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Gender-Affirming Healthcare: FreeState’s Look Back on the 2024 Legislative Session

Joel Medina • Jul 17, 2024

This post is part of a series providing in-depth and accessible breakdowns of Freestate Justice’s various policy objectives and accomplishments over the past 2024 Legislative Session within the Maryland General Assembly. For more posts like this, check out Freestate’s 2024 Legislative Session Reflection Series.  


2024 has been quite eventful for LGBTQ+ Marylanders, with Freestate Justice and its coalition partners being involved in advocating for many bills that will affect the lives and well-being of Maryland’s LGBTQ+ community. 


One such piece of legislation that FSJ helped to pass this previous session was Senate Bill 119. This law will modify Maryland’s Health Code to include gender-affirming treatment (such as top surgery and hormone replacement therapy) within the definition of “legally protected healthcare.” Under the previous state of affairs, state law did not explicitly protect gender-affirming healthcare. This lack of protection led to much ambiguity regarding whether healthcare providers who administered this kind of care to patients (or the individuals who received it) would be subject to legal penalties, including fines and incarceration. 


Gender-affirming care is critically important to so many members of the LGBTQ+ community. The ability of people to define and express their gender is a human right, with a wealth of literature showing that access to gender-affirming healthcare for transgender and nonbinary individuals mitigates feelings of gender dysphoria (distress associated with a mismatch between one’s gender identity and their sex-related physical characteristics). Solidifying access to this form of support within the health code makes progress toward addressing many existing health inequities and injustices, creating a more affirming Maryland for all. 




When the bill was presented within the legislature, Freestate’s Policy Advocate and Legal Impact Coordinator submitted their testimony to the Health and Government Operations Committee Chair. They wrote that if the General Assembly did not add gender-affirming care to the definition of “legally protected healthcare,” then the state would leave medical professionals and facilities subject to criminalization - the act of providing life-saving care could result in criminal punishment. Especially since many of Maryland’s neighboring states lik Ohio, Pennsylvania, and West Virginia, have criminalized or are moving towards criminalizing gender-affirming care. FSJ corresponded with multiple representatives to get their opinions on this legislation, and many of our staff members provided insightful testimony on the topic. We remain steadfast in ensuring that the Maryland General Assembly heard the voices of those affected by the medical necessity of gender-affirming healthcare. 


We are glad that Maryland passed this critical legislation, a step towards progress for the LGBTQ+ community. We foresee that this law will help empower people to pursue the procedures that they need without fear of homophobic and transphobic out-of-state harassment via extradition and subpoenas of their medical records. This, and the ongoing advocacy of FSJ and organizations like it, brings us closer to an MD where LGBTQ+ people can live freely with their rights protected by the law. 


However, we also recognize that much work still needs to be done. With many LGBTQ+ people still reporting discrimination and mistreatment from healthcare providers and the high costs of some gender-affirming healthcare presenting issues for low-income LGBTQ+ Marylanders, FSJ commits itself to the ongoing fight for health equity. By deepening its involvement in partnerships, initiatives, and legislative efforts that address healthcare disparities along gender and sexuality-based lines within this state, Freestate Justice intends to create a Maryland where all have access to the medical care they need and everyone has an equal opportunity to thrive. 


This article was written by Nic Oke, a Legal and Policy Intern at Freestate Justice. 

