The U.S. Department of Health and Human Services Office for Civil Rights has issued a final rule on Friday under Section 1557 of the Affordable Care Act advancing protections against discrimination in health care prohibiting discrimination on the basis of race, color, national origin, age, disability, or sex (including pregnancy, sexual orientation, gender identity, and sex characteristics), in covered health programs or activities. 

The updated rule does not force medical professionals to provide certain types of health care, but rather ensures nondiscrimination protections so that providers cannot turn away patients based on individual characteristics such as being lesbian, gay, bisexual, transgender, queer, intersex, or pregnant.

“This rule ensures that people nationwide can access health care free from discrimination,” said HHS Secretary Xavier Becerra. “Standing with communities in need is critical, particularly given increased attacks on women, trans youth, and health care providers. Health care should be a right not dependent on looks, location, love, language, or the type of care someone needs.”

The new rule restores and clarifies important regulatory protections for LGBTQ people and other vulnerable populations under Section 1557, also known as the health care nondiscrimination law, that were previously rescinded by the Trump administration.

“Healthcare is a fundamental human right. The rule released today restores critical regulatory nondiscrimination protections for those who need them most and ensures a legally proper reading of the Affordable Care Act’s healthcare nondiscrimination law,” said Omar Gonzalez-Pagan, counsel and health care strategist for Lambda Legal.

“The Biden administration today reversed the harmful, discriminatory, and unlawful effort by the previous administration to eliminate critical regulatory protections for LGBTQ+ people and other vulnerable populations, such as people with limited English proficiency, by carving them out from the rule and limiting the scope of entities to which the rule applied,” Gonzalez-Pagan added. “The rule released today has reinstated many of these important protections, as well as clarifying the broad, intended scope of the rule to cover all health programs and activities and health insurers receiving federal funds. While we evaluate the new rule in detail, it is important to highlight that this rule will help members of the LGBTQ+ community — especially transgender people, non-English speakers, immigrants, people of color, and people living with disabilities — to access the care they need and deserve, saving lives and making sure healthcare professionals serve patients with essential care no matter who they are.”

In addition to rescinding critical regulatory protections for LGBTQ people, the Trump administration’s rule also limited the remedies available to people who face health disparities, limited access to health care for people with Limited English Proficiency, and dramatically reduced the number of healthcare entities and health plans subject to the rule.

Lambda Legal, along with a broad coalition of LGBTQ advocacy groups, filed a lawsuit challenging the Trump administration rule, Whitman-Walker Clinic v. HHS, and secured a preliminary injunction preventing key aspects of the Trump rule from taking effect.

These included the elimination of regulatory protections for LGBTQ people and the unlawful expansion of religious exemptions, which the new rule corrects. The preliminary injunction in Whitman-Walker Clinic v. HHS remains in place. Any next steps in the case will be determined at a later time, after a fulsome review of the new rule.

GLAAD President Sarah Kate Ellis released the following statement in response to the news:

“The Biden administration’s updates to rules regarding Section 1557 of the ACA will ensure that no one who is LGBTQI or pregnant can face discrimination in accessing essential health care. This reversal of Trump-era discriminatory rules that sought to single out Americans based on who they are and make it difficult or impossible for them to access necessary medical care will have a direct, positive impact on the day to day lives of millions of people. Today’s move marks the 334th action from the Biden-Harris White House in support of LGBTQ people. Health care is a human right that should be accessible to all Americans equally without unfair and discriminatory restrictions. LGBTQ Americans are grateful for this step forward to combat discrimination in health care so no one is barred from lifesaving treatment.”

The Biden-Harris administration’s revised Title IX policy “protects LGBTQ+ students from discrimination and other abuse,” Lambda Legal said in a statement praising the U.S. Department of Education’s issuance of the final rule on Friday.

Slated to take effect on Aug. 1, the new regulations constitute an expansion of the 1972 Title IX civil rights law, which prohibits sex-based discrimination in education programs that receive federal funding.

