Rejecting Calls for Book Bans

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The vast majority of book bans that are taking hold across the country specifically aim to remove books that are by and about LGBTQ people, communities of color, and other marginalized groups. Students have the right to equal educational opportunity and a First Amendment right to speak and receive information freely.

On January 23, 2023, GLAD and the ACLU of Massachusetts sent a letter urging Massachusetts public school districts to protect students’ legal rights by rejecting censorship in school libraries. Read the letter.

On May 16, 2023, GLAD and the ACLU of Maine sent a letter to Maine’s public school leaders demanding they uphold their own legal obligations and students’ First Amendment rights by stopping efforts to ban and censor books. Read the letter.

ID Documents | Maine

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The Transgender ID Project is a free resource for transgender people living in New England who want to update their legal name and gender marker on state and federal documents.

If you need assistance updating your legal name and gender on federal and state documents, visit the Maine page for the Transgender ID Project.

News

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New Law Ensures Pathway to Essential Healthcare for Transgender Minors

Governor Mills Signs LD 535, An Act Regarding Consent for Gender-affirming Hormone Therapy for Certain Minors

A new law signed by Governor Mills today will allow transgender minors who have reached a minimum age of 16, have a diagnosis of gender dysphoria, and are being harmed or will be from being denied medically necessary health care, to have a medical pathway to receive such care. LD 535 authorizes 16- and 17-year-olds in those circumstances and who meet detailed requirements of counseling and informed consent to receive evidence-based, medically recommended non-surgical care if they are deemed competent to give such consent and their parents refuse to provide the required care.

Broad medical consensus recognizes that puberty-blocking medication and/or cross-hormone therapy is the standard of care for minors in appropriate circumstances. Evidence shows that minors who have been diagnosed with gender dysphoria have better life outcomes and more successful treatment when they receive timely care and are able to go through puberty congruent with their gender identity.

While many transgender minors receive care with the support and involvement of their parents, LD 535 ensures minors capable of informed consent and who have had detailed counseling with a physician and some other health care providers are not denied necessary and timely care.

“Getting real information about transgender people, and the process of acceptance and understanding, can be challenging and complex for families of transgender youth. Pediatricians strive to create a safe environment for parents to better understand and listen to the needs of their children while receiving support, and for adolescents to understand their parents’ concerns as well – but unfortunately parental acceptance isn’t always attained by adolescence,” said Joe Anderson, DO, Advocacy Chair of the American Academy of Pediatrics, Maine Chapter. “Gender dysphoria is a well-recognized medical diagnosis with an established and effective treatment and delaying access to care can have harmful consequences. LD 535 will help ensure that mature transgender minors receive the care they need when they need it, which will lead to better long-term outcomes.”

LD 535 was introduced by Representative Sheehan and cosponsored by Senator Tipping and Representatives Malon, Moonen, Osher, and Rana. It creates a pathway for a limited set of 16 and 17-year-olds with diagnosed gender dysphoria and who are experiencing harm to access care in line with existing avenues under Maine law regarding other kinds of medical treatment such as mental health care and substance use treatment.

“LD 535 will protect the lives of young transgender people who will certainly be harmed by a delay in receiving the medical care recommended by their providers,” said Representative Sheehan. “Parents of trans youth may withhold consent for care for a variety of reasons, including out of a desire to protect their children from possible adverse consequences, yet medical research makes clear that for some youth there are grave risks associated with delaying or denying gender-affirming care. This law assures that transgender young people can be spared harmful long-term consequences of delayed care while allowing the family the opportunity to continue the work of developing mutual understanding and support.”

The legislation received wide support from parents, youth, medical providers, and youth advocates who testified at House and Senate hearings. It passed by significant margins in the House and in the Senate.

“Despite broad medical consensus and well-established standards of care, transgender healthcare remains highly stigmatized, and as a result youth don‘t always get the care they need,” said Quinn Gormley, Executive Director, Maine TransNet. “It is completely understandable that parents may have fears and questions about what their transgender kids are going through, but the fact is that choosing not to act is not neutral – delaying access to care can have serious consequences for transgender young people. LD 535 will ensure that mature minors who have worked through an extensive evaluation with their healthcare team and whose providers recommend that they begin hormones are not denied medically necessary care simply because the care they need is misunderstood and stigmatized.”

LD 535 requires that a minor seeking care be at least 16-years-old and that a health care professional establishes that they meet the following thresholds: the minor has been diagnosed with gender dysphoria; the minor is experiencing or will experience harm if the care is not provided; and the minor is mentally and physically capable to consent and has provided informed written consent.

“A strong relationship with parents is a protective factor for young people, and parents have an important role in loving, supporting and guiding decisions for their children, including healthcare decisions consistent with medical standards of care. But young people who are 16 or 17 and capable of informed consent as determined by a doctor and some other health care professionals and who need care should not suffer needlessly because other people, even the parents they love, do not understand their condition or support their care,” said Mary Bonauto, Senior Director of Civil Rights and Legal Strategies at GLBTQ Legal Advocates & Defenders. “Maine has been responsive to the needs of young people by enacting laws to allow them to get needed care, particularly for stigmatized conditions. In that tradition, LD 535 provides specific guidelines to allow transgender young people to access necessary care that will allow them to thrive, while limiting disruption to family relationships.”

“Young people should have access to the health care they need,” said Meagan Sway, Policy Director, ACLU of Maine. “While state law recognizes that health care decisions for minors typically involve the consent of a parent or guardian, it also allows that some forms of life-saving care are so important that minors should be able to receive it, even in the absence of parental support. LD 535 will ensure older transgender teenagers who are 16 and 17 years old can access this life-saving standard of care.”

Health Care | Transition-Related Care | Maine

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Can health care plans discriminate against LGBTQ+ people?

In general, under federal and Maine state law, nearly all health plans cannot discriminate on the basis of sex, and, because the Supreme Court ruling in Bostock v. Clayton Co. concluded that all gender identity and sexual orientation discrimination is a form of sex discrimination, nearly all health plans cannot discriminate against LGBTQ+ people.

What health care plan protections are provided by Maine?

Maine Insurance Code

In 2019, the Maine Insurance Code was amended to include a prohibition of discrimination by any health plans that are regulated by the Maine Bureau of Insurance. The Code provides a list of examples of prohibited discrimination, including but not limited to:

Denial of insurance coverage
Limitations on sex-specific procedures
Exclusion of transition-related services
Discriminatory limits on transition-related care

These essentially parallel the federal protections of Section 1557 of the Affordable Care Act (ACA). For more information, see: Title 24-A, §4320-L: Nondiscrimination.

Maine Medicaid (MaineCare)

Also in 2019, MaineCare, Maine’s Medicaid program, began to provide coverage for medically necessary treatment for gender dysphoria, removing an outdated and discriminatory exclusion for transition-related care and adding vital standards of care that reflect current medical practices recognizing the healthcare needs of transgender individuals. These changes bring MaineCare policy into alignment with the professional medical community and into compliance with both state and federal law, including Section 1557 of the Affordable Care Act.

Are there any health care plans that are not protected under Maine law?

Yes. Medicare and employer health plans that are self-funded (also known as self-insured) are governed by federal law.

What health care plan protections are provided by the federal government?

Medicare

In 2013, Medicare removed the ban on coverage for treatment of gender dysphoria because it was “experimental” and began to cover medically necessary treatment for gender dysphoria.

Section 1557 of the Affordable Care Act (ACA)

Section 1557 makes it unlawful for any health care provider that receives funding from the Federal government to refuse to treat an individual– or to otherwise discriminate against the individual– based on sex (as well as race, color, national origin, age or disability). Section 1557 imposes similar requirements on health insurance issuers that receive federal financial assistance. Health care providers and insurers are barred, among other things, from excluding or adversely treating an individual on any of these prohibited bases. The Section 1557 final rule applies to recipients of financial assistance from the Department of Health and Human Services (HHS), the Health Insurance Marketplaces and health programs administered by HHS.

