Previously, thirty-one medical institutions including the Endocrine Society signed a letter dated May 24, 2019, opposing the Trump Administration’s actions encouraging discrimination against LGBT patients.
The Endocrine Society reiterated their position in a press release Friday (see below) opposing the Administration’s effort to roll back protections for transgender health saying that the “rule would restrict LGBTQ population’s access to care amid COVID-19 pandemic”.
Newswise 5/1/20 — WASHINGTON—The Endocrine Society is alarmed by the Administration’s proposed rule to roll back protections for transgender individuals and narrow the scope of the Affordable Care Act (ACA), especially during the COVID-19 pandemic, when everyone needs access to health care. The Society calls on the Administration to maintain access to care protections for all, particularly vulnerable populations.
The Society shares the concerns expressed by the Chairs of the House Committees that oversee the Department of Health and Human Services in a letter sent to the Administration today and urged the White House to not move forward with the rule.
The regulation will weaken the previous administration’s definition of “sex discrimination” to remove protections for gender identity, among other protections. Patients could be turned away or denied medical care because they are transgender, and the Society strongly opposes restricting access to care. The Society has already signed onto a letter to HHS along with 30 other health care organizations and submitted comments expressing serious concerns with the proposed rule.
The Endocrine Society’s position is to maintain access to care and protect transgender individuals from being turned away based on gender discrimination. It’s essential that transgender care is covered by insurance, and the Society encourages further research into transgender health to address gaps in knowledge.
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Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.
The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.
May 24, 2019
Sent Via Email and Fax (read in full HERE)
The Honorable Alex Azar
Department of Health and Human Services
200 Independence Ave. SW
Washington, DC 20201
Dear Secretary Azar,
The undersigned health professional associations representing providers of all disciplines and
patients across the country are deeply concerned with the Department’s announcement today
of plans to weaken nondiscrimination protections for lesbian, gay, bisexual, transgender, and
questioning (LGBTQ) individuals under Section 1557 of the Affordable Care Act. We oppose
these efforts and express our strong support for providing the strongest nondiscrimination
protections available for LGBTQ people.
Section 1557’s nondiscrimination protections assist some of the populations that have been
most vulnerable to discrimination, including LGBTQ people, and help provide those populations
equal access to healthcare and health coverage.
Federal courts, including in the context of Section 1557, have recognized repeatedly over many years that sex discrimination includes discrimination based on gender identity. The subsequent regulations promulgated under
Section 1557 further clarify that discrimination based on gender identity and sex stereotyping is
prohibited in healthcare coverage and access.
Despite advances in acceptance for LGBTQ people, stigma and discrimination continue to be the
greatest problems facing sexual and gender minorities. In fact, many LGBTQ people develop an
internalized shame that can contribute to problems with self-acceptance, anxiety, depression,
difficulty forming intimate relationships, and being open about their sexual orientation or
gender identity. The literature on the “minority stress model” highlights the impact of social
prejudice, isolation, and invisibility as the primary factors leading to an increased health burden
and greater risk of mental health issues, homelessness, and unemployment.
LGBTQ patients also have higher rates of suicide with 40 percent of transgender people reporting attempting
suicide. Additionally, the risk of physical conditions is also exacerbated by increased rates of
tobacco use, HIV and AIDS, and weight problems.
LGBTQ patients are already more likely to delay getting necessary medical care. In the latest
Report of the 2015 U.S. Transgender Survey, nearly one in four respondents reported not seeing
a doctor when they needed to for fear of being mistreated. For those that had sought health
services in the last year, respondents reported having at least one negative experience, such as
refusal of treatment or having to teach the provider about transgender people.4 Moreover, the
lack of data in national surveys and administrative claims makes it a challenge to
comprehensively study disparities in this population, and more research is needed to enhance
The data that we do have indicates that discrimination has detrimental impacts on the physical
and mental health of the LGBTQ population.
To reduce the cost of health care and achieve our goal of creating a healthier nation, the specific needs of LGBTQ patients must be examined and effectively addressed.
All the undersigned associations have adopted policies or otherwise support addressing the
specific health concerns of LGBTQ people, including opposition to discrimination in health care
and insurance coverage based on an individual’s sexual orientation or gender identity. As part
of that commitment, our organizations support public and private health insurance coverage
for the treatment of gender dysphoria when medically necessary.
In sum, we stand firmly behind Section 1557’s gender identity protections and oppose any
modifications to the rule that would weaken those protections and thereby jeopardize the
health and well-being of LGBTQ populations.
We urge you to reconsider plans to revise the Section 1557 regulations and ensure HHS adopts
strategies to focus on better access to health services and improved health outcomes for the
millions of LGBTQ people in the United States.
American Academy of Nursing
American Academy of PAs
American Academy of Pediatrics
American Academy of Psychiatry and The Law
American Association for Geriatric Psychiatry
American College Health Association
American College of Physicians
American Medical Association
American Medical Student Association
American Medical Women’s Association
American Nurses Association
American Pediatric Surgical Association
American Psychiatric Association
American Psychological Association
American Public Health Association
Association of American Medical Colleges
Association of Nurses in AIDS Care
Doctors for America
GLMA: Health Professionals Advancing LGBTQ Equality
HIV Medicine Association
LBGT Physician Assistant Caucus
National Association of Social Workers
National Council for Behavioral Health
National Council of Asian Pacific Islander Physicians
Society for Adolescent Health and Medicine
Society of General Internal Medicine
Society of Physician Assistants in Pediatrics
The Association of Gay and Lesbian Psychiatrists
United States Professional Association for Transgender Health
World Professional Association for Transgender Health