Tag: transgender

Trump erases health care protections for transgender patients during Pride Month

Just two weeks into Pride Month — and on the anniversary of the Pulse nightclub shooting — the Trump administration announced that it is rolling back Obama-era health care protections for people who are transgender. The rule, announced Friday, will impact transgender patients’ ability to fight against discrimination by doctors, medical facilities and health insurance providers. 

Former president Barack Obama’s administration changed federal health care guidelines in 2016 to expand sex-based protections based to include protections based on gender identity, “which may be male, female, neither, or a combination of male and female.” His administration also pushed for discrimination protections for those who have had abortions. 

But the Department of Health and Human Services (HHS) released a statement on Friday saying the final rule is based on “the plain meaning of the word ‘sex’ as male or female and as determined by biology.”

“All of these are essentially legislative changes that the Department lacked the authority to make,” the administration said of the 2016 changes in the final rule. “They purported to impose additional legal requirements on covered entities that cannot be justified by the text of Title IX, and in fact are in conflict with express exemptions in Title IX.”

In the summary of the final rule, HHS responded to several comments that criticized the lack of protection for people who do not identify with the sex they were assigned at birth. In one response to the comments, HHS compared gender identity to political affiliation. 

“For example, in the unlikely event that a healthcare provider were to deny services to someone based solely on his or her political affiliation, the Department would not be able to address such denial of care under Section 1557,” HHS said. “Unlike other bases of discrimination, the categories of gender identity and sexual orientation (as well as political affiliation) are not set forth in those statutes.”

The rule summary also argued that health care based on sex assigned at birth, rather than gender identity, is necessary for health care, and insinuated that transgender health care may be confusing for providers.

“The 2016 Rule risked masking clinically relevant, and sometimes vitally important, information by requiring providers and insurers to switch from a scientifically valid and biologically based system of tracking sex to one based on subjective self-identification according to gender identity,” the summary said. “…The 2016 Rule’s mandate cannot answer, for example, how a provider is to determine whether or when a transgender individual is entitled by law to be referred to a women’s mental health support group, a men’s mental health support group, either group, or both at the same time.”

Roger Severino, director of the HHS Office for Civil Rights, maintained in the announcement that “HHS respects the dignity of every human being.”

“…and as we have shown in our response to the pandemic, we vigorously protect and enforce the civil rights of all to the fullest extent permitted by our laws as passed by Congress,” Severino said. “We are unwavering in our commitment to enforcing civil rights in healthcare.”

Transgender individuals have long faced discrimination in health care. A quarter of the 28,000 individuals who took the U.S. Transgender Survey reported that they have experienced an insurance issue because of their gender identity. Even more respondents reported that they have experienced verbal harassment, been refused treatment, or had a health care provider who did not know how to properly treat transgender individuals. 

Thousands of survey participants also reported they were denied routine health and sexual health screenings. Those who are transgender are more likely than the general U.S. population to be uninsured, according to the survey. 

The American Civil Liberties Union quickly responded to the administration’s announcement, writing on Twitter that the rule “will embolden health care discrimination against transgender people, those seeking reproductive health care, and many other individuals who need health care — all while a global pandemic is occurring.”

“Politicians have no business coming between us and our health care,” the organization added.

The announcement also came at the end of a week where two black transgender women were murdered. So far this year, at least 14 transgender or gender non-conforming individuals have been fatally shot or killed by other violent means in the U.S., according to the Human Rights Campaign. 

[CBS News]

HUD moves to allow discrimination against homeless transgender people

The Department of Housing and Urban Development is moving to roll back protections for homeless transgender people by enabling HUD-funded providers of shelters to consider a person’s sex or gender identification in determining whether they can be admitted.

The proposal, included in the department’s spring rule list out Wednesday, contradicts a pledge that HUD Secretary Ben Carson made to lawmakers just yesterday.

It would turn back requirements under an Obama-era rule that operators of single-sex shelters who receive HUD funding “provide equal access to programs, benefits, services, and accommodations in accordance with an individual’s gender identity.”

Carson told lawmakers on Tuesday that he was “not currently anticipating changing” the Equal Access Rule under questioning from Rep. Jennifer Wexton (D-Va.).