Section 1557 generally does not apply to self-funded group health plans under ERISA or short-term limited duration plans because the entities offering the plans are typically not principally engaged in the business of providing health care, nor do they receive federal financial assistance.

In May 2021, the Biden Administration announced that the Health and Human Services Office for Civil Rights (OCR) would interpret and enforce Section 1557 of the ACA and Title IX’s nondiscrimination requirements based on sex to include sexual orientation and gender identity. The update was made in light of the June 2020 U.S. Supreme Court’s decision in Bostock v. Clayton County and subsequent court decisions.

In enforcing Section 1557, OCR will comply with the Religious Freedom Restoration Act, 42 U.S.C. § 2000bb et seq., and all other legal requirements and applicable court orders that have been issued in litigation involving the Section 1557 regulations.

Title VII

For employers with 15 or more employees, Title VII bans discrimination on the basis of race, color, religion, sex and national origin in hiring, firing, compensation, and other terms, conditions or privileges of employment. Employment terms and conditions include employer-sponsored healthcare benefits. Historically, not all authorities have agreed that Title VII protects LGBTQ+ workers against discrimination.

However, the Supreme Court decision in Bostock v. Clayton Co. changes this because that ruling made it clear that sexual orientation and gender identity discrimination are forms of sex discrimination. Although the decision is about wrongful employment termination, it has implications for employer-sponsored health plans and other benefits. For example, employers may want to adjust group health plan coverage of gender dysphoria and related services, including gender-affirmation surgeries and review and compare benefits for same-sex and opposite-sex spouses.

Can religious employers discriminate against LGBTQ+ people?

On July 8, 2020, in Our Lady of Guadalupe School v. Morrissey-Berru, the United States Supreme Court reaffirmed its stance on the application of ministerial exception to employment discrimination cases as established in earlier rulings. In doing so, the Court simultaneously raised an unanswered issue under Title VII: does the ministerial exception for religious employers allow those organizations to discriminate against employees or candidates based on their LGBTQ+ status?

It’s unclear at this point how the Court’s ruling in Our Lady of Guadalupe School v. Morrissey-Berru may impact the LGBTQ+ employees of religious employers, but religious organizations and employers should recognize that the ministerial exception does not apply to every position within their organizations. Rather, it is limited to those employees who truly perform religious duties. For example, the position of a school janitor who is only present in the building outside of school hours and is not responsible for transmitting the faith would likely not be considered ministerial in nature.

What steps can I take to get coverage for treatment of gender dysphoria?

First check to see if your health plan provides coverage for the type of treatment that you want by getting a copy of the plan’s “Summary of Benefits and Coverage”.
Most insurance plans, both public and private, have detailed requirements that must be met in order to obtain coverage. This is particularly true if you are trying to obtain coverage for transition-related surgery. So, contact your health plan and request a copy of the requirements for the treatment you are seeking.
Work with your therapists and doctors to make sure that you satisfy all the health plan’s requirements. Documentation from your therapists and doctors is the most critical factor in determining whether your treatment request will be approved.
Check what treatment requires pre-approval. In most cases, any surgery will require pre approval, and the plan may only pay if you use a surgeon that takes their plan.
If your treatment request is denied, find out the reasons for the denial, and, if you still think that you qualify for the treatment, follow the plan’s appeal process. Usually there will first be an internal appeals process, and, if you are not successful there, you can sometimes appeal to an outside agency. Make sure that you adhere to the deadlines—failure to meet a deadline can automatically end your ability to appeal.
Keep GLAD informed if you are denied treatment. GLAD may be able to offer suggestions that can help you win your appeal. You can contact GLAD Answers by filling out the form at GLAD Answers or by phone at 800-455-GLAD (4523).
Although more health plans now cover treatment for gender dysphoria, the process for obtaining treatment, particularly for transition-related surgery, can be time consuming and frustrating. A great deal of documentation is required and finding a surgeon that does the type of surgery, and who is also acceptable to the health plan, can be difficult.
Don’t be afraid to be persistent and to refile if you are denied.

How do I find a surgeon who will take my health insurance?

More and more surgeons who perform gender-affirming surgeries take health insurance. You should research surgeons carefully to find one who is a good fit for you. You can look at the list of in-network providers provided by your plan to see if they are included or if it includes any surgeons in your area, and if not, you can contact the surgeon’s office to determine if they accept your insurance. Most health insurance plans require that you use a medical provider in your network, but if your network does not include a surgeon who performs the services you need, you may be able to go out of network if you seek prior authorization from your plan.

What should I do if I am being discriminated against in health care?

If you are being discriminated against by a health care facility or provider, you can file a discrimination complaint with the Maine Human Rights Commission. See the “Discrimination” Issue Area for detailed information about how to do this.

If you have a health care plan that is regulated by the Maine Bureau of Insurance, you can file a complaint with that agency: File a Complaint/Dispute | PFR Insurance.

If you have a health care plan that is governed by Section 1557 of the ACA, you can file a complaint with the federal Department of Health and Human Services Office of Civil Rights. For more information, see: How to File a Civil Rights Complaint.

If you have a self-funded health care plan through an employer with at least 15 employees, you can file a discrimination complaint with the federal Equal Employment Opportunity Commission (EEOC). For more information, see the “Discrimination” Issue Area.

Criminal Justice | Gender-Affirming Facilities | Maine

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I’ve just been convicted. How do I get assigned to the right facility?

When you first arrive at a new facility, an officer should conduct an “intake” with you. This is the best time for you to share if you are transgender or intersex. You can also tell the intake officer if you have a history of being “perceived”, or others seeing you as, transgender or intersex, or if you have recently had gender-affirming procedures or any similar care. If you have already had gender-affirming surgery, then you should tell your intake officer immediately. Maine’s policy is that people who have had gender-affirming procedures should be housed in accordance with their gender identity.

Once you tell the intake officer, they are responsible for contacting a person with the role of Chief Administrative Officer or someone who works for them. That intake officer should tell the Chief Administrative Officer if you are transgender or intersex. It is also possible that a defense attorney or prosecutor, a guardian, a department or jail staff member, or another officer of the court has already said that you are transgender or intersex. If someone else has told the facility, then the intake officer is still responsible for telling the Chief Administrative Officer even if you haven’t.

If the Chief Administrative Officer receives information from someone about your case before your first intake, then they might make a decision about your initial strip search and housing placement before you arrive.

What happens after my intake screening?

If your initial strip search has not been done before your intake, then the Chief Administrative Officer should consider different factors, including your personal preference, about the gender of the officer who will conduct it. That Chief Administrative Officer will document the reasons for choosing a particular officer in your Corrections Information System (CORIS).

The Chief Administrative Officer or someone who works for them will also decide where the best place for your immediate housing is. They will make that decision based on different factors including your risk to safety. They should document all the reasons for their decision in your CORIS file. Your housing assignment might change after they conduct a more in-depth review. In the meantime, your strip searches will be conducted by staff members of the same gender as other people who are in the unit you are assigned to. If the Chief Administrative Officer wants to assign a different person to search you, they will put this in your CORIS file.

You should be given an opportunity to use the bathroom and shower privately until a full assessment takes place.

If you are already on hormonal medications when you enter the facility, you should be able to continue using them. You can continue to use them at least until you have an appointment with the facility’s physician, physician assistant, or nurse practitioner. Your facility has to follow a policy about this called the Adult Facility Policy 18.7: Pharmaceuticals.

The Chief Administrative Officer should notify the facility’s Health Services Administrator as soon as they can about your case. The Health Services Administrator should prioritize your case so that they can make a determination about whether or not you have received a diagnosis of “gender dysphoria”, have received hormonal treatment, have received transgender or intersex-related medical procedures, or any other relevant medical assistance.

