How the Disability and LGBTQI+ Communities Intersect

Authors’ note: The disability community is rapidly evolving to using identity-first language in place of person-first language. This is because it views disability as being a core component of identity, much like race and gender. Some members of the community, such as people with intellectual and developmental disabilities, prefer person-first language. In this column, the terms are used interchangeably.

Introduction

On September 26, 2024, Texas Attorney General Ken Paxton (R), along with 16 other state attorneys general, filed a lawsuit against then-Health and Human Services Secretary Xavier Becerra challenging a new federal rule that reduces discrimination against disabled people in medical and social services under Section 504 of the Rehabilitation Act. Section 504 provides disabled people, including those with gender dysphoria, anti-discrimination protections in any federally funded program such as schools, health care, and social services. This can result in increased access to accommodations that help disabled people stay in their communities.

State of Texas et al. v. Becerra et al., filed in the U.S. District Court for the Northern District of Texas, argues that the entirety of Section 504 should be declared unconstitutional because it coercively mandates states to comply with specific rules or risk loss of federal funding. More specifically, the state attorneys general disagreed with Section 504’s expanded definition of disability to include gender dysphoria and its mandate to ensure disabled people the most integrated settings possible. In response to these attacks, some advocates are skirting the dispute around gender dysphoria and the expanded definition of disability in an attempt to save the rest of the protections afforded under Section 504.

The Center for American Progress urges disability organizations to center the transgender community within their own litigation and advocacy strategies. Similarly, LGBTQI+ organizations should collaborate with disability coalitions to fight to preserve the protections afforded under Section 504. CAP’s 2024 LGBTQI+ community survey found that LGBTQI+ people as a whole are more likely to identify as disabled than are non-LGBTQI+ people: In 2024, 48 percent of LGBTQI+ U.S. adults reported having a disability, compared with 36 percent of the general population in 2024.* Disability rights and LGBTQI+ rights are intertwined.

This column explores frequently asked questions about State of Texas et al. v. Becerra et al. and the importance of collaboration and coordination between the transgender and disability communities in the fight for equal rights. It also provides tangible actions that disability and LGBTQI+ advocates can take to defend against attacks on the protections afforded under Section 504 of the Rehabilitation Act.

Who is protected under the country’s major disability civil rights laws?

There are two major disability civil rights laws in the United States—the Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA) of 1990. The Rehabilitation Act specifically covers federal government employees, certain federal contractors, and disabled people accessing federally funded programs and services such as education and health care services. The ADA protects the civil rights of disabled people in all aspects of everyday life, including protections against discrimination in employment; public accommodations such as hotels and shops; telecommunications, including websites and hotlines; transportation; and more.

Since the passage of the Rehabilitation Act in 1973, the definition of disability has been expanded multiple times to more accurately identify who is included. Currently, the law recognizes individuals as disabled if they have “a physical or mental impairment that substantially limits one or more major life activities,” have “a record of such an impairment,” or are “regarded as having such an impairment.”

In 2008, legislators passed an amendment to the ADA to fully define “major life activities,” due to agencies such as the Equal Employment Opportunity Commission utilizing too high a standard to define who was protected under the law. Under the amendment, major life activities include “breathing, walking, talking, hearing, seeing, sleeping, caring for one’s self, performing manual tasks, and working,” as well as digestive, immune system, respiratory, and reproductive bodily functions. In addition, the amendment clarified that disabled people may experience limitations to major life functions all of the time or some of the time. Some people may not personally identify as disabled, but if they experience barriers to major life activities or are perceived as disabled, they are protected under disability rights laws.

What is Section 504?

Section 504 of the Rehabilitation Act of 1973 is a federal law that protects disabled people from discrimination. Because Section 504 operates through the spending clause of the U.S. Constitution, it applies to a wide range of settings, including health care clinics and schools. It defines the rights of individuals with disabilities to participate in, and have access to, federally funded program benefits and services, including public education, the National School Lunch Program, and Head Start.

In May 2024, the Biden administration published a Department of Health and Human Services (HHS) rule expanding Section 504 to include protections in medical treatment, accessible medical equipment, child welfare programs, and web/mobile accessibility. In addition, the rule change explicitly included gender dysphoria as a covered disability under Section 504. This enables the federal government to protect transgender people from discrimination in health care if they experience or are perceived to have gender dysphoria.

Are transgender people part of the disability community?

