The Affordable Care Act, aka Health care reform, aka Obamacare, aka that thing the Supreme Court said was constitutional, includes a ban on sex discrimination in federally-funded health services. In another big win for the transgender community, the Department of Health and Human Services (HHS) has clarified that this covers discrimination based on gender identity. This means that excluding someone from accessing health care because they are trans or gender non-conforming is discrimination. The HHS Office of Civil Rights will now hear and investigate complaints about gender identity discrimination, treating them as sex discrimination.
This comes on the heels of the EEOC saying they will hear complaints of gender identity discrimination in employment, making it part of a very exciting trend in wins for the trans community. And it’s a very necessary win – 1 in 5 respondents to the National Transgender Discrimination Survey reported being denied care by a medical provider. Hell, there are clinics with policies of trans exclusion. I really hope this does something about the claims that trans health care, and especially trans women’s health care, is just too complicated or different or weird, when it’s really just regular health care that a competent doctor should be able to provide. I mean, I’ve got even bigger hopes, like that the focus on health care discrimination means we’ll look at some of the other ways health care is made inaccessible to trans folks, like not giving us coverage for medication we need. I’m optimistic that this important step could open the door for more changes.
The new guidance came after a group of advocates (including the National Center for Transgender Equality, which informed me about this development) wrote to HHS asking for clarification on this issue. You can see there letter here and the HHS response here.
In order to help strengthen this policy clarification, advocates are encouraging trans folks who come up against discrimination to contact HHS. That way they’ll be able to follow the discrimination that’s happening, and they’ll see that covering gender identity discrimination is necessary. A law specifically targeting this discrimination would be a valuable next step, and showing that the need exists could help make this a reality. HHS will be releasing more guidance on what to do about health care discrimination, but you can already contact the Office of Civil Rights here.
Update: Here’s some useful information on what counts as discrimination and what you can do about it (the link is a pdf).