In order to do that, the facility will probably ask you for a release of information to get your healthcare documents. If you want to say yes, they will be able to look through those documents and hopefully more quickly decide how to move forward with your case. The Chief Administrative Officer will then decide if you need an evaluation for “gender dysphoria” or an expedited medical health assessment. They may also look for information from Adult Community Corrections to request information about how long they have known you were transgender or intersex.

If there is a safety issue relating to being transgender or intersex, you should let officers at the facility know right away. This could include risks to safety of yourself or of another person. It also includes anything that would require a change from your immediate housing placement that was made by the Chief Administrative Officer when you entered. The facility staff should follow department policy that sets out what to do in a situation like this. That policy is called the Adult Facility Policy 15.1: Administrative Segregation Status.

What is “Gender Dysphoria”?

Maine uses a definition for “Gender Dysphoria” from a book, written by doctors at the American Psychiatric Association, called the Diagnostic and Statistics Manual of Mental Disorders [Fifth Edition], or the “DSM-5”. The definition is:

A difference between a person’s experienced and expressed gender and their assigned gender that has taken place for at least six months. It must include two of the following:

A marked incongruence between one’s experiences/expressed gender and primary and/or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics);
A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics);
A strong desire for the primary and/or secondary sex characteristics of the other gender;
A strong desire to be of the other gender (or some alternative gender different from one’s assigned gender);
A strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender);
A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender).

What happens after the Chief Administrative Officer starts their review?

Within 30 days of your report, the Chief Administrative Officer should put together a team to handle your case. People on that team should include your Unit Manager at your facility, the Health Services Administrator, the Department’s Medical Director, the Department’s Mental Health Director, a member of the facility’s security staff, a member of the facility’s classification staff, and the facility Prison Rape Elimination Act (PREA) monitor. There may be one or more other people on the team as well if the Chief Administrative Office thinks they should be. For example, they may contact the Chief Administrative Officer or Department’s Director of Classification at the facility where you could be transferred to.

What is the Prison Rape Elimination Act?

The Prison Rape Elimination Act (PREA) is a federal law passed in 2003. Under PREA, rather than automatically assigning people to a facility, transgender and intersex people are assessed for potential safety threats and housed “on a case-by-case basis” according to gender identity. Correctional staff have to consider housing and program assignments at least twice a year to review any threats to safety experienced by transgender and intersex people living in prison.

According to the law, they also have to take into account your own view of your safety. They are not allowed to separate you for housing or other program placements based solely on your LGBT+ status.

PREA also protects “involuntary segregation”, or the removal of a person to a different housing assignment against their will. You cannot continue to be kept in a different part of the prison against your will unless prison officials have determined that there is no other way to keep you safe. They have to make that determination within the first 24 hours if they do place you in separate housing against your will. People cannot be segregated against their will for more than thirty days, and they must be given access to all of the same work, educational, and programming opportunities as any other person.

What will the team do about my case, and how will they make recommendations?

The team will make the following recommendations about your case:

Whether male or female housing is more appropriate for you
Whether male or female staff will conduct searches
What property items you will be allowed to have
What your shower and toilet arrangements should be
Any safety or security precautions required
Any other relevant decisions.

The team should make these recommendations based on information available about your case. That includes things like whether or not you have a diagnosis for “gender dysphoria”, as well as any other relevant medical tests. If you haven’t had an assessment for “gender dysphoria” yet, then the team will decide if you need one. They will also decide if they want to request any other medical assessments.

In making decisions about your recommendations, the team will consider things like:

Your gender assigned at birth
Your views with respect to your own identity and safety, and whether or not those views have been “consistent”
Whether you have taken any steps toward gender-affirming surgery
Any of your “relevant characteristics”, like physical stature, tendency toward violence or predatory behavior, and vulnerability to violence or predatory behavior
Any relevant characteristics of other people with whom you might be housed or come into contact
Your correctional history (for example, if there are any previous management situations that impacted the safety of other persons or the security of the facility)
Whether you have any mental health concerns
Whether there are any perceived risks to the continuing safety and health of the prisoner or others.

What happens after the review is complete?

The Chief Administrative Officer or someone who works for them should make the final decision about the full team’s recommendations for your current facility. They will make decisions about your health care plan and transfer to another facility in conjunction with other people.

That final decision on the recommendations should be used to create a case plan for you. That plan might include an evaluation for “gender dysphoria”, for example. If it does, then you should be brought for an assessment for “gender dysphoria” or any other relevant medical assessment. Within 15 days of that assessment, the Chief Administrative Officer should share the results with your team and finalize its recommendations.

Even after that, the Chief Administrative Officer can also bring your team together periodically or any time appropriate to make further recommendations about your care. Any time that your team meets, as well as all of your recommendations, should be documented in your CORIS file.

Your unit management team is responsible for reassessing your case and housing situation at least every six months, or more frequently if it is necessary. If you experience threats or a change in safety, you should let an officer at your facility know. Your care team should give specific attention to any threats to safety you report.

I’ve been in prison for a while. What happens if I want to request a transfer to a facility that conforms with my gender identity?

It can be more difficult to request transfer if you’ve been in a facility for a while, but there is a procedure to do so. The main differences with asking for a transfer after you have already been in a facility are that, until a full review has been completed, you will not be placed in a different housing unit with people of a different gender than where you have been living. You will also not be given the opportunity to shower or use the bathroom privately.

The first step is to let staff at your facility know that you are transgender or intersex. From there, they should contact the Chief Administrative Officer of the facility. The Chief Administrative Officer should reach out to the Health Services Administrator as soon as possible after they receive your report. The process from there looks similar to what would have happened if you had requested the transfer from the beginning.

The Health Services Administrator should prioritize your case so that they can make a determination about whether or not you have received a diagnosis of “gender dysphoria”, have received hormonal treatment, have received transgender or intersex-related medical procedures, or any other relevant medical assistance.

In order to do that, the facility will need you to sign a “Release of Information” to get your healthcare documents. If you want to say yes, they will be able to look through those documents and hopefully more quickly decide how to move forward with your case. The Chief Administrative Officer will then decide if you need an evaluation for “gender dysphoria” or an expedited medical health assessment.

The Chief Administrative Officer will also ask staff at your facility and staff from other departments about whether they knew you were transgender or intersex or had perceived you to be before you made your own disclosure. They may reach out to the adult community corrections as well.

What if I disagree with the Chief Administrative Officer’s decision, or the team’s decision?

There are options if you don’t think that the Chief Administrative Officer or the team made the right decision about your custody level or if they did not approve a transfer. You can “appeal” this decision through the Classification Appeal Process. You can ask an officer for a copy of the Prisoner Appeal of Classification Decision form. Here is a link to Procedure J of the Classification System, which also describes the process.

To make an appeal, you have to submit the Prisoner Appeal of Classification Decision form within five business days of receiving your decision—this does not count weekend days or holidays. You should submit this form to the Department’s Director of Classification for custody level or facility transfer decisions, specifically. You should submit this form to the facility Chief Administrative Officer for all other classification issues.

Appealing the decision itself will not stop it from taking place, so you will have to remain housed in your current facility during the appeals process. Whoever you submitted your appeal to, such as the Department’s Director of Classification or the facility Chief Administrative Officer, should give you a decision about your appeal within 30 days. They can choose to approve the decision, reverse the decision, modify the decision, or “remand” the decision to the Unit Management Team (UMT) for further consideration. “Remanding” the decision means that the UMT will take over and decide what to do.

It is important to remember that the Department’s Director of Classification is the final authority for appeals about custody level or facility transfer. For all other appeals, the facility Chief Administrative Officer is the final authority.

If you want to appeal a decision made about your case that has to do with something besides custody and transfer, you can use the regular “grievance process” at your facility by filing a grievance.

All appeals will be put into your CORIS file. You can also find more information about Maine State Prison policies in this Handbook.

Parentage | Maine

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What is the Maine Parentage Act?