By Joel Medina 27 Aug, 2024
FSJ has launched our 2024 FSJ Policy Report! This is your one-stop guide to the 2024 legislative session in Maryland, a comprehensive report where you'll learn about everything FSJ did to fight for LGBTQ+ rights in this year's legislature. You can read all about what bills passed/didn't pass, the many excellent groups who worked together on inclusive policy, and everything FSJ did to raise awareness about these critical issues at the button below! 
By Joel Medina 14 Aug, 2024
Each legislative session, FreeState Justice's policy team travels to Annapolis to protect the rights of LGBTQ+ Marylanders at a legislative level. As an LGBTQ+ advocacy organization, while we focus on many issues, our efforts are always centered on bills directly related to the LGBTQ+ community and the defense of their rights in this state. This has allowed us to accomplish great things, like successfully blocking discriminatory anti-trans sports bans and ensuring trans communities have access to life-saving, gender-affirming healthcare. But beyond pushing for LGBTQ+-specific policies, what else can legislators do to ensure LGBTQ+ Marylanders' needs are met? To learn more about what policy issues were most important to LGBTQ+ voters in Maryland, FSJ's policy team partnered with SOURCE interns, a service-learning program at Johns Hopkins Bloomberg School of Public Health. Between January and March 2024, this team conducted ten in-depth interviews and one focus group discussion with 15 LGBTQIA+ Marylanders. While these interviews do not represent the views and opinions of the whole MD LGBTQ+ community, they do provide a snapshot of what many locals are worried about today. At the end of the collaboration, the students provided FSJ with a final report detailing the policy concerns that those interviewed described as most relevant to their daily lives. This report - now available on our website - will help guide FSJ's legislative, educational, and legal efforts during the 2025 legislative session. 
By Joel Medina 10 Jul, 2024
This post is part of a series providing in-depth and accessible breakdowns of Free State Justice’s various policy accomplishments over the past 2024 Legislative Session within the Maryland General Assembly. For more posts like this, check out Free State’s 2024 Legislative Session Reflection Series. 2024 has been quite eventful for LGBTQ+ Marylanders. Free State Justice and its various coalition partners were deeply involved in advocacy regarding multiple bills affecting LGBTQ+ Marylanders that will impact their well-being for decades to come. One policy area that saw tremendous progress within the past session was education. This year, through the contributions of Free State Justice and many other coalition partners, the Maryland General Assembly passed the Freedom to Read Act (HB785/SB738). Among other things, this law dictates that all libraries within the State of Maryland will not be able to remove any piece of media (such as books, magazines, and digital materials) from their physical and digital catalogs simply because of the identity/background of the creator. The Act also raises fines for those who damage or ‘misplace’ controversial texts after checking them out, as this was proven to be a tactic by individuals to ensure nobody else could check these out. This crucial piece of legislation comes when we as a state and nation are experiencing a wave of attacks on the education system and freedom of expression. In particular, a multitude of individuals and organizations have initiated campaigns to remove certain aspects of school curriculum and make specific materials within schools and libraries inaccessible to the public. According to the Maryland State Library Agency, by the time of this Act’s passage, Maryland’s libraries had experienced a 133% increase in formal challenges to works within their collections and a 263% increase in informal challenges since 2019. Many of these were attempts by individuals to make (often baseless) objections to the inclusion of particular works within a library. Notably, many of the subjects of these attacks are works that are either written by LGBTQ+ authors or involve LGBTQ+ characters or topics - as well as many revolving around the histories and experiences of other marginalized groups, such as Black people, Indigenous people, and other people of color. As such, before the passage of this act, there was still so much ambiguity around whether Maryland’s libraries and media centers would begin to remove diverse and LGBTQ+-affirming materials from their collections or even fire librarians and media specialists who refused to do so. Under growing pressure from a small but vocal minority of those with a discriminatory agenda, it began to look like Maryland was completely unprepared against this assault on people’s ability to access the information and entertainment they desired.
By Joel Medina 08 Jul, 2024
This post is part of a series providing in-depth and accessible breakdowns of FreeState Justice’s various policy objectives and accomplishments over the past 2024 Legislative Session within the Maryland General Assembly. For more posts like this, check out FreeState’s 2024 Legislative Session Reflection Series. The year 2024 has been quite eventful for LGBTQ+ Marylanders. FreeState Justice and its various coalition partners were involved in much advocacy regarding a multitude of bills that will affect the lives and wellbeing of Maryland’s LGBTQ+ community. FreeState Justice worked hard this past year to repeal a longstanding law within Maryland that criminalizes the transmission of HIV. Under current statute, Maryland penalizes people (with significant fines and even imprisonment) for “knowingly transferring or attempting to transfer the human immunodeficiency virus to another individual.” This law has long been regarded for its role in further stigmatizing HIV-survivors and communities that are disproportionately affected by the condition, such as men who have sex with men (MSM). Furthermore, the law inhibits people from getting tested for the virus, as a person who do not make themselves aware of their status cannot be prosecuted under the law. Given this significant impact of this law on public health and the rights/dignity of so many LGBTQ+ community members, FreeState went into action, working to ensure that House Bill 485 - a bill to repeal the criminalization of HIV - would make it through each stage of the Maryland General Assembly. Through the Maryland Coalition to Decriminalize HIV that FreeState Justice had organized earlier, FreeState brought together various organizers and HIV-affected individuals from across the state to conduct outreach to legislators, organize public awareness campaigns, and develop testimony during the bill hearing. At the hearing, representatives gave valuable insights to General Assembly members regarding