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Wednesday, January 4, 2017

Texas Federal Judge Grants Injunction to Group Who Wants to Discriminate against Trans People's Right to Health Care

Yesterday, I read an article online in the Washington Examiner that a Federal judge in Texas granted a temporary injunction against regulations in the Affordable Care Act that mandates health care providers provide medically necessary health care services to people who identify as transgender.

 "The Catholic Benefits Association, which represents more than 700 Catholic employers including many hospitals, filed a lawsuit in federal court Dec. 28 in an effort to get its members exempted from the rule. Five states and several other Christian healthcare providers are already fighting the requirement in another case against the rule. A Texas judge halted the rule over the weekend.

The rule, which went into effect Jan. 1, says that doctors can't refuse to provide medically necessary health services within their scope of practice because of a patient's gender identity. For instance, a gynecologist couldn't refuse to perform a cervical Pap test for a transgender man .The rule doesn't explicitly require doctors to perform gender transition services, but it says providers can't refuse services they already provide based on discrimination. The Department of Health and Human Services wrote that it would deal with complaints of discrimination on a case-by-case basis, by looking into whether a doctor provides the same service when it's not related to gender transition.
"These provisions do not … affirmatively require covered entities to cover any particular procedure or treatment for transition-related care," the rule says." ( Washington Examiner 1/3/16)

Those who are suing believe that the rule can be interpreted so that medical providers would be compelled to specifically provide medical care for medications and procedures that are directly related to transitioning, such as prescribing hormones, gender reassignment surgery, feminizing voice therapy, or mental health services.

I think that their argument is specious at best; no health care professional can be compelled to practice in an area that they have no training or expertise (or interest for that matter). As a transsexual, I would not wish to place my health care for specific services that related to my own transition in the hands of a provider who did not have expertise in those areas related to my transition and ongoing medical care.

However, there are many areas of health care that we receive that have nothing to do with our transition. For instance, everyone needs to have the blood chemistrys, lipids and blood counts done done once or twice a year as part of routine health care. People need to be treated for high blood pressure and screened for breast cancer, colorectal cancers and other health conditions related to aging, regardless of their gender identity if they are biologically at risk for these conditions. I'm reminded of Robert Eads, who had ovarian cancer and was unable to find health care professionals in Georgia who refused to investigate symptoms that suggested cancer until it was too late for him to be cured and he died needlessly due to blatant discrimination based on his identity. I think such callous treatment of any human being is criminal.

It is concerning that some members of the new Trump Administration appear to be opposed to transgender rights established by the Obama Administration, notable Vice President elect Mike Pence. The nominee for the Health and Human Services Tom Price has also voiced opposition to the Obama Administration's policies as well, but Obama's agenda included allowing those who have not had gender reassignment surgery to use locker rooms and showers with cis gender individuals and personally, while I am for free access to public rest rooms, I think the Obama Administration's position on locker rooms and shower facilities were only trying to create a political wedge issue and there would have been much less opposition to enacting rules that allow for bathroom use only. 

It is difficult to find whether these individuals are strictly anti trans in every circumstance or whether they have more nuanced views. Primarily, I find the truth difficult to come by because the media is openly biased and does not report the news objectively any more. Transpeople are lumped in with GLB coalitions and people don't even understand who we are. The media certainly doesn't distinguish in reporting news that pertains to us. In any case, I think that if a health care professional refuses to provide medically necessary treatment that is non transition in nature, that health care provider should lose their license to practice.

 Again, time will tell. Mr. Trump himself appears to be at worst, neutral towards transgender people, and in some instances has expressed support for us.

I think it is incumbent for us to communicate with our legislators of every political persuasion by writing to them and writing in a respectful and well reasoned tone about what we believe. If one wants to persuade a legislature, one should not engage in hyperbole or be antagonistic in nature. We have more to gain by respecting civility, rather than engaging in a rant. 

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