National
HHS expands hospital visitation rights for gay couples
Patients may designate visitors during hospital stay
The Department of Health & Human Services on Wednesday unveiled a new policy to enhance hospital visitation rights for same-sex couples.
The Centers for Medicare & Medicaid sent a letter on Wednesday to states building off the memorandum President Obama issued last year mandating that hospitals receiving Medicare and Medicaid funds allow patients to designate their own visitors during a hospital stay, including a same-sex partner.
In November, HHS issued the final rule implementing Obama’s proposed change. The letter sent to states on Wednesday provides the enforcement mechanism by which state survey and certification groups can ensure hospitals are abiding by the policy.
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Jesse Moore, an HHS spokesperson, said his department generally works with hospitals to bring them into compliance with rules and, at this point, HHS hasn’t heard of any problems with the guidance related to same-sex couples.
However, Moore said if a hospital doesn’t comply with the new rule and fails to fix the problem, HHS has “the power to terminate a Medicare provider agreement.”
The guidance that will be given to state survey agencies marks the last step in implementing the change that Obama proposed on hospital visitation last year.
Additionally, the letter also issues guidance mandating that hospitals recognize advance directives designating a same-sex partner as someone who can make emergency medical decisions for a patient who’s incapacitated. The department clarifies hospitals should defer to patients’ wishes concerning their representatives — whether expressed in writing, verbally or through other evidence — unless prohibited by state law.
HHS Secretary Kathleen Sebelius emphasized the importance of the policy change to LGBT couples in a statement.
“Couples take a vow to be with each other in sickness and in health and it is unacceptable that, in the past, some same-sex partners were denied the right to visit their loved ones in times of need,” Sebelius said. “We are releasing guidance for enforcing new rules that give all patients, including those with same-sex partners, the right to choose who can visit them in the hospital as well as enhancing existing guidance regarding the right to choose who will help make medical decisions on their behalf.”
The new guidance updates the conditions of participation for hospitals participating in Medicare and Medicaid, which are the health and safety standards that these hospitals must meet. The change applies to all patients of these hospitals — even if the patient isn’t on Medicare or Medicaid.
Don Berwick, the CMS administrator, said the updated guidance to states is beneficial for same-sex couples and enhances the quality of health care throughout the country.
“This announcement is another step toward equal rights for all Americans, and it is another step toward putting the patient at the center of our health care system,” Berwick said. “All patients should be afforded the same rights and privileges when they enter our health care system, and that includes the same opportunity to see their significant other.”
LGBT rights groups were quick to praise the updated policy as a means to ensure LGBT Americans are treated fairly during hospital stays.
Rea Carey, executive director of the National Gay & Lesbian Task Force, commended HHS for issuing the updated policy in a statement as she said more work is necessary.
“Ensuring that the medical wishes of [LGBT] people are respected is an example of the federal government recognizing the life of LGBT families,” Carey said. “An emergency situation in a hospital is the last place where anyone should feel unsafe. While a positive step forward, it is critical we continue to work at all levels of government to make sure our families are fully recognized and treated fairly.”
Michael Cole-Schwartz, spokesperson for the Human Rights Campaign, also said the guidance is beneficial to LGBT people seeking hospital treatment.
“This is a great step to help ensure enforcement of a common sense policy,” Cole-Schwartz said. “No one should be denied the ability to visit their loved ones in the hospital and this next step ensures that principle will be carried out.”
In addition to sending out this letter, the Health Resources & Services Administration, an agency within HHS, is set to announce a $248,000 grant to help create a national training and technical assistance center aimed at helping community health centers improve the health of LGBT populations. The grant was awarded to Fenway Health, a Boston-based center that works to provide the LGBT community access to health care, education, research and advocacy.
NOTE: This article has been updated.
CORRECTION: An earlier version of this article, quoting HHS spokesperson Jesse Moore, incorrectly stated HHS could revoke accreditation for hospitals that fail to comply with the change.
Federal Government
DOE investigates Smith College’s trans-inclusive policy
New investigation into the historic, exclusive all-women’s college signals a ramp-up by the Trump administration in rolling back transgender rights.
The U.S. Department of Education announced on Monday that it opened an investigation into Smith College for admitting transgender women.
Smith College, a private and famously all-women’s college in Northampton, Mass., established in 1871 and opened in 1875, has a long list of women who make up its historic alumni — including first ladies, influential political figures, and cultural leaders.
