HHS finalizes Section 504 rule excluding gender dysphoria from disability definition

Clinical takeaway: Physicians and healthcare organizations that receive HHS funding should be aware that HHS has formally excluded gender dysphoria not resulting from physical impairments from the definition of disability under Section 504, potentially affecting how federal disability protections are applied in healthcare settings.

The US Department of Health and Human Services (HHS) has finalized a rule stating that gender dysphoria not resulting from a physical impairment does not qualify as a disability under Section 504 of the Rehabilitation Act. The agency says the change aligns its regulations with statutory exclusions enacted by Congress and resolves ambiguity created by a 2024 Section 504 rule, whose preamble suggested gender dysphoria could potentially qualify for disability protection.

Section 504 prohibits discrimination based on disability in programs and activities receiving federal financial assistance. HHS officials said the new rule codifies longstanding statutory exclusions and clarifies obligations for healthcare organizations, hospitals, health systems, and other recipients of HHS funding.

The move comes amid ongoing legal and policy debates over the scope of federal protections for transgender individuals. Several federal courts in recent years have reached differing conclusions on whether gender dysphoria may qualify as a disability under federal disability laws, making the issue consequential for healthcare institutions, insurers, and patients. While the rule addresses HHS's interpretation of Section 504, it does not change other federal or state laws that may apply to discrimination claims.

HHS received more than 380 public comments on the proposal before issuing the final rule.

Source: HHS Office for Civil Rights. (2026 Oct 30). HHS Final Rule Amends Section 504 Regulations to Codify Statutory Exclusions from the Definition of Disability