Both chambers of the Maryland legislature have passed a bill that would require the state's Medicaid program to cover gender affirming care.

While some gender affirming treatments are currently covered by Medicaid, the Trans Health Equity Act would expand coverage to all forms of gender affirming treatment that are consistent with current clinical standards.

Last year - the Williams Institute at the University of California, LA - estimated there are 24,000 Transgender Marylanders.

The legislation was introduced in the House by state Del. Anne Kaiser - D-Montgomery County - and she said she sees it as telling Trans Marylanders they are part of the community.

"I like to think," said Kaiser, "that this legislation tells trans Marylanders, as I said at the hearing on Valentine's Day, 'We love you, you are welcome here, you are our neighbors, you're our friends, you belong, you're welcome' - which is obviously quite different from what is happening in some other states."

An amendment put forward on Friday by state Del. Mark Fisher - R-Calvert County - would have prevented Medicaid from providing gender-affirming care, including puberty blockers, to qualified patients under age 18.

Supporters of the amendment believe the science surrounding puberty blockers is not settled, but the amendment was rejected after an hour of debate.

The current standard of care in medicine including in Maryland allows children to access gender affirming care with the approval of parents and doctors.

Each bill will now be considered by the opposite chamber before going to the governor.

A similar bill passed the Senate last year but failed in the House. This time around supporters include Gov. Wes Moore - who, Kaiser said, is in favor of the measure.

"The governor spoke in favor of this legislation by name during the campaign and put out supportive documentation at the time," said Kaiser. "I spoke with his staff at the time and so we've connected with him now he's ready to sign the bill into law. "

If signed into law, the bill would take effect October 1.





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Rural LGBTQ+ youth in Indiana face greater mental health challenges, but have found ways to build community online, according to a new report. 48% of the state's LGBTQ-plus youth live in a small city or town, according to the 2024 Survey on the Mental Health of LGBTQ+ Young People in Indiana study. The next largest region is the suburbs.

Michael Parent, principal researcher with HopeLab, said the demographic has difficulty finding support in their communities, compared to their urban peers, but noted that there are some positive trends too.

"They had a lot of sense of internal pride in their identity," he said. "So despite being in some more challenging circumstances, they also had really positive internal feelings about themselves."

Parent added that, while young LGBTQ+ people in rural areas struggle to connect in person, they often find friends online. Those communities can be based around a shared LGBTQ+ identity but can also involve a shared passion for gaming or art. 53% of this demographic in Indiana are aged 18-to-24, while 47% are between 13 and 17.

Data from the survey found that family and community are seen as places of affirmation - an environment of validation through a sense of belonging, safety, and respect. Parent agrees community plays an important role, but pointed to a lack of in-person support for rural LGBTQ+ youth.

"Rural LGBTQ+ young people are having a lot of challenges in their circumstances and environments," he added. "But finding that they had a lot of internal sense of pride in their identity is really positive and was surprising, because we didn't really think that would show up."

Other ways to show support for the community include not supporting politicians that advocate for anti-LGBTQ+ legislation, accepting their partner, and doing research about gender identities.


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Advocacy groups are speaking out about how they believe congressional cuts to Medicaid will disproportionately affect caregiver LGBTQ+ communities in Illinois.

Jaimie Worker, senior director of policy and research for the advocacy group Caring Across Generations, said Medicaid can be a lifeline for LGBTQ+ people who are aging or living with disabilities, especially those without traditional family support. She explained for many, care is provided by "chosen family" or friends, with support from Medicaid largely making that possible.

"LGBTQ+ communities are impacted in a unique way when it comes to self-directed care: being able to choose who your care provider is as an older adult or person with a disability," Worker pointed out. "Many of these programs are heavily supported by Medicaid."

She noted as people already face barriers to receiving the care they need, Medicaid cuts would unnecessarily force some into institutional settings like nursing homes, where they would never have chosen to receive care.

An estimated 700,000 people nationwide are on waiting lists to receive home- and community-based care through Medicaid. Last year, more than 15,000 were in Illinois. No matter how dire their need, Worker stressed people can wait years to access these services and LGBTQ+ individuals face additional barriers.

"Those are the folks who already know about the services; not everyone is aware about the services that are available. LGBTQ folks are also more likely to experience discrimination while trying to access care needs."

Currently, people who make less than $22,000 a year in Illinois could qualify for Medicaid. Worker predicts new federal qualifications will make it more difficult for people to qualify, even with extremely limited resources.

"And make it harder for people to live and age with dignity, and largely in their own homes and communities where most people would prefer to live and age," Worker underscored.

She reported starting July 24, Caring Across Generations will host a 60-hour vigil for Medicaid in Washington, D.C., to amplify the stories of caregivers, people with disabilities, older adults and families from across the country.

June is Pride Month, and people who fight for LGBTQ+ health care are speaking out against huge proposed cuts to Medicaid, known as Medi-Cal in the Golden State.

The U.S. Senate is about to vote on the reconciliation bill, known as the "One Big Beautiful Bill Act." Republican backers say they want to add more work requirements and make people reapply every six months.

Juan Carlos Guerrero, western regional organizing manager for the nonprofit Caring Across Generations, said that will kick eligible people off the program.

"This is part of a misinformation that we're trying to really address and make clear that these are cuts to Medicaid services that are going to be felt in the community around us," he said, "through people who use it for in-hospital services, people who use it for in-home supportive services."

The bill's supporters have said they want to use the Medicaid savings to fund an extension of President Donald Trump's 2017 tax cuts.

LGBTQ+ people are three to four times less likely to have children and twice as likely to be single and living alone as adults, so they often depend on Medicaid. Caring Across Generations is organizing a 60-hour vigil for Medicaid on the U.S. Capitol grounds July 24-26. By that time, Guerrero said, the Senate and House will have each passed their own version of the bill and will need to hash out a compromise.

"There will have to be a larger discussion between them to reach a strong consensus on what the cuts should include," he said, "but with both their packages being different enough where it will lead to larger-scale conversations."

The mobilization protests in July will also highlight some important anniversaries coming up. July 28 is the anniversary of the Americans with Disabilities Act, July 30 marks Medicaid's 60th birthday, and in mid-August, the Social Security Act will turn 80 years old.