The fiscal year 2024 appropriations process has been littered with anti-LGBTQ attacks. Republican members of the House of Representatives have inserted anti-LGBTQ provisions into all 12 of the must-pass appropriations bills. These riders include restrictions on gender-affirming care, allowances for discrimination against same-sex couples, prohibitions of drag performances, banning of pride flag displays, and restrictions on diversity and inclusion programs.

These harmful anti-LGBTQ provisions come at a time when legislative attacks against the LGBTQ community are at an all-time high. As of this month, 506 anti-LGBTQ bills have been introduced in state legislatures this year alone. Bills such as the Protection of Women and Girls in Sports Act, which would prohibit transgender students from participating in sports teams that align with their gender identity, have been introduced in the House of Representatives at alarming rates. In fact, the House has already passed other pieces of legislation that are considered to be must-pass bills, such as the National Defense Authorization Act for Fiscal Year 2024, with provisions that ban gender-affirming care, drag performances, and pride flag displays.

Mapping Attacks on LGBTQ Rights in U.S. State Legislatures

In the last few years states have advanced a record number of bills that attack LGBTQ rights, especially transgender youth. The ACLU is tracking...

Out of all the appropriations bills, however, the Labor, Health, and Human Services, Education, and Related Agencies Appropriations Bill for FY 2024 is arguably the most nefarious and dangerous for the transgender community. The anti-LGBTQ riders in this bill seek to prohibit funds from being used for implementing anti-discrimination and equity programs, taking discriminatory action against anyone that speaks or acts in accordance with the belief that marriage is between a man and a woman, or displaying pride flags. Section 534 of this bill would also prohibit funds from being used for gender-affirming surgical procedures or hormone therapies. If passed, this will have extensive, damaging effects.

The Centers for Medicare and Medicaid Services (CMS) is an agency within the U.S. Department of Health and Human Services, one of the departments funded by the Labor-HHS Appropriations Bill. CMS provides health coverage through Medicaid to about 84.5 million enrollees as of July 2023, including eligible low-income adults. Currently, Medicaid is one the largest payers for health care in the United States.

Protect Trans Care Now

As wave after wave of extreme measures to criminalize and strip trans people of rights and safety continue, tell Congress to act.

As of December 2022, about 276,000 transgender people in the United States are enrolled in Medicaid and about 60 percent of these beneficiaries reside in states or territories where Medicaid programs specifically include coverage for gender-affirming care, including hormone therapy, surgical procedures, and other gender-affirming treatments. Another 27 percent of transgender Medicaid beneficiaries live in states where laws are silent or unclear on coverage for gender-affirming care. In 14 states, laws do not include express statutes or policies addressing gender-affirming care under Medicaid. In four additional states, policies explicitly exclude this care under state Medicaid programs, but actions by state legislatures, officials, and courts have indicated that these states have inconsistently enforced or may not be enforcing these policies. Unfortunately, about 14 percent of transgender Medicaid beneficiaries reside in states that expressly ban access to gender-affirming care covered by Medicaid.

This 14 percent will grow drastically with the passage of the Labor-HHS Appropriations Bill. Without funding for the U.S. Department of Health and Human Services, Medicaid programs will be unable to cover gender-affirming surgical programs or hormone therapies for thousands of transgender people, many of whom are low-income.

Not only will too many lack the sufficient funds to turn to private medical programs or services, but states are also increasingly introducing and passing restrictions on gender-affirming care across the country. There are currently 135 state bills targeting health care for transgender people, many of which seek to ban gender-affirming care, establish criminal penalties for providing such care, or block funding to medical centers that offer this life-saving care.

You and your elected members of Congress are our last line of defense against this national threat. All of us, collectively, must work to stop any effort to harm or criminalize our trans friends, families, and communities. Tell your members of Congress that gender-affirming care is safe, medically necessary, evidence-based, and life-saving. Tell your members of Congress that every leading medical organization in the country, including the American Medical Association, the American Psychiatric Association, and the American Academy of Pediatrics, all strongly oppose efforts to criminalize and deny gender-affirming care. Tell your members of Congress that individual health care decisions should be made between a patient and their doctor —not with fear-mongering politicians who have little to no medical expertise.

Together, we can work to protect trans people and prevent more nefarious attacks on the trans community, and the greater LGBTQ community at large, from coming to fruition.

Earlier this month, the United Nations Human Rights Committee delivered a searing report highlighting the U.S. government’s failure to meet its human rights obligations under the International Covenant on Civil and Political Rights (ICCPR). This international treaty, ratified by the U.S. in 1992, is one of only three key human rights treaties that the U.S. has ratified.

