Care-protection policy restored
Preventing discrimination of gay, transgender people is goal
WASHINGTON — The federal government will protect gay and transgender people against sex discrimination in health care, the Biden administration declared Monday, reversing a Donald Trump-era policy that narrowed rights at the intersection of changing social mores and sensitive medical decisions.
It marked the latest step by President Joe Biden to advance the rights of gay and transgender people across society, including in military service, housing and employment opportunities.
The policy announcement by the Department of Health and Human Services affirms that federal laws forbidding sex discrimination in health care also protect gay and transgender people. The Trump administration had defined “sex” to mean gender assigned at birth, thereby excluding 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 department Secretary Xavier Becerra. “Everyone — including LGBTQ people — should be able to access health care, free from discrimination or interference, period.”
Both opponents and supporters of the action said it’s likely to lead to litigation.
Speaking for the medical community, the American Medical Association said in a statement that the Biden administration “did the right thing” by ending “a dismal chapter [in] which a federal agency sought to remove civil rights protections.” But some conservatives warned that doctors could be forced to perform gender reassignment procedures against their professional judgment.
Becerra said the Department of Health and Human Services will now be aligned with a landmark 6-3 Supreme Court decision last year in a workplace discrimination case, which established that federal laws against sex discrimination on the job also protect gay and transgender people.
Monday’s action does not fully reverse the Trump administration’s interpretation of the law. It encourages people who believe they have been discriminated against to bring complaints to the federal government. Biden administration officials said they were working to write more complete regulations on the civil-rights provision of the law, known as Section 1557.
“We do anticipate engaging in further rule-making,” said Robinsue Frohboese, the acting director of the Office for Civil Rights. She said the administration did not have a timeline for when a formal regulatory change would be announced.
Since the Trump administration’s transgender rule had been blocked by a federal judge, the Biden administration action essentially restores a policy established during the Barack Obama years. The Patient Protection and Affordable Care Act prohibited sex discrimination in health care but did not use the term “gender identity.” The Obama administration interpreted the law as shielding gay and transgender people.
Behind the dispute over rights for transgender people is a medically recognized condition called “gender dysphoria” — discomfort or distress caused by a discrepancy between the gender that a person identifies as and the gender assigned at birth. Consequences can include severe depression. Treatment can range from gender confirmation surgery and hormones to people changing their outward appearance by adopting a different hairstyle or clothing.
LGBTQ groups say explicit protections are needed for people seeking gender transition treatment, and even for transgender people who need care for illnesses such as diabetes or heart problems.
But Tony Perkins, president of the religious conservative Family Research Council, called sex “an objective biological reality” and said the Biden administration is promulgating “a nonsensical definition” of discrimination. “While this decision will advance America’s cultural psychosis, it will potentially put the physical well-being of individuals at grave risk,” Perkins said in a statement.