Peyton Restauri
WHAT'S IMPEDING THE MOVEMENT?
- SECTION 1557 OF THE AFFORDABLE CARE ACT
The Affordable Care Act (ACA) is a healthcare reform law that was put into effect in March of 2010. ACA was designed to reduce health insurance costs for low-income families and individuals. In June of 2020, an amendment attacking nondiscrimination protections was made to section 1557 of ACA. Section 1557 established that it is illegal to discriminate based on sex, race, color, national origin, age, or disability in certain federally funded health programs and activities.
"Section 1557 of the Affordable Care Act (ACA) that maintains vigorous enforcement of federal civil rights laws on the basis of race, color, national origin, disability, age, and sex"
In 2016, a revision of section 1557 laid out new protections for gender identity, defining it as “male, female, neither, or a combination of male and female," Which in turn expanded protections based on “sex” to include gender identity. In June of 2019, the Office for Civil Rights in the Department of Health and Human Services proposed a rule that would reverse these gender identity protections. The amendment would change the government’s interpretation of sex discrimination according to the definition of “sex” as being “male or female and as determined by biology.”
Under this new rule, gender transitioning surgeries could become inaccessible to transgender people. Transgender men could be refused treatment for ovarian cancer or a hysterectomy could not be covered by an insurer, or be more expensive if the procedure is linked to gender transitioning. The amendment also uses language that defends denying medical care if the procedure violates a provider’s “moral or religious beliefs.”
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“distinctions made on the basis of sexual orientation are not necessarily based on stereotypes, as they may instead be based on ‘moral or religious beliefs about sexual, marital, and familial relationships.’ [203] ‘There is nothing irrational or improper’ in such beliefs.”
Transgender people already face several barriers when seeking out medical care, including socioeconomic barriers (housing, access to transportation, and mental health), health system barriers (clinic facilities, uneducated providers, lack of access to care, and improper execution of medical care), and, most prominently, discrimination. Stigma, whether it be real or perceived, and discrimination, attitudes, and barriers within the medical field may impact the desire of a transgender person to seek out medical care as well as their access to appropriate care. This rule could make transgender people, who are already reluctant to seek out medical care, further avoid it. This is particularly dangerous as we are currently amid a global pandemic. Additionally, the impediment of gender transitional surgeries and treatment has the potential to affect a transgender person’s mental health in a truly detrimental sense.
-So, what does this mean for transitional treatments?
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Some transgender people seek out medical care and transformative surgery as an avenue to treat gender dysphoria.
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Gender dysphoria: the condition of feeling one's emotional and psychological identity as male or female to be opposite to one's biological sex.
Gender dysphoria plays a large role in the disproportionately high suicide attempt rate for transgender people. Transition-related care has been portrayed in media as cosmetic and non-essential although it has been recognized by medical professionals as both effective and necessary for many transgender people. This amendment to section 1557 moves to further stigmatize transformative surgery and make it even more difficult to access, which could prove to be disastrous.
that transgender people are at a higher risk of suicide than straight, gay, bisexual, and lesbian people and experience mental illness at higher rates than the rest of the population. The added risk stems from the fact that transgender people face unique stressors, including stress from not identifying with one's biological sex and feeling uncomfortable in one's own body. When left untreated, these mental health complications can lead to suicidal tendencies.
RISK FACTORS-
-Distress related to a conflict between one’s physical or assigned gender and the gender with which they identify
-Institutional prejudice manifesting as laws and policies which create inequalities and/or fail to provide protection from discrimination
-Isolation from conventional society
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THE UPDATES TO THE POLICY WILL CONTRIBUTE TO ALL OF THE FACTORS ABOVE.
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A study done in the UK in 2014 showed that trans people who have medically transitioned experience reduced rates of suicidal thoughts and attempts.
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67% thought more about suicide pre-transition.
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3% thought more about suicide post-transition.
-This information tells us many things.
Most prominently, it tells us that this new amendment to section 1557 of ACA is incredibly dangerous for transgender people. In addition to restricting their access to healthcare, it has the potential to cause increased suicide rates for transgender people in the United States. This change is dangerous, and it is unacceptable.
visit SUPPORT to see how you can help the movement, and stop
the changes to ACA.
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