'Transgender mandate' struck down by federal court - Politics Forum.org | PoFo

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#15042360
Dallas, Texas, Oct 15, 2019 / 04:00 pm (CNA).- A federal judge struck down the so-called “transgender mandate” on Tuesday, vacating an Obama-era requirement that doctors perform gender-transition surgeries upon request.

Judge Reed O’Connor of the North District of Texas—who had issued a preliminary injunction on the transgender mandate at the end of 2016—struck down the mandate Oct. 15 in the case of Franciscan Alliance v. Azar, after doctors around the country filed suit against the mandate on religious freedom grounds.

“Our clients look forward to joyfully continuing to serve all patients, regardless of their sex or gender identity, and continuing to provide top-notch care to transgender patients for everything from cancer to the common cold,” Goodrich said.

In 2016, the Obama administration issued a regulation that would require most doctors throughout the country—900,000 physicians, by the agency’s estimate—to perform gender-transition surgeries upon request, despite any conscience-based or prudential objections.

The rule omitted any clear religious exemption for doctors, and did not allow doctors to refuse a request for surgery if they deemed it harmful to the patient; surgeries would also have had to be performed on children.

The regulation stemmed from Section 1557 of the Affordable Care Act, which prohibits discrimination in health care on the basis of race, color, national origin, sex, age, or disability. HHS interpreted “sex discrimination” under this rule to include gender identity, thus mandating the provision of gender-transition surgeries.

In response to the rule, an alliance of more than 19,000 health care professionals, nine states, and several religious organizations combined in two lawsuits against the mandate, saying that it unlawfully required doctors to, in cases of objection, violate their religious beliefs or the Hippocratic Oath to do no harm to the patient.

In December of 2016, two different federal courts ruled against the mandate, and in May of 2019, the Trump HHS proposed a rule to roll back the inclusion of “gender identity” within the nondiscrimination rule. While the proposed rule has not yet been finalized, the previous regulation was still valid.

Another lawsuit against the mandate, New York v. HHS, is still pending in federal courts.

In other recent cases in California, two Catholic health systems are facing lawsuits from two women identifying as transgender men, who claim that they requested hysterectomies at Catholic hospitals but were denied the procedures.

Goodrich, in a series of tweets on Tuesday, said that two different federal circuit courts—the First and the Fifth Circuits—have said that no consensus in the medical community exists that gender transition surgeries should be mandatory.

“The doctors and hospitals in these cases argued that they shouldn’t be forced to perform procedures that violate their consciences and could harm their patients. The federal court today agreed,” Goodrich tweeted.

https://www.catholicnewsagency.com/news ... ourt-14459
#15042362
:?:

Your country is weird...none of that makes any sense. Every single physician is 'required to perform gender reassignment surgery on request' - are most of them even qualified for that? And how do drs religious beliefs have any bearing on anything, presuming they were qualified & paid to carry out a specific job, they ought to do it.

Utter insanity...from the crazed liberals and the insane catholic conservatives.
#15042369
In May 2019, the Department of Health and Human Services (HHS) released a proposed new rule which would fix the transgender mandate and keep the federal government from interfering in decisions that should remain between doctors and their patients, but the previous rule remained on the books while the proposal was being considered.

Becket pointed to research, backed by HHS, which shows there are significant risks with gender reassignment therapy – especially in childhood – such as heart conditions, increased cancer risk and loss of bone density. According to studies presented by Becket, fewer than one in four children referred for gender dysphoria continued to experience that condition into adulthood.

The government's panel of medical experts concluded these therapies can be harmful and advised against requiring coverage of these medical and surgical procedures under Medicare and Medicaid, which were exempt from the mandate.

https://www.foxnews.com/us/court-doctor ... er-surgery
#15042399
Presvias wrote:Every single physician is 'required to perform gender reassignment surgery on request' - are most of them even qualified for that?


