Medical negligence. Rude support staff. Illnesses gone untreated.
These are just some of the problems some say they have endured when trying to treat a broken bone or a harsh cold, just because they are transgender. Now, a new rule proposed by the Department of Health and Human Services could make medical care for transgender people not only worse, but potentially protected by federal policy.
In May, HHS announced it would determine whether to effectively allow federally funded healthcare providers and insurers to legally deny care to transgender people.
The proposal came from the department’s Office of Civil Rights, the head of which, Roger Severino, was appointed by President Trump, after working at the Heritage Foundation, a staunch conservative think tank. In an act antithetical to his office’s mandate, Severino’s plan for legalized discrimination is packaged as religious freedom for providers. In response to request for comment, Severino said that “HHS is committed to vigorously enforcing all of the civil rights laws as entrusted to us by Congress, before, during, and after any rulemaking.”
Upon announcement, a 90-day comment period began, during which the public is invited to share support for or dissent from the proposed rule. That period ends August 13, and as of publishing,HHS has collected more than 70,000 messages from anyone who has wanted to weigh in. But they’re not releasing any of them yet. With the rule soon set to enter into its final stage of consideration, the National Center for Transgender Equality partnered with the Transgender Law Center to procure comments of their own. According to an NCTE spokesperson, the organizations have collected over 18,000 condemnations of the proposed rule, which they have submitted as public comment. Below are a selection of those comments, which illustrate how the passage of a rule to legalize discrimination against trans people in health care would devastate the lives of trans people across the country by worsening already fraught access to healthcare.
Comments have been edited and condensed for clarity and length.
I write today to say no to this new rule. I am a 29-year-old non-binary person who is an extremely hard worker as a manager at an animal shelter. I support a family and uplift my community. I deserve access to healthcare without fear of discrimination. Currently, I already struggle to seek healthcare services. I have been living with a chronic painful condition that affects my genitals. The last time I went to the doctor, I was argued with over my gender identity. I was told that it was confusing and my concerns were not valid. My pain level is at about seven [out of ten] any given day. I fear that it could get worse. I have to choose between being treated poorly and not listened to or maybe receiving some relief (which has not been achieved yet). This new rule could potentially make my situation much worse. All people deserve the right to promote their health and take care of themselves freely. Trans and gender non-conforming people will continue to exist even if the current administration would like to eliminate us.
Eden Prairie, Minnesota
I am a college-educated, tax-paying trans person. A few years back, I had food poisoning, and being very sick for several hours, I called 911 for an ambulance. The EMS team arrived while I had my head in a trash can throwing up (for the 26th or 27th time over about 10 hours, I was very dehydrated). They asked me a strange question about some stuffed cat decorations in my room and while trying to answer I threw up into the trashcan again. So the guy asking me the question (seeing I was trans) said, "OK, so you want us to leave," and the EMS team started packing up and leaving. I had to say "No!, I'm sick, I need to get to a hospital." To repeat the point: This EMS crew, seeing I obviously needed medical attention, also saw that I was transgender and would have left without even a cursory examination or the trip to the hospital I had called 911 for. I now wear a "EMS Do Not Resuscitate" bracelet and carry a doctor signed [Do Not Resuscitate] order in my purse because, as a trans person, I do not expect competent care from a random healthcare professional and would prefer to be left to die. But if I am conscious and able to ask for emergency care to possibly prolong my life, it is unconscionable to leave me to possibly die or suffer longterm health damage when I have health insurance, just because I am transgender.
I am a transgender woman. … I once had a cold that lasted longer than a week, and I was concerned. I could not get an appointment with my regular doctor, so I went to an urgent care facility. The nurse there was going over my medical history and got to my medications. She saw the prescription medications I take as part of hormone replacement therapy (HRT). Quickly, her demeanor turned from pleasant to suspicious and aloof. I tried to steer the conversation back to my persistent cough, but she kept asking prying questions about my personal life. I grew so uncomfortable with the fact that she was ignoring the reason I was there and left. Imagine if my condition was far more serious than a lingering cold. I could be denied critical, necessary, and immediate medical care that could leave me permanently injured or even dead, simply because someone thinks they have more right than I do to define my very existence. Nobody should live with this fear. Transgender people are people. We are citizens, taxpayers, civil servants, members of the military, your relatives, your friends, your coworkers. We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.
As someone who served 14 years in the military, I find it appalling that any right be taken from anyone. While I can support many economic policies pushed by the Trump White House, I feel it’s very important for citizens to stand up and make their voices heard, for without action politicians do not realize when the public disagrees with policy or attempted policy change. As someone who has been straight their entire life, I used to think that the entire trans thing was bullshit, I have allowed my views to change from meeting and dating incredible trans women. My hope is that more will allow their views to change as they experience life like I have and have the courage to stand up for it.
I work with teenagers in Montana, where our teen suicide rate is three times higher than anywhere else in the country. I see many of my students go through hospitalization and intensive treatment for mental health issues. Some of these students identify as non-binary or transgender. Homelessness and suicide rates for teens are directly linked to sexual and gender identity and it is our responsibility as a society to make these kids feel safe, included, and celebrated. Some studies show that as many as half of transgender teens have attempted suicide. We know that family rejection, discrimination, and violence lead to large numbers of transgender teens becoming homeless. These realities are failures of our humanity and American values.
Transgender people deserve the same rights as everyone else, and further protections when it comes to vulnerable situations for them. This abhorrent proposed rule threatens the lives of my friends, my students, and their families.