The Maine Parentage Act (MPA) is a set of state laws that was passed in 2016 and strengthened in 2021. It clarified and expanded the ways someone can legally establish that they are the parents of a child. The MPA addresses who is able to, and how to, establish legal parentage. See: Title 19-A, §1851: Establishment of parentage.

Specifically, the MPA ensures greater protections and equal treatment for children of LGBTQ+ parents. The law allows many LGBTQ+ parents to establish parentage through a simple form, an Acknowledgement of Parentage (AOP), ensuring LGBTQ+ parents are able to establish their legal relationship to their child immediately at birth or any time before the child turns 18.

The MPA also extends an accessible path to parentage for children born through assisted reproduction and for children born through surrogacy.

What does parentage mean?

“Parentage” means that you are a legal parent of a child for all purposes. Parentage comes with a host of rights (e.g., decision-making for medical care or education, parenting time in the event of separation from your child’s other parent) as well as responsibilities (e.g., providing health insurance, providing for basic needs, payment of child support). A secure legal parent-child relationship is core to a child’s long-term stability and well-being.

Why is it important to establish parentage quickly?

Establishing parentage soon after birth ensures that a child is secured to their parents for all purposes and increases clarity for all involved in a child’s life. For example, established parentage will allow a parent to make any early medical decisions in a child’s life, ensure that a child will receive insurance benefits or inheritance rights, and protect parents’ parental rights if they separate.

How can Maine families establish parentage under the MPA?

The MPA provides that Mainers can establish their parentage in the following ways:

Giving birth (except for people acting as surrogates)
Adoption
Acknowledgement (by signing an Acknowledgement of Parentage)
Presumption (including the marital presumption)
Genetic connection (except for sperm or egg donors)
De facto parentage
Intended parentage through assisted reproduction
Intended parentage through a gestational carrier agreement
Adjudication (an order from a court)

Also, the Court may accept an admission of parentage that is made under penalty of perjury, or the Court may assign parentage to a party in default as long as the party was properly served notice of the proceeding (see 19-A MRS §1841 and §1842).

Who is an intended parent?

An intended parent is a person who consents to assisted reproduction with the intent to be a parent of the child or is an intended parent under a gestational carrier agreement. Ideally, a person who consents to assisted reproduction with the intent to be a parent will memorialize that intent in writing, but the law does allow other ways to prove intent to be a parent.

Who is a presumed parent?

A presumed parent is a non-birth parent that the law recognizes because of certain circumstances or relationships. A presumed parent is established as a legal parent through the execution of a valid Acknowledgement of Parentage, by an adjudication, or as otherwise provided in the MPA.

You are a presumed parent if any of the below are true:

You are married to the child’s birth parent when the child is born;
You were married to the child’s birth parent, and the child is born within 300 days of the marriage being terminated by death, annulment, or divorce;
You attempted to marry the child’s birth parent and the child is born during the invalid marriage or within 300 days of it being terminated by death, annulment or divorce;
You married the child’s parent after the child was born, asserted parentage and are named as a parent on the birth certificate; or
You resided in the same household with the child and openly held out the child as your own from the time the child was born or adopted for at least two years and assumed personal, financial or custodial responsibilities for the child.

Who is a de facto parent?

A de facto parent is a parent based on their relationship with the child. Establishing de facto parentage requires a judgment from a court. You can petition a court to establish your de facto parentage by demonstrating, with clear and convincing evidence that you have fully and completely undertaken a permanent, unequivocal, committed and responsible parental role in the child’s life. To make that finding a court must determine all of the following:

You lived with the child for a significant amount of time;
You consistently took care of the child;
A bonded and dependent relationship has been established between the child and you, the relationship was fostered or supported by another parent of the child, and you and the other parent have understood, acknowledged or accepted that or behaved as though you are a parent of the child.
You took full and permanent responsibility for the child without expectation of financial compensation;
Continuing a relationship with the child is in the best interests of the child.

What is an Acknowledgement of Parentage?

Federal law requires states to provide a simple civil process for acknowledging parentage upon the birth of a child. That simple civil process is the Acknowledgement of Parentage program.

Federal regulations require states to provide an Acknowledgement of Parentage program at hospitals and state birth record agencies. Acknowledgement of Parentage forms themselves are short affidavits in which the person signing affirms that they wish to be established as a legal parent with all of the rights and responsibilities of parentage. The person who gave birth to the child must also sign the form, and both parents have to provide some demographic information about themselves.

By signing an Acknowledgement of Parentage, a person is established as a legal parent, and the child’s birth certificate is issued or amended to reflect that legal parentage. Properly executed, an Acknowledgement of Parentage has the binding force of a court order and should be treated as valid in all states.

How do I establish my parentage through an Acknowledgement of Parentage?

You can voluntarily acknowledge the parentage of a child by signing a form from the Maine Department of Health and Human Services known as an Acknowledgement of Parentage (AOP). An Acknowledgement of Parentage must be signed by the birth parent and the other parent (i.e., the person establishing parentage through the Acknowledgement of Parentage). The other parent can be the genetic parent (except for sperm or egg donors), an intended parent of a child born through assisted reproduction or a gestational carrier agreement, or a presumed parent (see definition of presumed parent above).

Signing an Acknowledgement of Parentage form is voluntary, and it can be done at the hospital soon after birth or until the child turns 18 by contacting the Maine Department of Health and Human Services. Here is a sample of the form, VS-27-A: Acknowledgement OF PARENTAGE (AOP).

An Acknowledgement of Parentage form must be notarized. To be valid, the people signing the form must be given oral and written notice explaining the legal consequences, rights, and responsibilities that arise from signing an Acknowledgement of Parentage. If either the birth parent or the non-birth parent does not want to sign this form to establish parentage for the non-birth parent, then either of them can try to have a court determine parentage.

If you have any questions about whether to sign an Acknowledgement of Parentage form, you should consult with a lawyer before signing. An Acknowledgement of Parentage is the equivalent of a court judgment of parentage, and parentage is a considerable, life-long responsibility.

When can I not establish parentage through an Acknowledgement of Parentage?

A presumed parent who seeks to establish parentage in situations in which the other parent is not the child’s birth parent, e.g., the child was adopted by the other parent, must establish parentage through an adjudication and cannot establish parentage through an Acknowledgement of Parentage.
Parentage cannot be established through an Acknowledgement of Parentage if there is a third person who is a presumed parent, unless that person has filed a Denial of Parentage.
A person who is establishing parentage based on residing with the child and holding out the child as the person’s child for the first two years of the child’s life cannot establish parentage through an Acknowledgement of Parentage until the child is two.

When can a parent sign an Acknowledgement of Parentage?

Acknowledgements of Parentage can be signed after the birth of a child, up until the child’s 18th birthday. An Acknowledgement of Parentage can also be completed before the child’s birth but will not take effect until the child is born.

How can an Acknowledgement of Parentage be rescinded?

If you aren’t married, and you signed an Acknowledgement Parentage, you have sixty days to go to court and rescind, or take back, that acknowledgement. If it has been more than 60 days since you filed the acknowledgement, but less than two years, you can still go to court to challenge the acknowledgement if:

You were lied to about being the parent;
You were forced or coerced into signing the Acknowledgement; or
You or the other parent were wrong on the facts that made you think you were the parent.

These same rules apply if you believe you are the parent, but someone else has acknowledged that they are the parent of the child.

You can’t challenge an acknowledgement after the child is two years old.

You will need to prove to the court that the person who acknowledged paternity is NOT the parent.

If you believe you are the parent of a child, but you had no way of knowing it when the child was born, you can challenge an acknowledgement of parentage. You have two years from the time you found out you might be the parent to challenge an Acknowledgement. This is the only situation where someone can challenge an Acknowledgement of Parentage that is more than two years old.

What if I am a non-biological parent? How can I establish myself as a legal parent?

