BOSTON, October 7, 2020—Today, The Fenway Institute of Fenway Health released a policy brief demonstrating that during its four years in office, the Trump Administration enacted more anti-LGBTQIA+ policies than any previous administration in history. Titled “Trump-Pence Administration policies undermine LGBTQ health equity,” the brief also shows that these policies are harming the health and well-being of LGBTQIA+ people in America and around the world. Additionally, the Trump Administration’s openly racist policies and rhetoric harm Black, Indigenous, and People of Color, especially those who are also LGBTQIA+.
“As President Trump’s first term in office comes to an end, the toll of his administration’s anti-LGBTQIA+ policies is staggering,” said Sean Cahill, PhD, Director of Health Policy Research at The Fenway Institute. “In less than four years, the president, vice president, and their appointees have reversed decades of progress in LGBTQ health equity. As a result, LGBTQIA+ people have died, and countless others have needlessly suffered.”
During President Trump’s first term in office, LGBTQIA+ people and people living with HIV became much more vulnerable to discrimination in health care, social services, employment, education, and access to basic government services. At least two transgender women seeking asylum in the United States who were detained in facilities that have been sued for their alleged abuse of LGBTQIA+ migrants have died. And two initiatives by the Trump Administration aimed at improving the conditions of LGBTQIA+ people around the world and ending the transmission of HIV have been undermined by the administration’s own anti-LGBTQIA+ policies.
In June, 2020, the Trump administration repealed all health care regulations that prohibit discrimination based on sexual orientation and gender identity. These regulations prohibited discrimination over a wide range of services, including the provision of public and private health insurance, including Medicaid, the benefit design practices of health insurance issuers covered by the Affordable Care Act (ACA), and services offered by the Program of All-inclusive Care for the Elderly.
The Trump administration is repealing regulations prohibiting discrimination based on sexual orientation and gender identity by organizations that receive funding from the US Department of Health and Human Services (HHS). HHS awards more than $500 billion in grant funding annually to organizations that provide a wide array of health and social services, including health care at federally funded community health centers, HIV and STI testing and prevention, refugee resettlement, elder care programs, childcare and after-school programs, community meal programs, and adoption and foster care services.
“These programs are vital to millions of Americans, especially for marginalized communities including LGBTQIA+ people, who already experience pervasive discrimination that acts as a barrier to accessing care and services,” Cahill said. “It’s hard to fathom what the impact would be if nondiscrimination provisions were rolled back.”
In the wake of the police murder of George Floyd on May 25, 2020 and the massive, nationwide Black Lives Matter protests in response, President Trump sought to delegitimize the grievances of protesters. On May 29, 2020 Trump called those engaging in violence “thugs” and warned that “When the looting starts, the shooting starts.” On June 1, 2020 Trump loosed federalized riot police on peaceful protesters in Lafayette Square, across from the White House, to enable a photo op in front of a church in which Trump held up a bible. Over the summer of 2020, Trump denounced efforts to ban confederate flags from NASCAR races and remove confederate war statues, called Black Lives Matter a “symbol of hate”—something he has refused to call confederate symbols—and portrayed fair housing laws as an attempt to destroy the suburbs. He alternately refers to COVID-19 as the “China virus” or “Kung Flu.”
These racist acts and sentiments buttress racist immigration policies enacted by the Trump Administration. In September 2017, the Trump Administration announced that it would end protections for some 800,000 undocumented immigrants under the Deferred Action for Childhood Arrivals (DACA) program. In 2018, the Trump Administration began separating children of refugees and asylum seekers from their parents at the southern border, in violation of international law. In 2019 the Department of Homeland Security finalized a proposed rule regarding the public charge definitions used to determine whether an immigrant is inadmissible to the United States.
Other examples of actions taken by the Trump Administration throughout its first term in office that undermine the health and well-being of LGBTQIA+ people and people living with HIV include:
- Nominating judges for lifetime federal appointments who have expressed anti-LGBTQIA+ sentiments and/or have histories of ruling against the interests of LGBTQIA+ Americans.
- Arguing before the U.S. Supreme Court in favor of limiting existing nondiscrimination provisions under Title VII that have been used to protect LGBT workers.
- Dismissing Peace Corps volunteers who tested positive for HIV, and refusing to provide pre-exposure prophylaxis for HIV prevention (PrEP) to at-risk volunteers;
- Placing transgender inmates of the Federal Bureau of Prisons, especially transgender women, at much higher risk of rape by incarcerating them according to their biological sex at birth instead of their gender identity;
- Ending the practice of issuing G-4 visas to same-sex domestic partners of foreign diplomats or employees of international organizations—such as the World Bank or the United Nations—who are working and living in the United States;
- Implementing a ban on transgender troops that was first proposed in 2017 and which puts an estimated 13,600 transgender individuals at risk of being discharged;
- Rescinding guidance to schools that discrimination based on gender identity violates Title IX of the 1964 Civil Rights Act;
- Rescinding a Housing and Urban Development nondiscrimination provision that protected the right of transgender people to access federally funded homeless shelters consistent with their gender identity;
- Failing to show leadership by ignoring LGBT Pride Month in June, banning the flying of rainbow flags at U.S. embassies around the world, and signaling to other nations that the Trump administration does not prioritize human rights, including the rights of LGBT people in countries where they are persecuted.
- Eliminating disparate impact civil rights regulations which treat policies that are neutral on paper but have an unequal impact in practice as forms of discrimination, even if there was no discriminatory intent.
The policy brief, “Trump-Pence Administration policies undermine LGBTQ health equity” is the fourth annual analysis released by The Fenway Institute assessing the Trump Administration’s policies affecting the health and well-being of LGBTQIA+ people. All four briefs are available online.
“Trump-Pence Administration policies undermine LGBTQ health equity” (October 2020)