The Trump administration may well go down in history as the one of the most discriminatory administrations in modern history. There are few things more inhumane than denying medical care to someone in need. Yet, that is exactly what the Trump administration is proposing: allowing doctors, nurses, hospitals and even health insurance companies to deny care and treatment to members of the LGBT+ community based not upon medical science, but upon their personal religious beliefs.
On January 18, the Department of Health and Human Services assembled a “Conscience and Religious Freedom Division” for the sole purpose of encouraging discrimination primarily upon the transgender community. This comes on the heels of a December 8th memo prohibiting members of the Centers for Disease Control and Prevention from even using the word “transgender” in official documents.
Under President Obama and the Affordable Care Act, transgender individuals received protection from such discrimination. Under Obama, thousands of transgender individuals availed themselves of these protections to obtain gender reassignment surgery, a costly set of procedures that otherwise could cost upwards of tens of thousands of dollars. However, tens of thousands more individuals who have begun the transitional process may not get to complete the procedure.
Gender reassignment surgery cannot simply be had on a whim. It is a lengthy process. To even be considered for the procedure, the patient first has to live as the gender they are for a period of at least one year following the expression of an interest in transitioning. They must also undergo hormone treatment for an additional year. In addition, they must have the recommendation of both a psychologist and a psychiatrist before they are permitted to proceed with the surgery. These protections all exist for various reasons; however, the new rules allowing discrimination will prohibit many from finishing the procedure.
The denial of care does not extend only to those transgender individuals who opt to undergo gender reassignment surgery. The Trump administration rules allow doctors, hospitals and insurance companies to deny any form of health care or coverage to individuals based upon their gender identity.
This means simple necessary care such as the ability to go to the doctor or Urgent Care when one falls ill could now be out of reach for many simply based upon the fact that they identify differently from their biological gender.
Not only does this proposed change to the Obama era rules set transgender rights back, the effect across all populations will undoubtedly be felt. Medical professionals who hold deep biases will now be more empowered to turn patients away simply due to the fact that the health care provider disapproves of the patient's lifestyle. As it stands, there is oversight in place for problematic physician employment arrangements, but this new proposal seriously muddies the water on what kind of behavior is acceptable for a medical professional and what is not.
And in the meantime, those unable to seek care for simple medical problems could not only go on to spread untreated contagious disease, but small health problems left untreated can also burgeon into bigger, life-threatening issues.
And yes, people will die.
Women, unfortunately, already know this reality. In many areas, the only hospitals available for miles are Catholic-run, and due to their connection with the church, providers at these hospitals are prohibited from performing abortions even if the woman's life is at risk. The 2016 case of Valentina Milluzo illustrates what happens when religious freedom trumps science-based medical care. Milluzo became desperately ill while pregnant with twins. Her doctor refused to perform a medically necessary abortion. Milluzo miscarried and died the next day.
How is it permissible in a free country that doctors can deny to perform medical care even if the result of this refusal is the patient's death? The very foundation of the Hippocratic Oath, the oath all new doctors swear to, mandates that doctors first do no harm. How can allowing a patient to suffer, and potentially die, simply because of their gender identity, not be doing irreparable harm?
The recent move by the Trump administration is far from the first blatantly discriminatory order they have enacted. Just as Trump campaigned on messages of hate and exclusion of anyone not white, cis and heteronormative, his policies have consistently enforced a discriminatory platform. The establishment of the Conscience and Religious Freedom committee of the Department of Health and Human Services being his latest weaponry in this battle against basic human rights and decency.
No one should be denied the right to health care in the wealthiest nation on earth, let alone in the nation that calls itself the “land of the free.” As our Founding Fathers stated, we are all guaranteed a right to life, liberty and the pursuit of happiness. None of that can occur without first having good health. Denying care based on gender identity is not just cruel; it is, theoretically, un-American.