how the criminalization of HIV prevents diagnosis and the treatments necessary to tackle the HIV epidemic in the first place. They also discussed how the law’s enforcement is highly discriminatory in nature, being wielded disproportionately against Black and Latino individuals. We are saddened to relay that the bill unfortunately did not pass this session. However, we remain determined that through our continued efforts, we will see the bill passed in forthcoming sessions. This year already marks the farthest any piece of legislation that decriminalizes HIV has made it within the Maryland General Assembly, having received bipartisan support and being cross-filed within the legislature for the first time in its history. It is long overdue that Maryland removes its archaic and deeply harmful legislation regarding HIV, and we here at FreeState Justice, along with our multitude of coalition partners, will work to ensure that this change becomes a reality and that we decriminalize HIV within the State of Maryland once and for all. Written by Nic Oke, a Legal and Policy Intern at FreeState Justice
By Joel Medina 28 Jun, 2024
Written by John-John Williams IV for The Baltimore Banner Ross Wojick said he was surprised to hear that President Joe Biden pardoned former U.S. service members convicted of violating a now-repealed military ban on consensual gay sex, which will clear the way for them to regain lost benefits. After all, the paralegal specializing in family law thought that after the controversial policy ”don’t ask, don’t tell” was repealed in 2010, many of the roadblocks that LGBTQIA+ military personnel faced were cleared. But he is glad it happened all the same. “I’m kind of shocked that this is still a thing,” said the 29-year-old Columbia resident, who is gay. “Unfortunately those who were convicted on primitive laws are still suffering, but in the larger public view went unnoticed. This pardon should have happened long ago, but I think it brings awareness to LGBTQ issues that don’t always get to the forefront of the public view.” Biden said Wednesday that he is “righting a historic wrong” for potentially thousands of military personnel who would be affected. The initial law only covered those still serving in the military, not those who were already out or discharged. Now, all service members who were convicted under the Uniform Code of Military Justice’s former Article 125, which criminalized sodomy, will receive a pardon. The 1951 law was rewritten in 2013 to prohibit only forcible acts. Those covered by the pardon will be able to apply to receive proof that their conviction has been erased, petition to have their discharges from the military upgraded and move to recover lost pay and benefits. The pardon will cover several thousand service members — the majority convicted before the military instituted the “don’t ask, don’t tell” policy in 1993, according to White House estimates. “Don’t ask, don’t tell” eased the way for LGBTQ troops to serve if they didn’t disclose their sexual orientation. That policy was repealed in 2011, when Congress allowed for their open service in the Military. Service members convicted of nonconsensual acts are not covered by Biden’s pardon action. And those convicted under other articles of the military justice code, which may have been used as a pretext to punish or force out LGBTQ troops, would need to request clemency through the normal Department of Justice pardon process. “Today, I am righting an historic wrong by using my clemency authority to pardon many former service members who were convicted simply for being themselves,” Biden said in a statement. “We have a sacred obligation to all of our service members — including our brave LGBTQI+ service members: to properly prepare and equip them when they are sent into harm’s way, and to care for them and their families when they return home. Today we are making progress in that pursuit.” Biden’s announcement during Pride Month felt “pretty good” for Lucas F. Schleusener, CEO of Out in National Security, a Washington, D.C.-based nonprofit, nonpartisan organization dedicated to empowering queer national security professionals. “Righting a historic wrong on this scale is one culmination of decades of advocacy,” Schleusener said. “It’s proof that fighting for what’s right is always worth it.” The Biden and Obama administrations have “frequently” used Pride Month as a marker for major policy reforms related to the LGBTQIA+ community, according to Schleusener, who said his organization has been fighting for this to happen since its inception six years ago. “It helps stakeholders work together towards common goals,” he added. Biden administration officials declined to say why the president did not act on the pardons sooner. Phillip Westry, executive director of FreeState Justice, a Baltimore-based legal advocacy organization that seeks to improve the lives of low-income LGBTQ Marylanders, called Biden’s pardon a “positive step,” but added that the damage to military personnel has been done. Veterans account for 3% of the organization’s cases — typically working with the Department of Veterans Affairs regarding their benefits. “Most veterans don’t know they can request a reinstatement of their benefits,” Westry explained, adding that his organization did a “big push” a couple years ago to get the word out how LGBTQ service members could have their discharge status upgraded and their benefits reinstated. “Providing these veterans with access to full benefits and services could be transformative and a significant step towards correcting this injustice,” saidLauren Pruitt, legal director for FreeState Justice. Schleusener points to more things that need to be done, such as codifying transgender military service, establishing standards for nonbinary service, and continuing to train and align personnel policies and medical care with the needs of LGBTQIA+ service members and dependents. “The Department also needs to continue its work, extending automatic service discharge upgrades to veterans kicked out under policies proceeding, “don’t ask, don’t tell,” he said. “The United States Department of Defense continues to be the single largest employer of LGBTQIA+ Americans, and we remain committed to working with the Department, the White House, and Congress, to make sure that our community is treated with dignity and respect and that past wrongs and harms are corrected and healed. The Associated Press Contributed to This Story
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Carlton R. Smith (1965-2024)
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FreeState justice is honored to be recognized by  wjz news baltimore
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come out to the 2024 sunset soirée and see this local advocate receive recognition for her amazing work!
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