New Proposal Could Threaten Transgender Healthcare Protections

A new Trump administration proposal introduced on Friday could threaten healthcare protections for transgender people, advocates say.

The Department of Health and Human Services’ proposed rule would change how nondiscrimination protections define “sex.” Discrimination on the basis of “sex” would no longer include protections specifically for transgender and gender non-conforming patients, and instead leaves the term open to interpretation.

“This proposed rule, thus, seeks to amend regulations that identify sexual orientation or gender identity as prohibited bases for discrimination for certain Department funded or administered programs,” the draft rule states.

Under the Obama administration, HHS redefined nondiscrimination protections on the basis of sex to include a broader definition of “gender identity.” The Obama-era regulation prevented healthcare providers, hospitals, and insurers from discriminating against transgender patients seeking medical care.

Advocates argue the proposed regulation puts transgender people at greater risk of discrimination.

A survey conducted by The National Center for Transgender Equality in 2015 found that nearly a quarter of transgender patients did not see a doctor when they needed to due to fear of being mistreated.

The HHS regulation would be especially harmful to the most marginalized people, including “trans people living with HIV, Black transgender people and people of color, trans people with disabilities, and rural and Southern trans folks,” said Kris Hayashi, the executive director of the Transgender Law Center.

The White House did not immediately respond to a request for comment for this story.

The HHS proposal is the third regulation to target protections for transgender people this week.

On Tuesday, the Trump administration finalized the “Conscience Rights in Health Care” regulation, allowing healthcare workers to refuse medical treatment—including procedures like abortion and sex reassignment surgery—on religious grounds.

Another draft rule proposed on Wednesday by the Department of Housing and Urban Development would allow federally funded homeless shelters and housing programs to bar transgender people from entry, also on the basis of religious freedom.

The HHS proposal is part of a broader conservative effort to restrict definitions of sex and gender, which has sparked a national debate in recent years.

Earlier this year, the Trump administration even tightened its definition of “biological sex” as based on a person’s “chromosomes, gonads, hormones, and genitals.” The policy came as the Department of Defense sought to ban transgender people from serving in the military.

HHS’s director of the Office for Civil Rights, Roger Severino said Friday that “discrimination on the basis of sex does not include gender identity or termination of pregnancy.” The regulation would also undo protections for people who have had abortions, a right that has been under attack this year as conservative lawmakers seek to ban the procedure altogether.

In a press release, Severino added: “When Congress prohibited sex discrimination, it did so according to the plain meaning of the term, and we are making our regulations conform.”

But trans rights advocates are prepared to fight the regulation.

“Predicated on little more than prejudice, this proposal will abandon 2 million Americans who already face significant barriers to accessing adequate and life-saving health care,” said Mara Keisling, the executive director for NCTE.