Health care groups warn of health consequences of Trump Administration plan to narrowly define sex under federal law

November 5, 2018—The Fenway Institute and GLMA: Health Professionals Advancing LGBTQ Equality announce today that over 35 national health care associations and providers have sent a letter to Attorney General Jeff Sessions, U.S. Health and Human Services Secretary Alex Azar, and U.S. Department of Education Secretary Betsy DeVos urging them to drop reported plans to narrowly define sex as an immutable condition determined by genitalia at birth.

Signers of the letter include the American Psychiatric Association, American Psychological Association, American Academy of Pediatrics, and the World Professional Association for Transgender Health, all of which endorse a standard of care for transgender people that includes mental health counseling, hormone therapy, and surgeries that affect primary and secondary sex characteristics. These organizations represent thousands of health care providers across the country.

“The science is clear. Genetic sex chromosomes, anatomy, sexual orientation, gender and gender identity are separate. In many people they are aligned with one another, and in millions of other people they are not,” said GLMA President Gal Mayer, MD, MS, who has considerable experience caring for LGBTQ patients as the former medical director of Callen-Lorde Community Health Center. “Any policy that tries to define an individual’s gender based solely on any one of these characteristics ignores decades of research and study, and contradicts the massive expertise of the healthcare providers and their associations represented on this letter. We can all confirm that gender and gender identity are not binary and in many cases not the same as the sex assigned at birth. Gender and gender identity exist on a spectrum, are personal experiences, are not always static, and can only be defined by the person living that experience.”

“Transgender people face discriminatory treatment in public settings, including hospitals and other health care facilities,” said Sean Cahill, Director of Health Policy Research for The Fenway Institute. “As a result, many transgender people avoid care due to prior mistreatment and the fear of anticipated mistreatment and stigma. It would be malpractice to rescind nondiscrimination protections for transgender people in health care settings.”

The plans were first made public October 21 by the New York Times in a report based on a U.S. Health and Human Services (HHS) memo that was leaked to the newspaper. The Times reported that HHS is proposing a legal definition of sex that would exclude transgender individuals under Title IX of the Education Amendments of 1972, which prohibits sex discrimination. A number of recent federal court rulings have found that anti-transgender discrimination constitutes sex discrimination under Title IX, and the sex discrimination provisions of the Civil Rights Act and Affordable Care Act. These rulings also were used as the legal basis for federal nondiscrimination rules affecting access by transgender people to healthcare, education, and other services that receive federal funding.

The full letter can be read online here.

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