非身体损伤所致性别焦虑不算残障：卫生与公众服务部发布《康复法》第504条终局规则 明确排除范围
美国卫生与公众服务部（Department of Health and Human Services，HHS）民权办公室（Office for Civil Rights，OCR）10月30日在 Washington 发布终局规则，明确在该部法规下，非身体损伤所致的性别焦虑（gender dysphoria）不构成1973年《康复法》（Rehabilitation Act）第504条所称的残障。该规则适用于一切接受 HHS 资助的项目与活动，目的是让该部法规与国会在法律中写明的排除范围保持一致。
第504条禁止接受联邦财政资助的项目与活动基于残障歧视个人。HHS 表示，法律制定时即已把若干情形排除在保障范围之外，其中包括非身体损伤所致的性别认同障碍（gender identity disorders）；2026年终局规则把这些法定排除项写入该部第504条法规第45 CFR 84.4(g) 条，并明确非身体损伤所致的性别焦虑属于这些排除情形。
卫生与公众服务部长 Robert F. Kennedy, Jr. 表示，国会已经界定了哪些情形依法可作为残障受到保护，HHS 有责任忠实按法律文本执行；这项终局规则让法规恢复清晰、尊重国会确立的区分，并确保该部按法定文本管理第504条。他还提到，其叔父 Ted Kennedy 是《美国残障人士法》的主要起草人，也是1978年强化《康复法》修正案的推动者。
HHS 说明，此次修订解决的是2024年终局规则留下的含糊之处：2024年规则的前言曾暗示性别焦虑可能构成残障，但法规正文对此并无规定；2025年4月，HHS 已在《联邦公报》发通知强调前言不具法律效力、法规并未涉及性别焦虑。民权办公室主任 Paula M. Stannard 表示，数十年来 HHS 的第504条法规一直按国会选定的措辞界定残障，这项规则确保接受 HHS 资助的机构遵循这些定义。
程序方面，Robert F. Kennedy, Jr. 于2025年12月在 Washington 的一场活动中宣布拟议规则，拟议规则于2025年12月19日公布；评论期内 HHS 收到来自个人、医疗服务提供者、教育工作者、残障倡导组织、信仰组织、专业协会、各州与国会议员的380多条意见，民权办公室逐条审阅，并在终局规则前言中回应了其中的重大问题。
HHS 表示，该规则与第14168号行政令以及第14219号行政令所列的去监管议程一致；终局规则全文已在《联邦公报》公布。认为自己或他人在 HHS 直接运营或资助的项目中受到歧视的人，可向民权办公室投诉。
Gender Dysphoria Not Resulting From Physical Impairments Is Not a Disability: HHS Issues Final Rule Amending Section 504 Regulations
The Office for Civil Rights (OCR) of the U.S. Department of Health and Human Services (HHS) on October 30 published a final rule in Washington 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. The rule applies to all programs and activities that receive HHS funding, aligning the agency's regulations with the exclusions Congress wrote into law.
Section 504 prohibits programs and activities receiving federal financial assistance from discriminating against individuals based on their disability. HHS said 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's Section 504 regulation at 45 C.F.R. section 84.4(g) and makes clear that gender dysphoria not resulting from physical impairments falls within the exclusions.
Secretary Robert F. Kennedy, Jr. said Congress defined which conditions qualify for protection as disabilities under federal law and HHS has a duty to faithfully apply the law as written, adding that the final rule restores clarity to the regulations, respects the distinctions Congress established, and ensures HHS administers Section 504 according to its statutory text. He noted that his uncle Ted Kennedy was the primary author of the Americans with Disabilities Act and the 1978 amendments that strengthened the Rehabilitation Act.
HHS said the update resolves an ambiguity in the 2024 final rule: its preamble suggested gender dysphoria could qualify as a disability, although the regulation itself 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 that the regulation did not address gender dysphoria. HHS OCR Director Paula M. Stannard said HHS's Section 504 regulations have for decades defined disability consistently with the words Congress chose, and the rule ensures recipients of HHS funding follow those definitions.
Secretary Kennedy announced the proposed rule at an event in Washington, DC in December 2025, and HHS published the proposed rule on December 19, 2025. During the comment period, HHS 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.
HHS said the rule is consistent with Executive Order 14168 and the administration's deregulatory agenda outlined in Executive Order 14219, and that the final rule has been published in the Federal Register. Anyone who believes they or someone else has been discriminated against in programs HHS directly operates or funds may file a complaint with OCR.
来源：GSM·美国（原文链接）
图片来源：图：美国卫生与公众服务部总部休伯特·汉弗莱大楼（华盛顿），ajay_suresh 摄，Wikimedia Commons，CC BY 2.0。 / The Hubert Humphrey Building, headquarters of the U.S. Department of Health and Human Services in Washington, by ajay_suresh, Wikimedia Commons, CC BY 2.0.
