The U.S. Department of Health and Human Services (HHS) has clarified that sex-based discrimination that is prohibited by the Patient Protection and Affordable Care Act (ACA) includes discrimination on the basis of gender identity and sex stereotypes. Furthermore, the Department has made clear this includes discrimination against transgender people and discrimination based on how masculine or feminine a person presents.

HHS’s clarification, expressed in a letter to a coalition of LGBT groups, follows a trend among courts and government agencies in interpreting sex discrimination laws to include discrimination against transgender people. This April, in a case brought by Transgender Law Center – Macy v. Holder, the Equal Employment Opportunity Commission (EEOC) ruled that transgender employees are protected from discrimination under Title VII of the Civil Rights Act of 1964 which prohibits employment discrimination based on race, color, religion, sex and national origin.

In response to a letter submitted by several LGBT rights organizations seeking clarification of the new health care law, HHS Civil Rights Director Leon Rodriquez stated, “We [HHS] agree that [the health care law’s] sex discrimination prohibition extends to claims of discrimination based on gender identity or failure to conform to stereotypical notions of masculinity or femininity and will accept such complaints for investigation.”

“This is an important clarification for all transgender people, who so often face extraordinary barriers in accessing health care,” said Masen Davis, Executive Director of Transgender Law Center. “I’m incredibly proud of Transgender Law Center, our partner organizations, and the thousands of individual advocates who have made this moment possible through years of tireless education and advocacy.”

Transgender patients who experience discrimination from service providers that accept Medicare, Medicaid, or other types of federal funding should file complaints of discrimination with HHS. Transgender Law Center’s legal helpline is available as a resource to help transgender patients navigate the complaint process.

Transgender Law Center continues to advocate for laws and policies that would explicitly require insurance companies to remove exclusions for transition-related care. Recently, after years of advocacy by Project HEALTH, a collaboration between Transgender Law Center and Lyon-Martin Health Services, the San Francisco Board of Supervisors voted unanimously on a resolution encouraging the city’s Department of Health to remove such exclusions from the city health care access plan.

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