Chapel Hill, North Carolina
I am a pediatrician. I oppose this newly proposed rule. No one deserves limitations on their access to health care. This new proposal is discriminatory and WILL prevent patients from seeking care even for non-sex-related issues. This proposal will weaken our healthcare system and make providers like me have to work harder to find ways around it. My cousin killed themselves at the age of 22. They were transgender and could not find anyone to talk to who would listen. The suicide note spoke to the heartbreak of facing discrimination at every turn. I hope no other American citizen will have to grapple with these negative thoughts, especially when needing critical assistance from a doctor. I have made it my mission to bring acceptance to the field of pediatrics where a child is introduced to the health care system. Hopefully, this tolerance and acceptance I show, regardless of legislation, will change the life of a teen in crisis.
My name is Gabriel and I am against this proposed rule. I have already faced discrimination in health care. One of my doctors, when I called and had an acute crisis, stopped returning my phone calls once I had disclosed that I was transitioning. This was my gynecologist. Trans men need gynecological care and many do not get it because we face this sort of discrimination. Infections, STIs, both have made it more likely that a trans man will need to have an emergency hysterectomy, and if he is not going to the doctor, he is not getting screened for cervical cancer regularly. Despite the propaganda, no one is forcing doctors to do surgeries on trans patients for their transition. No trans person would trust such a doctor to provide optimal care. Anyone saying differently is lying. Doctors are under an oath to “Do No Harm” and if they object to treating the broken arm or the cancer of a patient that happens to be trans they are breaking their oath and should never have gone into healthcare in the first place. Trans people deserve life, liberty, and happiness, as is guaranteed in our Declaration of Independence. This rule would deny us our first freedom—life.
Brooklyn, New York
My name is Simon and I am against this proposed rule. I am against this proposed rule because it will make it harder for transgender people to obtain life-saving care. It is important to me that transgender people can access health care without discrimination, because I am a transgender person with a disability, and the proposed rule will compromise my unalienable rights. … I need constant access to healthcare, and I have experienced discrimination many times in the past. A major hospital refused my name change, even though it was already legalized through the courts and on my insurance. This made it impossible for me to access medication at the pharmacy.
I have also, as a transgender man, been put in a women's ward without my having any say. I have dealt with the same hospital misgendering me, and asking why I would want to be a man. I could not deal with these issues at the time because I was physically dying and fighting for my life. In this same hospital, I was denied access to hormones, and repeatedly refused an explanation. In a separate hospital visit, I was refused an observation room and forced to remain in the ER, for the sole reason that I am transgender. I have this on video, but it's too traumatizing for me to watch again.
While dealing with my disability, I have also encountered sexual harassment from doctors. One doctor, who was treating my disability (unrelated to my transgender health), asked me to remove my shirt, and then asked me when my breasts were going to grow. He also asked me if I knew any transgender women, and asked me to give him their phone numbers so he could go on a date with them. This was while he was doing a procedure on me. Obviously, I have never been able to return to this doctor, or get access to procedures that only he can do. My story, and many others' stories, matter. I am not the only one. There are many more people who are unable to speak, and we all matter. Please take us all into consideration and take a stand for transgender people. We are all human beings.
I OPPOSE this new rule STRONGLY. I am a transgender man. I also have multiple chronic illnesses and severe allergies. I had a doctor last year blame me being transgender for my cough. Turned out I had a dangerous infection that was left untreated for over a month. My story is definitely not unique. There will be more stories like mine should this new rule be put into effect.
My name is Oliver McMahon and I am against this proposed rule. I am against this rule because it will increase the medical discrimination that transgender people face on a daily basis. I regularly face discrimination at the doctor's office, due primarily to behavioural problems as a result of chronic childhood abuse and negligence. This has bled repeatedly into my attempts to be treated for gender dysphoria, as doctors who are not trauma-informed have increasingly accused me of developing emotional instability due to hormone therapy, leading them to threaten to take my prescriptions. This is a huge threat because I have had a hysterectomy at this point, and a loss of hormone therapy will mean that I no longer have any hormones in my body and I will fall into fatigue, depression, and brittle bone issues on-par with those of a geriatric patient.
Transgender care in medicine is already so hard to find. The doctors do not need their religious freedoms "protected"—they already refuse to see us, they just don't give us reasons. They don't need to be validated in their discrimination against transgender people.
I am an elected official in Doraville, GA. I am also transgender and have personally had to deal with being discriminated against in healthcare simply for being transgender. I was denied care for an ear infection, and at another time a broken toe, by medical professionals once they learned I was transgender, which had nothing to do with my medical problems. I was told both times, "We don't treat people like you." I can't tell you how many times I have been denied even making an appointment once they learn I am a transgender woman. I've also had basic preventative care like mammograms denied by my insurance company based on my gender identity.
This new ruling you are proposing will put American lives at risk not only for treatment and preventative care, but by dehumanizing transgender Americans in this way, you will increase the already high suicide rates of transgender youth. This endless assault on transgender Americans needs to end now.
I personally have been harassed, discriminated, and assaulted by surgeons, physicians, and hospital staff for being transgender. I've been left to bleed out after surgery by nurses in a hospital because they simply don't care to treat us. I've also been denied corrective surgery from the surgeon who was certain of a successful outcome. She called me on a private line and told me to stop bothering her with my medical concerns and paperwork to find out I had sutures imbedded inside me, filled with bacteria due to lack of required education, which left me with complications the surgeon would not take ownership for and are yet to be resolved. I've been falsely diagnosed multiple times because of the insufficiency of care and knowledge when it comes to transgender medical and health care.
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