HHS proposes a new rule to protect families, children and doctors

On May 24, 2019, the U.S. Department of Health and Human Services proposed a new regulation that protects patients, aligns with current medical research, and complies with rulings from two federal courts. The Transgender Mandate, issued in 2016, had required doctors to perform gender transition procedures on any patient referred by a mental health professional, including a child, even if the doctor believed the procedure would be harmful. That rule was struck down in court after it was challenged by nine states, several religious organizations, and an association of over 19,000 healthcare professionals. Today’s rule would bring the regulations in compliance with the court decision, ensuring that the personal decision to undergo transgender medical procedures is kept between a patient and their doctor, free from government interference. 

What is the HHS Transgender Mandate?

In 2016, HHS mandated that doctors[1] must perform gender transition procedures on any child referred by a mental health professional, even if the doctor believes the treatment or hormone therapy could harm the child. Doctors who followed their Hippocratic Oath to act in the best interest of their patient instead of this new mandate would have faced severe consequences, including losing their job[2]

The Transgender Mandate also required virtually all private insurance companies and many employers to cover gender transition procedures or face stiff penalties and legal action[3]. There were two major insurance plans exempted from HHS’s mandate, however—the plans run by HHS: Medicare and Medicaid. 

Why were the government’s plans exempt? Most children referred for gender dysphoria grow up not to be transgender and the government’s own panel of medical experts concluded that these gender transition procedures can be harmful[4]

Medicare and Medicaid didn’t even have to pay for these procedures because HHS’s medical experts believed gender transition procedures can be harmful[5]. But HHS’s political appointees pushed through a rule that would have ruined doctors whose best medical judgment was that they could not perform the very same procedures because it would harm the child under their care

This is not a question of access to care but of forcing a political ideology on doctors against their medical judgment. This mandate was unique in requiring doctors to violate their Hippocratic Oath.

A decision to undergo a gender transition procedure is a difficult and deeply personal one, and it is especially complicated in the case of children. It is a private healthcare decision that should be between a family and their doctor, not decided by politicians and government bureaucrats.