Trump Administration Eliminates Transgender Health Care Protections During Pandemic

In an utterly heartless move, the Trump administration on Friday eliminated health care protections for transgender people during an ongoing global pandemic that has claimed more lives in the U.S. than in any other country.

It did this by finalizing a rule under Section 1557 of the Affordable Care Act (ACA), which prohibits health programs or activities from discriminating on the basis of race, color, national origin, sex, age, or disability. The Trump administration rule—announced on the fourth anniversary of the Pulse nightclub shooting and in the middle of Pride month—changes the definition of sex discrimination, eliminating protections due to gender identity, and considers the word “sex” to refer to “male or female and as determined by biology.”

In an interview with the New York Times, Roger Severino, the director of the Office for Civil Rights at the Department of Health and Human Services, the unit responsible for the rule, said that the rule was “equivalent to housekeeping.” The federal government was updating its books to reflect the legal reality, he said.

Severino said that health providers and health insurers were still free to adopt their own gender identity policies. He also said releasing the new rule during Pride month and on the Pulse nightclub anniversary was “purely coincidental.”

“It’s not the role of the federal bureaucrat to impose their own meanings on the words that their representatives have enshrined into law,” Severino said.

The nondiscrimination provisions were established by the Obama administration in 2016. That year, the Obama administration issued a rule to implement Section 1557 that redefined sex discrimination to include gender identity, which it defined as, “an individual’s internal sense of gender, which may be male, female, neither, or a combination of male and female, and which may be different from an individual’s sex assigned at birth.”

Under the new rule, a transgender person could be refused care for a checkup at a doctor’s office, according to NPR. Other possible scenarios include a transgender man being denied treatment for ovarian cancer, or a hysterectomy not being covered by an insurer. Some experts say that the rule opens the door for medical providers to refuse to test someone for covid-19, the disease caused by the novel coronavirus, simply because they’re transgender.

When it comes to health insurance and health care, transgender people are vulnerable to being treated negatively by their insurance and health care providers. According to the 2015 U.S. Transgender Survey carried out by the National Center for Transgender Equality, transgender people have been denied coverage for care related to their gender transition, for routine care because they were transgender, or for transition-related surgery.

The survey found that 23 percent of respondents reported not going to see a doctor when they needed to because of fear of being mistreated as a transgender person. Of those who did go see a healthcare provider, 33 percent reported that they had had at least one negative experience related to being transgender, such as being refused treatment, verbally harassed, or physically or sexually assaulted, among other horrible experiences.

The Human Rights Campaign, an LGBTQ civil rights organization, said it would sue the Trump administration over the new rule.

“LGBTQ people get sick. LGBTQ people need healthcare. LGBTQ people should not live in fear that they cannot get the care they need simply because of who they are. It is clear that this administration does not believe that LGBTQ people, or other marginalized communities, deserve equality under the law,” said Alphonso David, president of the Human Rights Campaign, in a statement. “But we have a reality check for them: we will not let this attack on our basic right to be free from discrimination in health care go unchallenged.”