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Hospital Report

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The premier resource for hospital professionals from Relias Media, the trusted source for healthcare information and continuing education.

Trump Administration Reverses Protections for Transgender People

June 15th, 2020

By Jill Drachenberg, Editor, Relias Media

The Trump Administration revoked healthcare protections for transgender people, once again opening the possibility of barriers to medical care for transgender patients.

The June 12 statement from the Department of Health and Human Services (HHS) explained it was overturning an Obama Administration rule change from 2016 that defined sex discrimination to include gender identity, defined as “one’s internal sense of gender, which may be male, female, neither, or a combination of male and female.” According to HHS, the 2016 rule change “exceeded the scope of the authority delegated by Congress in Section 1557. HHS will enforce Section 1557 by returning to the government’s interpretation of sex discrimination according to the plain meaning of the word “sex” as male or female and as determined by biology.”

Despite this decision, HHS “respects the dignity of every human being,” according to Roger Severino, director of the HHS Office for Civil Rights. "[A]s we have shown in our response to the pandemic, we vigorously protect and enforce the civil rights of all to the fullest extent permitted by our laws as passed by Congress,” he said in a statement. “We are unwavering in our commitment to enforcing civil rights in healthcare.”

Reaction from the medical community and civil rights organizations was swift. Transgender patients may face barriers to healthcare, including gender reassignment treatments or even care for basic medical conditions. “The federal government should never make it more difficult for individuals to access health care—during a pandemic or any other time,” American Medical Association (AMA) President Susan R. Bailey, MD, said in a statement. The AMA also wrote in a prior comment letter that the policy “legitimizes unequal treatment of patients by not only providers, health care organizations, and insurers, but also by the government itself—and it will harm patients. Such policy should not be permitted by the U.S. government, let alone proposed by it.” LGBTQ rights groups The Human Rights Campaign and Lambda Legal announced intentions to filed lawsuits to challenge the rule.

In 2015, the National Center for Transgender Equality (NCTE) reported 33% of survey respondents experienced verbal harassment or refusal of care when seeking healthcare. Twenty-three percent did not seek needed healthcare because of fears of discrimination or mistreatment. “The new rules ... are hateful and cruel, and will keep people from being able to get the care they need to live happy, healthy and productive lives,” said NCTE Executive Director Mara Keisling.

In other news for the LGBT community, the Supreme Court on Monday ruled that employers cannot discriminate against gay, lesbian, and transgender employees, expanding discrimination protections under the Civil Rights Act of 1964.

“As physicians, and as leaders in medicine, we believe that LGBTQ+ individuals must be protected from workplace discrimination in order to prevent negative health outcomes,” Bailey said in a statement. “The AMA supports everyone’s access to quality, evidence-based health care regardless of gender or sexual orientation, and will continue to work diligently at the state and federal levels to expand access to medical services, reduce stigma in treating patients with unique needs and break down discriminatory barriers to care.”