Denny Chan: Hello, everybody, welcome to at this time’s webinar. I do know people are nonetheless trickling in, so thanks for becoming a member of us at this time. This can be a joint webinar dropped at you by Justice in Ageing, our pals at Sage, and Lambda Authorized. And the title is LGBTQ Older Adults: Updates and Rising Threats. That is in some methods a component two primarily based on a webinar that all of us did again final yr (Points Going through LGBTQ+ Older Adults in 2025 and Past). And so we’re right here to let you know some updates of issues which have occurred, some issues that we’re persevering with to observe, and likewise welcome your questions, and we’ll get to some Q&A on the finish of at this time. When it comes to webinar logistics, everyone seems to be on mute, and we ask that you just use the questions perform for all substantive questions, in addition to in case you are working into any tech points. If you’re having issues getting onto the webinar, please ship an electronic mail to our inbox, trainings@justiceinaging.org, and we’ll make certain to get that taken care of.
All of our coaching supplies, together with at this time’s webinar, however earlier trainings, will be present in our useful resource library, which is linked right here, in addition to a recording can be posted to our Vimeo web page, which can also be linked right here. And in the event you do want closed captioning, you’ll be able to allow that within the Zoom management panel. And I will move it over to Aaron who will do an intro for himself in addition to Sage.
Aaron Tax: Hey, everybody. I’m Aaron Tax, I exploit he/him pronouns, I head up authorities affairs at Sage. We’re the nation’s largest and oldest group devoted to bettering the lives of LGBTQ+ older people. We’re based in New York Metropolis in 1978, the place we at present run 4 LGBT-friendly senior facilities, two low-income condominium buildings, and supply direct companies to people in, I consider, all of the boroughs. We additionally do direct companies… or present direct companies in South Florida in each Miami-Dade and Broward. Along with that, we’ve a complete bunch of nationwide applications and initiatives, together with our federally-funded Nationwide Useful resource Middle on LGBTQ+ getting old.
We’ve a brand new initiative referred to as SAGEYou, which is… you may consider it as a digital senior middle, a spot for people to attach wherever they reside all throughout the nation, and to seek out sources about the right way to age extra efficiently and with the assist they want. We’ve our LGBT Housing Initiative. After which I oversee our authorities affairs staff the place, in a nutshell, we attempt to be sure that federal, state, and native getting old insurance policies are inclusive of the wants of LGBT people and other people residing with HIV. After which on the flip facet, if one thing is shifting ahead within the LGBT house, that folk are fascinated by the wants of older individuals, identical factor with respect to the advocacy within the HIV house. So I am going to go away it there. Our big due to Justice in Ageing as at all times for organizing this and our companions at Lambda Authorized for becoming a member of us too. Thanks once more.
Denny Chan: Nice. Thanks, Aaron. I will move it to Kell for his intro in addition to Lambda’s intro.
Kell Olson: Thanks, Denny, and thanks all for having me. My title is Kell Olson, I exploit he/him pronouns. I am an lawyer with Lambda Authorized and our designated strategist for problems with getting old. Lambda Authorized was based in 1973 and is a nationwide authorized group working to realize the complete recognition of the civil rights of LGBT individuals and everybody residing with HIV. Along with the circumstances we litigate straight, Lambda Authorized additionally operates a authorized assist desk, and whereas we don’t provide authorized recommendation by that assist desk, we do provide info and sources to assist individuals with authorized points. We’re finest recognized for our work within the courtroom, we additionally do coverage and training work, and we’re the oldest authorized group that’s dedicated to our mission of serving these populations. We’re actually glad to be right here at this time.
Denny Chan: Nice. An enormous thanks to Kell and Aaron for becoming a member of us. My title is Denny Chan… I forgot to introduce myself initially. So my title is Denny Chan, I am our Managing Director for Fairness Advocacy right here at Justice in Ageing, and I exploit he/him/his pronouns. Justice in Ageing is a nationwide authorized advocacy group devoted to utilizing the ability of regulation to battle senior poverty, and significantly of curiosity for at this time’s webinar since our founding in 1972, we targeted our authorized advocacy efforts on these teams of older adults who’ve been traditionally marginalized and excluded from justice, together with girls, older adults of coloration, LGBTQ older adults, as we are going to discuss at this time, and older adults with restricted English proficiency. We’ve a dedication to justice right here at Justice in Ageing that we consider as a way to advance our mission, everybody, as they age, has to have entry to what they want with out discrimination and with out regard to their social identities.
And so we push for insurance policies that may guarantee these individuals experiencing obstacles will get entry to the applications and companies that they want. All proper. So if you have not already, it is best to be at liberty to affix our community at justiceinaging.org. You’ll be able to click on enroll, or you can even ship an electronic mail to data@justiceinaging.org, and you’re going to get all of our emails about sources associated to LGBTQ older adults, and different older adults with low earnings, notifications about our trainings, different truth sheets, and far, far more. All proper. So I will move it now over to our colleague, Sahar. And earlier than I move it over to Sahar, I am going to simply flag that we’ve a few blocks of content material for you all at this time. We will be speaking a bit about who LGBTQ older adults are. That is one thing that we lined in our final webinar, however we will do a refresher. And for a deeper dive, we might refer you again to final yr’s coaching.
We’ll discuss a bit concerning the modifications implicated for older adults who’re LGBTQ below H.R. 1, the One Massive Stunning Invoice, that was handed final yr, and a few updates round gender-affirming care. Aaron’s going to speak a bit a few California Supreme Court docket resolution, in addition to some modifications we predict with the Older Individuals Act, after which Kell’s going to present us a litigation replace on the very finish, and we may have a while for Q&A. And so with that, I will move it over to Sahar for her introduction and for her to kick us off on LGBTQ older adults. Thanks.
