ORLANDO | A Central Florida nonprofit organization dedicated to providing sexual health resources reflects on a recent rule issued by the U.S. Department of Health and Human Services that invalidates healthcare protections for members of the transgender community.
The rule, which was initially proposed by the HHS Office for Civil Rights in June of last year and finalized by the Trump Administration on June 12, takes aim at the nondiscrimination provisions located in Section 1557 of the Affordable Care Act, a law “prohibit[ing] discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs or activities.”
Under the Obama Administration in 2016, nondiscrimination protections relating to the category of sex were explicitly defined to “encompass … gender identity, which it defined as ‘male, female, neither or a combination of male and female.’”
The newly-finalized HHS rule would rescind these protections and revert to a definition of sex that is based solely on a person’s biological sex.
The implications of this revision could be far-reaching. Lindsey Dawson, an associate director from the Kaiser Family Foundation, told NPR in a recent interview that transgender people could be refused care by doctor’s offices, denied treatment or have certain medical procedures raised in price or go uncovered by their insurance due to their trans identity.
Bliss CARES, a medical nonprofit based in Orlando, embraces the trans experience. One of the services offered by the organization, in partnership with Bliss Healthcare Services, includes the provision of transgender medicine to patients. They have also created the TRANSformation Program, an education series that teaches its trans participants “how to cope, advocate for their rights, live and succeed through the power of peer-to-peer led groups.”
Juan Rodriguez, executive director of Bliss CARES, started the organization in 2016 to help realize the vision of founder Dr. Roberto Ortiz, who had the goal of “treating and preventing the spread of HIV, Hepatitis and STD’s[, as well as]… serv[ing] every person who walks through [their] doors, regardless of ability to pay.”
Rodriguez said the revision of healthcare protections outlined by the HHS rule directly undermines the advocacy efforts of Bliss CARES in pursuing social equality and empowering their transgender clients.
“So, if we’re delivering a message of rights and equality and this amendment comes along, well, it affects what we’re trying to accomplish in the community, which is to empower the trans community to be self-sufficient, have health insurance and be able to get trans medicine,” Rodriguez said.
For Rodriguez, the rule’s fixation on biological sex overlooks the bigger picture of what it means to recognize and affirm the humanity in others.
“Sex … is not what defines an individual,” Rodriguez said. “We define an individual for who that person is and we respect that person’s beliefs, thoughts and whatever differences that we may have … No one should be denied services because of [their] sex.”
Furthermore, Rodriguez believes that a concerted effort to fully understand LGBTQ+ individuals and their unique needs is required before more inclusive legislation can be passed.
“Even if we have a law where we can protect the LGBTQ+ community, I think it’s based on understanding how to treat these individuals before they even pass a law,” Rodriguez said. “Because if you don’t know how to treat them, then they won’t be getting their treatment accurately.”
Even though the HHS rule presents the risk of discouraging trans people from seeking treatment, due to the potential discrimination they could face from healthcare providers, Rodriguez views this as a deep-seated issue that has existed within the trans community long before this revision came into play.
“The fear has always been there,” Rodriguez said. “Even though we say we’re all-inclusive and we’re all equal, it’s not a reality. We[’ve] already [seen] the lack of [trans people] accessing treatment, even before [the HHS rule] came along.”
While the HHS rule has been finalized, its permanency is not yet set in stone. Congress could use the Congressional Review Act to void the rule, but the time-sensitive nature of its implementation may limit its viability as an effective remedy.
“That would only happen in this case if — within 60 days that Congress is in session — Trump were no longer president, and simple majorities in both chambers of Congress voted to block the rule,” NPR reporter Selena Simmons-Duffin pointed out.
Rodriguez believes that the June 15 Supreme Court ruling, which expanded Title VII of the Civil Rights Act of 1964 to include protections based on gender identity and sexual orientation, will shape the public reception of the rule because of how it goes against the momentum toward full equality.
“It will affect [things] because at the end of the day we’re not obeying the equal rights of individual[s],” Rodriguez said. “This has discrimination everywhere. If we don’t collaborate together as a country and as human beings in this country, we won’t be able to face the situation or solve it.”
Rodriguez also emphasizes that health insurers are not obligated to adhere to the HHS rule and points to Florida Blue, a Jacksonville-based health insurance provider, as an example.Blue Cross Blue Shield Association – of which the company is a member – recently stated that they do not intend to follow the rule, which means Florida Blue will continue to provide transgender medicine. Bliss CARES uses the services of Florida Blue for its healthcare subsidy program, which allows qualified clients to enroll themselves in the Affordable Care Act.
Ultimately, Rodriguez believes that long-term change is possible but that a multilayered approach will be required to achieve it.
“We have the power of making a change, but it takes a lot of moving pieces before we can do that,” Rodriguez said.
Within Rodriguez’s ideal of a trans-inclusive world, trans people are given full access to healthcare treatment and are not denied access to certain procedures because of their gender.
“You own your body and you are free to change whatever you feel that you need to change to [be] mentally stable and see yourself for who you are,” Rodriguez said.
Bliss CARES is open Monday-Friday, 8:30 a.m.-5 p.m. To learn more about their services, please visit their official website.
