Project 2025 Tracker / What’s done, what’s next

14. Department of Health and Human Services · Notable

Remove Biden guidance on gender identity under Section 1557

Done

495 14. Department of Health and Human Services · abridged

“Remove all guidance issued under the Biden Administration concerning sexual orientation and gender identity under Section 1557, particularly the May 2021 announcement of enforcement and March 2022 statement threatening states that protect minors from genital mutilation.”

What has happened

  1. Done

    The Secretary rescinded, effective immediately, the "Notification of Interpretation and Enforcement of Section 1557 of the Affordable Care Act and Title IX of the Education Amendments of 1972", 86 FR 27984 (May 25, 2021) — the May 2021 announcement of enforcement this Quote names first. Three other informal guidance documents went with it. With the March 2, 2022 statement rescinded on 2025-02-20 and the May 2021 notification rescinded here, **both documents the Quote names by name are gone** and the named object is in the asked-for state. The rung moves from `partial` to `done` on the strength of the February letter, which the earlier pass could not read. The Quote's wider "all guidance" sweep is not separately evidenced as complete, but under §3 the two named core objects are the test, and both are met.

  2. Partially done

    OCR rescinded the second of the two guidance documents this Quote names. Its letter *Recission of "HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy" (issued March 2, 2022)*, dated February 20, 2025, was read in full on 2026-09-03: "Pursuant to Section 5(b) of Executive Order ('E.O.') 14187, 'Protecting Children from Chemical and Surgical Mutilation,' the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) **hereby rescinds**, 'HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy,' originally issued on March 2, 2022 … **This recission is effective immediately.**" The letter recites what the 2022 guidance had said — Section 1557 gender-identity non-discrimination, gender dysphoria as a possible Section 504/ADA disability, and PHI protections for gender-affirming care — and gives its reasons, beginning with the October 1, 2022 vacatur in *Texas v. EEOC*, No. 2:21-cv-00194-Z (N.D. Tex.). **Correction to an earlier pass:** this item previously recorded that the March 2022 statement "has no Federal Register record of withdrawal". It has none because OCR did it by signed letter posted as a PDF under `hhs.gov/sites/default/files/`, not by notice — the negative was false, not merely unproven.

Research log

What was searched, and what didn’t count as evidence

Research notes

  • Full text read at govinfo.gov/content/pkg/FR-2025-05-14/html/2025-08393.htm; the fourth bullet in the Secretary’s rescission list is the May 2021 Section 1557 notification by its Federal Register citation.
  • Executive Order 14187 section 5(b) ordered the Secretary to withdraw the March 2, 2022 guidance. The Federal Register negative was correct and misleading: OCR performed the withdrawal by signed letter, which never enters the Federal Register. The letter was found by going through the 11,156 addresses in hhs.gov’s sitemap and read on 2026-09-03. hhs.gov is not closed to us — it opens to an ordinary full browser request.
  • The contrast with #1401 is the finding, and it is invisible if the two items are read separately. The same OCR, under the same administration, rescinded the gender-affirming-care guidance within a month of EO 14187 and has left the June 2022 HIPAA reproductive-health guidance standing for twenty months. Recorded in both notes.
  • For an open-ended “all X” ask, done needs either the named core object gone or an allowlisted statement that the sweep is complete. Here the Quote names two documents and both are rescinded by dated instruments, which is the first branch. The item stood at partial only because the February 2025 letter had not been found; that is the whole of the change.
Action
rescind
Object
Biden Administration Section 1557 SOGI guidance
ID
1396