Well, I am not a surgeon but the male-to-female surgery seems, at first thought, to be a pretty simple one :D
#15042401
Ter wrote:Well, I am not a surgeon but the male-to-female surgery seems, at first thought, to be a pretty simple one :D

I know you're mostly joking but it's actually not. There's some harrowing stuff on the internet about how it's basically a need to keep a wound open instead of closed and so-on, usually with multiple follow-up surgeries.
#15046896
:?:

I dont get why any doctor can be forced to do such an extremely problematic operation as gender transformation. Dont you want somebody with as much experience as possible for that job ?!? Its sexual organs with sensitive areas and they're using sharp knifes ! :eh:
#15046901
I know two women who used to be men. They're a couple.

Honest to God, they both look like men dressed up as women. Neither of them were good looking when they were guys, so now they're pretty ugly as far as women go.

The blonde, Wendy, doesn't enjoy any sort of intimacy whatsoever. Ergo, she allows her partner, Liann, to have what she refers to as "playthings" on the side. I'm pretty sure her "playthings" are other women, but I'm not 100% certain about that.

Would that mean that, when she was a he, he was a lesbian trapped in a man's body?

They both carry around photos of themselves when they were guys. I don't understand that. It seems to me that, if you were a guy and want to be a woman, you wouldn't be carrying around a photo of yourself from when you were a man to show people. Wouldn't you want people to view you as a woman? They are, for the most part, psychological train wrecks.

Now, of course, I have no way to appreciate what it's like to be a guy who wants to be a woman. I'm pretty damn happy being a guy, so I can't even imagine the thought process which leads a person to make such a decision.

At the end of the day, though, I don't think any doctor should be forced to perform any such procedure, for whatever reason he doesn't want to do it...
#15047856
The article that @Sivad cited is very misleading . First of all , no , sex reassignment surgery is not specifically covered under Section 1557 of the Affordable Care Act . https://www.verywellhealth.com/transgender-healthcare-and-health-insurance-4065151 And from this article ,
A federal judge on Tuesday overturned ObamaCare protections for transgender patients, ruling that a 2016 policy violates the religious freedom of Christian providers.

Judge Reed O’Connor in the Northern District of Texas vacated an Obama-era regulation that prohibited insurers and providers who receive federal money from denying treatment or coverage to anyone based on sex, gender identity or termination of pregnancy.

It also required doctors and hospitals to provide “medically necessary” services to transgender individuals as long as those services were the same ones provided to other patients.

O’Connor, the same judge who last year ruled that the entire Affordable Care Act is unconstitutional, said the rule violates the Religious Freedom Restoration Act.

His ruling is likely to be appealed.

The ObamaCare rule was initially challenged in court in 2016 by a group of Christian providers called the Franciscan Alliance as well as five conservative states.

They argued that the rule forces insurers to pay for abortions and compels doctors to perform gender transition services even if they disagree with those services on moral or medical grounds.

O’Connor agreed and issued a nationwide injunction against enforcing the rule. The injunction meant that even though the provisions remained in effect, the Obama administration could not sue a hospital or provider for not complying.

President Obama’s Department of Health and Human Services initially defended the rule, but the Trump administration decided to drop its defense and argued the rule should be sent back to the agency to be rewritten.

The Trump administration is working on a regulatory fix and has issued a proposed rule that would scrap ObamaCare's definition of "sex discrimination" to remove protections for gender identity.

Advocates argue removing those protections will allow health care providers, hospitals and insurers to discriminate against transgender patients.
#15047862
I thought that the whole point of removing these protections was so that people can discriminate against trans people.

There is a certain strain of religious thought that thinks it is okay to oppress and bully people because their god says so.
#15047881
Side comments about religion aside.

There is certainly no consensus in the medical community that gender reassignment surgery should be available "on demand". As with all surgeries, doctors and the patients should decide together whether or not the surgery is advisable. If the doctor believes that it is not a good idea then the doctor should not do the surgery regardless of his/her reasons for thinking that. I certainly would not want any surgery done by a physician who disapproves of the procedure for any reason.

As for reassignment surgery for children. I oppose it in all cases and point to the weak evidence supporting it as curative in all cases. In fact, as was pointed out, without surgery the overwhelming majority of gender dysphoria cases resolve to the birth identity without intervention at all.

