Trump Administration Erases Transgender Civil Rights Protections in Health Care

WASHINGTON — The Trump administration on Friday finalized a regulation that will erase protections for transgender patients against discrimination by doctors, hospitals and health insurance companies, a move announced on the four-year anniversary of the massacre at a gay nightclub in Orlando and in the middle of Pride Month.

The rule, which does not differ much from a proposed version released last year, is part of a broad Trump administration effort across multiple areas of policy — including education, housing, and employment, as well as health care — to narrow the legal definition of sex discrimination so that it does not include protections for transgender people.

The Affordable Care Act, the 2010 law often known as Obamacare, established broad civil rights protections in health care, barring discrimination based on race, color, national origin, sex, age or disability in “any health program or activity” that receives federal financial assistance.

Mr. Severino defended the timing of the rule’s release during Pride Month and on the Pulse massacre anniversary, saying it was “purely coincidental.”

Transgender rights advocates criticized the timing for another reason: the coronavirus.

“It’s really, really horrendous to not only gut nondiscrimination protections, but to gut nondiscrimination protections in the middle of a pandemic,” said Rodrigo Heng-Lehtinen, the deputy executive director of the National Center for Transgender Equality. “This rule opens a door for a medical provider to turn someone away for a Covid-19 test just because they happen to be transgender.”

The announcement also prompted an outcry from the Human Rights Campaign, a prominent lesbian, gay, bisexual, transgender and queer advocacy group, which said it plans to sue the Trump administration.

“We will not let this attack on our basic right to be free from discrimination in health care go unchallenged. We will see them in court, and continue to challenge all of our elected officials to rise up against this blatant attempt to erode critical protections people need and sanction discrimination,” the organization said in a statement.

Mr. Severino, who spent seven years in civil-rights enforcement at the Justice Department and once oversaw the DeVos Center for Religion and Civil Society at the Heritage Foundation, said that the Trump administration would defend the decision in court.

Mr. Severino has extensive experience litigating religious liberty cases. His current office is responsible for investigating discriminatory violations in health care.

Katie M. Keith, who teaches health law at Georgetown University and has closely tracked this area of civil rights law, said the rule finalized Friday needed to be seen as part of a broad pattern of regulatory changes that eliminate civil rights protections for transgender people and establishes a definition of sex as being biologically determined at birth. That idea “is what they are pushing forward on all of these different policy angles across different agencies,” she said.