The DOE released a statement about the investigation into the institution through the Department’s Office for Civil Rights, saying it was looking into the possibility that Title IX of the Education Amendments of 1972 was violated by allowing trans women, referred to in the statement as “biological males,” into women’s intimate spaces protected by IX.
The statement explicitly highlighted that this stems from trans women being granted “access to women-only spaces, including dormitories, bathrooms, locker rooms, and athletic teams” while also allowing their audience into the school itself.
This is the first time the Trump-Vance administration has taken a step into admissions processes, a stark jump past investigating policies that allowed trans women to participate in women’s sports and use women’s bathrooms, and allows for the administration to go more after trans acceptance policy as a whole.
Smith’s admission policy allows for “any applicants who self-identify as women,” including “cis, trans, and nonbinary women,” according to the college’s website, and has since 2015, when it updated its policy.
“The college is fully committed to its institutional values, including compliance with civil rights laws,” Smith’s statement in response to the DOE’s investigation said. “The college does not comment on pending government investigations.”
“An all-women’s college loses all meaning if it is admitting biological males,” said Assistant Secretary for Civil Rights Kimberly Richey. “Allowing biological males into spaces designed for women raises serious concerns about privacy, fairness, and compliance under federal law. The Trump administration will continue to uphold the law and fight to restore common sense.”
This move continues to align with actions the Trump-Vance administration has taken to curtail LGBTQ — and specifically trans — rights in America, as members of the administration attempt to break down safeguards and protections that have long been used to protect marginalized communities.
Since Trump took office in his second term, there have been significant legal challenges. According to the National LGBTQ+ Bar Association, there are over 35 court cases that have emerged since his second swearing-in that directly relate to the administration’s attempts to minimize the rights and protections of trans Americans — from medical care and educational protections to military policy.
Much of this anti-trans policy direction was outlined beginning in 2022 with the Project 2025 playbook, which Trump officials have used as a guide to scale back protections for LGBTQ people, Black Americans, poor and Indigenous communities, while also increasing costs for lower-income Americans and providing tax cuts to the wealthy and ultra-wealthy. The plans also “erode” Americans’ freedoms and remove crucial checks and balances that have allowed the executive branch to remain in line with the Constitution without becoming too powerful over either the courts or the legislative branch.
New York
Gay ICE detainee freed after 150 days in detention
Cayman Islands native taken into custody before green card interview
Following nearly half a year in U.S. Immigration and Customs Enforcement detention, Allan Marrero has been released and is back home with his husband in New York.
Marrero spent 150 days in ICE custody, held in multiple detention centers across the U.S. after missing an immigration court hearing while in a rehabilitation program for alcohol addiction — a circumstance widely considered “good cause” for failing to appear.
The Washington Blade first reported on Marrero’s case in March after the Cayman Islands native was detained by ICE officers during what was supposed to be a routine marriage-based green card interview at 26 Federal Plaza in New York City.
Marrero had been married to his husband, Matthew Marrero, for two years at the time of the interview. But almost immediately, the experience turned hostile.
The Rev. Amanda Hambrick Ashcraft, a minister at Middle Church in Manhattan who accompanied the couple to provide spiritual support, later described the process as “dehumanizing” and “barbaric.”
During the interview, it became clear the couple was facing an uphill battle. At one point, when asked how they met, Matthew Marrero instinctively looked over at his husband and was “snapped at” and told not to look at him. As the interview continued, the outlook only grew more grim.
Unaware that he had a prior removal order tied to the missed court date while he was in rehab, Allan Marrero was detained on the spot.
Over the following months, Allan Marrero was transferred through multiple detention facilities, including centers in Arizona and Texas, the Everglades Detention Facility — also known as “Alligator Alcatraz,” which has been described as having “unsanitary inadequate conditions” — and ultimately a detention center in Mississippi.
While in custody, Allan Marrero was denied access to prescription medication and, according to advocates, was psychologically pressured by ICE agents to self-deport rather than remain detained while his legal case proceeded.
Although a judge later reopened his case and granted bond after Allan Marrero provided proof that he had been in rehab — a valid medical reason for missing his court date — ICE used procedural mechanisms to keep him detained. A separate judge later issued a ruling denying relief, leaving Allan Marrero in custody.
