The proposal would reverse an Obama-era policy that the Trump administration already is not enforcing.
The Transgender Law Centre claims the new rule will put up unnecessary borders between two million transgender people and the health care they need and would also weaken civil rights protections for patients.
Most recently a rule announced by Housing and Urban Development Department that would allow federally funded shelters to turn away people citing religious objections and force transgender women to use men's bathrooms. A bigger number - 4.5% of the population- identify as lesbian, gay, bisexual or transgender (LGBT), according to Gallup. A rule enacted in 2016 interpreted the ban on sex discrimination to include discrimination on the basis of gender identity, building on similar interpretations in other federal civil rights laws and court rulings, and termination of pregnancy.
HHS said it has not enforced the protections since December 2016 after a federal court found they conflicted with a separate existing law.
Lambda Legal pledged to fight the proposed change, charging that it was "not grounded in science or the law". "Do they move their home?"
"Sex means a person's status as male or female based on immutable biological traits identifiable by or before birth", the health department proposed in the memo, which was obtained by The New York Times. Treatment can range from sex-reassignment surgery and hormones to people changing their outward appearance by adopting a different hairstyle or clothing.
He said the new rule wouldn't preempt state regulations and it wouldn't urge medical providers not to treat certain patients. Such notices often come with insurer "explanation of benefits" forms. That would save more than $3.2 billion over five years, Severino said. A coalition of states with Democratic attorneys general have filed a federal lawsuit in New York City challenging the legitimacy of the rule.
Laura Durso, vice president of LGBT research and communications at the Center for American Progress, said in a conference call with reporters the rule would have devastating effects on both women and LGBT people. Because these individuals lack state-level protections, federal law offers the only remedy if they are turned away from, or provided sub-standard, health care or insurance coverage based on their gender identity.
Obama banned adoption and foster-care agencies from receiving federal funding if they refused to work with same-sex couples.
Seventeen states, including MA, have passed laws that protect transgender residents from discrimination in health care facilities and other settings. Her organization, she added, will see the administration in court.
Lori Windham, senior counsel at Becket, a religious rights advocacy group, applauded the move in a statement. "Eliminating the strong, clear rules prohibiting discrimination will lead to confusion, unequal access, and potential rollbacks of landmark progress".
The proposed rule will now go through a 60-day public comment period, as the original Obama-era rule did in 2013 and 2015.
The HHS proposal is part of a broader conservative effort to restrict definitions of sex and gender, which has sparked a national debate in recent years.
"We determined based on extensive analysis of the law and the way that the law had been applied under employment discrimination laws and education discrimination laws that sex discrimination included not just discrimination against women and men, but also discrimination based on sex stereotyping and gender identity", says Samuels, who is now director of the Williams Institute at the UCLA School of Law.
"All Americans, regardless of who they are, deserve respect and access to care and support when they are most in need", she said in a statement.