In a move applauded by President Donald Trump’s 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 “according to the plain meaning of the word ‘sex’ as male or female and as determined by biology.” This rewrites an Obama-era regulation that sought a broader understanding shaped by a person’s 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 “gender dysphoria” — 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.
“Under the old Obama rule, medical professionals could have been forced to facilitate gender reassignment surgeries and abortions — even if they believed this was a violation of their conscience or believed it harmful to the patient,” said Mary Beth Waddell of the religious conservative Family Research Council.
But House Speaker Nancy Pelosi said, “Religious freedom is no justification for hatred or bigotry, and every American has the right to seek and receive care without intimidation or fear.”
The American Medical Association strongly criticized the Trump administration’s action.
“The federal government should never make it more difficult for individuals to access health care — during a pandemic or any other time,” said Dr. Susan Bailey, the group’s president.
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 “gender identity.”
Women’s groups say the new regulations also undermine access to abortion, which is a legal medical procedure.