Sahar Takshi: Thanks, Denny. Hiya, everybody. My title is Sahar Takshi, she/her pronouns. I am a senior lawyer at Justice in Ageing, and I work with Denny on our fairness advocacy staff. I wish to kick us off at this time by giving a little bit little bit of details about LGBTQ+ older adults. Subsequent slide, please. So whereas there are information limitations that make nationwide estimates troublesome, there are dependable research that point out that there are roughly 2.7 million LGBTQ+ people who find themselves over the age of fifty in america, and 1.1 million who’re over 65. And lots of advocates estimate that this quantity is anticipated to develop to 7 million older adults figuring out as LGBTQ+ by the yr 2030, which isn’t that distant. We do know, nonetheless, for a incontrovertible fact that LGBTQ+ individuals expertise many inequities typically because of inequities and discrimination that begins in youthful age, comparable to these regarding employment or healthcare, and these rework into distinctive and exasperated obstacles as soon as they’re older.
For instance, practically a 3rd of LGBTQ+ older adults reside under 200% of the federal poverty line, 30% report having at the least one incapacity, and LGBTQ+ older adults are twice as seemingly as their non-LGBTQ+ counterparts to depend on Medicaid as their major supply of healthcare protection. In order that’s a little bit bit concerning the inhabitants that we will discuss. Subsequent slide, please. Subsequent, I will leap into our first main subject, which is H.R. 1, also called the… this was a significant reconciliation invoice that was handed final yr and is usually referred to by its sponsors as One Massive Stunning Invoice. So some prime line impacts, as I discussed, H.R. 1 turned regulation final summer time, however we will be feeling its impacts over the following a number of years. So at this time, I will give attention to the impacts that we count on to see for older adults in healthcare and long-term care settings.
So before everything, H.R. 1 lower Medicaid spending by over $900 billion over the following 10 years. And naturally, we all know that well being wants usually are not anticipated to lower in that point, so these cuts will certainly shift the strain onto state budgets, which means, that we count on states to make troublesome selections to chop again on companies, eligibility, and supplier reimbursements. These cuts are going to hurt not solely individuals who use Medicaid, but in addition those that are enrolled in Medicare and depend on Medicaid to fill in essential protection gaps, or to make their excessive premiums extra reasonably priced.
H.R. 1 additionally added a number of eligibility restrictions for accessing Medicaid. The one which we will give attention to for at this time’s webinar are work necessities, however another restrictions embrace these regarding immigrants, in addition to recertification… extra frequent recertification necessities. And at last, H.R. 1 included $500 billion in cuts to Medicare over the following 10 years. Subsequent slide, please. So let’s dive into the impacts on Medicaid. As I discussed, the cuts will shift prices to the states, and because of that, there are a couple of particular ways in which we anticipate it will impression older adults. The primary is that states will look to chop what are thought-about non-compulsory companies, and sadly, a majority of those non-compulsory companies are used primarily by older adults. For instance, below the Medicaid statute, residence and community-based companies are thought-about an non-compulsory service, and we’ll be speaking extra about that on the following slide.
One other non-compulsory factor is the Medicaid particular earnings rule, which permits individuals with considerably greater incomes to qualify for Medicaid in the event that they require a nursing residence degree of care. A second impression of H.R. 1 that we count on is limiting eligibility below the aged and disabled program, which permits for larger eligibility for older adults, in addition to the Medicare Financial savings Program, which makes Medicare premiums, deductibles, and copays extra reasonably priced for low-income people. And lastly, we may even see supplier reimbursement charges go down, which can certainly worsen current shortages in long-term care amenities with residence well being suppliers and different direct care staff who assist older adults age with dignity. Subsequent slide, please.
So let’s discuss extra concerning the particular impacts for residence and community-based companies, also called HCBS. As I mentioned earlier, we consider that HCBS is extremely a danger, in actual fact, it’s, it makes up over half of all the non-compulsory Medicaid spending throughout the nation, and it will certainly have destructive impacts for LGBTQ+ older adults. Hundreds of thousands of older adults depend on HCBS as a substitute for being institutionalized, for instance, getting into a nursing facility after they would fairly proceed getting old of their houses. And for LGBTQ+ older adults, HCBS is nearly at all times most well-liked, partially as a result of institutional settings carry an elevated danger of discrimination. So funding cuts below H.R. 1 are prone to imply that we are going to see a drop within the variety of people who find themselves in a position to entry HCBS in any respect, we’re additionally prone to see an extended wait listing for HCBS. We would additionally see the varieties of companies which can be provided go down. Subsequent slide, please.
All proper. Lastly, I wish to discuss concerning the Medicaid work necessities, which is without doubt one of the eligibility restrictions launched below H.R. 1. Beneath H.R. 1, work necessities would imply that people who find themselves below the age of 65 would want to display that they are performing 80 hours of neighborhood engagement month-to-month, whether or not that is working, or taking part in trainings, or different varieties of related applications. There are some exceptions for people with sure disabilities and those that are caregivers, nonetheless, it could nonetheless result in over 5 million individuals with none healthcare protection because of this, together with LGBTQ+ older adults who usually are not but 65 or who do not in any other case fall into an exemption.
Even those that are exempt from work necessities may be impacted as a result of the verification and documentation methods required to hold this out could be administratively burdensome and significantly onerous for older adults to navigate. And people administrative burdens would make it onerous for everybody to entry Medicaid as a result of it slows down the methods, and it causes delays and errors. Earlier than I move it again to my colleague, Denny, I wish to flag that Justice in Ageing is internet hosting a webinar on February fifth that may dive extra into Medicaid work necessities. So in the event you’re fascinated by studying about that, I extremely encourage you to register, and if you cannot make it, you’ll obtain the slides and recording in a while. All proper. Properly, thanks very a lot. I will move it again to Denny Chan for the following part.