“Yesterday, I asked Secretary Carson directly if he was anticipating any changes to HUD’s Equal Access Rule, and he said no,” Wexton told POLITICO. “The announcement today that HUD will now allow anti-trans discrimination in shelters demonstrates that he either lied to Congress or has no idea what policies his agency is pursuing. Either way, it’s unacceptable.”

HUD said the proposal would give more leeway to shelter providers on the admission of people who “may misrepresent their sex.”

“Later this year, HUD will be proposing a change to the 2016 rule that will offer local homeless shelter providers greater flexibility when making decisions about individuals who may misrepresent their sex to access sex-specific shelters,” a spokesperson said in an emailed statement. “HUD is, and will always be, committed to ensuring that every person accessing its programs can do so without discrimination.”

The proposal says shelter providers “may establish a policy, consistent with state and local law, by which such Shelter Provider considers an individual’s sex for the purposes of determining accommodation within such shelters and for purposes of determining sex for admission to any facility or portion thereof.”

Providers would be able to “consider a range of factors in making such determinations, including privacy, safety, practical concerns, religious beliefs, any relevant considerations under civil rights and nondiscrimination authorities, the individual’s sex as reflected in official government documents, as well as the gender which a person identifies with,” according to the proposal.

[Politico]

Trump poised to roll back transgender health protections


The Trump administration appears ready to roll back health care protections for transgender people, and advocates are gearing up for a fight.

A proposed rule from the Department of Health and Human Services (HHS) that’s expected in the coming days would make it easier for doctors, hospitals and insurance companies to deny care or coverage to transgender patients, as well as women who have had abortions.

Coming on the heels of the military transgender ban, there are fears the administration could go even further and use the proposal as an opportunity to narrow the definition of gender.

The administration hinted in a recent court filing that new health regulations could be published as soon as next week. The rule is expected to weaken or eliminate an anti-discrimination provision enshrined in ObamaCare.

The provision says patients cannot be turned away because they are transgender, nor can they be denied coverage if they need a service that’s related to their transgender status.

Religious providers say they expect the administration’s rule to reinforce their right not to provide treatment that is against their beliefs.

Advocates, meanwhile, say they are concerned that the proposal could jeopardize the gains made in making sure transgender individuals receive equal access to care.

The proposal is “likely to send an even stronger signal that the administration endorses discrimination in health care against transgender people,” said Harper Jean Tobin, director of policy at the National Center for Transgender Equality.

The rule “won’t mean that overnight transgender people can’t get health care, but it will be a steady drip of allowing more discrimination,” Tobin said.

Chase Strangio, an attorney at the American Civil Liberties Union (ACLU), said access to health care can be a life or death circumstance, and the rule could have “catastrophic effects” if it is finalized.

“To have the government take a stand in favor of discrimination is deeply upsetting, ” Strangio said.

Once the proposal is released, a public comment period will follow. After that, a final rule will be issued.

As for what comes next, Strangio said the ACLU has had two years to prepare for that.

“If the final rule looks like the proposal we are anticipating, we and our partners will file suit as soon as possible,” Strangio said. “We can expect many legal challenges to any final rule.”

President Trump repeatedly pledged support for the LGBTQ community on the campaign trail in 2016. But advocates say the president’s words increasingly ring hollow, and his administration has been steadily eroding protections for transgender individuals.

For example, the military’s transgender ban took effect earlier this month, despite objections from advocacy groups and medical experts. And the Supreme Court on Monday said it would hear arguments this year on three cases concerning whether federal law applies to transgender identity.

Additionally, the Justice Department has argued that the main federal civil rights law doesn’t protect employees from discrimination based on gender identity. Former Attorney General Jeff Sessions in 2017 wrote a memo saying the law “does not encompass discrimination based on gender identity per se.”

The existing health care rule was first issued in 2016, six years after the 2010 Affordable Care Act was signed into law. The rule prohibited providers and insurers who receive federal money from denying treatment or coverage to anyone based on sex, gender identity or termination of pregnancy.

It also required doctors and hospitals to provide “medically necessary” services to transgender individuals, as long as those services were the same ones provided to other patients.