This rule was idiotic and should have been struck down long ago.
#15047882
Drlee wrote:Side comments about religion aside.

There is certainly no consensus in the medical community that gender reassignment surgery should be available "on demand". As with all surgeries, doctors and the patients should decide together whether or not the surgery is advisable. If the doctor believes that it is not a good idea then the doctor should not do the surgery regardless of his/her reasons for thinking that. I certainly would not want any surgery done by a physician who disapproves of the procedure for any reason.


Even if the doctor has no good reason for their disapproval of the procedure?
#15047901
Even if the doctor has no good reason for their disapproval of the procedure?


Define good reason.

Then read again what I wrote.
#15047904
Drlee wrote:
There is certainly no consensus in the medical community that gender reassignment surgery should be available "on demand". As with all surgeries, doctors and the patients should decide together whether or not the surgery is advisable. If the doctor believes that it is not a good idea then the doctor should not do the surgery regardless of his/her reasons for thinking that. I certainly would not want any surgery done by a physician who disapproves of the procedure for any reason.

As for reassignment surgery for children. I oppose it in all cases and point to the weak evidence supporting it as curative in all cases. In fact, as was pointed out, without surgery the overwhelming majority of gender dysphoria cases resolve to the birth identity without intervention at all.

This rule was idiotic and should have been struck down long ago.



Every medical procedure is supposed to be researched for safety and effectiveness. Mostly that hasn't happened for gender changes, and my impression (from my admittedly limited perspective) is that we need to develop a process to weed out candidates that are unlikely to benefit from the treatment.

As part of my cancer treatment, I was shot full of girl hormones for a year. I was supposed to get 2 years, but I refused the second year. It was a horrific experience. Not to mention it gave me diabetes.
#15047930
A reason based on logic or evidence.


If this is the case then there would be no gender reassignment actions taken before the age of 18 or so. Logic and evidence shows us that the greatest majority of these dysphoria cases resolve with nothing more than psychiatric care, if that.

Since you are all for the evidence, I am glad that you agree with me on this.

But you mentioned religion. I would offer that we do a great many unscientific things in honor of the religious beliefs of others. For example, we preserve public lands just because some native Americans a few hundred years ago buried someone on them. We allow Islamic students to violate otherwise strict dress codes. In the Army we provide Kosher diets. Many more. I would offer that none of these has the slightest scientific necessity. But you seem to want to carve out a doctors personal religious beliefs as special. Why?
#15047943
Drlee wrote:If this is the case then there would be no gender reassignment actions taken before the age of 18 or so. Logic and evidence shows us that the greatest majority of these dysphoria cases resolve with nothing more than psychiatric care, if that.


No, it does not follow logically that there would be no gender reassignment action taken before the age of 18 if doctors were required to act in the patient's best interest and could only refrain from doing so if there was a good reason.

Since you are all for the evidence, I am glad that you agree with me on this.


Agree with you on what exactly? You mentioned several ideas.

But you mentioned religion. I would offer that we do a great many unscientific things in honor of the religious beliefs of others. For example, we preserve public lands just because some native Americans a few hundred years ago buried someone on them. We allow Islamic students to violate otherwise strict dress codes. In the Army we provide Kosher diets. Many more. I would offer that none of these has the slightest scientific necessity. But you seem to want to carve out a doctors personal religious beliefs as special. Why?


Because it directly impacts the health of others, while these other examples do not.

Doctors should not be allowed to withhold medical treatment just because of their religious beliefs.
#15047977
No, it does not follow logically that there would be no gender reassignment action taken before the age of 18 if doctors were required to act in the patient's best interest and could only refrain from doing so if there was a good reason.


It absolutely does follow. In the vast majority of cases this sort of therapy is contraindicated. Sorry if that is politically unacceptable to you.

So pay attention or stop posting. Within the last few posts are the statistics that show that if doctors jump the gun on reassignment surgery or drug therapy they are harming their parents. If you use your criteria and go with the science, no surgery or drug therapy would be done before adulthood.

Doctors should not be allowed to withhold medical treatment just because of their religious beliefs.


