U.S. Government Quietly Expands Transgender Rights

This almost certainly means there will be legal challenges to come. For one thing, certain state laws might come into conflict with the federal government’s interpretation of the law: Mississippi, for example, says it’s legal for any doctor to tag himself out of treatment that violates his religious belief in people’s “immutable biological sex as objectively determined by anatomy and genetics at time of birth.” Some religiously affiliated hospitals have already been accused of gender-identity-based discrimination. Last summer, for example, a transgender woman accused Medstar Georgetown, a hospital in Washington, D.C. with a “Catholic, Jesuit identity and heritage,” of denying her access to a procedure for this reason.

Although religious groups have successfully fought for exemptions to other Obamacare requirements on sex and gender, this ruling may be more difficult to challenge. In 2014, for example, the Supreme Court ruled in favor of religious organizations in Burwell v. Hobby Lobby. The Affordable Care Act requires employers to provide insurance plans that cover certain kinds of contraceptives, but some business owners had a religious objection to a handful of these kinds of birth control, which they saw as abortifacient. “In Hobby Lobby, the justices are still chasing this unicorn of compromise where everybody is happy,” said Carolina Mala Corbin, a law professor at the University of Miami. “The religious organizations agree with whatever the compromises are, and there is still seamless provision of contraceptive services to women.” In cases having to do with gender-related medical services, though, this kind of compromise probably doesn’t exist, she said. “The unicorn is harder to imagine in the anti-gender-identity discrimination context.”

The timing of this ruling doesn’t seem to be a coincidence. HHS has stepped in line behind the Justice Department and other agencies during a time of immense backlash to transgender discrimination in North Carolina and elsewhere. As a result, it was able to announce this ruling quietly and move on.

But the reach of HHS is huge, and the ruling carries symbolic import, as well. “It’s significant that the federal government is now saying, ‘Listen, we are not going to give taxpayer money to organizations that discriminate based on gender identity,’” said Corbin. That this news was hardly noted shows just how strong the administrations’ push to support transgender rights really is. All at once, the government is changing the way it interprets the law on gender and discrimination. It’s a relatively new area of civil-rights law, but soon enough, it might just be part of the status quo.