That rule was challenged in court by a group of Christian providers called the Franciscan Alliance. They argued the rule forces insurers to pay for abortions and compels doctors to perform gender transition services, even if they disagree with those services on moral or medical grounds.

A federal judge in Texas agreed with that argument, issuing a nationwide injunction in late 2016 that is still in effect. The ruling said Congress had outlawed discrimination based on “the biological differences between males and females” but not transgender status.

The new proposed rule has been under review at the White House Office of Management and Budget for more than a year, something that experts say is highly unusual.

That delay is causing confusion in the health care industry: ObamaCare’s nondiscrimination statute is the law, even if a rule implementing it has been put on hold.

In a court filing earlier this month, the administration said it would be publishing the proposal soon, a move that would likely affect the lawsuit in Texas.

Luke Goodrich, senior counsel with the Becket Fund for Religious Liberty and a lead attorney for the plaintiffs, said providers would be better served by a ruling from the judge. He said they just want to make sure their religious protections are upheld.

Katie Keith, a health care consultant and professor at Georgetown Law, said, “It’s going to be really hard for people to understand their rights in health care” while the confusion continues.

Tobin, of the National Center for Transgender Equality, said the uncertainty is having a harmful effect.

“At a time when the administration is trying to overturn the entire Affordable Care Act, at a time when the transgender ban in military is taking effect, transgender people are scared for their ability to get the health care they need, and that their providers know they need,” Tobin said.

Goodrich argues that providers won’t turn away patients just because they are transgender, so long as the doctors aren’t giving transition-related care or “being pressured to perform abortions.”

He said the plaintiffs have been treating transgender people for years and “won’t stop doing that, because they provide care for everyone. That’s not what the lawsuit is about in our view.”

Transgender advocates are concerned the administration will use the lawsuit as an excuse to redefine gender.

The New York Times last year reported that HHS proposed in a memo that government agencies adopt a narrower definition of gender in a way that would essentially end federal recognition of transgender individuals.

No rules have been issued, but advocates say administration officials have been telegraphing their views.

The HHS memo is a “blueprint” for discrimination, and the nondiscrimination proposal is a major part of it, Tobin said.

[The Hill]

The Trump administration reportedly wants the government to revoke civil rights protections from transgender people

The Trump administration is weighing making its biggest attack on transgender rights yet in a maneuver that would strip federal recognition of the gender identity of some 1.4 million Americans — and require genetic testing in some cases to match a person’s gender with the sex they were assigned at birth.

Erica Green, Katie Benner, and Robert Pear of the New York Times reported on Sunday that the Department of Health and Human Services is floating a memo that would establish the legal definition of sex under Title IX — the federal civil rights law that bans discrimination in education on the basis of gender — that would render immutable the sex of a person at birth. In other words, the government would not recognize a person’s gender other than the one based on their genitalia when they’re born.

Per the Times:

The department argued in its memo that key government agencies needed to adopt an explicit and uniform definition of gender as determined “on a biological basis that is clear, grounded in science, objective and administrable.” The agency’s proposed definition would define sex as either male or female, unchangeable, and determined by the genitals that a person is born with, according to a draft reviewed by The Times. Any dispute about one’s sex would have to be clarified using genetic testing.

According to the Times, it would “eradicate federal recognition” of some 1.4 million transgender Americans.

HHS is preparing to formally present the new definition to the Justice Department before the end of the year, and if the department decides the change is legal, it could be enforced across Title IX laws and government agencies, including the Departments of Education, Justice, Health and Human Services, and Labor.

The effects could be far-reaching — it could impact which locker rooms and bathrooms transgender students could use as well as which sports teams students join or what happens to single-sex classes, the Times points out. If enacted, it could even require some people to produce DNA tests as part of their educational experience — an unprecedented step to enforce a biological definition of gender.

The Trump administration has been terrible on transgender rights

The Obama administration worked to advance transgender rights and loosen federal regulations to allow for more gender fluidity — including defining gender identity as protected by Title IX. President Donald Trump and his administration have taken steps to reverse that.