The U.N. committee’s concluding observations echo many of the concerns and recommendations raised by civil society groups last month during the U.S. review, where they sounded the alarm on violations of various human rights issues including Indigenous rights, voting rights, freedom of expression and assembly, gender equality and reproductive rights, criminal legal reform, immigrants’ rights, and more. Here are three key takeaways from the committee’s report.

Among their concluding observations, the committee stressed the lack of progress in establishing a national human rights institution (NHRI). An NHRI would play a crucial role in monitoring and ensuring that international human rights standards are being upheld at the national level.

While the Biden administration has called for continued dialogue around an NHRI in the U.S., concrete actions have yet to materialize. The committee’s urgent recommendations corroborate the longstanding demand from civil society groups to establish a presidential commission to explore options for creating an NHRI. Already, this call to action has been backed by several members of Congress and the International Association of Official Human Rights Agencies.

The committee urged the U.S. to “redouble its efforts to ensure the reunification of all separated children with their families, guarantee that such family separations are prohibited in the future, and ensure that victims have access to effective remedies and receive full reparation, including adequate compensation and appropriate support services.” These recommendations align with those in the ACLU’s shadow report on family separation, and coincided with the ACLU’s announcement of a major settlement in Ms. L. v. ICE, which established that the U.S. government must continue to identify families that were separated by Trump’s zero-tolerance policy and provide a pathway for them to seek asylum in the U.S. The committee also raised concerns regarding racial discrimination and due process violations in the U.S. child welfare system, including the disproportionate number of Black and Indigenous children separated from their families.

Shadow Report to UN Human Rights Committee: Family Separation in the U.S. Child Welfare System, at the U.S.-Mexico Border, and of Indigenous Communities

The committee concretely addresses a wide range of human rights violations in the U.S. criminal legal system, including extreme sentencing, which the ACLU has raised in our joint report with the Princeton Advocacy Policy Clinic. Most notably, the committee called on the U.S. to “establish a moratorium on the imposition of sentences to life imprisonment without parole.” This was a result of powerful testimonies and advocacy by various groups, including the Abolitionist Law Center and the Center for Constitutional Rights, which raised the torturous practice of death by incarceration to the committee.

The committee also urged the U.S. to establish a federal moratorium of the death penalty, abolish life without parole sentences for children, as well as the mandatory and non-homicide-related sentence of life imprisonment without parole, and make parole more accessible to all prisoners, including those sentenced to life imprisonment. For the first time, the committee called on the U.S. to expand parole eligibility for all incarcerated individuals, irrespective of age or the crime committed. These recommendations were also echoed in the recent report by the U.N. Expert Mechanism to Advance Racial Justice and Equality in Law Enforcement, which visited the U.S. last spring.

Michigan Lawmakers Must Protect the Rights of Children and Join the Global Consensus

Efrén Paredes, Jr., incarcerated since the age of 15, explains why Michigan must turn the page on juvenile-life-without-parole sentences.

The U.S. touts itself as a global leader of universal human rights. Yet the committee’s report memorializes the immense gap between U.S. laws and policies and international human rights norms — even in the area in which the U.S. has heralded itself as a leader for decades: civil and political rights. And while the Biden administration has prioritized human rights in some ways, it has failed to pursue bold actions to demonstrate that it is leading by the power of example.

While the responsibility to implement the committee’s concluding observations lies with federal, state, and local governments, the Biden administration should immediately devote the necessary attention and resources to realizing these recommendations.

It can start by creating a transparent and permanent executive branch human rights monitoring body to review and create a plan of action to implement the committee’s recommendations. It can also convene a White House summit on domestic human rights to celebrate the 75th anniversary of the Universal Declaration of Human Rights. This would be an excellent opportunity to appoint a presidential commission to study the creation of an NHRI in the U.S. Additionally, the White House should instruct all federal departments and agencies to review and implement the committee’s observations and create incentives for state and local governments to do so under their jurisdiction.

The committee has asked the U.S. to follow up in three years with its progress in three main areas: reproductive rights, voting rights and freedom of assembly. While the next U.S. periodic review will take place in 2031, the U.S. government must immediately start implementing these recommendations and ensure that this process is informed by meaningful consultation with civil society organizations. As the world watches, we cannot waste any time to realize human rights for all in the U.S.

Voting is the cornerstone of our democracy and the right that empowers us to enact change and hold elected officials accountable. It is also key to achieving systemic equality, particularly given our country’s long history of limiting access to the ballot for communities of color, especially Black voters, which persists today. Discriminatory policies and legislation continue to prevent voters of color from exercising this right easily, if at all.

As another presidential election year draws near, the ACLU continues to protect the right to vote and push back against attempts to suppress our voices at the ballot box. The ACLU voting rights team is working to expand and protect voting rights around the country. So we decided to put their expertise to the test with some rapid-fire voting rights questions. Watch their answers below, or take a shot at answering some of the questions yourself.

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