He said: “They wonder, ‘What is going to happen when I go to the doctor? Am I going to be mis-gendered? Am I going to be mocked or ridiculed? Is my doctor going to actually listen and respect my knowledge about my own body and my health?’”
When the Department of Health and Human Services proposed the rule last year, nearly 160,000 people weighed in with written comments. Many of the writers were affiliated with the Family Research Council, the American Civil Liberties Union, or other organizations. Others were individuals whose affiliations were not noted.
One doctor, Terry McDole, typified the view of physicians who supported the proposal.
“The issue is not providing patient care, but whether or not the government can coerce me into abandoning my ethical commitments and medical judgment and force me to participate in certain controversial procedures and prescriptions,” Dr. McDole wrote. “Many health professionals like me who adhere to moral and ethical principles, which often reflect deeply held faith values, already face significant pressure and discrimination. The pressure to conform to abortion and transgender ideology can be particularly intense.”
But nearly all the nation’s medical organizations, as well as insurance groups, objected to the final rule. Matt Eyles, president and chief executive of America’s Health Insurance Plans, said, “Health insurance providers will continue to work with other health care leaders to eliminate barriers that stand between Americans who identify as a member of the L.G.B.T.Q.I.A. community and their better health.”
In a statement, Dr. Susan R. Bailey, president of the American Medical Association, said that the organization’s longstanding policy bars discrimination based on race, gender, sexual orientation, gender identity or a woman’s decisions about pregnancy, including termination.
Some legal experts cautioned that despite the outpouring of support from medical groups, the protections once endowed under the Affordable Care Act would themselves need protecting in order to last.
“A huge contribution of the A.C.A. was to prohibit, for the first time, sex discrimination in health care,” said Elizabeth Sepper, a law professor at the University of Texas. “This rule not only narrows what is considered sex discrimination, it also narrows who has to comply with anti-sex-discrimination policy.”