HHS's Nonstop Attacks on Transgender People

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November 14, 2019

This is part of our blog series written by Lambda Legal staff in honor of Transgender Awareness Week 2019. 

Read Part I: Committing To A Year of Action: Five Ways to Honor Our Community.

Health and Human Services (HHS) is the federal agency tasked with enhancing the health and well-being of all Americans. Yet under the Trump-Pence administration, no other federal agency has leveled more attacks targeting the LGBTQ community—particularly the transgender community. Their litany of hateful actions represent a grave threat to the health and wellbeing of transgender people.

Transgender people are everywhere. We aren’t a new phenomenon. We’ve always been here and will always be here. But HHS has engaged in a nonstop campaign focused on attempting to erase the existence of transgender people from the record. One of the agency’s first moves was to eliminate data collection on transgender seniors—important data that is used to determine which programs HHS should fund. HHS also erased language from their website referencing protections for LGBTQ people and instructed the CDC not to use the word “transgender.”

HHS has also attacked transgender people in more direct ways. Earlier this year, the agency released a proposed rule that attempts to carve out explicit nondiscrimination protections for transgender people under the Affordable Care Act. The effect would be to first create confusion with health care providers about their rights and obligations under the law.

This would promote discrimination through encouraging hospitals to deny care to transgender people, and it would enable insurance companies to deny transgender people coverage for health care services that they cover for non-transgender people.

If that wasn’t enough, HHS also issued a proposed rule seeking to allow health care providers the right to deny LGBTQ people health care based on a health provider’s religious or personal beliefs, effectively furnishing them with a license to discriminate. We will not allow this dangerous discrimination to stand. We have joined with allies and we are fighting this attack in court.

Most recently, HHS announced a proposed rule that will allow recipients of grant funding to discriminate against LGBTQ people. HHS awards more than $500 billion in grants each year to provide critical services in a wide array of programs. These important, tax-funded programs should never be used to discriminate against vulnerable populations, but that is exactly what HHS is seeking to do.

This rule, if finalized, would allow occurrences like Meals on Wheels programs refusing to deliver food to LGBTQ elderly adults. It would allow adoption agencies to turn away LGBTQ prospective parents.

Nearly all of the attacks emanating from HHS are coming straight from the Office of Civil Rights (“OCR”), headed by OCR Director Roger Severino, a former Heritage Foundation employee who has repeatedly denigrated LGBTQ and especially transgender people before joining the Office of Civil Rights at HHS. Mr. Severino has gone on record stating that he believes that openly serving transgender military service “dishonors” the service of others service members, and referred to Gavin Grimm, a male transgender plaintiff in a Title IX case as “a gender-dysphoric teen girl.”

Mr. Severino has referred to the existing health care protections for transgender people as “special privileges” and propagated the dangerous myth that doctors will be forced to provide care they are not already providing Mr. Severino has also repeatedly disparaged the clinical effectiveness of transition-related health care.

Nearly half of the U.S. population already avoids medical appointments when they need them due to cost, and many avoid care because of fear of discrimination. One in four transgender people report experiencing discrimination like being denied coverage for care related to transition, and one-third report verbal harassment or refusal of treatment.

The combination of cost and fears of discrimination falls hardest on people of color, people with low incomes, and LGBTQ people. Transgender women of color often live at the intersection of all of these identities, compounding the effects of multiple forms of marginalization.

These attacks from the agency tasked with ensuring health and well-being only exacerbate the fact that many transgender people already avoid health care providers. To avoid painful and humiliating experiences of discrimination, many transgender and nonbinary people avoid seeking health care coverage altogether. According to the 2015 U.S. Transgender Survey, 23% did not seek needed health care for fear of being mistreated. These persistent experiences can lead many people to avoid seeing doctors altogether, which inevitably leads to serious negative long-term health care outcomes.

The proposed rules and ideological stances taken by HHS seek to endanger the health and wellbeing of transgender people. We can’t and won’t let that happen. We have fought these attacks by this lawless administration at every turn, and we won’t stop fighting.

If you have been or believe that you will be affected by any of these attacks from HHS, please reach out to us. We want to hear from you.