The MPA has many provisions that protect non-biological parents. If you are your child’s presumed parent, or if you are the intended parent of a child born through assisted reproduction or a gestational carrier agreement or have a genetic connection (except for sperm or egg donors), you can establish parentage by signing an Acknowledgement of Parentage.

Some non-biological parents can establish parentage through the MPA’s de facto parent provisions, which require a court to adjudicate the person to be the child’s de facto parent.

How does the MPA help people conceiving through assisted reproduction?

The MPA provides important clarity and protections for children born through assisted reproduction (i.e., you did not have sexual intercourse or use a gestational carrier to conceive). The MPA confirms that a gamete donor (e.g., sperm or egg donor) is not a parent of a child conceived through assisted reproduction. Also, the MPA affirms that a person who consents to assisted reproduction with the intent to be a parent of the resulting child is a legal parent and can establish that parentage by signing an Acknowledgement of Parentage.

Does Maine require private health plans to provide coverage for fertility care?

Yes, Governor Janet Mills signed LD 1539, An Act to Provide Access to Fertility Care, on May 2, 2022, and the law applies to private health plans which are regulated by the Maine Bureau of Insurance that are issued or renewed on or after January 1, 2023. This includes employers who offer insured health plans. Some employers have self-insured plans, and these are not regulated by the Maine Bureau of Insurance.

The law requires all carriers who offer health plans in Maine to provide coverage for medical interventions including fertility diagnostic care, fertility treatment, and medically necessary fertility preservation.

What is the difference between joint, second-parent (also known as co-parent) and single-parent adoptions?

A joint adoption is when both partners adopt a child together at the same time. A second-parent or co-parent adoption is when one partner adopts the other partner’s child. A single-parent adoption is when a single individual adopts a child. All three of these are legal in Maine.

If I am a parent who has signed an Acknowledgement of Parentage, do I also need to do a second parent adoption?

No. A parent who has signed an Acknowledgement of Parentage should not need to do a second parent adoption to establish parentage. An Acknowledgement of Parentage establishes legal parentage under state law, is the equivalent of a court judgment of parentage under state law and gives you all the rights and duties of a parent. Under federal law, an Acknowledgement of Parentage is the equivalent of a judicial decree of parentage and should be recognized in all states.

Since expanded access to Acknowledgements of parentage is an emerging development, some parents might feel more comfortable completing a second parent adoption in addition to or instead of an Acknowledgement of Parentage. To understand what is best for your family, individualized legal advice is recommended.

How does the MPA address surrogacy?

The MPA has comprehensive provisions about how to establish parentage through gestational carrier agreements. Before starting any medical procedures to conceive a child through a carrier process, you must have a written and signed agreement that meets all of the requirements of the statute. This agreement is between you, any other intended parents, the person acting as the surrogate, and that person’s spouse (if applicable). This agreement will establish that you are the parent(s) of the child and that the surrogate and their spouse (if applicable) do not have parental rights or duties

To enter into a surrogacy agreement, all of the following must be true:

The surrogate must be at least 21 and have previously given birth to a child.
All intended parents and the person acting as the surrogate must have completed a medical evaluation and mental health consultation,
The intended parent(s) and the person acting as the surrogate must be represented by separate lawyers for the purposes of the agreement, and the attorney for the person acting as the surrogate must be paid for by the intended parent(s).

The law requires surrogacy agreements to incorporate several terms to be valid, such as allowing a person acting as a surrogate to make their own health and welfare decisions during pregnancy and requiring the intended parent(s) to pay all related healthcare costs.

Can Mainers use genetically related gestational carriers?

Yes. If a carrier is a family member, they can serve as a gestational carrier using their own gametes or genetic material. Someone who is not a family member cannot be a genetic gestational carrier. Otherwise, the same laws, including the need for a valid agreement, apply to genetic and non-genetic carriers.

What if I am not married?

The MPA explicitly provides that every child has the same rights as any other child without regard to the marital status of the parents, or the circumstances of the child’s birth. By not differentiating between parents based on their marital status, the MPA aims to treat all Maine families equally.

What if I am transgender or non-binary?

The MPA explicitly provides that every child has the same rights as any other child without regard to the gender of the parents or the circumstances of the child’s birth. The MPA, by not including gendered terms such as mother or father, is inclusive of all genders. By not differentiating between parents based on their gender, the MPA aims to treat all Maine families equally.

Can a child have more than two legal parents?

Yes. Under the MPA, a court may determine that a child has more than two legal parents if the failure to do so would be detrimental to the child. To determine detriment to the child, courts will consider factors such as the nature of the potential parent’s relationship with the child, the harm to the child if the parental relationship is not recognized, the basis for each person’s claim of parentage of the child, and other equitable factors.

Where can I go if I need help resolving a parentage issue?

As with any family law issue, individualized legal advice is recommended. GLAD Answers can provide information as well as referrals to local practitioners. If you have questions about how to protect your family, contact GLAD Answers by filling out the form at GLAD Answers or call 800.455.4523 (GLAD).

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New Maine Confirmatory Adoption Law Increases Security for LGBTQ+ Families

A new law championed by Rep. Matt Moonen and signed yesterday by Governor Janet Mills provides key protections for LGBTQ+ families that reflect and amplify Maine’s longstanding commitment to protecting all children. LD 1906 will provide LGBTQ+ parents and their children with greater security, particularly if they travel or move to places outside of Maine that are less LGBTQ-friendly.

The legislation, LD 1906 An Act to Enable Confirmatory Adoption, streamlines the adoption process for parents who have had a child through assisted reproduction and are already parents under Maine law, to secure their parentage through an adoption decree. The new law removes cumbersome, costly, and unnecessary barriers, like waiting periods and home inspections, that non-biological parents often face when adopting their own children.

“We’re grateful for the leadership of Representative Moonen and for the thoughtful consideration of the Judiciary Committee, as well as to Governor Mills for signing this important law to advance fair and equal treatment for LGBTQ+ families,” said Mary Bonauto, GLBTQ Legal Advocates & Defenders (GLAD) Senior Director of Civil Rights and Legal Strategies.

“LGBTQ+ parents are rightfully worried about the safety of their children and families in light of escalating bias and discrimination across the country,” added Polly Crozier, GLBTQ Legal Advocates & Defenders (GLAD) Director of Family Advocacy. “We have seen judges in other states strip non-biological parents of their parental rights, and we all know that extremists are escalating legislative attacks on LGBTQ+ people. An adoption decree provides additional security for LGBTQ+ families especially if they travel or move outside of Maine.”

Maine has been a leader in ensuring every child has the security of a respected legal relationship with their parent or parents. The state passed the comprehensive Maine Parentage Act in 2015, which clarified the law of parentage and served as an impetus for other states to improve their protections. In 2021, Maine became the 10^th state in the country to permit LGBTQ+ parents to secure their parentage through a simple administrative form, an Acknowledgment of Parentage, that has been available to different-sex parents for decades.

Under the new law parents of children born through assisted reproduction who are parents under the Maine Parentage Act need only submit to the court a petition signed by both parties that includes a copy of the child’s birth certificate, an explanation of the circumstances of the child’s birth through assisted reproduction, an attestation that each petitioner consented to the child’s birth through assisted reproduction, an attestation that no competing claims of parentage exist, and a copy of the parents’ marriage certificate, as applicable.

The court will then grant the adoption within 60 days of finding that either the parent who gave birth and the spouse were married at the time of the child’s birth and the child was born through assisted reproduction; or, for nonmarital parents, that the person who gave birth and the non-marital parent consented to the assisted reproduction; and that no competing parental claims exist.

A report published earlier this month by the Movement Advancement Project (MAP) with COLAGE, Family Equality, GLAD, and NCLR, Relationships at Risk: Why We Need to Update State Parentage Laws to Protect Children and Families chronicles how the current patchwork of parentage laws across the country – many of which, unlike in Maine, have not been updated in decades – leaves LGBTQ+ parents and their children vulnerable. In the context of that continuing vulnerability throughout the country, LD 1906 adds one more critical avenue of protection for LGBTQ+ families in Maine.