On the outside, Matthew Marrero said his life felt as though it had been put on pause so ICE could meet enforcement quotas.
“[It feels like] somebody came in and kidnapped someone close to you and took away all of your control and power,” Matthew Marrero told the Blade on March 7. “You shouldn’t be able to have this much control over somebody’s life, especially if they are trying to do the right thing … You’re not going after criminals, you’re not going after the worst of the worst. You’re trying to fill a quota.”
Alexandra Rizio, Allan Marrero’s attorney with Make the Road New York, a progressive grassroots immigrant-led organization, told the Blade that “there seems to be an underlying element of cruelty baked into not only this administration, but everything.”
“It didn’t have to go down that way,” Rizio continued. “If someone goes in for a green card interview and their marriage interview, and they learn that they have a removal order, what the USCIS officer could have done is say, ‘Look, you have a removal order in your name. You need to go hire an attorney right away to get this taken care of. I can’t adjudicate your green card…’ And if you hire a lawyer, you know, you might be able to get it straightened out. Of course, that’s not what happened. And so ICE, which was in the building, were called and they did arrest Allan.”
The Marreros are scheduled to hold a press conference on Tuesday at Middle Church, where Allan Marrero will speak publicly for the first time about his detention.
For additional information on the press conference please visit middlechurch.org.
Federal Government
Republicans attach five anti-LGBTQ riders to State Department funding bill
Spending package would restrict Pride flags on federal buildings, trans healthcare, LGBTQ envoys
As Congress finalizes its funding for fiscal year 2027, Republicans are attempting to include five anti-LGBTQ riders in the National Security and Department of State Appropriations Act.
A rider is an unrelated provision tacked onto a bill that must pass — in this instance, the bill provides funding for national security policy and for the State Department.
The riders range from restricting Pride flags in federal buildings to banning transgender healthcare, but all aim to limit the visibility and rights of LGBTQ Americans.
The five riders are:
Section 7067(a) prohibits Pride flags from being flown over federal buildings.
Section 7067(c) restricts the United States’ ability to appoint special envoys, representatives, or coordinators unless expressly authorized by Congress. These roles have historically been used to promote U.S. interests in international forums — including advancing human and LGBTQ and intersex rights and other policy priorities. The change would halt what the Congressional Equality Caucus describes as providing “critical expertise to U.S. foreign policy and leadership abroad.”
Section 7067(d) reinforces multiple anti-equality executive orders signed by President Donald Trump, effectively requiring that foreign assistance funded by the United States comply with those orders. This includes rescinding federal contractor nondiscrimination protections, including for LGBTQ people.
Section 7067(e) prohibits funding for any organization that provides or promotes medically necessary healthcare for trans people or “promotes transgenderism” — effectively banning funds for organizations that recognize trans people exist. This is despite the practice of gender-affirming care being supported by nearly every major medical association.
Section 7067(g) reinforces two global gag rules put forward by the Trump-Vance administration. One is the Trans Global Gag Rule, which prohibits foreign assistance funding for organizations that acknowledge the existence of trans people or advocate for nondiscrimination protections for them, among other activities. The second is the DEI Global Gag Rule, which prohibits foreign assistance funding for organizations that engage in efforts to address the ongoing effects of racism, sexism, and other forms of bigotry outside the United States.
The global gag rule has its roots in anti-abortion policy introduced by President Ronald Reagan in 1984, when the 40th president barred foreign organizations receiving U.S. global health assistance from providing information, referrals, or services for legal abortion, or from advocating for access to abortion services in their own countries. Planned Parenthood notes that the policy also affects programs beyond abortion, including efforts to expand access to contraception, prevent and treat HIV/AIDS, combat malaria, and improve maternal and child health.
If organizations funded by the State Department engage in these activities, they could lose funding.
This anti-LGBTQ push aligns with broader actions from the Trump-Vance administration since the start of Trump’s second term, which have focused on restricting human rights — particularly those of trans Americans.
The House Appropriations Committee is responsible for drafting the appropriations legislation. U.S. Rep. Tom Cole (R-Okla.) serves as chair, with U.S. Rep. Rosa DeLauro (D-Conn.) as ranking member. The committee includes 34 Republicans and 27 Democrats.
For FY27 appropriations, Congress is supposed to pass and have the president sign the funding bills by Sept. 30, 2026.

