For some time, the LGBT Left have insisted that various elective procedures and medications to help transgender people approximate the opposite sex are “medically necessary treatments.” Their passion has been fueled by the threat that the Trump administration is preparing to enforce existing law that allows physicians and hospitals to discriminate against transgender people on religious grounds.
The Affordable Health Care Act banned discrimination based on sex, as well as other standard characteristics, in any health program. As The New York Times states, “Under the existing rule, health insurers cannot place arbitrary limits or restrictions on health services that help a person transition from one gender to another. These services may include counseling, psychotherapy, hormone therapy and a variety of surgical treatments.”
Eight states, many Roman Catholic hospitals, and the Christian Medical and Dental Associations (which represents around 18,000 physicians) opposed the rule. A federal judge in Texas ruled that law only applies to biological sex. The Times continued, “Jennifer C. Pizer, the law and policy director at Lambda Legal, a gay rights group, said, “That is an excruciatingly narrow and legally incorrect definition of the term ‘sex’ that would jeopardize legal protections for lesbian, gay, bisexual and transgender people.”
On July 17, 2018 the Transgender Law Center and National Center for Transgender Equality held a rally in Washington DC under the banner “Protect Trans Health.” Many advocacy organizations demonstrated. The participating National Women’s Law Center tweeted, “We cannot let the Trump-Pence Administration continue the unprecedented attacks on our healthcare by rolling back the Health Care Rights Law…Our health and even our very lives could depend on it,” as well as, “my son and many others could be subject to harassment and humiliation if they seek medical care…no one should fear a trip to the emergency room or doctor if they need care.”
The LGBT group Human Rights Campaign joined in, demanding, “In the past year, 1 in 3 #transgender people experienced discrimination from a doctor. Now, the Trump-Pence administration wants to let doctors pick & choose who deserves care. It’s time to tell HHS to #ProtectTransHealth!” and “Nobody should be turned away from medical care, with their health and lives put at risk, because of who they are. We must #ProtectTransHealth and stop the Trump-Pence administration from green-lighting discrimination.”
I Require Medical Treatment That Mutilates Me
Without citing the statistic or indicating what medical services a transgender person might be denied, it is difficult to fully appreciate what the activists are arguing against. But looking at recent articles detailing the experiences of transgender people claiming to have been denied medical treatment gives us insight into their argument.
In an article titled, “What It Was Like to Be Denied Medical Care Because of My Gender,” Evan Minton described being denied a scheduled hysterectomy at Mercy San Juan Medical Center, a Catholic hospital. Minton called two days prior and explained Minton was transgender and preferred the pronoun “he,” although his records showed him to be female. The hospital canceled the procedure and offered to transfer Minton to another nearby hospital.
Dignity Health, a large medical system of which Mercy San Juan Medical Center is a part, stated, “[T]he services we provide are available to all members of the communities we serve without discrimination. We understand how important this surgery is for transgender individuals, and were happy to provide Mr. Minton and his surgeon the use of another Dignity Health hospital for his surgery within a few days. We do not provide elective sterilizations at Dignity Health’s Catholic facilities in accordance with the Ethical and Religious Directives for Catholic Health Care Services (ERDs) and the medical staff bylaws.”
ACLU of Northern California lawyer Elizabeth Gill argued in response, “The refusal of Dignity Health to allow a doctor to perform this common procedure simply because the patient is transgender is discriminatory.” She continued, “This is a hospital that is open to the general public so it’s illegal for them to turn away someone based on gender identity.”
Minton’s doctor said this was the first hysterectomy the hospital had prevented her from performing and believed the sole reasoning was because the patient is transgender. The ACLU lawsuit states, “Dr. Dawson routinely performs hysterectomies for her patients, and in fact performed another hysterectomy at MSJMC the same day that Mr. Minton’s surgery had been scheduled. Other physicians who practice at MSJMC also regularly perform hysterectomies at the hospital for patients who have not been diagnosed with gender dysphoria, for indications such as chronic pelvic pain and uterine fibroids.”
I Am a Man Who Needs a Hysterectomy
In a self-reflection, Minton said, “I had come so far in my transition, and the actions by the hospital felt like a complete rejection of who I am. I had rejected myself for 29 years; having my surgery canceled brought back all of those feelings, despite five years of progress and acceptance. It made me feel like I wanted to crawl out of my own skin again.”
