Debate Over Texas Transgender Youth Health Directive

Obamacare’s potential involvement in making surgeries and pharmaceuticals like hormone therapy, operations, and puberty blocks more available has prompted an ideological struggle over gender identity.

The Biden presidency is reversing Trump-era measures that limited transgender people’s legal recourse against discrimination.

Obamacare plans will also offer essential health benefits, including medically needed mental healthcare and surgical procedures.

Ethics and Political Discourse

“This will set up a significant dispute over medical and religious ethics,” said Jay Richards of the Heritage Foundation’s DeVos Center for Religion and Civil Society.

“It’s one thing to argue that diseased tonsils must be removed from boys. It’s another thing to claim if you do a double mastectomy for serious breast cancer, you must do it for gender identity disorder in 15-year-old healthy females.”

Transgender youth are increasingly the targets of state-level efforts to deny them the medical care they and their families believe they need.

It’s important to note that in February, Texas passed a law that made “gender transitioning” operations for adolescents child abuse. This has drawn a lot of attention and criticism.

The order, which a Texas judge put on hold earlier this month, required healthcare providers and teachers to report parents who let their trans kids get treatment for gender dysphoria, which is when a person’s natal sex doesn’t match their gender identification.

The decision has enraged many parents of transgender children, activists, and medical professional groups, such as the American Academy of Pediatrics.

No feminizing or masculinizing hormonal therapy is usually used on young children. Doctors can delay hormone therapy until the youngster is 16, but they can also give anti-puberty medicines.

Conservatives claim taking these medications early puts kids at risk for long-term health issues, like reproductive issues. It also increases the possibility of the youngster resenting the decision to transition and trying to reverse it.

Opposition and the 1557 Statute

“Many of us do not believe this is true healthcare. We think it’s harmful,” Jay Richards said.

Richards said, in February, he was questioning evolutionary basics like sexual dimorphism, or how people of different anatomical sexes are different.

Insurance companies and doctors who are opposed to such operations could sue on religious freedom grounds, citing instances like Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania.

The Supreme Court ruled in 2020 the religious order was not subject to an Obama-era rule that required it to cover control in its health insurance plans. This was a victory for religious liberty supporters.

The White House Department of Management and Budget is now reviewing the Obamacare coverage rule; they will make the final decision on whether or not to make it law.

However, the coverage adjustment would only reinforce an existing Obamacare obligation. Section 1557 of the comprehensive healthcare bill already mandated state insurance on the Obamacare marketplaces to include treatments for gender dysphoria.

“I don’t interpret it as a requirement for gender-affirming treatment,” said Katie Keith, a Georgetown University healthcare policy advisor.

“It doesn’t say what to cover when or how. It implies denying transgender people the same type of care as non-transgender people is affirmatively discriminatory.”

According to Out2Enroll’s analysis, the vast majority of silver-level marketplace insurance plans in 2021 did not exclude transgender people. Keith, the CEO of Out2Enroll, said since the 1557 law took effect in 2017, trans-specific exclusions have dropped.