Why Trump Is Rolling Back LGBTQ Health-Care Protections

The Atlantic 
by Emma Green
May 24, 2019


On Friday, Donald Trump’s administration started rolling back two controversial legal provisions related to the Affordable Care Act: protections against discrimination based on gender identity, and based on the termination of a pregnancy. Advocates for LGBTQ and women’s health care see this proposed reversal as a pointed attack on transgender people and patients who have received abortions—the latest in a series of moves by the Trump administration to limit the rights of marginalized populations.

But beyond the alarmed reactions, a larger legal question is at stake, about both the authority of government agencies and the very nature of discrimination. In the absence of a clear federal law protecting LGBTQ and other rights in housing, hiring, and public accommodations, including health care, this culture-war fight is being played out in the courts and agencies, where officials are left to decide just how far interpretations of the law should go when it comes to protecting minority rights.

For years, across the legal system, people have been debating whether civil-rights prohibitions against sex discrimination should be interpreted expansively to include sexual orientation and gender identity, thus offering specific protections for LGBTQ people. The Supreme Court just agreed to take up this question in a different area of law: It will hear three cases about alleged discrimination against LGBTQ people in the workplace, which also turn on this question of what “sex discrimination” actually means.

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