Denny Chan: Thanks, Sahar. So Sahar’s part actually specializing in H.R. 1 and the impacts to LGBTQ older adults. We can be flagging on the finish of our presentation a truth sheet that we labored on with our pals at Sage that actually spells out what H.R. 1 means for LGBTQ older adults, and actually, why Medicaid is so essential. So we’ll direct you to that useful resource once we get there. I will discuss a bit about gender-affirming care, there are a lot of names. The administration has a sure title for gender-affirming care, we will use the phrases gender-affirming care on this context. This was one thing that sure political… politicians tried to get into H.R. 1, the One Massive Stunning Invoice, however didn’t find yourself shifting in any particular manner, however there have been plenty of updates since we final spoke final yr for final yr’s webinar. Identical to nearly every part else on this webinar, what I will be reviewing is altering actually regularly in generally unpredictable methods, whether or not it is by litigation, policymaking from the administration.
So we encourage you, particularly in the event you’re watching the recording, to just remember to’re getting essentially the most correct and up-to-date info as attainable, particularly for a subject like gender-affirming care. So gender-affirming care, I will begin with simply an summary of what it’s, so we’ve a typical understanding. It’s a broad method to healthcare and assist that acknowledges and respects a person’s gender id, making certain that every one people can reside wholesome, fulfilling lives by addressing their distinctive wants. That is the definition that I took from HRC. After which below the World Well being Group, they’ve kind of specified that gender-affirming care on this context can vary from a number of various things. That broad method that we talked about within the first bullet actually applies throughout the board. So it could possibly be counseling, it could possibly be modifications to social expression, medicines, for instance, hormone remedy, and in some circumstances, surgical procedure.
So that is the little little bit of context round what gender-affirming care is, and we’re utilizing the acronym GAC. When it comes to coverage developments, I needed to flag for you a few various things, and I’ll word that that is significantly true for minors, so that is the place the majority of the policymaking has been. In subsequent slides, in only a minute, I am going to discuss concerning the impression and what this implies for LGBTQ older adults, however at the least with respect to the policymaking from this administration and what’s been tied up loads within the courts is a give attention to youth. In order you may know, and what we lined in our final webinar final yr was that the president signed an government order 14187, simply really one yr in the past. So at this time marks the one-year anniversary of that government order, which was actually utilizing and stating that it was the administration’s perception and coverage stance that gender-affirming care shouldn’t be offered to minors, and spelling out a complete host of actions for the administration to take to observe that administrative or that coverage place.
Since that government order was signed, did plenty of issues, and most notably, late final yr, earlier than the vacation, issued two notices of proposed rulemaking. The primary would prohibit using federal Medicaid {dollars} to fund procedures for people below 18 in state Medicaid plans. So principally, it could prohibit, with some notable exceptions, using Medicaid funding by the state plan mechanism to offer gender-affirming care to people below 18. In that very same rulemaking, there was additionally a prohibition by CHIP, the Kids’s Well being Insurance coverage Program for people below 19. The second discover of proposed rulemaking would revise what’s referred to as the circumstances of participation for hospitals that obtain Medicare and Medicaid funding that may prohibit them, as a way to take part and obtain funding from Medicare and Medicaid, from performing gender-affirming care on kids.
I ought to word that these notices of proposed rulemaking are nonetheless lively. So you’ll be able to, at this time, submit feedback, and that feedback are due February seventeenth. Once more, as I’ve emphasised initially of this slide, the main focus of the administration’s policymaking has been on minors. There was, as I’ll element within the subsequent slide, little or no modifications to gender-affirming care and entry, at the least from a policymaking perspective, for older adults. However once more, these feedback are due February seventeenth. The hyperlinks within the slide are to each the notices of proposed rulemaking the place you’ll be able to submit feedback to regulation.gov. On the identical time final yr on December nineteenth, Secretary Kennedy issued a declaration the place he famous that gender-affirming take care of youth didn’t meet requirements of care. I’ll word that that declaration was instantly challenged a number of days later by plenty of state attorneys common in courtroom, and there was a pause on basically enforcement of that declaration whereas the litigation has been pending.
That litigation didn’t contact on the notices of proposed rulemaking, though the problems are, as you’ll be able to recognize, associated. Okay. So what does this imply for older adults, and particularly for older adults who’re LGBTQ on the lookout for gender-affirming care below Medicare? It has been the longstanding case that Medicare… there was no nationwide protection willpower for gender-affirming care within the Medicare context. So the identical guidelines that utilized earlier than this administration took workplace proceed to use. Medicare mustn’t deny protection for healthcare simply because that care is usually offered to individuals of a particular gender. Beneath Medicare, gender-affirming surgical procedures are authorized on a case-by-case foundation in accordance with the World Skilled Affiliation for Transgender Well being, WPATH, Requirements of Care. We simply launched earlier this month with partnership from our pals at Sage, a truth sheet on Medicare and transgender older adults that is linked right here, what advocates must know.
So in the event you’re on the lookout for a deeper dive on Medicare and gender-affirming take care of trans older adults, be at liberty to take a look at that useful resource. And now, that wraps up our part, I will move it over to Aaron to speak a bit extra about that California Supreme Court docket case that I discussed, in addition to some developments that we’re probably monitoring with respect to the Older Individuals Act. So thanks, Aaron.
Aaron Tax: All proper. Properly, thanks a lot, Denny, and be at liberty to go to the following slide. So I will discuss concerning the LGBT Lengthy-term Care Facility Residents’ Invoice of Rights. So a little bit little bit of historical past, the very first one within the nation was written simply over 10 years in the past by an lawyer named Daniel Redmond, who’s at present practising within the San Francisco Bay Space. And that was the very first one within the nation, in order that was a metropolis ordinance in San Francisco. And since that point, there’s now roughly 10 of those all throughout the nation, one metropolis, one county, one district, and 7 states. So once more, San Francisco was the primary one to change into regulation, that was in April of 2015. That was adopted by the primary statewide one in California in October of 2017. That was adopted by the District of Columbia, Montgomery County, Maryland, New Jersey, Oregon, New York, Massachusetts, and final however not least, Connecticut final summer time.