Soon after taking office, the Trump administration sent out a letter officially revoking Obama-era guidance on protecting trans students in federally funded schools, saying it was federal overreach. Trump has sought to ban transgender people from serving in the military, rescinded a memo protecting trans workers, and stripped protections for trans prisoners. It has also worsened protections for transgender people in health care.

Trump on the campaign trail said he would embrace LGBTQ people and said he would “fight” for them while Hillary Clinton would bring in “more people that will threaten your freedoms and believes.” But as Vox’s German Lopez pointed out, he’s done quite the opposite:

As president, Trump has acted more or less how you would expect a typical anti-LGBTQ Republican to act. Maybe that reflects his own opinions. Maybe it reflects the views of the people he’s surrounded himself with in his administration, including Vice President Mike Pence and Attorney General Jeff Sessions, both of whom have very long histories of anti-LGBTQ causes.

This new assault on transgender people — and one that includes genetic testing — is just the latest chapter.

[Vox

]

Trump moves to ban most transgender troops

President Donald Trump on Friday issued orders to ban transgender troops who require surgery or significant medical treatment from serving in the military except in select cases — following through on a controversial pledge last year that has been under review by the Pentagon and fought out in the courts.

The memorandum states that while the secretary of defense and other executive branch officials will have some latitude in implementing the policy, “persons with a history or diagnosis of gender dysphoria — including individuals who the policies state may require substantial medical treatment, including medications and surgery — are disqualified from military service except under limited circumstances.”

The document provides few details about how the ban will be implemented, what will happen to those who are currently serving and under which limited circumstances transgender troops may be able to serve.

The memo also said that Secretary of Defense Jim Mattis, “in the exercise of his independent judgment, has concluded [the policies] should be adopted by the Department of Defense.”

It added that “the Secretary of Homeland Security concurs with these policies with respect to the U.S. Coast Guard,” which would also be affected by the policy.

In a subsequent statement, the White House press office explained that the policy was “developed through extensive study by senior uniformed and civilian leaders, including combat veterans.”

“The experts’ study sets forth a policy to enhance our military’s readiness, lethality, and effectiveness,” it continued, adding that officials “concluded that the accession or retention of individuals with a history or diagnosis of gender dysphoria — those who may require substantial medical treatment, including through medical drugs or surgery — presents considerable risk to military effectiveness and lethality.”

“This new policy will enable the military to apply well-established mental and physical health standards — including those regarding the use of medical drugs — equally to all individuals who want to join and fight for the best military force the world has ever seen,” the White House statement concluded.

LGBT advocates who have sought to head off such a move in the courts swiftly slammed the decision, calling it “appalling, reckless and unpatriotic.”

“Donald Trump and Mike Pence are literally wreaking havoc on the lives of our military families,” said Ashley Broadway-Mack, president of the American Military Partner Association. “This unconscionable attack on our military families cannot stand — we refuse to allow it.”

[Politico]

CDC banned from using ‘evidence-based’ and ‘science-based’ on official documents

The Trump administration has reportedly banned the Centers for Disease Control from using the phrases “evidence-based” and “science-based” on official documents.

Senior CDC officials distributed the list of “forbidden” words and phrases to policy analysts at the CDC on Thursday, the Washington Post reported Friday. The list also bans the use of “vulnerable,” “entitlement,” “diversity,” “transgender” and “fetus.”

Analysts are reportedly prohibited from using the phrases on official documents they prepare for the 2019 budget, which is expected to be released in February.

An analyst who attended the meeting at the CDC in Atlanta told the Washington Post that instead of “evidence-based” or “science-based,” policy analysts are instructed to use the phrase, “CDC bases its recommendations on science in consideration with community standards and wishes.”

The analyst told the Post that other branches of President Trump’s health department are likely adhering to the same list of banned words. The source said that others at the meeting reacted with surprise when given the list.

“It was very much, ‘Are you serious? Are you kidding?’” the analyst said, “In my experience, we’ve never had any pushback from an ideological standpoint.”

The Trump administration has been repeatedly scrutinized for declining to acknowledge science-based findings, particularly related to climate change. Trump himself has not said whether he believes in climate science, and numerous members of his administration and his appointees have denied aspects of scientific consensus related to global warming.

