On June 15 in a 6-3 decision, the U.S. Supreme Court held that the protections enshrined under Title VII of the 1964 Civil Rights Act apply to discrimination based on sexual identity and gender orientation. Continuing in the recent tradition of upholding and protecting the rights of gay and transgender people, the Court signaled a move that may transform the legal condition of people whose sexual orientation or gender identity don’t conform to traditionally held beliefs. Justice Neil Gorsuch, writing for the majority, stated, “An employer who fires an individual merely for being gay or transgender defies the law.”
Explore This IssueSeptember 2020
Much is at stake in the current climate of consternation and fear surrounding the COVID-19 pandemic, the social justice movement related to police violence and the death of George Floyd, and the potential economic reverberations of these two events. This legal action put in place workplace protections that may affect millions of employees across the country.
The Supreme Court often moves in accordance with public opinion; however, the medical fate of LGBTQ individuals remains murky. On June 12, three days before the aforementioned Supreme Court decision, the Department of Health and Human Services (HHS) released a rule change that reversed healthcare and health insurance nondiscrimination protections for LGBTQ people. Stating that the previous interpretation (2016 Rule) of section 1557 of the Affordable Care Act “exceeded its authority in promulgating parts of the legislation,” the HHS vacated and terminated some of those protections. The rule change is expected to save insurance companies and hospitals $2.9 billion over five years, but it restricts essential care for transgender individuals.
Changing Public Opinions
Estimated to include over 1.9 million individuals in the U.S., the transgender population is one of the most marginalized in our society. The 2015 U.S. Transgender Survey for the National Center for Transgender Equality found disturbing trends within the transgender community: Of the 28,000 transgender people completing the survey, 54% reported verbal harassment, 29% lived in poverty, 33% reported negative experiences with healthcare providers, and 40% had attempted suicide (approximately nine times the 4.6% national rate). While the majority of respondents expressed a desire for access to gender-affirming care, only 49% had transitioned medically and 25% had undergone surgical transition. This underlines the concept of unmet needs for transpeople, as supported by temporal trends in increasing interest in and search for transgender services (J Craniofac Surg. 2020;31:606-607).