There are at present plenty of different ones in course of the place we and our companions on the bottom are advocating for them, or the same regulation to be handed, and that is in Minnesota, Illinois, Pennsylvania, and the town of Atlanta. I ought to word, in the event you’re fascinated by engaged on considered one of these in your neighborhood, by all means, attain out and we’re pleased to accomplice with you. So what does the California regulation say, and what do these different legal guidelines which can be on the e-book say? We’ll take a look at the California one as an excellent instance of this as a result of that was the topic of the litigation that Denny referenced. So the primary part includes findings, it talks concerning the historical past of stigma and discrimination that LGBTQ+ people and other people residing with HIV have confronted all through their life course. It references a web based studying device, a few of these payments mandate trainings.
After which in part three of the California statute, it is actually the center of it, and it talks about not solely definitions, however a number of prohibitions. So you’ll be able to’t deny somebody admission to a long-term care facility, or switch them, or whatnot primarily based on their sexual orientation, gender id, or HIV standing. Room assignments should be primarily based on gender id. I am not going to undergo each final little bit of the regulation, however the one that actually form of rose to the highest within the litigation is the supply that claims that folk can’t willfully and repeatedly fail to make use of a resident’s most well-liked title or pronouns after being clearly knowledgeable of the popular title or pronouns. So you’ll be able to’t deliberately misgender somebody. There’s additionally a posting requirement, a record-keeping requirement, and a few guidelines round privateness and confidentiality. In order Denny talked about, there was a authorized problem to this regulation by a gaggle referred to as Taking Offense, and so they had been dubbed, quote, unquote, “God’s lawyer” on the duvet of everybody’s favourite journal, California Lawyer.
And apparently, they take offense at a number of issues. In order that they weighed in on a complete bunch of points, together with abortion, evolution, homeschooling, mother and father’ faculties, and the fitting to die. So this group, Taking Offense, decides to problem the regulation, and their foremost beef with the regulation is they are saying this impairs their free speech rights. And they also take this to courtroom and so they win in courtroom, and so they gained within the appeals courtroom, the place the appeals courtroom dominated in July of 2021 that this regulation was arguably impeding worker’s proper to freedom of speech. Sage joined Justice in Ageing in an amicus temporary because the problem of the regulation went to the California Supreme Court docket. And fortunately, earlier this yr… Oh God, I haven’t got the date on my calendar, I feel it was this yr… possibly it was late final yr, the California Supreme Court docket rejected the First Modification declare.
And in brief, what the California Supreme Court docket mentioned is that this regulation is regulating conduct and it solely by the way impacted individuals’s speech. So the courtroom mentioned, quote, “That it correctly regulates discriminatory conduct geared toward susceptible seniors who usually represent a captive viewers residing in long-term care amenities which have change into in impact their houses.” It additional mentioned, quote, “The pronouns provision constitutes a regulation of discriminatory conduct that by the way impacts speech.” And it distinguished a case that a few of you’ve gotten may need heard about from 1995 referred to as Hurley v. Irish-American Homosexual, Lesbian and Bisexual Group of Boston, that is the place an LGBT group needed to march within the St. Patrick’s Day parade in that metropolis. And it mentioned, quote, “In contrast, the current case doesn’t contain any analogous artistic product or expressive affiliation.” The one little wrinkle to the California statute that we do not see in any of the opposite ones throughout the nation is it does have a prison misdemeanor provision to it.
And the courtroom addressed this by saying, quote, “It appears obvious that the legislature doesn’t intend for such prison penalties to be imposed besides as a final resort in essentially the most egregious circumstances.” So in brief, the courtroom was okay with that provision. And once more, I feel it was… I do not know if it was deliberately put in there or not, I do not consider so, as a result of this regulation occurred to amend an underlying statute, however in not one of the different legal guidelines throughout the nation are there prison provisions identical to this California regulation. So with that, let’s go to the following slide the place we will discuss concerning the Older Individuals Act. All proper. So what’s the Older Individuals Act? The Older Individuals Act happened 1965 below Lyndon Johnson’s Nice Society as a counterpart to Medicare and Social Safety. Arguably talking, if Medicare is there to care for your medical wants, and social safety is there on your monetary wants as you grow old, the Older Individuals Act is every part else that ought to allow you to age in place in your neighborhood.
So it funds applications like residence delivered meals, congregate meals, meals in senior facilities, these types of issues, tour help, transportation help, authorized help, once more, all types of applications which can be designed to allow people to age in place of their neighborhood. It is funded to the tune of roughly $2 billion a yr, and at the least form of at current till just lately, it has been administered by an company referred to as the Administration for Neighborhood Dwelling, which falls below the US Division of Well being and Human Providers. The Trump administration has introduced that it plans to eliminate the Administration for Neighborhood Dwelling and merge it with a newly created entity referred to as the Administration for Kids, Households, and Communities. Form of sounds just like the administration for the entire world, however they’re simply lumping all of them collectively on this new administration. Hasn’t technically occurred but, however they’ve, for instance, fired all of the regional directors of ACL, and sadly, gotten rid of an entire lot of employees from ACL because it, once more, tries to reorganize the company.
So ACL, once more, administers the regulation, after which cash will get funneled all the way down to the 56 or so State Models on Ageing throughout the nation, and the greater than 600 space businesses on getting old all throughout the nation. And so they, in flip, fund service suppliers, identical to Sage, who present companies on to older people all throughout the nation. In order that’s form of typically what the OAA is, and the way it’s funded, and the way it works. It’s at present being reauthorized, which means, the regulation is at present being up to date. It’s stalled in Congress at this second. And knock on wooden, advocates try to verify it does get up to date someday quickly. Whereas the regulation is being reauthorized, the opposite information on the place the regulation is, is the regulation has some laws, and so they had been up to date for the primary time in roughly 30 years in February of 2024. And within the regulatory replace in that course of, Sage and folks on this name at this time advocated for some tweaks to the language by way of how the regulation is carried out.