Pursuant to the U.S. Supreme Court’s ruling in the landmark 2020 Bostock v. Clayton County case, the department’s revised policy clarifies that discrimination on the basis of sexual orientation and gender identity constitutes sex-based discrimination as defined under the law.

“These regulations make it crystal clear that everyone can access schools that are safe, welcoming and that respect their rights,” Education Secretary Miguel Cardona said during a call with reporters on Thursday.

While the new rule does not provide guidance on whether schools must allow transgender students to play on sports teams corresponding with their gender identity to comply with Title IX, the question is addressed in a separate rule proposed by the agency in April.

The administration’s new policy also reverses some Trump-era Title IX rules governing how schools must respond to reports of sexual harassment and sexual assault, which were widely seen as imbalanced in favor of the accused.

Jennifer Klein, the director of the White House Gender Policy Council, said during Thursday’s call that the department sought to strike a balance with respect to these issues, “reaffirming our longstanding commitment to fundamental fairness.”

“We applaud the Biden administration’s action to rescind the legally unsound, cruel, and dangerous sexual harassment and assault rule of the previous administration,” Lambda Legal Nonbinary and Transgender Rights Project Director Sasha Buchert said in the group’s statement on Friday.

“Today’s rule instead appropriately underscores that Title IX’s civil rights protections clearly cover LGBTQ+ students, as well as survivors and pregnant and parenting students across race and gender identity,” she said. “Schools must be places where students can learn and thrive free of harassment, discrimination, and other abuse.”

The Food and Drug Administration is planning to lift its ban on sperm donations from men who have sex with men, according to a report in the Wall Street Journal. The report also says the FDA would simultaneously lift the ban on donations of other tissues and organs from gay and bisexual men.

The Wall Street Journal report suggests that the FDA could put out a draft of the new policy for public comment by the summer, with a final rule in place by the end of 2024 or early 2025.

Reached for comment, a spokesperson for the FDA would not confirm the Wall Street Journal story, but acknowledged that, “the FDA routinely reviews approaches regarding donor screening and testing for donors of human cells, tissues and cellular and tissue-based products (HCT/Ps) to determine what changes, if any, are appropriate based on technological and evolving scientific knowledge.” 

The FDA imposed the sperm donation ban on men who have sex with men in 2005, as part of an expansion on existing prohibitions on blood donations from gay and bisexual men which were meant to mitigate the risk that HIV could be spread through donations.

The policies stemmed from an erroneous belief that gay men were more likely to carry HIV, regardless of their individual behaviors and risk factors.

Last year, the FDA finally ended the ban on blood donations from men who have sex with men, which had been in place since the early days of the AIDS crisis. The FDA now requires that blood donors are screened based on individual behaviors in a gender-neutral manner, in addition to the donations themselves being tested for HIV and other blood-borne illnesses.

Alice Ruby, executive director of the Sperm Bank of California in Berkeley, says the lifting of the blood ban should provide a template for ending the sperm ban.

“I’m hoping it’s similar to the blood donation screening, where it’s based on behaviour, rather than being part of a population,” she says. “We test donors repeatedly for HIV as required by the FDA.”

The Sperm Bank of California has served many lesbian, bisexual and transgender people and Ruby says that she’s often told her clients would like a queer donor, to ensure that the biological father won’t be someone who disapproves of queer families. The ban removes that choice from would-be mothers.

The Sperm Bank of California has been opposed to the gay sperm donation ban since the policy was first proposed 20 years ago and has advocated in tandem with the National Center for Lesbian Rights for the policy to be scrapped.

“People are pretty unaware that the ban exists. I think there’s a lot of gay men who would be happy to contribute in this way, especially since a large number of people using sperm donation are LGBT couples and single people,” Ruby says.

Sperm banks across the country have been experiencing shortages of donor sperm, especially from donors of color. Opening the donor pool to gay and bi men could help ease the shortage. Ruby has told the Blade that the Sperm Bank of California has had to turn away gay and bi donors every week, up to 400 men in a single year.

When the FDA releases its draft policy around sperm donation, there will be a public comment period before the regulation is made final. Ruby says anyone interested opening up sperm donation to gay and bisexual men should submit a comment to support the change.