A consortium of Catholic and Christian groups is calling on the U.S. Department of Health and Human Services to abandon possible plans of requiring health insurers to cover transgender procedures.
In a memo published in early January, HHS said it was proposing a rule updating certain regulations to conform with a Biden Administration executive order “preventing and combating discrimination on the basis of gender identity and sexual orientation.”
“Unfortunately, the proposed regulations go beyond access to care by suggesting that nondiscriminatory health plans must cover procedures that are not medically indicated, may harm rather than heal, and may violate the religious and moral convictions of an insurer, plan sponsor, or other stakeholder,” says a comment filed by the United States Conference of Catholic Bishops and five other organizations. “Most problematic are the provisions of the proposed regulations that relate to ‘gender identity’ and that, read in conjunction with the preamble, appear to mandate coverage of ‘gender transition’ procedures.”
Protecting patients from discrimination on the basis of gender identity should not include a mandate to cover gender transition procedures, said the consortium, which also includes the National Catholic Bioethics Center, the Thomas More Society, the National Association of Catholic Nurses, the Christian Legal Society, and the National Association of Evangelicals. But they argue that many of the procedures are harmful or ineffective and are morally objectionable, and declining to cover such procedures are “not discrimination at odds with the goals of the Department in ensuring access to care for everyone.”
“Like many health care providers, we believe that medical and surgical interventions that purport to alter one’s sex are, in fact, detrimental to patients. Such interventions are not properly viewed as health care because they neither cure nor prevent disease or illness. Surgical alteration of the genitalia, in particular, mutilates the body by taking a healthy bodily system and rendering it dysfunctional,” they wrote.
The signatories cited a study employing the world’s largest data set on patients receiving “gender-affirming” surgeries. It found no benefit from hormonal procedures, and in 2020, an update published in the American Journal of Psychiatry found that “the results demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care.”
Of even more concern, a study by the Karolinska Institute in Sweden, which tracked patients over a 30-year period, “revealed that beginning about 10 years after having the surgery, the transgendered began to experience increasing mental difficulties. Most shockingly, their suicide mortality rose almost 20-fold above the comparable nontransgender population.”
Finally, the consortium warned against creating conflicts with the federal Religious Freedom Restoration Act (RFRA). “HHS is currently a party to litigation in which federal courts have concluded that Department regulations issued under the Affordable Care Act (ACA) violated RFRA by requiring religious stakeholders to provide and cover such procedures,” the signatories wrote.
“For all these reasons, we believe HHS should decline to include in the regulations language that is unnecessary to protect people from discrimination in receiving health care,” they said, “and that could, instead, be construed to require coverage of procedures or treatments that health insurance issuers have determined are unsupported by medical evidence or that violate the religious and moral convictions of insurers, plan sponsors, and individual purchasers.”