There are particular populations outlined within the statute as populations of larger social want, and usually, these teams are outlined by cultural and social isolation. And we predict again to a number of the points that you just heard earlier on this presentation about a number of the challenges that LGBT people face, and the challenges that older individuals residing with HIV have confronted all through their life course, and so they match the definition of biggest social want fairly effectively. So through the regulatory replace, once more, we advocated with others on this name at this time, and others across the nation, for the Administration for Neighborhood Dwelling to say within the laws themselves that, in actual fact, LGBT people and other people residing with HIV are these so referred to as populations of larger social want. And ACL agreed, and it did say that when the regs bought rolled out in February of 2024. In order that was actually excellent news. Individuals all throughout the nation working on this house had been actually pleased to see that and put these laws to work. Sadly, we’ve heard by the grapevine that the administration plans to open up these laws once more, which is kind of uncommon, I might say.
And you will be shocked to know the one factor they’re planning on altering in these regs, that are a whole bunch of pages lengthy, is to take away the language round LGBT people and other people residing with HIV. We do not consider they’ve any substantive motive for doing this, we consider it is purely primarily based on animus, and it is arbitrary and capricious. And that is the place it stands at this second, we do not know if or when precisely that is going to occur, however we’re attempting to organize for that second. And right here is our ask for you, as you concentrate on the potential of those regs being undone and this language about LGBT people and other people residing with HIV being eliminated, one factor we would like people to start out fascinated by is the way you may submit a remark when this opens up for a 30-day remark interval, which we count on to occur.
And I will spotlight a number of the issues that you just may wish to discuss if these regs are opened up. Maybe you would write a remark speaking about your expertise you’ve gotten relating to LGBT people or individuals residing with HIV and serving them, your experience, any information you’ve gotten about these populations, tales you can share about these people, the burden, or not, of implementing these regs, we do not suppose it’s burdensome, how the regs have been impactful, how they have been helpful, and the way essential this work is in ensuring that every one older individuals, together with LGBT people and other people residing with HIV have the companies and helps they should stay impartial. So with that, I will flip it again to Denny or Kell for the following a part of the presentation.
Denny Chan: Thanks, Aaron. Earlier than Kell hops on, I simply needed to flag that we’re nonetheless working our Q&A. So to the extent that you’ve questions on what individuals have talked about, whether or not that is H.R. 1, gender-affirming care, Aaron’s items across the LGBTQ Older Adults Invoice of Rights, in addition to this piece across the OAA, be at liberty to start out dropping them within the chat. What normally occurs is we get a flood of questions on the finish, and it helps us simply even to type what individuals are asking about if we get them as they arrive in. So encourage you to make use of the Q&A perform now and through Kell’s presentation. Additionally, on the piece across the OAA regs, we’re watching that very intently. You’ll be able to ensure that you’ll hear from all of us when that discover or proposed rulemaking does go reside. We can be again.
So this isn’t your final probability, however Aaron’s forecasting what we predict, and hopefully, planting the seed for you all to start out fascinated by the way you may wish to weigh in throughout that remark interval, which once more, we suspect can be a 30-day remark window. And there can be advocacy each throughout that and after that to attempt to mitigate the impression as a lot as attainable. Okay. So I am going to return off mute and off digital camera, again on mute and off digital camera, and welcome Kell, who will do a portion round id paperwork in addition to funding restrictions, after which we’ll get to the Q&A. So take it away, Kell. Thanks.
Kell Olson: Thanks, Denny. At Lambda Authorized, we’re engaged in a full vary of authorized points affecting LGBTQ individuals and other people residing with HIV, however at this time, I am going to simply deal with a few subjects given the time we’ve out there right here. So first, I am going to communicate to id paperwork as that continues to be the primary request for info from our authorized assist desk. And second, I am going to communicate to the standing of authorized challenges to the administration’s terminating or conditioning federal funding that helps social companies as that clearly impacts the work a lot of you do. First, turning to id paperwork. Having correct id paperwork is extremely essential for all individuals, and specifically methods, for transgender individuals. That’s as a result of having identification that doesn’t match an individual’s present presentation can out them as transgender in plenty of conditions the place they’ve to indicate their identification, risking harassment or violence. And simply as importantly, stopping updates to demographic info on id paperwork like passports undermines the aim of getting that info on the doc, which is, typically, to confirm that the doc belongs to the holder.
That’s the reason we replace our photos, our different demographic info like our peak and weight as we develop. The standing of federal identification for transgender individuals specifically continues to be the topic of lively litigation. The present administration modified the US passport coverage, which had beforehand allowed modifications to gender markers on passports to match gender id, present gender. A number of circumstances had been filed and had some preliminary success, together with people who I’ve listed on the slide right here, the Schlachter case introduced by Lambda Authorized, the Orr case introduced by the ACLU, and people circumstances had efficiently blocked the administration’s new coverage, permitting individuals for an extended time period in 2025 to have the ability to replace their passports. On November sixth of 2025, the Supreme Court docket granted the federal government’s request for a keep of that order. So it is a little bit tough as a result of it is a block of a block, however basically, what meaning is that the Supreme Court docket ended the order that had allowed plaintiffs and sophistication members within the Orr case to proceed to acquire correct passports.
So the present state of affairs is that that order reinstated the state division’s passport coverage adopted in January 2025, requiring the passports solely be issued bearing a person’s intercourse designated at start. To be clear, as you are speaking with individuals concerning the present standing, present passports are nonetheless legitimate whether or not or not they mirror an individual’s intercourse assigned at start. If in case you have a present passport with an up to date gender marker, it nonetheless works, it is nonetheless legitimate, you’ll be able to nonetheless use it. We at our assist desk are at all times fascinated by listening to from anybody that has any issues utilizing present passports, and thus far, we aren’t listening to of any individuals unable to make use of present passports with an X marker or with an up to date gender marker.
Nevertheless, if somebody at this level applies to acquire a brand new passport, or to resume their passport, or to get a passport with a modified title, you are able to do typically title modifications, however in the event you’re going again into the system and attempting to replace something with a gender marker or replace your passport, you’re going to get a passport that lists your intercourse assigned at start if the State Division can decide that, no matter what marker you request. These circumstances will proceed, the litigation continues to be lively, as with most of the issues we’ll discuss at this time, as a result of these circumstances take a number of years to work their manner by the system. Most of those determinations are technically preliminary, and so they’re preliminary for plenty of years earlier than you attain the tip of a case. So this is not the ultimate phrase on this, however that is the present standing.
