The administration’s potential new definition removes recognition of intersex and trans individuals.
The Trump administration asks that government agencies define “sex as either male or female, unchangeable and determined by the genitals that a person is born with … Any dispute about one’s sex would have to be clarified using genetic testing,” according to a memo first published by The New York Times. This instruction, if followed by government agencies and medical professionals, would erase the identities of transgender people from the medical establishment.
The policy proposal would work to undermine the protections and recognitions of transgender rights put into practice during President Obama’s administration. When questioned about his previous campaign promises to defend LGBTQ rights, President Trump commented, “I’m protecting everybody. I want to protect our country.”
The administration’s mandate could allow for the misgendering of patients, hospitals assigning roommates of the wrong sex to trans people and the denial of sex reassignment surgeries. This is of particular weight in the 30 states that don’t have separate, state-level laws that protect trans people for gender-based discrimination.
Health professionals have also speculated that medically denying the existence of transgender people would stop patients from discussing any gender uncertainty they may be experiencing. Barring this sort of discussion from even taking place may have devastating impacts on the mental health of young transgender people, the American Academy of Pediatrics’ policy statement on transgender youth speculated.
Doctors who choose to medically aid transgender people through their transition may be put in an awkward situation if they work at a hospital that uses federal funds. They could risk unemployment if they treated a transgender patient with the federal government’s funding.
Katie Keith, a Georgetown policy analyst specializing on transgender issues, comments that if the definitional change to gender were to happen, it would likely take several months to see any concrete changes, and it’s incredibly likely that it would be taken to court by transgender individuals seeking medical care.
The proposed policy’s stance on children born as intersex is not clear, but it seems that medical professionals would be required to assign the infant as either “male” or “female” at birth. Alice Dreger’s book “Galileo’s Middle Finger” recounts the history of surgical medical interventions that occasionally occur during the infancy of an intersex child. If the genitalia doesn’t fit a clear binary, Dreger explains that it’s possible that surgeons will “[rip] out everything that [doesn’t] seem right [and rebuild] genitals from scratch using Frankenstein stitches.” Although it’s not clear how extensively the Trump administration wants to apply the mandate, there is a gruesome precedent to this line of binary thought.
Health and Human Services spokeswoman Caitlin Oakley has denied that the mandate has been put into effect, stating that the office does not “comment on alleged, leaked documents that purport to indicate the status of deliberations or the focus of the department. The court order remains in full force and effect today and HHS is bound by it as we continue to review the issue. Everyone deserves to be treated with respect and HHS’s Office for Civil Rights will continue to vigorously enforce all laws as written and passed by Congress, prohibiting discrimination in health-care on the basis of race, color, religion, national origin, sex, age and disability.”