National Center for Lesbian Rights

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Cases & Advocacy

D.H. v. Snyder

D.H. and John Doe are transgender teenagers who require male chest reconstruction surgery to treat their gender dysphoria. Arizona is refusing to cover this medically necessary treatment because of a categorical exclusion on covering surgical treatments for gender dysphoria in the state’s Medicaid regulations.

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Cases & Advocacy

Prescott v. Rady Children’s Hospital-San Diego

On September 26, 2016, the mother of a transgender teenaged boy who was admitted into Rady Children’s Hospital-San Diego (RCHSD) for inpatient care filed a lawsuit against the hospital for discrimination against her son, Kyler. One day into his 72-hour stay, and after several failed attempts by his mother to correct the discrimination by the hospital, the hospital’s psychiatrist determined that despite his serious mental health issues, Kyler should be discharged early. About five weeks later, Kyler died by suicide.

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Legislation & Policy

Health Care Rights Law

Section 1557 is the key nondiscrimination provision of the Affordable Care Act (ACA). It prohibits discrimination in health programs and activities receiving federal financial assistance, health programs and activities administered by the executive branch, as well as entities created under the ACA, including the Marketplaces and health plans sold through the Marketplaces. Section 1557 protects against discrimination on the basis of race, color, national origin (including language access), sex, age, and disability, and does so by building on existing civil rights laws. It is the first federal law to ban sex discrimination in health care.

Under the Obama administration, the U.S. Department of Health and Human Services (HHS) underwent an extensive, 6-year process to develop regulations for enforcing Section 1557. The Final Rule that it issued in 2016 provides that discrimination on the basis of sex includes discrimination on the basis of pregnancy, false pregnancy, termination of pregnancy, or recovery therefrom, childbirth or related medical conditions, sex stereotyping and gender identity. This was a major victory for LGBTQ people.

Unfortunately, the Trump administration is trying to roll back this victory by replacing the 2016 rule with a new one that would take away the explicit protections for our community. NCLR submitted comments opposing this harmful policy change.

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Legislation & Policy

Denial-of-Care Rule

In January of 2018, the U.S. Department of Health & Human Services (HHS) issued a proposed federal regulation that would allow widespread discrimination in health care delivery in the name of religious liberty. The rule would allow health care providers to refuse to treat someone if their refusal is based on a religious reason. NCLR submitted extensive comments opposing the rule, which was nevertheless issued in final form in May of 2019. A number of organizations and state and local governments sued HHS to prevent the rule from going into effect. NCLR filed amicus briefs in the litigation challenging the rule. The rule was struck down in court. The Trump Administration has appealed the orders vacating the rule.

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Cases & Advocacy

Ketcham v. Regence Bluecross Blueshield of Oregon

Christina Ketcham is a 60-year-old transgender woman who started her transition over four years ago and continues to experience significant distress from the incongruence between her typically masculine facial features and her identity as a woman. To alleviate that distress, Christina’s treating healthcare providers determined that certain facial feminization procedures are medically necessary to treat her gender dysphoria. But, the health insurance offered by her employer has a categorical exclusion for all facial feminization procedures.

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Supreme Court Rules on Title VII! Give now & Celebrate!