Federal law protects Transgender people against discrimination in health care, the U.S. Department of Health and Human Services (HHS) said on May 10.

In affirming that laws against "sex" discrimination apply to Trans people, HHS reverses the Trump-era policy holding that "sex" refers only to biological sex determined at birth.

The policy shift brings HHS into line with last year's landmark U.S. Supreme Court decision which established that federal laws against sex discrimination on the job also protect Gay and Transgender people.

In defiance of that ruling, the Trump administration tried to narrow the legal protections against health care discrimination by issuing rules that narrowly defined "sex" in biological terms. A federal judge later blocked those rules from
taking effect.

The HHS action means that the HHS Office for Civil Rights will again investigate complaints of sex discrimination on the basis of sexual orientation and gender identity. Hospitals, clinics and other medical providers can face government
sanctions for violations of the law.

"Fear of discrimination can lead individuals to forgo care, which can have serious negative health consequences," said HHS Secretary Xavier Becerra. "Everyone — including LGBTQ people — should be able to access health care, free from discrimination or interference, period."

Obama rule restored

The Biden administration action essentially restores the policy established during the Obama years. The Affordable Care Act, passed in 2010, included a prohibition on sex discrimination in health care but did not include the term "gender identity." The Obama administration interpreted the law as applying to Gay and Trans people as well, relying on a broad understanding of the word "sex."

Under the Obama-era rule, a hospital could be required to perform gender-confirmation procedures if the facility provided similar kinds of treatment for other
medical conditions.

More than 1.5 million Americans identify as Transgender, according to the Williams Institute, a think tank focusing on LGBT policy at the UCLA School of Law.

Major medical groups such as the American Medical Association, along with human rights organizations, have supported health care protections for Gay and Transgender people.

One of President Joe Biden's first steps after taking office was a Jan. 20 executive order on combating discrimination on the basis of gender identity or sexual orientation. The new president directed every executive branch agency to examine what it could do to combat such discrimination.

Biden quickly followed that up with another order reversing a Trump-era Pentagon policy that barred Trans people from serving in the military. Earlier this spring, the Department of Housing and Urban Development withdrew a Trump policy that allowed taxpayer-funded homeless shelters to deny access to Trans people.