Opponents decry rollback of federal health care protections for transgender people
State lawmakers and advocates objected Tuesday to what they say is President Donald Trump’s latest assault on federal protections for transgender people.
Connecticut is the latest state to join an alliance opposing a Trump administration proposal to repeal and replace an Obama-era regulation prohibiting health care providers from discriminating against transgender people. The new rule would eliminate an expanded definition of sex which recognized gender identity as an avenue for sex discrimination.
Under the Trump administration proposal, health care workers could object to performing procedures such as gender reassignment surgery, and insurance companies would not be required to cover all services for transgender patients. The public comment period for the new rule ends August 13.
The U.S. Department of Health and Human Services rule would impact approximately 12,400 transgender people in Connecticut, state officials said.
Eva Gold, a Connecticut 13-year-old, said the proposal is disheartening because it means transgender people like herself would not have equal rights under the law.
“This would mean that I would not have blockers or hormones,” Gold said. “This is important to me because these services and medications make me my whole self.”
Gold said transgender people have one of the highest attempted suicide rates in the country — a national study estimates that approximately 41% of non-binary youth have at one-point attempted suicide. Gold said she is among that group.
“I felt out of place. I was made fun of daily and discriminated against so I tried to take my life because my body did not match who I am,” Gold said. “How would you feel if your loved one took their own life because they couldn’t get the emotional or medical support they needed to live their best life as their authentic self?”
Sen. Richard Blumenthal said he expects 29 of his colleagues to co-sign a letter objecting to the proposal.
“This administration, in effect, wants to turn back the clock, roll back the law and enable rampant systemic discrimination,” Blumenthal said. “The consequences here are severe and immediate. One out of every four transgender people reports some serious discrimination based on their gender identity. This is not some hypothetical problem in the future.”
Tony Ferraiolo, a North Branford resident and advocate, said he knows what it feels like to be denied health care because of his trans status, and echoed others’ predictions about the dire consequences of implementing the proposal.
“Eliminating the general prohibition on discrimination based on gender identity, as well as specific health insurance coverage protections for transgender individuals will literally kill members of the transgender and non-binary communities,” Ferraiolo said.
“We can’t go back to the days when health care providers and first responders could stand around a trans person and watch them die.”
Diana Lombardi, executive director of the Connecticut TransAdvocacy Coalition, said the health care coverage at risk is not frivolous but medically necessary and supported by the American Medical Association, American Psychiatric Association and the World Association of Transgender Health, among other groups.
Lombardi said a 2015 survey revealed that the majority of transgender people in the United States get their health insurance on the open market and not through an employer.
“We are concerned about health care providers being able to invoke religious exemptions and refusing to give medical care to us. There have been a number of cases where medical providers refused to provide care and resulted in death or serious injury,” Lombardi said. “In Connecticut, one woman was denied health care when she went into the emergency room and they found out she was trans. They told her to go home and take two Aspirin. She later found out she had a broken hip and spine.”
State Attorney General William Tong said the Obama-era regulation struck a balance between individual liberties, particularly the rights of the LGTBQ+ community and religious liberty, while but new federal regulation seeks to upset that balance by prioritizing health care providers’ right to deny care on religious grounds over a transgender person’s right to health care.
Tong said that his office will stand with the multi-state coalition, which includes Massachusetts and New York.
Prior to the Trump administration, transgender people with health insurance in Connecticut were protected by both state and federal law. In this latest rollback of federal protections however, there will no longer be a federal umbrella of protection, leaving self-insured plans at risk.
The Affordable Care Act forbids discrimination based on race, national origin, disability, age or sex in health-related programs that receive federal funding. The language includes gender identity as an aspect of sex.
A coalition of states and religious health providers challenged the law in court, however, and in December 2016 a federal judge in Texas temporarily blocked that portion of the regulation. The judge, Reed O’Connor, based his decision on the Supreme Court’s Hobby Lobby decision of 2014, ruling that the plaintiffs in the current case, three Christian-affiliated medical groups, should have the “religious freedom” to turn away transgender people.
O’Connor has yet to issue a final ruling, however, and a preliminary injunction remains in place.
The U.S. Justice Department agreed with O’Connor in court filings this year, and the Trump administration rewrote the rule. However, the new proposal would additionally eliminate protections for LGTBQ+ patients, patients who have had or are considering abortions, those with limited English proficiency, and populations that already experience worse health outcomes, said Lieutenant Governor Susan Bysiewicz.
Bysiewicz said a pattern is emerging in the Trump administration’s series of federal rollbacks that target transgender people. She said the administration’s gutting of anti-discrimination prohibitions at the Department of Housing and Urban Development and the ban on transgender people serving in the military are just a few examples of the pattern.
“I just want to put this in context because this is a constant battle against discrimination that we are fighting at the state and the federal level now,” Bysiewicz said. “What the president is trying to do is to institutionalize discrimination in yet another federal law and so we are here today to stand up and forcefully and clearly say that transgender people in our state and our country should have equal access to health care.”
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