In this June 26, 2015 file photo, people gather in Lafayette Park to see the White House illuminated with rainbow colors in commemoration of the Supreme Court鈥檚 ruling to legalize same-sex marriage in Washington. The Trump administration Friday, June 12, 2020, finalized a regulation that overturns Obama-era protections for transgender people against sex discrimination in health care. (AP)
WASHINGTON 鈥� In a move applauded by President Donald Trump鈥檚 conservative religious base, his administration on Friday finalized a rule that overturns Obama-era protections for transgender people against sex discrimination in health care.
The Department of Health and Human Services said it will enforce sex discrimination protections 鈥渁ccording to the plain meaning of the word 鈥榮ex鈥� as male or female and as determined by biology.鈥� This rewrites an Obama-era regulation that sought a broader understanding shaped by a person鈥檚 internal sense of being male, female, neither or a combination.
LGBTQ groups say explicit protections are needed for people seeking sex-reassignment treatment, and even for transgender people who need care for common illnesses such as diabetes or heart problems.
But conservatives say the Obama administration exceeded its legal authority in broadly interpreting gender.
Behind the dispute over legal rights is a medically recognized condition called 鈥済ender dysphoria鈥� 鈥� discomfort or distress caused by a discrepancy between the gender that a person identifies as and the gender at birth. Consequences can include severe depression. Treatment can range from sex-reassignment surgery and hormones to people changing their outward appearance by adopting a different hairstyle or clothing.
Many social conservatives disagree with the concept.
鈥淯nder the old Obama rule, medical professionals could have been forced to facilitate gender reassignment surgeries and abortions 鈥� even if they believed this was a violation of their conscience or believed it harmful to the patient,鈥� said Mary Beth Waddell of the religious conservative Family Research Council.
Under the Obama-era rule, a hospital could be required to perform gender-transition procedures such as hysterectomies if the facility provided that kind of treatment for other medical conditions. The rule was meant to carry out the anti-discrimination section of the Affordable Care Act, which bars sex discrimination in health care but does not use the term 鈥済ender identity.鈥�
Women鈥檚 groups say the new regulations also undermine access to abortion, which is a legal medical procedure.
鈥淣o one should fear being turned away by a medical provider because of who they are or the personal health decisions they have made,鈥� said Fatima Goss Graves, president of the National Women鈥檚 Law Center.
The ACLU says it has already moved to try to prevent the rollback of protections for transgender people.
More than 1.5 million Americans identify as transgender, according to the Williams Institute, a think tank focusing on LGBT policy at the UCLA School of Law. A bigger number 鈥� 4.5% of the population鈥� identify as lesbian, gay, bisexual or transgender, according to Gallup.
鈥淭he changes to this rule could further harm transgender people鈥檚 health care access at a time when they face serious challenges related to COVID-19,鈥� said Jody Herman, a public policy expert at the Williams Institute.
But Roger Severino, head of the Health and Human Services Department unit that enforces civil rights laws, said transgender people continue to be protected by other statutes that bar discrimination in health care on account of race, color, national origin, age, disability and other factors.
鈥淗HS respects the dignity of every human being,鈥� Severino said. 鈥淲e are unwavering in our commitment to enforcing civil rights in health care.鈥�
For the Trump administration it鈥檚 the latest in a series of steps to revoke newly won protections for LGBTQ people in areas ranging from the military to housing and education.
The administration also has moved to restrict military service by transgender men and women, proposed allowing certain homeless shelters to take gender identity into account in offering someone a bed for the night, and concluded in a 2017 Justice Department memo that federal civil rights law does not protect transgender people from discrimination at work.
The new rule would also affect the notices that millions of patients get in multiple languages about their rights to translation services. Such notices often come with insurer 鈥渆xplanation of benefits鈥� forms. The Trump administration says the notice requirement has become a needless burden on health care providers, requiring billions of paper notices to be mailed annually at an estimated five-year cost of $2.9 billion.