GLAD was joined in testimony supporting LD 1906 by Equality Maine and American Academy of Pediatrics, Maine Chapter.

Jóvenes | Derechos y protecciones | Maine (Español)

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Preguntas y respuestas sobre los derechos de los jóvenes en Maine

¿Cuáles son mis derechos como estudiante LGBTQ+?

Todos los estudiantes de escuelas públicas de Maine tienen derecho a lo siguiente:

Estar seguros en la escuela sin sufrir acoso escolar.
Acceder a información sobre personas LGBTQ, incluido el sitio web educativo.
Vestirse y presentarse de manera coherente con su identidad de género.
Hablar y expresarse libremente. Esto significa que usted tiene derecho a expresar ideas que pueden ofender a otras personas y a estar en desacuerdo con los demás, siempre y cuando exprese esas ideas de forma respetuosa.

Los estudiantes de todas las escuelas públicas y de muchas escuelas privadas de Maine tienen derecho a lo siguiente:

Estar protegidos de la discriminación o el hostigamiento por su orientación sexual, identidad o expresión de género, o situación en relación con el VIH.
Formar una alianza de personas gais o heterosexuales que sea tratada de la misma manera que los demás grupos extracurriculares. Esto significa que debe tener la misma financiación, acceso a instalaciones y la capacidad de elegir el nombre del grupo.

Fuera de la escuela, tiene derecho a lo siguiente:

Estar protegido de la discriminación por su orientación sexual real o percibida, situación frente al VIH o identidad de género en el empleo, la vivienda y las prestaciones públicas (como restaurantes o tiendas).
Dar su consentimiento para que le realicen pruebas de VIH sin el permiso de sus padres. Para obtener información más específica, consulte el Área de problemas de “VIH o sida”.
Denunciar ante la policía que una persona de la escuela o ajena a ella le ha causado daños, lo ha amenazado o ha vandalizado su propiedad.

¿Maine tiene una ley contra el acoso escolar que protege a los estudiantes de escuelas públicas?

Sí. En 2012, Maine aprobó una ley, la “Ley para prohibir el acoso escolar y el ciberacoso en las escuelas” (disponible en el capítulo 659 de la Ley Pública, Ley para prohibir el acoso escolar y el ciberacoso en las escuelas).

La ley define el acoso escolar como toda comunicación (escrita, oral o electrónica), o acto o gesto físico que tiene las siguientes características:

daña o amenaza gravemente su persona o sus pertenencias;
crea un entorno escolar hostil;
interfiere con su desempeño académico o su capacidad de participar en las actividades escolares.

La ley identifica determinadas características que suelen ser objeto de acoso escolar, como la raza, la orientación sexual, o la identidad o expresión de género real o percibida, o la asociación con otra persona que tiene una o más de estas características reales o percibidas.

Para el 1 de enero de 2013, el Departamento de Educación de Maine debe desarrollar una política modelo que incluya lo siguiente:

La exigencia de que el personal escolar denuncie el acoso escolar y los procedimientos para que los estudiantes, el personal, los padres y otras personas denuncien el acoso escolar.
Un procedimiento para investigar los incidentes de acoso escolar y responder a ellos de forma inmediata, lo que incluye la documentación por escrito de los incidentes y el resultado de las investigaciones.
Un proceso para comunicar a los padres de un estudiante que ha sido víctima de acoso escolar las medidas adoptadas para garantizar la seguridad del estudiante y prevenir otros actos de acoso escolar.
La política contra el acoso escolar de cada escuela debe ser tan exigente como la política modelo, y debe publicarse y difundirse ampliamente y por escrito todos los años a todos los estudiantes, los padres y el personal.
Cada escuela debe capacitar al personal en los mejores enfoques para implementar la política contra el acoso escolar.

¿Las escuelas pueden regular políticas contra el acoso escolar fuera de las instalaciones escolares?

Sí. En el caso Mahanoy Area School Dist. V. B. L., además de concluir que los estudiantes tienen amplitud de derechos de habla y expresión fuera de la escuela, la Corte Suprema de los Estados Unidos estableció que

“Las circunstancias que pueden implicar los intereses regulatorios de una escuela [fuera de la escuela] incluyen casos graves de acoso escolar u hostigamiento hacia personas particulares y amenazas dirigidas a docentes u otros estudiantes…”.

¿Maine tiene lineamientos que las escuelas deban seguir para proteger a los estudiantes transgénero?

No existen lineamientos estatales, pero varios distritos escolares han creado políticas sobre los derechos, las responsabilidades y las prácticas educativas recomendadas para estudiantes transgénero y de género no binario.

Esta es la política de las escuelas de Portland, Maine: ESTUDIANTES TRANSGÉNERO Y DE GÉNERO EN EXPANSIÓN A. Propósito y alcance El distrito se esforzará por 1) promover un entorno de aprendizaje que.

¿La ley contra la discriminación de Maine protege también a los estudiantes?

Sí. La ley contra la discriminación del estado protege específicamente a los estudiantes de escuelas públicas y privadas, así como a las instituciones o los programas educativos postsecundarios de la discriminación por orientación sexual, incluida la identidad y expresión de género, en toda capacitación académica, extracurricular, deportiva, de investigación u ocupacional, u otro programa o actividad. También protege a los estudiantes durante el proceso de admisión y en la obtención de asistencia financiera. Para obtener más información sobre la ley contra la discriminación de Maine y cómo presentar una queja por discriminación, consulte el Área de problemas de “discriminación”.

¿Hay instituciones educativas exentas de la ley?

Sí. Todo centro educativo perteneciente a una “corporación, asociación o sociedad religiosa de buena fe” o controlado u operado por ella está exento (artículo 4602 del título 5 de las Leyes Revisadas de Maine).

¿Existen leyes federales que protejan a los estudiantes?

Sí, el título IX prohíbe la discriminación contra los estudiantes por motivos de sexo en toda escuela o universidad que reciba fondos federales. A la luz del fallo de la Corte Suprema en el caso Bostock v. Clayton County, que determinó que la discriminación por orientación sexual e identidad de género son formas de discriminación sexual, el Departamento de Educación federal, que implementa el título IX, ha establecido que interpretará toda discriminación por orientación sexual e identidad de género como discriminación sexual.

Para presentar una queja ante la Oficina de Derechos Civiles del Departamento de Educación federal, consulte https://www2.ed.gov/about/offices/list/ocr/docs/howto.html.

Puede presentar quejas ante el coordinador del título IX de su escuela y a la siguiente dirección:

Office of Civil Rights
The U.S. Department of Education
John W. McCormack Post Office & Courthouse, Room 222
Post Office Square
Boston, MA 02109 Además, algunos tipos de discriminación y hostigamiento pueden infringir los derechos constitucionales de los estudiantes.

¿Qué puedo hacer si estoy siendo discriminado o acosado en la escuela?

Hay muchas formas de abordar el problema. Una consiste en pedir apoyo a un amigo, docente o terapeuta y hablar con las personas que lo están molestando. Sin embargo, si no se siente seguro haciendo esto, ya no sería una opción.

Consulte las políticas de su escuela e informe a la persona a la cual se debe notificar; por lo general, se trata del vicedirector o el coordinador del título IX. Debe registrar todo incidente de hostigamiento o discriminación por escrito con la fecha y la hora como mínimo. Una vez que se haya reunido con los funcionarios correspondientes, escriba notas para sus registros sobre lo que les dijo y en qué fecha, y pregunte cuándo se pondrán en contacto con usted para darle una respuesta. Si no lo ayudan o no realizan un seguimiento con usted, podría escribirle al director y al superintendente y pedirle que ponga fin a la discriminación.

Si esto falla, también puede iniciar una acción legal contra el pueblo comunicándose con la Comisión de Derechos Humanos de Maine o con la Oficina de Derechos Civiles del Departamento de Educación federal.