[The Hill]

Sessions’ DOJ reverses transgender workplace protections

Attorney General Jeff Sessions has reversed an Obama-era policy explicitly defining transgender workers as protected under employment discrimination laws, CBS News’ Paula Reid reports.

The Wednesday policy reversal of what qualifies as employment discrimination under Title VII of the Civil Rights Act comes down to an idealogical disagreement over whether “sex” is decided by a person’s birth certificate, or whether sexual discrimination includes broader gender identity. Title VII prohibits any employment discrimination based on race, color, religion, sex and national origin. Former Attorney General Eric Holder in 2014 interpreted “sex” discrimination to apply to discrimination based on gender identity, while Sessions’ DOJ interprets that it only applies to discrimination between men and women.

Sessions’ DOJ argues Holder went beyond the definition of the 1964 law by including transgender discrimination.

“The Department of Justice cannot expand the law beyond what Congress has provided,” DOJ spokesperson Devin O’Malley said. Unfortunately, the last administration abandoned that fundamental principle, which necessitated today’s action. This Department remains committed to protecting the civil and constitutional rights of all individuals, and will continue to enforce the numerous laws that Congress has enacted that prohibit discrimination on the basis of sexual orientation.”

The move comes after President Trump has announced he will prohibit transgender individuals from serving in the military, a decision that shocked his own party and caused backlash from Democrats and civil liberties groups.

Sessions’ latest policy shift could very well could end up in court, Reid reports. Already, it’s under fire from civil liberties groups like the American Civil Liberties Union (ACLU).

“Today marks another low point for a Department of Justice, which has been cruelly consistent in its hostility towards the LGBT community and in particular its inability to treat transgender people with basic dignity and respect,” James Esseks, director of the ACLU’s LGBT & HIV Project, said in a statement.

“This Department of Justice under Jeff Sessions has time and time again made it clear that its explicit agenda is to attack and undermine the civil rights of our most vulnerable communities, rather than standing up for them as they should be doing,” Esseks continued. “Discrimination against transgender people is sex discrimination, just as DOJ recognized years ago. We are confident that the courts will continue to agree and will reject the politically driven decision by Attorney General Sessions.”

[CBS News]

Trump Signs Order For Military to Discriminate Against Transgender Recruits

President Donald Trump on Friday signed a directive reinstating a ban on transgender individuals from serving in the military, although it defers to the Pentagon on whether to remove those now in uniform and leaves open the door for it to seek changes.

Trump’s directive, issued to the Defense and Homeland Security Departments, reinstates a prohibition of transgender service members lifted last year, putting a formal stamp on a politically divisive change in military personnel policy that Trump first announced last month.

It also bars funding to pay for gender-reassignment surgeries except when “necessary to protect the health of an individual who has already begun a course of treatment to reassign his or her sex.”

The guidance gives Defense Secretary Jim Mattis until Feb. 21, 2018, to submit a plan for implementing the new policy. It also leaves decision of whether to remove current troops to Mattis.

The White House memo also leaves the door open for further changes in the transgender policy, stating that Mattis may advise him on changes.

“The Secretary of Defense, after consulting with the Secretary of Homeland Security, may advise me at any time, in writing, that a change to this policy is warranted,” the memo states.

Then-Defense Secretary Ash Carter announced in June 2016 the ban on transgender troops would be lifted. Mattis, however, delayed implementation of the policy for new recruits by six months to allow for further study.

Trump first revealed he would reverse the policy in a series of tweets on July 26, announcing transgender individuals would not be allowed “to serve in any capacity” in the military.

Trump’s announcement last month on Twitter that he planned to reverse the Obama policy was hailed by some conservatives who argue that the military has become a social experiment.

But it also drew widespread condemnation from Democrats and some Republicans, who argue the policy shift is discriminatory and would disrupt military readiness.

Pentagon spokeswoman Dana White Friday confirmed in a statement that the department had received the guidance but provided no further details.

“The Department of Defense has received formal guidance from the White House in reference to transgender personnel serving in the military,” White said. “More information will be forth coming.”

Experts predict that implementation of the ban will prove a lethal thicket and predict a series of court challenges that will likely delay the policy.

