The National Association of Pediatric Nurse Practitioners (NAPNAP) is deeply disappointed in the Trump administration’s announcement that it will roll back policies in Section 1557 of the Patient Protection and Affordable Care Act (ACA) that protected against sex and gender identity discrimination in health care. The new rule, which impacts multiple federal regulations, means that insurance companies and healthcare providers can deny services to individuals who identify as transgender or non-binary. The Department of Health and Human Services (HHS) states the government's interpretation of sex discrimination will be based on "the plain meaning of the word 'sex' as male or female and as determined by biology."
Protecting the health, well-being and civil rights of all children and adolescents remains a top concern for our association. Our “Health Risks and Needs of Lesbian, Gay, Bisexual, Transgender, and Questioning Adolescents Position Statement” clearly states that discriminatory actions can have a profound negative effect on the emotional and physical health of transgender adolescents. Transgender youth are at risk for social stigma, victimization and discrimination. Without adequate support, transgender youth are at increased risk for isolation, mental health disorders, suicidal thoughts and behaviors, and substance use/misuse. They also experience increased risk of bullying, physical and emotional abuse, homelessness and interpersonal violence when compared to heterosexual, cis-gender, and gender conforming youth.
Issuing the rule change while the country is experiencing turmoil from significant health and societal impacts of the COVID-19 pandemic and protests of racial inequality and discrimination conveys lack of respect for the diverse health needs of our nation’s children. Support of the social and emotional well-being of all children, regardless of their gender expression, is critical to societal health.
It remains imperative that pediatric healthcare professionals continue to advocate for equitable treatment and support of transgender children, adolescents and young adults.
June 16, 2020