Esta es un área complicada de la ley y, además, es compleja en términos emocionales. Comuníquese con GLAD Answers completando el formulario en GLAD Answers por correo electrónico o por teléfono, al 800-455-4523 (GLAD), para hablar sobre las opciones.

¿Los estudiantes tienen el derecho de formar alianzas de personas gais o heterosexuales en sus escuelas?

Sí, tanto los estudiantes de la escuela secundaria como los estudiantes de la escuela intermedia. Una ley federal llamada “Ley de Acceso Igualitario” exige que todas las escuelas secundarias con fondos federales brinden acceso igualitario a los clubes extracurriculares. Si una escuela tiene como mínimo un club extracurricular liderado por estudiantes, debe permitir la organización de clubes adicionales y debe brindarles igualdad de acceso a espacios de reunión, instalaciones y fondos sin discriminarlos por el fin del club, ya sea religioso, filosófico, político o de otro tipo (artículo 4071 del título 20 del Código de los Estados Unidos [United States Code, USC]).

¿Maine tiene una ley que prohíbe la terapia de conversión?

Sí, en 2019, Maine se convirtió en el décimo séptimo estado en aprobar una ley, LD 1025, una ley para prohibir la provisión de terapia de conversión a menores por parte de determinados profesionales con licencia. Esta ley les prohíbe a los profesionales con licencia publicitar y administrar la denominada terapia de conversión a menores. No respetar la ley puede desencadenar la revocación de la licencia del profesional. Las organizaciones médicas, de salud mental y de bienestar infantil estatales y nacionales se oponen a la práctica de la terapia de conversión, una práctica que busca cambiar la orientación sexual o la identidad de género de una persona. Una amplia bibliografía profesional demuestra que la práctica es ineficaz para cambiar la orientación sexual o identidad de género y es dañina para los jóvenes. Los jóvenes que se han sometido a la terapia de conversión tienen un mayor riesgo de sufrir depresión, tener ideas suicidas, intentar suicidarse y consumir drogas ilegales.

Derechos de las personas transgénero | Atención médica | Maine (Español)

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Preguntas y respuestas sobre la atención médica de las personas transgénero en Maine

¿Los planes de salud pueden discriminar a las personas LGBTQ+?

En general, de conformidad con la ley federal y del estado de Maine, casi todos los planes de salud tienen prohibido discriminar por motivos de sexo y, dado que el fallo de la Corte Suprema en el caso Bostock v. Clayton Co. concluyó que toda discriminación por identidad de género u orientación sexual es una forma de discriminación por sexo, casi todos los planes de salud tienen prohibido discriminar a las personas LGBTQ+.

¿Qué protecciones para planes de salud establece Maine?

Código de Seguros de Maine

En 2019, el Código de Seguros de Maine se modificó para incluir la prohibición de la discriminación por parte de los planes de salud regulados por la Oficina de Seguros de Maine. El Código ofrece una lista de ejemplos de discriminación prohibida, que incluye, entre otras cuestiones, lo siguiente:

Denegación de la cobertura del seguro
Limitaciones en procedimientos específicos según el sexo
Exclusión de servicios relacionados con la transición
Límites discriminatorios en la atención relacionada con la transición

Esto es básicamente paralelo a las protecciones federales del artículo 1557 de la Ley de Atención Médica Asequible (Affordable Care Act, ACA). Para obtener más información, consulte Artículo 4320-L del título 24-A: No discriminación.

Medicaid de Maine (MaineCare)

También en 2019, MaineCare, el programa de Medicaid de Maine, comenzó a brindar cobertura para el tratamiento necesario desde el punto de vista médico de la disforia de género, de manera que se eliminó una exclusión discriminatoria y obsoleta de la atención relacionada con la transición y se incorporaron tratamientos de referencia fundamentales que reflejan las prácticas médicas actuales que reconocen las necesidades de atención médica de las personas transgénero. Estos cambios alinean la política de MaineCre con la comunidad médica profesional y hacen que cumpla con la ley federal y estatal, incluido el artículo 1557 de la Ley de Atención Médica Asequible.

¿Existen planes de salud que no estén protegidos por la ley de Maine?

Sí. Medicare y los planes de salud de empleadores autofinanciados (también conocidos como “autoasegurados”) están regulados por la ley federal.

¿Qué protecciones para planes de salud establece el gobierno federal?

Medicare

En 2013, Medicare eliminó la prohibición de la cobertura del tratamiento de la disforia de género por ser “experimental” y comenzó a cubrir el tratamiento necesario desde el punto de vista médico para la disforia de género.

Artículo 1557 de la Ley de Atención Médica Asequible

El artículo 1557 de la Ley de Atención Médica Asequible (Affordable Care Act, ACA) establece que es ilegal que un profesional de atención médica que recibe fondos del gobierno federal se niegue a tratar a una persona, o discrimine de otra manera a una persona, por su sexo (así como por su raza, color de piel, nacionalidad, edad o discapacidad). El artículo 1557 impone requisitos similares para las aseguradoras de salud que reciben asistencia financiera federal. Los profesionales de atención médica y las aseguradoras tienen prohibido, entre otras cosas, excluir o tratar de forma adversa a una persona por cualquiera de estos motivos prohibidos. La disposición final del artículo 1557 se aplica a los beneficiarios de asistencia financiera del Departamento de Salud y Servicios Sociales (Department of Health and Human Services, HHS), los Mercados de Seguros Médicos y los programas de salud que administra el HHS.

Por lo general, el artículo 1557 no se aplica a planes de salud grupales autofinanciados de conformidad con la Ley de Seguridad de los Ingresos de los Jubilados (Employee Retirement Income Security Act, ERISA) o planes de duración limitada o a corto plazo porque las entidades que ofrecen los planes no suelen estar principalmente comprometidas con el negocio de brindar atención médica ni reciben asistencia financiera federal.

En mayo de 2021, la gestión de Biden anunció que la Oficina de Derechos Civiles (Office for Civil Rights, OCR) del HHS interpretaría que el artículo 1557 de la ACA y los requisitos de no discriminación del título IX basados en el sexo incluyen la orientación sexual y la identidad de género, y que haría respetar esto último. La actualización se implementó en el contexto de la decisión que tomó la Corte Suprema de los Estados Unidos en el caso Bostock v. Clayton County en junio de 2020 y las decisiones posteriores de la corte.

Al implementar el artículo 1557, la OCR respetará la Ley de Restablecimiento de la Libertad Religiosa (Religious Freedom Restoration Act), sección 2000bb y subsiguientes del título 42 del Código de los Estados Unidos (United States Code, USC), y todos los demás requisitos legales y órdenes del tribunal que se emitieron en litigios que involucraban las disposiciones del artículo 1557.

Título VII

El título VII les prohíbe a los empleadores que tienen 15 empleados o más discriminar por motivos de raza, color de piel, religión, sexo y nacionalidad en la contratación, el despido, el pago y otros términos, condiciones o privilegios del empleo. Los términos y las condiciones del empleo incluyen los beneficios de salud solventados por el empleador. Históricamente, no todas las autoridades han estado de acuerdo en que el título VII protege a los trabajadores LGBTQ+ de la discriminación.

Sin embargo, la decisión de la Corte Suprema en el caso Bostock v. Clayton Co. cambia esta situación porque la resolución dejó en claro que la discriminación por orientación sexual e identidad de género es una forma de discriminación por sexo. Aunque la decisión se relaciona con el despido indebido, tiene consecuencias en los planes de salud solventados por el empleador y otros beneficios. Por ejemplo, los empleadores podrían querer ajustar la cobertura de los planes de salud grupales para la disforia de género y los servicios relacionados, incluidas las cirugías de afirmación de género, y revisar y comparar los beneficios para cónyuges del mismo sexo y del sexo opuesto.