As Denny talked about, these items change very quickly, so it is essential to at all times be sure you have essentially the most correct and up-to-date info at any given time when somebody’s attempting to replace their id paperwork, which is why on the finish of this slide, I will discuss the very best locations to achieve that up to date info. However first, I simply wish to discuss state id paperwork, as a result of that’s in fact a separate challenge, and it varies state to state once we’re speaking about start certificates, or driver’s licenses, or different id paperwork. The overall development by the tip of 2024 was to permit updates, we had steadily had success in a number of states that had been left not doing that and bringing them as much as present requirements.
Most of these avenues nonetheless stay, some locations have regressed, some states have pulled again on their insurance policies and imposed new obstacles to altering gender markers, specifically, on start certificates or driver’s licenses. Thus far, this laws, we’re already seeing a handful of payments pop up proposing limits or bans on altering gender markers on start certificates and driver’s licenses. After all, these issues will proceed to unfold because the legislative classes proceed, and we’ll see if any of these make it by. And so they’re completely different, some set the next bar for altering a gender marker, like surgical procedure, some block it altogether. Persons are nonetheless getting gender updates on paperwork, it is nonetheless value checking in and seeing what individuals can do to have as many correct paperwork as they’ll.
Listed below are the sources I like to recommend to get essentially the most present info. The Advocates for Trans Equality, which is that A4TE Doc Middle referenced on this slide, I am going to have an additional slide that offers you kind of a snapshot of what that appears like, however they’ve actually essentially the most present info as to state by state, the right way to undergo the method to replace your id paperwork. After which for explicit particular person questions that may’t be addressed by that common useful resource, the Lambda Authorized Assist Desk at lambdalegal.org is a good place to go subsequent. So the following couple of slides give snapshots of the place you could find a few of these updates as issues change. So this slide talks about… is a web page from the Lambda Authorized web site, and if individuals want these hyperlinks, simply tell us within the Q&A and we will make certain we get you them for updates on the passport litigation. Additionally, in the event you simply search for that ACLU FAQ on the Orr case, they’re holding an up to date FAQ as effectively, as these issues change and develop.
After which on the following slide, you will see what that A4TE useful resource appears like for the paperwork middle. So you will see there is a dropdown the place you’ll be able to select your state, you’ll be able to select what kind of doc you are attempting to replace, and you may attempt to get some up to date info there. It is a good place to have individuals begin after which see in the event that they run into any points in order that they’ll attain out to us for extra info. The opposite challenge I needed to cowl at this time was within the space of funding restrictions. So we proceed to see dozens of circumstances difficult the present administration’s interference with funding that has been appropriated to social companies and analysis, both by the direct termination of grants or funds or by the conditioning of funds in ways in which may frustrate all the goal of the funding. For instance, certifications that you’ll abide by new administrative insurance policies that apply sure phrases of government orders to the work.
For instance, a really latest resolution out of Rhode Island blocks sure circumstances imposed in a discover of funding alternative for HUD Continuum of Care Youth Homelessness Program, which included a bar on candidates who acknowledge the identities of transgender individuals. So these form of circumstances proceed to be challenged. The large image is that there are many circumstances which can be nonetheless in flux. We’ve dozens of circumstances and a number of jurisdictions introduced by numerous organizations and people which have offered some kind of aid from these restrictions. In a earlier seminar… in our earlier webinar, I mentioned the varieties of claims which can be dropped at problem a few of these actions and to discern which of those are attainable simply coverage shifts and that are actually illegal, as a result of they possibly battle with the statute in a manner they can not, or they’re overly imprecise, or they’re irritating the aim of the funding, or the method was flawed and illegal in a sure manner, for instance. And so this slide is only a very fast abstract of what we actually went into in depth final time.
At the moment, what I needed to do was a distinct kind of path at it, kind of speaking about a number of the developments that we’re seeing on this panorama of difficult net of litigation, and to possibly give a little bit extra sensible content material about the right way to decide which actions are in impact and are not, and whether or not they apply to you or not. To be clear, I am not going to have the ability to inform any particular person particular person whether or not a situation has been blocked as to them or not, and hopefully, the following slides will present you why, however I am going to provide you with some tips about the right way to get there. So the developments we’re seeing is that we’ve narrowed aid that’s as utilized to simply individuals bringing a lawsuit. In order that development continues and can proceed. And meaning if the federal government is discovered to have performed one thing illegal with a situation, a courtroom just isn’t robotically going to have the ability to inform the federal government that they’ll not try this to anybody, they may be restricted to telling the federal government that they can’t try this to the one who introduced the lawsuit.
So this makes it, in fact, far more difficult to seek out out what’s in impact and what’s not. We’re additionally seeing many unsettled problems with regulation which can be particular to the funding enviornment, the place do individuals need to carry a lawsuit? It differs primarily based on whether or not you are difficult a situation or whether or not you are attempting to implement a contract given to you by america authorities. And as you’ll be able to think about, on this space, whether or not to characterize a case as one or the opposite kind is difficult, and we’re getting various opinions which can be going to maintain taking part in out over the following variety of years.
Subsequently, it is essential to depend upon somebody monitoring your native state of affairs and your explicit funding streams to know the place you stand. So the following slide offers an instance of a method that a few of us observe a few of these points. I’m not related to Simply Safety, however that is at justsecurity.org, one useful resource that I exploit and that a number of people use, there are others. This website, for instance, tracks 597 challenges, as of this morning, to actions by the present administration, and also you’re in a position to filter by challenge. So below the problem dropdown, in the event you take a look at authorities grants, loans, and help, you will see 125 circumstances, and it bumps as much as 147 in the event you embrace the DEI-related challenge, which form of sweeps in a pair extra associated circumstances that problem circumstances primarily based on these government orders. So you’ve gotten about 150 circumstances, which is why it is troublesome for me to reply any explicit query about anybody.