Why? Nobody is harmed. Patients are free to find a doctor that will conform to their wishes or confirm that their wishes are unsound.

It is amazing how little liberals think about basic human rights. Fortunately in the US we have free expression of religion in our constitution. It protects us from idiots who wish to tell us that we do not have freedom of conscience..

And for the record, I would never do gender reassignment. I do not believe the science is sound. Are you telling me I should do whatever any patient wants even if I believe it is bad for them?

As a patient, when I go into the operating room or the doctor's office I do not want a surgeon who believes what he is doing is unconscionable cutting on me or prescribing powerful life altering drugs.

And, as usual, you descend into hyperbole. Nobody is withholding treatment. Everyone is free to find another doctor. There is no imperative, except in emergencies, for any doctor to accept any patient. Gender reassignment is never an emergency so their is no need to offend anyone's sensibilities.

And Rancid is also correct. Only very specialized physicians should even be treating GID not to mention doing gender reassignment. And the ones who are doing it on children are dangerous quacks.
#15048036
Drlee wrote:It absolutely does follow. In the vast majority of cases this sort of therapy is contraindicated. Sorry if that is politically unacceptable to you.


You misread my sentence. Please reread it.

The lack of a good reason for not doing it does not it make a nad idea to do it.

Within the last few posts are the statistics that show that if doctors jump the gun on reassignment surgery or drug therapy they are harming their parents. If you use your criteria and go with the science, no surgery or drug therapy would be done before adulthood.


Where are these stats and how do they show harm?

Why? Nobody is harmed. Patients are free to find a doctor that will conform to their wishes or confirm that their wishes are unsound.


The way medical care is structured in the US, it may be difficult to find a doctor or insurance provided who will do it.

The stunning lack of access to abortion is a good example of how you guys theoretically have access but real access is very limited.

It is amazing how little liberals think about basic human rights.


These rude little comments you make? I am going to simply ignore them for the childish behaviour they are.

Fortunately in the US we have free expression of religion in our constitution. It protects us from idiots who wish to tell us that we do not have freedom of conscience..


This is about the freedom to impose the doctor’s religious beliefs on the patient. That is not freedom, since it limits the patient’s ability to seek medical help.

Are you telling me I should do whatever any patient wants even if I believe it is bad for them?


No.

I said doctors would need a GOOD reason to deny care, and I defined that as a reason based on logic or evidence.

You are arguing that doctors can withhold medical treatment even without good reason.

And, as usual, you descend into hyperbole. Nobody is withholding treatment. Everyone is free to find another doctor. There is no imperative, except in emergencies, for any doctor to accept any patient. Gender reassignment is never an emergency so their is no need to offend anyone's sensibilities.

And Rancid is also correct. Only very specialized physicians should even be treating GID not to mention doing gender reassignment. And the ones who are doing it on children are dangerous quacks.


You are contradicting yourself here.

On the one hand, you say that it would be easy to dind another doctor, then turn around and say that these specific doctors are specialists and are few and far between.

Also, learn how to use notifications.

Either quite someone’s post directly, like I quoted yours, or use the
@Drlee function.
#15048135
1) A surgeon is a human being like any other. S/he is free to refuse to perform any specific acts of surgery barring those explicitly stipulated by a contractual agreement freely entered into. A law or administrative edict does not have the moral power to alter or abolish a fundamental liberty. More succinctly, "fuck off slaver."

2) Why in the name of all that is holy would a hypothetical transsexual patient ever want to have PERMANENT SURGERY OF THEIR GENITALS performed on them by a surgeon who is fundamentally opposed to the procedure?!? It is not a fucking wedding cake!

3) The entire concept of "sexual reassignment surgery" strikes me as uncommonly silly, in the "cart-before-the-horse" sense, akin to liposuction or cosmetic breast enlargement. But as long as all parties are consenting adults, it's their funeral. On the other hand, performing such a procedure on minors is flat-out psychopathic and an outrage of the highest magnitude. "Medical" practitioners who do so deserve permanent outlawry and exile from all civilised society
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