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Trump administration removes non-discrimination protections for transgender people in health care

HHS says protections on the basis of sex apply only to ‘male or female as determined by biology’

Transgender woman Alison Gill of Maryland joins LGBTQ supporters in front of the U.S. Supreme Court in October. (Manuel Balce Ceneta/AP)
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The Trump administration on Friday reversed non-discrimination protections for transgender people in health care, a policy shift that has been among the top priorities of social conservatives who constitute the president’s base.

The rule change, part of a host of updates pertaining to abortion, birth control and families undertaken by federal officials over the past three years, represents an important setback in the movement for LGBTQ rights. Under President Barack Obama, the concept of gender in many areas of the law had been broadened beyond biological sex to encompass the myriad identities that different Americans embrace.

Roger Severino, director of the Office for Civil Rights at the Department of Health and Human Services, has argued that when members of Congress who passed the 2010 Affordable Care Act prohibited providers receiving federal funding from discrimination on the basis of sex, they meant “the plain meaning of the term.”

HHS elaborated in a statement Friday that it believes those anti-discrimination provisions apply only to “male or female as determined by biology.” It described the change as part of efforts to remove “costly and unnecessary regulatory burdens” that it said were costing American taxpayers $2.9 billion.

When health officials first announced their intention to change the rule in May, civil rights groups said the reversal would allow health-care providers, as well as insurers, to deny services to transgender individuals.

On Friday, the American Civil Liberties Union and Lambda Legal’s Transgender Rights Project said they would challenge the rule in court.

“This rule change serves no other purpose than to target and discriminate against LGBTQ people. The cruelty is the point,” Sasha Buchert, a senior attorney for Lambda Legal, said in a statement.

Buchert said the change was especially dangerous in the middle of the coronavirus pandemic and in an era when LGBTQ people are experiencing discrimination at disproportionately higher rates when seeking medical care.

Democratic presidential candidate Joe Biden called the action “unconscionable,” saying in a statement that taking it "during Pride Month, on the fourth anniversary of the deadly terrorist attack at the Pulse Nightclub that claimed 49 lives, many of them members of the LGBTQ+ community, is despicable.”

Civil rights groups described the new rules as part of a broader attack on reproductive and sexual rights. The Trump administration over the past three years has taken numerous measures to restrict abortion, emphasize abstinence over birth control and define the concept of family as a man and a woman in settings from schools to the military.

The Department of Housing and Urban Development has separately sought to allow federally funded shelters to turn away transgender people for religious reasons, and the Department of Defense has sought to allow troops to serve only in positions that match the sex stated on their birth certificates.