How Do You Interpret Sex? Trump vs. Obama & Section 1557 of The Affordable Care Act

Medical claim denied form shows refused costs for health expenses. Healthcare insurance claim disallowed - 3d illustration

History of Affordable Care Act

When the ACA law passed in 2010, doctors and hospitals were prohibited to discriminate based on race, color, age, disability or sex.  The Office for Civil Rights at Health and Human Services Program issued a rule, a few years later, that when it refers to sex, it includes a broader definition that takes into account the LGBT population, according to Obama’s definition and some argue, executive overreach.

According to CBS NOW, the Department of Health lacked authority to make or impose additional legal requirements on covered entities that can not be justified by the text of Title IX, and in fact are in conflict with the express exemptions in Title IX” (1972), the main purpose of which is to prohibit discrimination on the basis of sex in any education program or activity that is federally funded.

Trump’s New Law

Trump’s rule, which goes into effect this August, classifies sex as a biological immutable condition.  You are either male or female and the sex that is assigned on your birth certificate.  This law, announced on June 12th, will eclipse Obama’s and roll back protections for the LGBT population.

This new law does not take into effect gender dysphoria, a discomfort or distress caused by discrepancy between gender at birth and what a transgender identifies with.  It is a common condition in the transsexual population and leads to gender reassignment operations and hormone therapy that Trump’s new law will not pay for.

Transgenders At a Loss

One in three transgender individuals in the U.S. report experiencing discrimination in health care and are reluctant to seek health care. The Human Rights Campaign since January, has counted 14 transgender individuals that have been shot or killed in the United States.  Many doctors are not trained in treating transgender individuals so transgenders do not receive equitable health care.  Neither do LGB patients who often hide their sexual orientation from their doctors who should be well-versed in the unique medical conditions of that population.

According to The Centers for Disease Control, 1.8% identify as transgender in U.S. high schools at which they report substance use, violence, victimization and suicide risk. Williams Institute, an LGBT Think Tank at the University of California, counts 1.4 million transgender adults and 150,000 transgender teenagers, 13 to 17.

With the COVID-Pandemic,  the timing couldn’t be worse. Trump’s new rollback could make it easier for doctors, hospitals and insurance companies to deny transgender and LGBTQ people seeking health care even though it will only be forced on Health and Human Services programs.

All Those Opposed Say Aye!

Needless to say, the actions of Trump have goaded The Human Rights Campaign, Lambda Legal, and The American Civil Liberties Union have filed their own lawsuits.  Senator Chuck Schumer has tweeted that in this month of Pride, anniversary of the Pulse shooting, and during the Pandemic, this new rule is not timely.  It will affect a population that is already marginalized and in need of services.


When Your Child is Gay

When Your Child Is Gay: What You Need To Know

For more detailed advice, see book, co-authored with a mother of a gay son and a psychiatrist, Jonathan L. Tobkes, M.D.

Wesley Cullen Davidson

Wesley Cullen Davidson is an award-winning freelance writer and journalist specializing in parenting as well as gay and lesbian content. For the past two years, Wesley has concentrated almost exclusively on the lesbian and gay community, specifically on advising straight parents of gay children on how to be better parents and raise happy, well-adjusted adults

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