Just hours after the Obama administration on Friday stood up for transgender students, it took unprecedented steps to protect transgender patients.



Transgender people must be provided transition-related services and cannot be denied health care by providers or professionals who receive federal funding, according to a final rule announced Friday by the U.S. Department of Health and Human Services. The rule specifically bans the denial of coverage or health care itself on the basis of gender identity.

The rule, which comprises several regulations, was formed under Section 1557 of the Affordable Care Act, which includes first-of-its-kind civil rights protections in health care for several classes of people — including a ban on discrimination on the basis of sex.

In protecting transgender people, federal officials cite legal trends in both courts and federal agencies to conclude the ban on sex discrimination encompasses gender identity.

The policies apply to providers and insurance carriers that serve millions of Americans.



During a comment period last fall, some groups requested that "the rule should exempt faith-based providers from providing particular services, such as services related to gender transition, that are inconsistent with their religious beliefs," the rule says.

However, it continues, federal officials "decided against including a blanket religious exemption," instead noting that existing federal laws that protect religious freedom were already sufficient.

LGBT advocates had hailed an earlier draft of the rule, which was released last September, for telegraphing the unprecedented new federal protections for LGBT people. By including gender identity in the regulations, they said, insurance and service providers would have to cover drugs, surgeries, and other services associated with some transgender people’s gender transitions.

While the final rule does not explicitly ban discrimination on the basis of sexual orientation, the guidance does cover sex stereotyping. The rule suggests that legal trends on that issue may cover gay, lesbian, and bisexual patients.

In a press release Friday, the Department of Health and Human Services said its civil rights office will “evaluate complaints that allege sex discrimination related to an individual’s sexual orientation to determine if they involve the sorts of stereotyping that can be addressed under 1557. HHS supports prohibiting sexual orientation discrimination as a matter of policy and will continue to monitor legal developments on this issue.”