¿Los empleadores religiosos pueden discriminar a las personas LGBTQ+?

El 8 de julio de 2020, en el caso Our Lady of Guadalupe School v. Morrissey-Berru, la Corte Suprema de los Estados Unidos reafirmó su posición en la implementación de la excepción ministerial en casos de discriminación en el empleo que se estableció en resoluciones anteriores. Esto implicó que, de forma simultánea, la Corte planteara una problemática sin resolver en virtud del título VII: ¿la excepción ministerial para empleadores religiosos les permite a esas organizaciones discriminar a los empleados o candidatos a puestos laborales por su condición de LGBTQ+? En este punto, no queda claro de qué manera la resolución de la Corte en el caso Our Lady of Guadalupe School v. Morrissey-Berru puede afectar a los empleados LGBTQ+ de empleadores religiosos, pero las organizaciones y los empleadores religiosos deberían reconocer que la excepción ministerial no se aplica a todos los puestos de sus organizaciones. Por el contrario, se limita solo a aquellos empleados que llevan a cabo obligaciones realmente religiosas. Por ejemplo, el puesto de un conserje escolar que solo está presente en el edificio fuera del horario escolar y no es responsable de transmitir la fe no se consideraría de naturaleza ministerial.

¿Qué pasos puedo seguir para obtener la cobertura del tratamiento de disforia de género?

1. Primero, verifique si su plan de salud cubre el tipo de tratamiento que desea; para ello, consiga una copia del “Resumen de beneficios y cobertura” del plan.

2. La mayoría de los planes de seguro, tanto públicos como privados, tienen requisitos detallados que se deben satisfacer para obtener la cobertura. Esto es así, en particular, si está intentando obtener cobertura para una cirugía relacionada con la transición. Por eso, comuníquese con su plan de salud y solicite una copia de los requisitos del tratamiento que desea.

3. Trabaje con sus terapeutas y médicos para asegurarse de que reúne todos los requisitos del plan de salud. Para determinar si su solicitud de tratamiento será aprobada, el factor más importante es la documentación proporcionada por sus terapeutas y médicos.

4. Verifique qué tratamientos requieren aprobación previa. En la mayoría de los casos, cualquier cirugía requiere aprobación previa y es posible que el plan solo pague si recurre a un cirujano que acepta el plan.

5. Si su solicitud de tratamiento es denegada, averigüe los motivos de la denegación y, si cree que de todos modos califica para el tratamiento, siga el proceso de apelación del plan. Por lo general, primero se llevará a cabo un proceso de apelación interno y, si no obtiene un resultado satisfactorio en esta instancia, en ocasiones, podrá apelar ante una agencia externa. Asegúrese de respetar los plazos, ya que, si no lo hace, podría perder la posibilidad de apelar.

6. Informe a GLAD si le deniegan un tratamiento. GLAD podría hacerle sugerencias que lo ayuden a ganar la apelación. Puede comunicarse con GLAD Answers completando el formulario en GLAD Answers o por teléfono llamando al 800-455-GLAD (4523).

7. Aunque ahora más planes de salud cubren el tratamiento de la disforia de género, el proceso para obtener el tratamiento, en particular, para obtener la cirugía relacionada con la transición, puede llevar tiempo y causarle frustraciones. Se necesita mucha documentación y puede ser difícil encontrar un cirujano que realice este tipo de cirugía y que sea aceptable para el plan de salud. 8. No tenga miedo de ser persistente y de volver a presentar una solicitud si recibe una respuesta negativa.

¿Cómo encuentro un cirujano que acepte mi seguro de salud?

Cada vez más cirujanos que realizan cirugías de reasignación de sexo aceptan seguros médicos. Busque cirujanos de forma minuciosa para encontrar el adecuado para usted. Puede consultar la lista de profesionales de la red de su plan para saber si forman parte de ella o si la lista incluye cirujanos en su área. Otra opción consiste en comunicarse con el consultorio del cirujano para preguntar si aceptan su seguro. La mayoría de los planes de seguro médico exigen que recurra a un profesional médico de su red; sin embargo, si su red no incluye un cirujano que preste los servicios que usted necesita, es posible que pueda recurrir a alguien fuera de la red si solicita la autorización previa del plan.

¿Qué debería hacer si el sector sanitario me discrimina?

Si está siendo discriminado por un centro o un profesional de atención médica, puede presentar una queja por discriminación ante la Comisión de Derechos Humanos de Maine. Consulte el Área de problemas de “discriminación” para obtener información detallada sobre cómo hacerlo.

Si tiene un plan de salud regulado por el Departamento de Seguros de Maine, puede presentar una queja ante esa agencia: Presentar una queja/disputa | Seguro de Regulación Profesional y Financiera.

Si tiene un plan de salud regulado por el artículo 1557 de la ACA, puede presentar una queja ante la Oficina de Derechos Civiles del Departamento federal de Salud y Servicios Sociales. Para obtener más información, consulte Cómo presentar una queja de derechos civiles. Si tiene un plan de salud autofinanciado a través de su empleador que tiene como mínimo 15 empleados, puede presentar una queja por discriminación ante la Comisión federal de Igualdad en las Oportunidades de Empleo (Equal Employment Opportunity Commission, EEOC). Para obtener más información, consulte el Área de problemas de “discriminación”.

Justicia penal | Hostigamiento policial | Maine (Español)

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Justicia penal | Hostigamiento policial | Maine

Con frecuencia, la policía me pide que “me retire” de áreas públicas. ¿Es legal?

No necesariamente. Si el área es pública y no hay carteles en los que se indique que hay horarios específicos, por lo general, tiene derecho a permanecer allí siempre y cuando sus actividades sean legales. Los espacios públicos son de todos. Incluso si un oficial de policía quiere impedir un delito, o tiene sospechas de algún tipo de intención ilegal, no tiene derecho general a pedirles a las personas que se desplacen de un lugar a otro, a menos que se esté llevando a cabo una conducta ilegal.

¿Cuáles son las reglas generales sobre la interacción con la policía?

La presencia de personas que parecen ser gais, lesbianas, bisexuales o transgénero, ya sea porque exhiben símbolos como banderas con los colores del arcoíris, un triángulo rosa o por otra razón, no debe desencadenar ningún escrutinio especial por parte de un oficial de policía aparte de la preocupación por la seguridad y el bienestar que el oficial tendría por cualquier otro usuario de un parque o área de descanso.

Por supuesto que la policía puede acercarse a una persona y hacerle preguntas, pero incluso si una persona fue condenada por un delito anterior, se niega a responder o responde de una manera que no satisface al oficial, esto por sí solo no constituye un motivo para que sea arrestada.

Un oficial puede entrometerse brevemente en las acciones de una persona si puede explicar por qué está preocupado y esa preocupación es razonable. Por ejemplo, si un oficial está preocupado por la seguridad de una persona o sospecha que la persona podría haber cometido un delito o una infracción de tránsito, detenerla será razonable. Una detención solo se puede realizar si existen “fundamentos probables” de que se ha cometido un delito.

¿Qué puedo hacer si creo que la policía me trató de forma inapropiada?

Se pueden presentar quejas ante cualquier departamento de policía particular por asuntos relativos a sus oficiales, y las quejas respecto a la policía estatal de Maine se pueden presentar ante el oficial comandante correspondiente al presunto hostigador. La persona de contacto es el teniente Luce, director de Asuntos Internos, (207) 624-7290. La policía estatal tiene una línea gratuita: (800) 452-4664. La queja debe especificar el nombre o el número de placa del oficial e indicar si la queja es por una mala conducta real, hostigamiento o discriminación.

En algunos casos, una persona puede decidir iniciar una demanda por lesiones, detención inadecuada u otro motivo. Estos asuntos son muy especializados y GLAD puede derivarlo a un abogado. Las personas también pueden registrar quejas graves ante la Unidad de Investigaciones de la Fiscalía General llamando al (207) 626-8800.