In a move applauded by US President Donald Trump’s conservative religious base, his administration on Friday finalized a rule that overturns protections for transgender people against sex discrimination in healthcare.
The US Department of Health and Human Services said that it would enforce sex discrimination protections “according to the plain meaning of the word ‘sex’ as male or female and as determined by biology.”
This rewrites a regulation from former US president Barack Obama that sought a broader understanding shaped by a person’s internal sense of being male, female, neither or a combination.
LGBT+ groups say that 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.
However, conservatives say that the Obama administration exceeded its legal authority in broadly interpreting gender.
The reversal comes in the middle of LGBTQ Pride Month.
Activists and Democratic lawmakers said that Friday was also the four-year anniversary of the mass shooting at the Pulse gay nightclub in Orlando, Florida, in which 49 people were killed.
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 their 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, senior legislative assistant of the religious conservative Family Research Council.
However, US House of Representatives 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 healthcare — during a pandemic or any other time,” American Medical Association president Susan Bailey said.
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 healthcare, 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.
The American Civil Liberties Union said that it has already moved to try to prevent the rollback of protections for transgender people.
The LGBT+ civil rights group Lambda Legal said it would sue.
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