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Biden Ends Trump Rule, Bans Discrimination Against Trans People in Health Care

Trans advocates demanded more decisive action from Biden, saying their rights shouldn’t be up to a president’s whim.

Activists from the National Center for Transgender Equality, partner organizations and their supporters hold a "We Will Not Be Erased" rally in front of the White House on October 22, 2018, in Washington, D.C.

The White House announced on Monday that President Joe Biden’s administration is reversing a Donald Trump-era rule that allowed discrimination against transgender people in health care.

Health care providers who receive federal funding will now be barred from discriminating against trans people, bringing the White House in line with the landmark Supreme Court decision from last year barring discrimination against transgender workers.

“The Supreme Court has made clear that people have a right not to be discriminated against on the basis of sex and receive equal treatment under the law, no matter their gender identity or sexual orientation,” said Biden’s Department of Health and Human Services (HHS) Secretary Xavier Becerra in a statement.

“Fear of discrimination can lead individuals to forgo care, which can have serious negative health consequences,” Becerra continued. “It is the position of the Department of Health and Human Services that everyone — including LGBTQ people — should be able to access health care, free from discrimination or interference, period.”

A press release about the decision from the HHS pointed out that research has found a significant portion of LGBTQ people delay getting medical care due to fear of facing discrimination. There are several reports showing that LGBTQ people are often discriminated against by doctors and other health care providers and administrators.

A survey by the Center for American Progress found that, in 2017, over a fifth of trans people reported avoiding receiving medical care, fearing discrimination.

Meanwhile, as the American Heart Association wrote, 56 percent of LGBTQ adults and 70 percent of trans or gender-nonconforming people report facing discrimination from health care professionals. This results in worse health outcomes for LGBTQ people; in communities where LGBTQ people are highly discriminated against, their lives are shortened by an average of 12 years.

The Trump administration had aimed to codify discrimination against trans people by rolling back protections for trans people receiving health care established under the Affordable Care Act.

In 2020, in spite of the Supreme Court ruling barring discrimination against transgender workers, Trump’s HHS said it would recognize the deliberately discriminatory definition of sex, calling it “the plain meaning of the word ‘sex’ as male or female and as determined by biology,” allowing federally funded health care and insurance policies to deny services to trans people without consequences.

The Biden administration’s announcement on Monday reverses that interpretation and restores the policies prohibiting discrimination against LGBTQ people in health care that were set in the Barack Obama era.

In Biden’s first joint address to Congress last month, he told trans people “Your president has your back.” In response, transgender rights activist and civil rights lawyer Chase Strangio said on Twitter, “I guess I appreciate the platitudes. But we need action. Things are desperate.”

It remains to be seen exactly how much more the Biden administration plans to do beyond this week’s reversal of the discriminatory health care rule.

Many states are still considering anti-trans bills that would endanger the lives of transgender adults and children across the country, and many LGBTQ advocates have criticized the Biden administration for not doing more.

Indeed, the Biden administration has delayed passing meaningful, permanent action against anti-trans bills being passed in states despite the fact that Biden signed an executive order on his first day in office pledging to support LBGTQ people.

“The attacks on trans kids are escalating and they are deadly, and both the president and Congress can and should do more,” Strangio told The 19th News last week. “Saying you have trans kids’ backs will ring a little hollow when they are denied health care, kicked off their sports teams, and fleeing the only home states they know.”

The Daily Beast reported last week that the White House is evidently preparing to address the wave of anti-trans bills being passed by Republicans at the state level, but it’s not yet clear exactly what the Biden administration is planning to do.

Many LGBTQ activists are urging Congress to pass the Equality Act, which would enshrine protections for LBGTQ people into law. Biden promised to sign the Equality Act within his first 100 days in office. That deadline has come and gone without passage of the law, which faces the nearly impassable hurdle of the filibuster in the Senate.

Responding to Monday’s decision, Media Matters for America editor Parker Molloy said, “What’s being done to prevent the next Republican administration from just switching it back [to the previous discriminatory language]? This is why the Equality Act needs to become law. I shouldn’t have to watch as my basic rights are turned on and off like a light switch.”

But even if the Equality Act somehow overcomes the filibuster, “there are significant limits to what formal civil rights protections can accomplish even at their best,” Strangio wrote in Truthout. And “given the many challenges to passing an uncompromised version of the Equality Act, it is important that the shiny, flashy, spectacle of congressional action does not lure us away from the urgent, messy and life-threatening fights playing out at the state and local level.”

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