Disability Advocates Alarmed by HHS Removal of Gender Dysphoria Protections

The U.S. Department of Health and Human Services (HHS) recently announced that gender dysphoria is not protected under Section 504 of the Rehabilitation Act.

In 2024, the Biden administration issued a final rule that interpreted Section 504 to include gender dysphoria. However, in a brief statement, HHS Secretary Robert F. Kennedy Jr. clarified his view that references to gender dysphoria in the preamble of the rule are not legally binding.

“The Department is nonetheless concerned there has been significant confusion about the preamble language referencing gender dysphoria in the 2024 Section 504 Rule,” Kennedy wrote. “It is well-established that where, as here, the language included in the regulatory text itself is clear, statements made in the preamble to a final rule published in the Federal Register, lack the force and effect of law and are not enforceable.”

Removing gender dysphoria from Section 504 significantly reduces protections for transgender people who face discrimination in health care, education, and housing. Under the previous interpretation of the Biden-era rule, recognition of gender dysphoria as a disability could be a legal basis for trans people to seek reasonable accommodations. The previous interpretation also provided a basis for legal arguments to combat discrimination.

“Removing gender dysphoria as a protected disability is yet another angle of attack on transgender rights by the Trump administration. This opens up those with gender dysphoria to discrimination in the workplace, school, and pretty much all aspects of life, without legal recourse,” LGBTQ legislative researcher Allison Chapman told Truthout.

Kennedy’s clarification was likely issued in response to an anti-trans lawsuit filed by Republican Texas Attorney General Ken Paxton, who opposed the Biden administration’s earlier interpretation that federal disability protections could apply to gender dysphoria, which was joined by 16 other Republican attorneys general. Although the lawsuit was specifically drafted to target transgender legal protections, the suit was written so broadly that it effectively challenged the entirety of Section 504.

HHS’s new statement appears to be an attempt to moot the lawsuit, aiming to settle the controversy by clarifying that gender dysphoria is not covered under Section 504 protections in the view of the Trump administration. Whether the coalition of attorneys general will drop their lawsuit remains to be seen; if they drop their lawsuit, Section 504 will remain in place — for now.

However, disability justice activists have loudly denounced the exclusion of gender dysphoria from section 504 protections, emphasizing that trans rights are an integral part of disability justice. DISrupt West Virginia, a disability justice collective formed to resist threats to Section 504, has said that “Disability justice includes trans people. Period.”

“RFK Jr. pointing out that the preamble isn’t law isn’t news, it’s exactly why we’ve been calling on attorneys general to drop this performative lawsuit before it causes real harm,” the DISrupt Coalition told Truthout.

The group told Truthout that, under the precedent set by Williams v. Kincaid, gender dysphoria is actually already recognized as a protected condition under the Americans with Disabilities Act (ADA) in the Fourth Circuit — which includes Maryland, North Carolina, South Carolina, Virginia, and West Virginia.

“504 has protected disabled people for 50 years,” the group said. “If they think we’ll let them gut it without a fight, they haven’t met DISrupt.”

Dom Kelly, cofounder of New Disabled South, agreed. “It’s clear that the Trump administration and the Republican party are willing to throw disabled people under the bus in pursuit of their bigoted, transphobic agenda. But even more, it’s clear that they don’t understand gender dysphoria or disability,” Kelly told Truthout. “At this point, the disability community needs to realize that this is just the beginning, and if we are to mitigate any of the harm this administration does, we have to remain in solidarity with the trans community.”

The Trump administration has increasingly targeted both trans individuals and disability rights — most notably by lumping “accessibility” into broader diversity, equity, and inclusion initiatives, while simultaneously dropping civil rights complaints filed by disabled and transgender people.

“We must urge states and local governments to pass and enforce anti-discrimination laws that include gender dysphoria and sexual orientation and gender identity protections, as it’s clear the federal government will not protect us,” Chapman told Truthout.