The Department of Health and Human Services issued a final rule on October 30, 2026, clarifying that "gender dysphoria not resulting from a physical impairment" is excluded from the definition of disability under section 504. The rule revises the regulation implementing section 504 of the Rehabilitation Act of 1973 as it applies to recipients of HHS funding.

The final rule was filed on October 30, 2026, with document number 2026-22380, and is scheduled for publication in the Federal Register on November 3, 2026. The rule becomes effective 60 days after its publication.

For the purpose of part 84, the term gender identity disorders not resulting from physical impairments includes gender dysphoria not resulting from physical impairments. The statute defines "individual with a disability" and "disability" to exclude "transvestism, transsexualism, pedophilia, exhibitionism, voyeurism, gender identity disorders not resulting from physical impairments, or other sexual behavior disorders." The statutory exclusions regarding gender identity disorders were enacted in the Americans with Disabilities Act in 1990 and aligned in the Rehabilitation Act in 1992.

This action follows a series of regulatory adjustments beginning with the "2024 Final Rule," which the Department published on May 9, 2024, to modernize and clarify regulations implementing section 504. The preamble to that rule stated that "gender dysphoria does not fall with the statutory exclusions for gender identity disorders." In April 2025, the Department published a clarification in the Federal Register stating that the 2024 Final Rule "does not say that gender dysphoria is a disability." That notice further stated that the preamble language regarding gender dysphoria "does not have the force or effect of law" and "cannot be enforced." On December 19, 2025, the Department published a proposed rule to amend 45 CFR part 84 to resolve ambiguity identified in the April 2025 notice. The comment period for the proposed rule was extended from January 20, 2026, to February 20, 2026, and the Department received over 380 comments in response.