Obama Admin: Transgender People Protected Under Healthcare Reform

Thanks to the Patient Protection and Affordable Care Act, it is no longer legal to discriminate against transgender people in a healthcare setting.

A July memo acquired by BuzzFeed confirmed that the Department of Health and Human Services considers both gender identity and gender nonconformity to be included in prohibitions against sex discrimination, and will thus enforce antidiscrimination policies that include transgender people.

Section 1557 of the Patient Protection and Affordable Care Act explicitly banned discrimination in healthcare settings, allowing the Department of Health and Human Services to review discrimination complaints nationwide for any healthcare facility that receives federal funding—including those in the 33 states that do not prohibit discrimination based on gender identity.  In affirming that the prohibition on sex discrimination includes both gender identity and gender conformity, the HHS is consistent with an Equal Employment Opportunity Commission ruling from earlier this summer that declared it illegal to discriminate against transgender people in hiring or firing.

“We agree that Section 1557’s sex discrimination prohibition extends to claims of discrimination based on gender identity or failure to conform to stereotypical notions of masculinity or femininity and will accept such complaints for investigation,” HHS Office of Civil Rights Director Leon Rodriguez wrote.

Rodriguez was responding to a letter from 12 civil rights organizations, including major LGBT lobbies and the ACLU, requesting that the HHS align itself with the earlier EEOC ruling.

Twenty-four percent of trans women and 20 percent of trans men report being refused medical care outright due to their gender identity. The most notorious and horrifying case is that of Tyra Hunter in 1995, a trans woman who lay dying after an automobile accident as paramedics stopped treatment to mock her pre-surgery genitalia (Her mother was later awarded over $2 million in a lawsuit against the city).  Transgender people are also at a high risk of mistreatment and even physical violence in a healthcare setting: 28 percent report facing verbal harassment at a clinic, hospital, or doctor’s office, and 2 percent say they were physically assaulted.

It is difficult for transgender people who medically transition to access appropriate care for these procedures, and insurance companies usually refuse to cover hormones or surgical transition. The policy’s effects on transition-related healthcare coverage are unknown — as is the HHS’s detailed plan for enforcing section 1557 of the ACA.

But another blow has been dealt to the legality of anti-transgender discrimination, and what the National Center for Transgender Equality described as “injustice at every turn” may end sooner than advocates expected.

Shay O'Reilly is a reporter with Campus Progress. Follow him on Twitter @shaygabriel.

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