Minton continued: “This is what happens when an organization is given a license to discriminate against you because their religious beliefs say people like you don’t exist. My story is one that is devastatingly all too familiar for other trans people across the country, and the situation continues to grow more dire with every passing day under the Trump administration.”
This situation is an important example of how very differently the Left and LGBT activists interpret fairly common situations to be intentionally harmful. As should be clear, Minton was not discriminated against for being transgender at all. Had Minton suffered from common medical conditions in which a hysterectomy is recommended, Minton would not have been denied the surgery at that facility.
The core issue is, despite Minton’s desire to remove Minton’s uterus, there was no medical reasoning for doing so. The procedure was elective, and any woman requesting elective sterilization would be denied in the same way. Even more stunning, the hospital affirmed the transgender treatment, used the patient’s preferred pronoun, and provided an immediate alternative hospital and Minton still perceived the experience as malicious. Minton ultimately received the surgery and therefore was denied nothing. The issue at hand is exclusively in how the individual interpreted the situation.
Pay For Me to Cut Off My Child’s Breasts
Another profound example was of Cheryl Enstad, an employee of a Catholic hospital named PeaceHealth St. Joseph Hospital. Cheryl is the mother of a transgender teenager named Pax. She attempted to have Pax’s double mastectomy covered by her health insurance. From the age of 12 on, she attempted to help with Pax’s gender dysphoria, stating, “We started interventions that were reversible, like shopping for all boy’s clothes, respecting his [sic] name change, and using he/him pronouns. He said binding his chest helped the overwhelming torment he felt.”
But doctors thought continually binding Pax’s breasts was compromising Pax’s breathing and therefore unhealthy. So Cheryl argued for an elective double mastectomy: “This was not an optional surgery; it was a necessity for Pax. I believed—and still believe—that his [sic] life depended on it. His doctor considered it a medically necessary intervention. The American Medical Association, the American Psychological Association, the American Academy of Pediatrics and WPATH (World Professional Association for Transgender Health) have also all recognized that this surgery is often medically necessary for transgender individuals, including adolescents.”
The hospital’s insurance, however, does not sponsor transgender services and the family paid out of pocket for the surgery. Pax’s mother argues, “As Pax’s suffering became more acute, we found out from his doctors that delaying preventative and necessary medical care would only increase his depression, while putting him at much greater risk for illness and suicide.”
She demanded, “Religion should never be used to deny people critical medical care or to justify discriminating against them. A patient’s healthcare decisions should be made by a patient and their doctor. And when medical procedures are prescribed as necessary, it should not matter whether the patient is transgender or not. Patients should be able to receive the treatment they need.”
The Transgender Narrative Is Simply Dishonesty
Again, as in the previous example, Pax was not denied any treatment. The elective procedure was not covered by the hospital’s employee health insurance. Had a double mastectomy been medically required, there would have been no concern. It is likely elective breast enhancement is not covered for teenage girls who feel insecure about their bodies, either.
That really is what is being discussed here. In both situations, as well as implied by activists and organizations, it is asserted people were denied a medical service because they were transgender. In reality, the individuals were asking for an exception to the policy based on their gender identity alone.
A larger conversation is happening here, in which LGBT activists are refusing to discuss the situation honestly. All transgender treatment is elective, and it involves sterilization and the surgical removal of healthy body parts or organs. The argument is not that individuals seeking these treatments are legally denied them, but that a select number of religious organizations are opposed to participating in or paying for them.
This is the whole of the “license to discriminate” argument the activists rally against with such dramatic fear-mongering. They believe transgender individuals have a right to seek any physical alteration necessary to satisfy their sense of gender identity, and that other people should pay for it through health insurance premiums, despite similar medical intervention not being covered for others who don’t suffer from this disorder. While no one argues transgender people should not be free to seek out these services, it is very important that physicians and hospitals be free to refuse to perform elective medical procedures they morally or ethically oppose.
No transgender person is denied any routine or emergency service, and there is no threat of this happening. The fear tactics and extreme language obscure that what is being demanded is unreasonable. While it is certainly worth considering arguments for various medical procedures in alleviating gender dysphoria, it should never be argued that such services should be compulsory, especially for religious organizations.
Doctors are simply not discriminating against transgender people for being transgender. However, religious medical organizations and physicians are facing the possibility of being coerced into participating in elective sterilization and surgical removal of healthy body parts or being accused of discrimination and legally pursued.