The Trump administration interpreted "sex" to mean gender assigned at birth, which excluded transgender people from the law's umbrella of protection.
Content warning: This story contains themes of gender dysphoria and transphobia that some readers may find distressing
America will protect gay and transgender people against sex discrimination in health care, the Biden administration announced on Monday. The federal government reversed a policy implemented by the Trump administration and will restore the policy established during the Obama administration. The previous administration interpreted "sex" to mean gender assigned at birth, which excluded transgender people from the law's umbrella of protection. “Fear of discrimination can lead individuals to forgo care, which can have serious negative health consequences," said Health and Human Services Secretary Xavier Becerra, reported ABC News. “Everyone — including LGBTQ people — should be able to access health care, free from discrimination or interference, period.” The earlier policy from the previous administration narrowed the scope of legal rights in situations involving medical care.
President Joe Biden had promised to reverse the decisions curbing the rights of gay and transgender people during his campaign for president. At the time, Trump called the proposed reversal "horrible and politically charged." After becoming President, Biden has implemented policy changes that extend rights across society, from military service, to housing, to employment opportunities. Xavier Becerra also added that the policy would be in line with a landmark Supreme Court decision last year in a workplace discrimination case. The case established federal laws against sex discrimination on the job also protect gay and transgender people. While the Trump administration narrowed the definition of sex, a federal judge blocked the rules from taking effect. The Trump administration officials argued that as a legal matter health care discrimination was a separate issue from the employment case ruling by the Supreme Court.
This development will now see HHS Office for Civil Rights investigate complaints of sex discrimination on the basis of sexual orientation and gender identity. Similarly, hospitals, clinics, and other medical providers can face government sanctions for violations of the law. The Affordable Care Act prohibited sex discrimination in health care, and the Obama administration had interpreted 'sex' as a broad understanding of sex shaped by a person’s inner sense. The Obama administration understood this to include gay and transgender people, but the Trump administration sought to establish the definition of 'sex' as sex assigned at birth. As per the rule under the Obama administration, it would be mandatory for a hospital to perform gender-transition procedures such as hysterectomies if the facility provided the treatment.
Doctors have clear message for the TX legislature: stop interfering in transgender kids’ health care @EqualityTexas @HRC pic.twitter.com/yJfaFmeJbE— Aliza Norwood, MD, AAHIVS (@alizanorwood) May 5, 2021
At the crux of the matter was treatment and support for gender dysphoria, a medically recognized condition. It refers to distress or discomfort arising from a person identifying as a gender different from one assigned at birth. The strong desire to be of another gender can affect the ability to perform even the simplest of tasks. Consequences of gender dysphoria include severe depression. Treatment to gender dysphoria can range from gender confirmation surgery and hormones to people changing their outward appearance by adopting a different hairstyle or clothing.
No one should ever be denied health care because of who they are.— Nina Turner (@ninaturner) May 11, 2021
The transgender community has been marginalized in every way possible. It’s time we finally pass the Equality Act so the well-being of LGBTQ+ people can no longer serve as a political bargaining chip. https://t.co/OFDnlaaB0X
A new study published in the national peer-reviewed journal JAMA Surgery found those who underwent gender-affirming surgery showed improved mental health outcomes for transgender adults, including lower rates of psychological distress and suicidal ideation, according to Them. It was found that transgender people who had received one or more gender-affirming surgical procedures had a 42% reduction in the odds of experiencing psychological distress in the past month while 44% were less likely to have experienced suicidal ideation over the past year.
Religious conservatives have wanted to narrow the scope of the term sex to deny such treatment whereas medical groups and civil rights organizations have sought broader legal protections for gay and transgender people. “This is inflaming the culture wars, especially when you are trying to circumvent the process,” said Conservative lawyer Roger Severino, before adding, “I expect lawsuits.” The American Medical Association hailed the move by the Biden administration and added that they “did the right thing” by ending “a dismal chapter which a federal agency sought to remove civil rights protections.” Conservatives argued that doctors will be forced to perform gender reassignment procedures against their professional judgment. Representative Katie Porter hailed the decision, writing, "The Trump Administration put lives at risk when it changed the rules to allow discrimination against LGBTQ+ Americans in healthcare. I'm grateful President Biden has restored these protections."
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