Federal judge blocks HHS from rolling back protections for transgender patients

Judge Frederic Block issued a preliminary injunction preventing the Trump administration from reversing an Obama-era expansion of antidiscrimination rules in healthcare.
By Kat Jercich
11:48 AM

(The Gender Spectrum Collection)

On Monday, Eastern District of New York Judge Frederic Block issued a preliminary injunction stopping the U.S. Department of Health and Human Services' move to roll back protections for transgender patients, one day before the changes were set to go into effect.

The Trump administration's final rule reversed Obama-era expansions of sex-based discrimination under Section 1557 of the Affordable Care Act to include gender identity or the desire to obtain an abortion.

Its longevity had been thrown into question earlier this summer, when the U.S. Supreme Court ruled in Bostock v. Clayton County that sex-based discrimination in the workplace encompasses discrimination based on gender identity or sexual orientation.

"The Court concludes that the proposed rules are, indeed, contrary to Bostock and, in addition, that HHS did act arbitrarily and capriciously in enacting them. Therefore, it grants plaintiffs’ application for a stay and preliminary injunction to preclude the rules from becoming operative," wrote Block in his order Monday.


The Trump administration's move to undercut antidiscrimination protections for LGBTQ people alarmed some clinicians, who pointed to the difficulty it could present in providing care. 

In June, UCLA Health's Dr. Amy Cummings and her colleague Heather Hitson spoke with Healthcare IT News about their years-long project to include information related to sexual orientation and gender identity in patients' electronic health records.

During that interview, Cummings pointed out that a patient's reluctance to disclose their identity out of fear of being denied care could affect their access to the appropriate screening. And from a broader health data perspective, Hitson said the new rule could make it harder to collect information that could help advance care. 

"If we're not collecting data and asking these questions" about transgender people and healthcare, "it's going to delay research," Hitson said. "There's limited research in the healthcare community around trans people, and this is going to increase the barrier."

Now, Cummings says she's cautiously optimistic.

"As you can imagine, [the] preliminary injunction is a glimmer of light," said Cummings. 

"The stripping of LGBTQ health protections by the Trump administration is abominable, and while the injunction is a sign of integrity from the judicial system, the fight is far from over.

"At UCLA Health, we will continue to keep protections for our LGBTQ populations at the front of our decision-making when it comes to data sharing, but at the same time, we will continue to develop supportive and inclusive programming for our LGBTQ and intersectional patients," Cummings continued.


Clinicians have pointed to inclusive IT – including EHRs – as a vital way to safeguard LGBTQ patient health on both individual and population-wide levels.

“What’s happening is that, with a lot of transgender patients, the provider isn’t being notified that the patient’s due for a procedure because these systems are not accurately pulling in the correct information,” said Chris Grasso, associate vice president for informatics and data services at the Fenway Institute, in an interview with Healthcare IT News in September 2019.

“The EHR was created for a documentation tool, but now we want it to be a lot smarter. We want it to provide us with more statistics and more data – and how do we best care for these patients,” said JoAnne Dombrowskas, MSHI, RN, manager of Massachusetts General Hospital eCare clinical informatics team.


"The Court reiterates the same practical concern it raised at oral argument: When the Supreme Court announces a major decision, it seems a sensible thing to pause and reflect on the decision’s impact," wrote Block in his ruling.

"Since HHS has been unwilling to take that path voluntarily, the Court now imposes it," he continued.


Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Healthcare IT News is a HIMSS Media publication.

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