The legal definition of disability under the updated rules of Section 504 includes people who have been diagnosed with gender dysphoria. Historically, Section 504 excluded protections for people with “gender identity disorder”—an outdated diagnosis not present in the Diagnostic and Statistical Manual (DSM), the official diagnostic reference book for health care providers, since 2013. The fifth and latest edition of the DSM identified the more accurate “gender dysphoria” diagnosis, which includes individuals who experience “clinically significant distress or impairment in social, occupational, or other important areas of functioning.” In 2021, federal courts recognized that gender dysphoria is a disability covered by the ADA and Rehabilitation Act.

In addition to gender dysphoria, transgender people are more likely to have other disabilities compared with their cisgender peers. In 2020, the Human Rights Campaign reported that more than one-third of all LGBTQ+ people identified as disabled, compared with only 24 percent of non-LGBTQ+ people. For these reasons, protection from discrimination for both gender dysphoria and other disabilities is crucial.

As part of efforts to deny transgender people protections under the ADA, anti-transgender attacks often rely on harmful stereotypes about disabled people. This narrative is destructive to the bodily autonomy and agency of the transgender and disability communities. For example, the Trump administration has directed the Department of Homeland Security and the U.S. attorney general to issue new interpretation guidance of the ADA regarding the placement of transgender people incarcerated in federal prisons and detention centers and simultaneously has argued that transgender people are unfit to serve in the U.S. military due to their alleged gender dysphoria. It is evident that the administration is willing to put politics over the needs of both communities, dismantling federal civil rights protections in the process.

Why are far-right state attorneys general attacking Section 504?

The far right has made no secret of its desire to ostracize and bully disabled people and transgender people. In response to the 2024 rule that expanded protections under Section 504, Texas Attorney General Paxton and 16 other state attorneys general filed State of Texas et al. v. Becerra et al. One of the attorneys general signed on to the case, Alan Wilson (R) of South Carolina, was motivated to join the lawsuit by the inclusion of gender dysphoria as a covered disability in the new rule.

The language of the original lawsuit shows that the end goal was to dismantle historically recognized Section 504 protections. The lawsuit argues that Section 504 of the Rehabilitation Act is unconstitutional, and the relief sought by the plaintiffs is that the courts “declare that the Final Rule violates the Administrative Procedure Act” and “declare Section 504, 29 U.S.C. § 794, unconstitutional.” In an updated status report on February 19, 2025, the plaintiffs’ claim that they do not plan to deem Section 504 unconstitutional. However, the joint status report did not amend their original demands for relief. Thus the risk to Section 504 remains.

If the plaintiffs succeed, millions of disabled people could lose fundamental protections against discrimination in education, housing, health care, and government programs. The case is currently paused, with the next status report due no later than April 21, 2025, while HHS “evaluate[s] their position in the case and determines how to proceed.”

What are the next steps?

Since the lawsuit is paused, disability and LGBTQI+ advocates have the opportunity to build an advocacy campaign to educate their communities and state attorneys general about the harms the lawsuit will cause if it moves forward. United efforts will be key in pushing back against attempts to weaken the Rehabilitation Act and the ADA, as well as other attacks on diversity, equity, inclusion, and accessibility; health care; and more.

State attorneys general who have not signed on to the case could help put pressure on the other attorneys general to withdraw from the lawsuit. Advocates can also continue to push state attorneys general to withdraw from the lawsuit.

State attorneys general included in the case have stated that they didn’t intend to eliminate school accommodations or Section 504. Yet disability experts disagree, saying that it is obvious these impacts were intentional and that the lawsuit is still a threat. Advocates can educate community members about the vast impacts this lawsuit could have and call out the misinformation being relayed by state attorneys general.

Conclusion

Transgender and disabled people have a shared history of fighting against ableism and discrimination, and they must further unify to defend against the current threats to people’s rights. State of Texas et al. v. Becerra et al. jeopardizes everyone’s right to bodily autonomy and basic civil rights protections. The state attorneys general who have signed on to the lawsuit are scapegoating transgender people and creating division and confusion within the movement. It is essential that both communities fight back in lockstep to communicate to the state attorneys general that attempts to drive a wedge between allies in the fight for civil rights will not succeed.

* The authors calculated this figure by utilizing data from an online survey developed by the Center for American Progress and NORC at the University of Chicago, conducted from June 2024 to July 2024. The original data are on file with the authors.

The authors would like to thank Chandler Hall for fact-checking; Rachael Eisenberg and Devon Ombres for their reviews; and CAP’s Editorial, Legal, and Art teams for their guidance.