June 12, 2020, the United States Department of Health and Human Services (HHS) repealed regulations under Section 1557, including the gender-identity specific regulations.  These regulations helped to clarify that discrimination towards individuals based on factors such as gender-identity was unlawful.  The regulation also made it easier to enforce a transgender person’s right to access medical necessary health care.  During a time where there are already significant barriers to care in place due to COVID 19, there is growing concern about how this repeal will impact the transgender community. 

Section 1557 is the civil rights provision of the Affordable Care Act which prohibits discrimination in health coverage and care on the basis of “race, color, national origin, sex, age, or disability.” Therefore, though this recent transgender specific regulation has been repealed, it is important to clarify that Section 1557 still remains intact and multiple federal court decisions have upheld the tenet that transgender individuals are protected under Section 1557.  Sex discrimination towards any individual, no matter their sexual orientation or gender identity, is still unlawful and should be reported.  However, due to the misinterpretation that transgender individuals are no longer protected under Section 1557, this could lead to not only increased health care discrimination but also serving as an additional barrier to healthcare access. 

As a healthcare community we are committed to making sure that we continue to provide high quality and accessible health care to our transgender community.  For example the UI Health Care LGBTQ clinic specifically serves the lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) community.  Additionally, UI Health Care has been recognized by the Human Rights Campaign Health Equality Index as a national leader in inclusive and equitable care for LGBTQ patients and their families.  Further information about our transgender and non-conforming services can be found here.

Prepared by:

Nicole Del Castillo, MD, MPH - Director, Office of Diversity Equity and Inclusion

Katie Imborek, MD – Director of Offsite Primary Care, co-Director UI Health Care LGBTQ Clinic, Clinical Associate Professor of Family Medicine

Denise Martinez, MD -  Associate Dean, Office of Diversity, Equity, and Inclusion