[Politico]

Trump: ‘Doing the Military a Great Favor’ with Transgender Troop Ban

President Trump said Thursday he is “doing the military a great favor” by banning transgender people from serving in the armed forces.

“I have great respect for the community,” Trump said from his golf club in Bedminster, N.J. “I think I’ve had great support, or I’ve had great support from that community. I got a lot of votes. It’s been a very complicated issue for the military, it’s been a very confusing issue for the military, and I think I’m doing the military a great favor.”

Trump announced the sudden shift in military policy last month in a series of tweets.

“After consultation with my Generals and military experts, please be advised that the United States Government will not accept or allow Transgender individuals to serve in any capacity in the U.S. Military,” Trump tweeted at the time.

“Our military must be focused on decisive and overwhelming victory and cannot be burdened with the tremendous medical costs and disruption that transgender in the military would entail. Thank you”

The announcement sparked immediate criticism, including from top Republican senators and dozens of retired generals and admirals.

Two LGBTQ rights groups announced Wednesday that they would sue Trump over the ban, claiming claim the president’s July tweets announcing plans to reverse the Department of Defense’s policy on transgender service members violates the equal protection component of the due process clauses of the Fifth Amendment.

[The Hill]

Trump Administration Appoints Anti-Transgender Activist To Gender Equality Post

The Trump administration has appointed an activist who led a campaign to restrict bathroom access for transgender students to the office of Gender Equality and Women’s Empowerment in the US Agency for International Development.

Bethany Kozma’s title is senior adviser for women’s empowerment, according to an agency spokesperson. Kozma did not return a message seeking comment for this story.

Kozma held positions in the White House and Department of Homeland Security under President George W. Bush, according to her LinkedIn profile, before dedicating herself full-time to raising her children. In 2016, she launched a campaign to oppose the Obama administration’s guidance to public schools that said transgender students have the right to use facilities matching their gender identity; the guidance was withdrawn by the Trump administration in February.

USAID has backed programs in several countries with the goal of supporting LGBT economic empowerment, access to housing and health care, and political participation. The agency also adopted guidelines in late 2016 barring contractors overseas from discriminating on the basis of sexual orientation or gender identity in providing services.

When asked whether Kozma’s appointment signaled a change in policy, the agency spokesperson responded, “USAID has not taken any measures regarding the discrimination policy for contractors, as is the case with many other policies. USAID is committed to promoting a work environment that is free from sexual-orientation and gender-identity discrimination, in accordance with existing federal law.”

Austin Ruse of the Center for Family and Human Rights, which opposes promoting LGBT and abortion rights in foreign policy, said he did not think the appointment represented a reversal from Obama administration policy. He believes the agency remains filled with LGBT rights supporters who he said “persecuted” people with views like Kozma under Obama, and argued the Trump administration hadn’t clearly reversed course since taking office.

“The LGBTs are ruthless street fighters,” Ruse said, citing efforts to discredit his organization as a “hate group” after it was included in a delegation to the UN’s Commission on the Status of Women. “This administration is no slam dunk for people like me or Bethany Kozma. The Trump administration is filled with squishes on this issue.”

“Bethany Kozma is a lovely, sweet woman who just happens to believe that girls with penises just ought not to be showering next to girls without penises,” he added.

In July 2016, Kozma published a post at the Daily Signal, a publication of the Heritage Foundation, a conservative think tank, calling for a national campaign in opposition to the Obama administration’s guidance saying transgender students have the right to use bathrooms matching their gender identity. She called the campaign “United We Stand,” and made her case against the policy by repeating the unsubstantiated assertion that policies allowing transgender people to access the bathroom matching their gender identity leads to sexual assault.

“To put it simply, a boy claiming gender confusion must now be allowed in the same shower, bathroom, or locker room with my daughter under the president’s transgender policies,” she wrote. “When I learned that predators could abuse these new policies to hurt children in school lockers, shelters, pool showers, or other vulnerable public places like remote bathrooms in national parks, I realized I had to do something.”

After President Donald Trump withdrew the guidance in February, Kozma wrote, “The silent majority must no longer be silent. With Trump, we now have a president who is focused on remedying the lawlessness of the prior administration.”

[Buzzfeed]

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