US restores health protections for gay and trans people
WASHINGTON – The United States will protect gay and transgender people against sex discrimination in health care, the Biden administration announced Monday, reversing a Trump-era policy that sought to narrow the scope of legal rights in sensitive situations involving medical care.
The action by the Department of Health and Human Services affirms that federal laws forbidding sex discrimination in health care protect gay and transgender people. The Trump administration defined “sex” to mean the 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,” HHS Secretary Xavier Becerra said. “Everyone – including LGBTQ people – should be able to access health care, free from discrimination or interference, period.”
Becerra said the policy shift will bring HHS into line 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 protect gay and transgender people.
Despite that ruling, the Trump administration tried to narrow the legal protections against health care discrimination, issuing rules that defined “sex” as biological gender. A federal judge blocked those rules from taking effect, although Trump administration officials argued that as a legal matter, health care discrimination was a separate issue from the employment case the Supreme Court decided.
Monday’s action means that the HHS Office for Civil Rights will again investigate complaints of sex discrimination on the basis of sexual orientation and gender identity. Hospitals, clinics and other medical providers can face government sanctions for violations of the law.
The Biden administration essentially restored the policy established during the Obama years. The Affordable Care Act included a prohibition on sex discrimination in health care but did not include the term “gender identity.” The Obama administration interpreted the law as shielding gay and transgender people. It relied on a broad understanding of sex shaped by a person’s inner sense of being male, female, neither or a combination.
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.
LGBTQ groups said 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.
More than 1.5 million Americans identify as transgender, according to the Williams Institute, a think tank at the UCLA School of Law. A bigger number – 4.5% of the population – identify as lesbian, gay, bisexual or transgender, according to Gallup.