Trump Administration Announces Immediate Repeal of Sexual Orientation and Gender Identity Nondiscrimination Provisions in Federal Health Regulations

On Friday, the Trump Administration announced that the Department of Health and Human Services (HHS) would eliminate nondiscrimination provisions for LGBTQ people in all of its grant programs, including those for HIV and STI prevention, public health, health research, health professional training and education, youth programming, anti-trafficking programs, elder services, homeless services, and other programs. HHS also announced that the new rule would be implemented immediately, even though such rules changes typically take place after the public has had an opportunity to offer comment.

Going forward, HHS said that the only protections guaranteed to grant recipients will be those required by federal statute, none of which prohibit discrimination on the basis of sexual orientation or gender identity. The most recent attempt by Congress to enact federal nondiscrimination provisions based on sexual orientation and gender identity took place in May, when the House passed the Equality Act. The Senate has declined to take action on the bill and is not expected to vote on it.

“There seems to be no purpose for this rule other than to repeal much-needed protections against discrimination for LGBTQ people in health and human service settings,” said Sean Cahill, Director of Health Policy Research for The Fenway Institute. “This will make it harder for LGBTQ people to access health care and important human services. It will also undermine President Trump’s Ending the Epidemic Initiative to reduce HIV infections in the United States.”

The rule change is the latest in a series of actions by the Trump Administration that undermine the health and well-being of LGBTQ people and people living with HIV. Such actions include:

  • Issuing a proposed rule from HHS that would allow health care providers to refuse to care for patients whose identities conflict with providers’ “religious belief or moral conviction” or would force providers “to act contrary to one’s belief”;
  • Repealing gender identity and sexual orientation nondiscrimination provisions related to implementation of the Affordable Care Act, marketplace insurance plans, Medicaid, and elder health care;
  • Eliminating references to inclusion and protection from discriminatory housing practices in the Department of Housing and Urban Development’s mission statement;
  • 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;
  • Banning transgender people from serving in the military;
  • Ending the U.S. Department of Education’s practice of hearing complaints from transgender students regarding their access to school facilities such as bathrooms and locker rooms that correspond to their gender identity;
  • Proposing to remove sexual orientation and gender identity questions from the National Crime Victimization Survey for 16- and 17-year-old respondents.

A detailed assessment of the Trump Administration’s anti-LGBTQ actions is available in the policy brief, “Trump Administration continued to advance discriminatory policies and practices against LGBT people and people living with HIV in 2018.”

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