Health care is new front for transgender rights under Trump

WASHINGTON (AP):

Military service. Bathroom use. Job bias. And now, health care.

The Trump administration is coming under fire for rewriting a federal rule that bars discrimination in health care based on "gender identity."

Critics say it's another attempt to undercut acceptance for transgender people.

The Health and Human Services Department rule dates to the Obama administration, a time when LGBT people gained political and social recognition. But a federal judge in Texas said the rule went too far by concluding that discrimination on the basis of gender identity is a form of sex discrimination, which is forbidden by civil rights laws.

Instead of appealing the judge's injunction, the Trump administration has opted to rewrite the rule, which applies to health care providers and insurers receiving federal funds.

Roger Severino, head of the department's Office for Civil Rights, said the rewrite will address the "reasonableness, necessity and efficacy" of the Obama-era requirement. He refused to discuss specifics, as the revision is under White House review before its official release.

Groups representing transgender people expect the Obama protections to be gutted and are preparing to take the administration to court.

"The proposed rollback does fit into a pattern of transphobia and anti-LGBT sentiment in this administration," said Omar Gonzalez-Pagan, a lawyer with Lambda Legal, a civil rights organisation.

Social and religious conservatives are one of the Trump administration's most steadfast constituencies, and the White House has been out front championing their causes, including restrictions on abortion and legal protections for health care providers with moral and religious qualms about particular procedures.

Gender dysphoria battle looms

Behind the latest health care dispute is a medically recognised condition called ‘gender dysphoria’ - discomfort or distress caused by a discrepancy between the gender that a person identifies as and the gender at birth.

Consequences can include severe depression. Treatment can range from sex-reassignment surgery and hormones to people changing their outward appearance by adopting a different hairstyle or clothing.

Under the Obama-era rule, a hospital could be required to perform gender-transition procedures such as hysterectomies if the facility provided that kind of treatment for other medical conditions.

The rule was meant to carry out the anti-discrimination section of the Affordable Care Act, which bars sex discrimination in health care but does not use the term "gender identity."

In the Texas case, a Catholic hospital system, several states and a Christian medical association argued that the rule went beyond the law as written and would coerce providers to act against their medical judgement and religious beliefs.

That rule "would have forced doctors to perform gender transition procedures on children, even if that would be against their best medical judgement and they believed it would be harmful to the child," said Luke Goodrich, a lawyer with the Becket Fund for Religious Liberty, which is involved in the case.