54 of these are categorized, as of at this time, as having offered some aid to plaintiffs, both by having a authorities motion blocked completely or quickly. And that short-term is… once more, as a result of these circumstances play out over time, so the courtroom may enter an order initially of a case that solely lasts whereas the case is being litigated, after which there can be one other closing order on the finish. So some issues to take a look at and take a look at as you are getting ahold of these items, in case your metropolis or state has sued, you may be extra prone to have a funding stream that comes by the state or metropolis to you be affected by considered one of these orders. So on this slide, I gave an instance, you would look, for instance, in the event you’re in Colorado, you would strive looking by Colorado and see that a few circumstances are pulled up.
And you may discover that it is not only a case that claims State of Colorado, it is this one that claims State of New York, and that is as a result of, typically, you do not see all the plaintiffs in a case title or in a case doc. You do not even see, in the event you take a look at an order, all the plaintiffs listed on the highest of that order, you typically solely discover the complete listing of plaintiffs in the event you return to the unique doc in a lawsuit, which is the criticism. And so this website does a pleasant job of placing that actually essential doc in simple view for you. So in the event you clicked on criticism on the State of New York website, you’d be capable of see that Colorado and different states are additionally listed in a part of this case and a part of the aid that was given. One other manner you’ll be able to filter, which I’ve proven on the following slide, is by specializing in funding stream.
And I’ll say simply as one caveat that these searches aren’t good, particularly for the town and state. I attempted a couple of issues to try it out, some issues had been caught, some issues weren’t. So that is only a method to get began, but it surely’s not an absolute match. So for instance, right here, I filtered by Continuum to attempt to catch HUD Continuum of Care funding associated circumstances, and there have been really 4 outcomes right here, you’ll be able to see a few them on the display screen. And in the event you appeared on the King County case and clicked on that second amended criticism, which is the latest one, you’d see an inventory of over 60 counties, municipalities, and different native housing and transportation businesses who’re all plaintiffs, and from throughout the nation, as a result of you’ll be able to have plaintiffs that attain past the area the place the case was introduced. So the aid that plaintiffs have gotten in that case would stretch to all of these entities.
I wish to… as a substitute of… Properly, I am going to simply give one fast instance, however I do know we wish to wrap up and go away some extra time for questions right here. However simply as a little bit context of the form of circumstances we’re right here, for instance, the King County case, problem circumstances imposed within the gender ideology, DEI, Hyde Modification, and Immigration Government Orders as utilized to HUD and DOT grants that fund housing and companies designed to offer long-term stability to individuals and households experiencing homelessness. And so forth the following slide, you see a little bit snapshot of the order that was entered in that case.
The highlighting is a little bit bit under the road as a substitute of on it, however basically, that is simply an instance of an order and why it is troublesome to generally learn these and why it is a little bit little bit of a puzzle. So it is enjoining sure funding as outlined within the motions, so then it’s a must to return and discover these, simply as utilized to the HUD plaintiffs. And once more, that is the place you’d have to return to the criticism, as a result of the highest of this order is just going to listing one plaintiff and never all of them. And so it offers you maybe a glimpse into a sophisticated state of affairs, and hopefully, helps you establish what inquiries to ask and to possibly interpret solutions you are getting that appear difficult or unsure. One other useful resource, once more, that I am going to reiterate is simply being in contact along with your native entities or lawyer’s common workplaces that could be concerned in a few of this litigation.
There are a variety of states which can be coming collectively in coalition and difficult circumstances, and in order that’s one method to hold observe of what applies to you. And for these of you who’re simply fascinated by what sorts of orders these courts are getting into, it may give you an concept of what circumstances and kind of pink flags of what varieties of circumstances are probably problematic and opposite to regulation. That is it.
Denny Chan: Nice. Thanks, Kell. I will ask all of our presenters to return again on display screen now or on digital camera. These are some sources that we have talked about, and I do know that folk have been dropping sources into the chat. So right here, we’ve a useful resource that Justice in Ageing and Sage labored on final yr round supporting LGBTQ older adults, primary wants, in addition to the Medicare truth sheet that I discussed, the A4TE Doc Middle that Kell flagged, in addition to the Lambda Authorized Assist Desk. And this slide has our contact info. So I am going to go away that up as we attempt to speedy hearth, undergo some questions.
As I predicted, we bought a bunch after I requested individuals to submit questions. So I’ve tried to group them in my head as a lot as attainable, and I’ll begin first with you, Aaron, as a result of I do suppose there have been a few buckets that individuals are asking about primarily based on what you talked about. So one is that there have been plenty of questions from people who’re fascinated by shifting native LGBTQ Lengthy-Time period Care Invoice of Rights of their areas, whether or not that is native or state degree. And so ideas and recommendation on the right way to get began, the place to get began, who ought to they be speaking to? What’s your fast and quick on that?
Aaron Tax: Certain. So you will see my electronic mail up right here, be at liberty to electronic mail me. Sage is pleased to assist, however we’ve our limits, we’ve a comparatively small staff. So what our position usually is is to assist present technical help, which means, we might help with drafting, discuss classes discovered in different states or different jurisdictions, however the place we actually lean on companions is for the legwork on the bottom, we do not have these relationships in communities and states all throughout the nation. So for instance, we’re working proper now, as I discussed, in Illinois, the place we’ve nice companions on the bottom, together with AIDS Basis Chicago, Equality Illinois, and different companions. And so they’re actually doing the legwork to maneuver the ball ahead in Illinois, however the place we helped out was the drafting and speaking once more about a number of the points we have seen come up in different jurisdictions.
So by all means, be at liberty to electronic mail me, we’re pleased to assist, and we’re extra accustomed to doing them on the state degree, however one factor we do wish to discover, significantly within the South and significantly in pink states, is attempting to maneuver these legal guidelines in cities the place we will. So by all means, attain out, and we’re pleased to speak and pleased that will help you out.
