The Trump Administration is expected today to expand protections for health care workers who refuse to provide health services, including healthcare for transgender patients and abortions, for religious or moral reasons, according to The Williams Institute.
The U.S. Department of Health and Human Services Office of Civil Rights ( HHS OCR ), which is charged with enforcing federal civil rights laws related to healthcare, is also expected to establish a new division at the agency dedicated to enforcing this policy.
The Human Rights Campaign notes that Politico reported that the White House is reviewing a proposed Department of Health and Human Services ( HHS ) regulation that would allow medical providers to refuse to perform abortions, treat transgender patients based on their gender identity, or provide any service if they claim a "moral" or religious objection.
In the United States, there are an estimated 1.55 million adults and youth identify as transgender, according to Williams Institute research.
While conservative groups praised the move, women's groups, LGBT-rights groups and physician organizations expressed concern that such a policy would further discriminate against vulnerable populations and worsen inequities within healthcare.
"If adopted, this proposal would be another harmful attack on LGBTQ people by Donald Trump and Mike Pence. Healthcare workers have a professional and ethical obligation to provide health care to all who need it," said HRC Legal Director Sarah Warbelow.
Pride at Work Executive Director Jerame Davis said, "President Trump's Health and Human Services Department is playing with people's lives in their latest attempt to upend LGBTQ rights. This new rule and division create a license to discriminate that will allow healthcare workers and HHS to deny life-saving services to LGBTQ people and certain women who are pregnant."
"Any healthcare worker who has moral objections to providing medically necessary care to an entire vulnerable population is in the wrong line of work," said Sarah Kate Ellis, president/CEO of GLAAD, in another statement. "Denying a transgender personor any personlife-saving care if they walk into an emergency room is far from a moral act, it is unjust and dangerous. Trump, Pence, and Trump's appointees have tried time and again to establish blatantly bigoted policies that harm transgender and gender non-conforming Americans, and history will neither forget nor forgive this Administration's attacks on its own people."
Also commenting was the Family Equality Council. "Denying LGBTQ people and women medically necessary, potentially life-saving care is extremely dangerous," said Rev. Stan J. Sloan, the organizations' CEO. "Allowing health and human services providers to refuse services to women or LGBTQ people based on personal, religious beliefs constitutes an attack on our community, our health, and our families."
Rea Carey, executive director of the National LGBTQ Task Force issued the following statement: "We are not fooled: The new office announced this morning is meant to make it easier for people to discriminate, not to protect people of faith. Health professionals have a duty to care for all their patients regardless of one's gender identity, sexual orientation, faith, creed, race, political views, gender, or disability, and no one should be denied care for being who they are. The overwhelming majority of people of faith support health care access for women and LGBTQ people. There is no contradiction between meeting your duty to care for all people and living by your moral and religious conviction. All people deserve access to care, including transgender people, those seeking assisted suicide, and those seeking reproductive health services such as an abortion or sterilization."
Transgender Law Center issued the following statement from executive director Kris Hayashi: "This extreme new HHS rule will quite possibly cost lives by giving medical providers cover not to treat people they disagree with, no matter how life-threatening or urgent the medical need. The rule grants an illegal license to discriminate against transgender people who come to the doctor or emergency room for help when our lives are in danger due to sickness, violence, or injury. It's also an attack against all people, including many in the transgender community, who rely on critical care ranging from reproductive services to emergency services to HIV medication. The agency charged with protecting our health is now inviting providers to deny life-saving medical care to people based on who we are. Once again, the Trump-Pence administration has shown they will do everything in their power to undermine the health and survival of transgender people. We will see them in court."
Williams Institute Executive Director Jocelyn Samuels, former Director of HHS OCR from 2014 to the end of the Obama Administration, said, "Research demonstrates the health disparities and discrimination to which the transgender community is subject. This new rule is likely to result in denials of critical health care to this vulnerable community in ways that will fundamentally undermine their health and wellbeing."
Transgender people have experienced persistent and pervasive discrimination in access to health care and by health care providers, which contributes to health disparities for this population:
In a recent study, transgender individuals had a higher prevalence of poor general health, more days per month of poor physical and mental health, and a higher prevalence of myocardial infarction.
Yet, the same study found that more transgender than cisgender people lacked health care coverage and a health care provider.
According to the 2015 U.S. Transgender Survey ( USTS ), one-third ( 33 percent ) of those who saw a health care provider in the past year reported having at least one negative experience related to being transgender.
In the year prior to the USTS, 23 percent of respondents did not see a doctor when they needed to because of fear of being mistreated as a transgender person.
One-quarter of USTS respondents experienced a problem in the past year with their insurance related to being transgender, such as being denied coverage for care related to gender transition or being denied coverage for routine care because they were transgender
Lambda Legal published an analysis of the U.S. Department of Health and Human Services' (HHS) new rule, issued earlier in the day, creating a new unit within the HHS Office of Civil Rights (OCR) called the "Conscience and Religious Freedom Division." The aim of the new unit is to shield from the consequences of violating anti-discrimination protections healthcare workers who refuse to perform certain procedures, such as abortion, or who refuse to treat transgender patients, or to provide other services because of moral objections. Lambda Legal's analysis shows that the rule will almost certainly result in the denial of medical care to people and cause potentially life-threatening harm, in violation of numerous laws and regulations that prohibit such discrimination. The analysis further shows that the creation of this unit is part of a pattern of Trump administration actions stripping LGBT people of civil rights, often in the name of religious freedom.
"It shocks the conscience that our government would invite healthcare providers to discriminate against their patients, but this is exactly what HHS's new unit is designed to do," said Lambda Legal CEO Rachel B. Tiven. "We know that people will be denied care as a result because discrimination against LGBT people is already widespread and LGBT people have already been turned away from hospitals and doctors' offices. The Orwellian 'Conscience and Religious Freedom' unit simply provides guidance on how they can try to get away with it."
Read the analysis here: www.lambdalegal.org/health-care-analysis .
Lambda Legal encourages anyone who experiences harassment, denial of service, or other discrimination in health care services on the basis of gender identity, sexual orientation, or HIV status to visit www.lambdalegal.org/healthcarehelp or call toll-free at 866-542-8336.