HHS Final Rule Amends Section 504 Regulations to Codify Statutory Exclusions from the Definition of Disability

Rule Clarifies That Gender Dysphoria Not Resulting from Physical Impairments Is Excluded Under the Rehabilitation Act

WASHINGTON, D.C.—OCTOBER 30, 2026—The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) today published a final rule clarifying that, under HHS regulations, gender dysphoria not resulting from physical impairments does not qualify as a disability under Section 504 of the Rehabilitation Act of 1973 (Section 504). This rule applies to all programs and activities that receive HHS funding, aligning the agency's regulations with the exclusions Congress wrote into law.

HHS Secretary Robert F. Kennedy, Jr. announced the proposed rule at an event in Washington, DC in December 2025.

“My uncle Ted Kennedy was the primary author of the Americans with Disabilities Act and the 1978 amendments that strengthened the Rehabilitation Act. The Biden-era pronouncements that indicated gender dysphoria may be a disability served the commercial interests of a predatory, multi-billion-dollar industry and betrayed the original intention of those laws,” said Secretary Kennedy. “Congress defined which conditions qualify for protection as disabilities under federal law, and HHS has a duty to faithfully apply the law as written. This final rule restores clarity to our regulations, respects the distinctions Congress established, and ensures that HHS administers Section 504 according to its statutory text. The Trump Administration will continue to bring transparency, accountability, and fidelity to the law back to federal policymaking.”

This update resolves an ambiguity in the 2024 Final Rule and ensures the rule aligns with the best reading of the law. The preamble to the 2024 Final Rule suggested that gender dysphoria could qualify as a disability, although the regulation was silent on the issue. In April 2025, HHS issued a notice in the Federal Register underscoring that the preamble has no force or effect of law and the regulation did not address gender dysphoria. Today’s rule aligns HHS’s implementing regulations with the statutory exclusion by determining that gender identity disorders not resulting from physical impairments include gender dysphoria not resulting from physical impairments.

OCR enforces Section 504, which prohibits programs and activities that receive federal financial assistance from discriminating against individuals based on their disability. Several conditions were excluded from coverage when the law was written, including gender identity disorders not resulting from physical impairments. The 2026 Final Rule adds those statutory exclusions to HHS’ Section 504 regulation at 45 C.F.R. § 84.4(g) and makes clear that gender dysphoria not resulting from physical impairments falls within the exclusions.

“For decades, HHS’ Section 504 regulations have defined disability consistently with the words Congress chose. This rule ensures recipients of HHS funding follow those definitions, eliminating confusion for the people they serve and restoring confidence in the statute,” said HHS OCR Director Paula M. Stannard.

HHS published the proposed rule on December 19, 2025. During the comment period, it received more than 380 comments from private citizens, healthcare providers, educators, disability advocacy organizations, faith-based organizations, professional associations, states, and members of Congress. OCR reviewed every comment and responded to the significant issues raised in the preamble to the final rule.

Although the clarification only affects one provision of the rule, it serves multiple goals:

• Updates HHS Section 504 regulation to identify the conditions Congress excluded from the definitions of “disability” and “individual with a disability.”
• Clarifies that gender dysphoria not resulting from physical impairments is excluded from coverage.
• Clarifies the existing obligations of organizations and entities that receive HHS funding.

The rule is consistent with Executive Order 14168 and the administration’s deregulatory agenda outlined in Executive Order 14219.

Read the final rule in the Federal Register.

If you believe that you or someone else has been discriminated against in programs or activities that HHS directly operates or for which HHS provides federal financial assistance, you may file a complaint with OCR.

OCR enforces protections based on race, color, national origin, disability, age, sex, religion, and the exercise of conscience.

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