Denny Chan: Thanks, Aaron. I will persist with you, and likewise flag for people, I do know that we’re working on the clock on this one, and we’ve 29 open questions. So no matter we do not get to, we are going to observe up with people. We’ve your contact info primarily based on the webinar registration, so we are going to attain out in some unspecified time in the future. However one other bucket, Aaron, for you was individuals actually getting very excited, in a great way, round desirous to weigh in on the OAA potential modifications. So are you able to remind us the place we’re with that? After which as you and I’ve talked about by way of technique, what you’ll be able to forecast for people when the discover of proposed rulemaking drops, what ought to they expect from us by way of the right way to weigh in?
Aaron Tax: Certain. So it might occur tomorrow, it might occur months from now, it might occur subsequent yr, we do not know. All we all know is we count on it to occur. And one little tip off is there was one thing posted within the federal register about this late final yr, which appeared to say it was shifting ahead, however then it stalled. So we count on it to occur. And by way of what you are able to do to assist and the timing, as Denny mentioned, if and when it occurs, we are going to you should definitely share it on our listing. So in the event you’re not on Sage’s Motion Squad listing, I encourage you to get on that listing. When you’re not on the Justice in Ageing listing that Kell and Sahar shared a little bit bit earlier, I encourage you to get on their listing. So you will undoubtedly hear it from our organizations throughout social media and on our listing.
And when it occurs, we count on there will be a 30-day remark interval, throughout which era, you’ll be able to weigh in along with your ideas about why the motion the administration is taking is bigoted and capricious and isn’t primarily based on something of substance, it is merely primarily based on animus. And everybody on this name, I presume, has its personal space of experience. So a few of you may be direct service suppliers, you’ll be able to discuss that have. When you’re information specialists, you’ll be able to discuss concerning the information on the topic. When you’re researchers, you’ll be able to discuss concerning the analysis you understand about these populations and why they’re in larger social want, so on and so forth. So we would like this to be genuine, and other people to share their experience and their tales. And in the event you’re an LGBT older particular person your self, share your story of challenges accessing getting old companies and helps, or successes, and why language like that is so essential.
So I feel lengthy story quick, keep tuned, we’ll let you understand when the second occurs. And when it occurs, we encourage you to put in writing in along with your feedback. And we’ll create a system so that you can try this, so don’t be concerned about it being difficult or having to poke across the federal register, between us and Justice in Ageing and the opposite teams, we will make it simple for you.
Denny Chan: Thanks, Aaron, for that. I will shift now to Kell, as a result of there’s a bucket of questions, I will attempt to summarize this bucket the very best I can in two minutes, round passports and start information, intercourse assigned at start. Are you able to remind us… and I do know a few of this you mentioned, however are you able to give us a fast reminder the place the litigation’s at? Are individuals nonetheless in a position to replace start certificates which can be in line with their gender id? How does that relate to the passports, and what we will count on from litigation?
Kell Olson: Yeah. So I used to be attempting to seize a couple of of those as we went. As for the particular start certificates change query, it’s state by state, is determined by the state you reside in, and that is why that Advocates for Trans Equality web site doc middle’s the place to start out, and that web site is transequality.org, or Google A4TE Doc Middle and you’re going to get there. In order that’s for checking on the present standing. Somebody requested concerning the potential consequence as to the last word resolution in that Orr v. Trump case, I want I might let you know what the last word consequence could be. We’ve a few indicators, the truth that the Supreme Court docket initially flagged that at the least one of many justices considered the gender marker on a passport as being just a few historic info, like the place you had been born, is a few indicator that there could possibly be a foul consequence from, at the least, or preliminary impression by some justices.
I am hoping that the sensible factors went on the market, which is that we use demographic info to be up to date so {that a} customs official can inform that you’re the particular person holding your doc, so it does not make sense that that may be historic, identical to I haven’t got on my passport that I weigh eight kilos and nonetheless many ounces, as a result of loads has modified since I used to be born. So having an F on my passport, for instance, doesn’t assist… as a transgender particular person, doesn’t assist that customs official matched that doc to me. And so I feel the sensible training can be actually essential in getting the fitting consequence in these circumstances to actually discuss how we use IDs and why.
So yeah, that is the place we’re. It will proceed to be litigated, it should proceed being a problem over the following couple of years. I do not know the way the State Division’s figuring out intercourse assigned at start, which was one other query, a number of these paperwork which can be referenced within the query are within the management of the state. So the clearest instance could be somebody who has modified their passport gender marker prior to now and needed to verify that particular field that we’ve to verify once we’re doing that. And so that may be within the federal system. So I do not know if they’ll catch everybody or not with that. There are additionally some questions on misgendering litigation and different issues, there have been an excellent resolution out of the California Supreme Court docket in that regard.
I want to say that if individuals are having points with misgendering and amenities, that Lambda Authorized would undoubtedly recognize listening to about these, flagging these, focusing on our advocacy towards that. And there are state and native insurance policies that may be enforced. So please do attain out and share these tales with us so we will be in contact and assess what is going on on.
Denny Chan: Thanks, Kell. I do know we’re a little bit bit over time, so I wish to simply give an enormous thanks to Kell, Aaron, and Sahar for his or her shows at this time, for all of you for sticking with us for the previous hour. To Kell’s level, these are the problems that we’re watching, we wish to hear from you all if issues are going effectively or not going effectively for the purchasers that you just serve. Equally, after I was speaking about Medicare and gender-affirming care, supplying you with the state of the land, and telling you that the coverage developments are actually as they relate to minors, however we do know that there could possibly be a possible chilling impact for older adults who’re looking for related care. So when issues are working effectively, when issues aren’t working effectively, please do attain out and tell us what you are seeing on the bottom. Our emails are right here on the slide, and this recording can be made out there to everybody who registered. Thanks once more to Kell, Aaron, and Sahar. Thanks to all of you, and we’ll be in contact. Thanks.
