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Image: Dept of Health & Human Services
The Department of Health and Human Services building in Washington on April 5, 2009.Alex Brandon / AP file

Altering ACA, Trump curtails protections for transgender Americans

Almost exactly four years after then-candidate Trump publicly vowed to "fight for" the LGBT community, he did the exact opposite.


The 2016 presidential election was bizarre in a variety of ways, but one of the most important curiosities was the effort to present Donald Trump as some kind of moderate. The New York Times ran this report in April 2016, just as he was wrapping up the Republican Party's presidential nomination, which said the future president's moderate views on the LGBT community "set him apart" from others in his party.

Readers were told at the time that while Republicans have opposed civil rights for LGBT Americans, Trump is "far more accepting of sexual minorities than his party's leaders have been."

It was an impression Trump seemed largely comfortable with, at least to the extent that he could exploit the dynamic for votes. As regular readers may recall, there was an odd point in the 2016 campaign, shortly after the Orlando nightclub massacre, in which the future president insisted that LGBT voters, en masse, should move to the right and vote Republican. Trump, in apparent seriousness, said he, not Hillary Clinton, would be the "better friend" of the "LBGT" [sic] community. Just two days after the Orlando shooting, Trump added, "Thank you to the LGBT community! I will fight for you."

That was in June 2016. In June 2020, almost exactly four years later, the president made clear how much those earlier commitments were worth.

The Trump administration on Friday finalized its rollback of protections against gender identity discrimination in health care regulated by the Affordable Care Act. The U.S. Department of Health and Human Services said in a statement it would recognize "sex discrimination according to the plain meaning of the word 'sex' as male or female and as determined by biology."

As NBC News' report added, as a result of the new policy, ACA-regulated plans "can deny services to transgender people." HHS said it is reverting to a time when the government "declined to recognize sexual orientation as a protected category under the ACA."

As regressive as the administration's policy is, the timing was of particular interest: Team Trump made the move late on a Friday -- these guys do love their news dumps -- during Pride Month.

What's more, the policy was announced on the anniversary of the Pulse nightclub massacre, and almost exactly four years after then-candidate Trump publicly vowed to "fight for" the LGBT community.

But as striking as the symbolism was, it's the substance that's going to do the most harm. Vox's report added:

Trans people especially face overwhelming levels of discrimination from health care providers. According to a 2010 study, almost one in five trans people said they had been denied care by a medical provider because of their gender identity, and 28 percent were subjected to harassment in a medical setting. It was that reality the Obama administration attempted to address by including LGBTQ people under the definition of sex discrimination, conforming to an increasing wave of state and federal court rulings. The Obama-era rule made it illegal for doctors, hospitals, and other health care workers to deny care to someone whose sexual orientation or gender identity they disapproved of.

The Trump administration's new rule, scheduled to take effect in August, rolls back the clock.

During a brief Q&A with reporters in October 2018, as the White House took steps to roll back protections for transgender Americans, Trump was asked, "What about your promise to protect the LGBTQ community?" He replied, "I'm protecting everybody."

The reporter added, "Transgender Americans say you've given up on them," to which the president added, "You know what I'm doing? I'm protecting everybody."

It's an open question as to whether Trump has any meaningful understanding of his own policies, but there's simply no way to credibly argue his betrayal of transgender Americans is part of an effort to "protect everybody." That was obvious at the time, and it's even more plainly true now.