seat once the lights dimmed and the overture started playing.”
Ramirez said he didn’t blame the guard individually, noting the broader context of the Kennedy Center’s uncertain future and the pressures staff were under.
“With the center closing in the coming months, some of these security guards being pressured to restrict our freedom of speech may only have a few weeks of work left.”
He believes the decision to remove him was driven less by disruption than optics, particularly given the presence of the press.
“It was very clearly about protection — whether protecting the president from visible dissent, or his image before the media present. There was no disruption as almost everyone was standing and reacting loudly to the arrival of the president and first lady, with cheers, applause, and hand gestures. The difference was that my reaction, unlike most, was negative.”
Drawing on his experience covering public officials, Ramirez said the incident felt more about controlling perception than security.
“Usually, law enforcement may monitor or intervene if there’s a disruption, but here there was no disruption at all. Simply expressing dissent in a public, cultural space drew the attention of security. It made it feel less like a matter of decorum and more like an effort to control the narrative around the president,” he said. “It’s about what happens when dissent is treated as disruption rather than a right.”
“The show hadn’t started. I threatened no one. Billy Flynn would have approved of the optics. The rest of us should be paying attention.”
Ramirez framed the incident as part of a broader constitutional concern, one that is plaguing the Trump-Vance administration as they continue to reject rules and normalcy set forth by other reserved presidents.
“Being singled out by security at a federally funded institution for expressing dissent shouldn’t be brushed off; it undermines the First Amendment,” he said, looking at it slightly distanced from it now. “Being of Cuban heritage, and a journalist, it’s a right I’m not willing to give up readily.”
“Publicly funded cultural institutions should allow visible dissent, even in politically charged moments,” he added. “Of course, I understand the need to manage disruptions during a performance, but that was not the case here.”
The themes of “Chicago”, a long-running satire about media manipulation and public perception, added another layer of irony to the experience, Ramirez explained.
“The satire truly leapt off the stage! A show about controlling the narrative, manipulating the press, and covering up truths by leaning on showmanship and distractions. The show is decades old, but could’ve been written today. We’re being razzle-dazzled daily and it’s getting harder to tell fact from fiction, no matter where you get your news.”
He, being gay, also acknowledged how hard it must have been for the performers on stage, assuming that at least some in the cast were also members of the LGBTQ community — and artists — two things Trump doesn’t always get along with.
“It was not lost on me that many of the actors on that stage, that the president and first lady presumably applauded, are members of the LGBTQ community which this administration has rolled back protections for under the guise of religious liberty and free speech, resulting in blatant discrimination.”
He pointed to a particular number that felt surreal given the circumstances.
“Its ‘Razzle Dazzle’ number celebrates keeping audiences off balance; at its climax, a massive American flag descends as the song celebrates blinding audiences to what is real. Watching that scene after being detained for a thumbs-down was surreal.”
Ramirez said the show’s closing lines were especially sharp given the presidential audience and what he just experienced.
“At the end of the show,
Velma says: ‘You know, a lot of people have lost faith in America.’
Roxie replies: ‘And for what America stands for.’
Velma: ‘But we are the living examples of what a wonderful country this is.’
Roxie: ‘So we’d just like to say thank you and God bless you.’
They had both just gotten away with murder!”
His closing lines, however, were a bit more pointed than “scintillating sinners” Roxie Hart and Velma Kelly’s were in the show.
“Democracy only works when citizens are allowed to boo,” he said. “Tuesday night at the Kennedy Center, ‘Chicago’ made that point better than I ever could.”
The Blade reached out to the Kennedy Center but did not receive a comment back.
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