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American College of Nurse-Midwives Issues Statement Strongly Opposing Withdrawal of Gender Identity Protections in Health Care

May 29, 2019
Contact: Maura Christopher
240-485-1822; [email protected]

The American College of Nurse-Midwives (ACNM) strongly opposes a new U.S. Department of Health and Human Services (HHS) proposal to dismantle important legal protections afforded under the Health Care Rights Law (Section 1557 of the Affordable Care Act) that prohibit discrimination by health care providers and insurers based on gender identity.

“ACNM’s Philosophy of Care is founded on a belief that all people have a right to health care that is equitable, ethical, and accessible and that respects human dignity, individuality, and diversity among groups,” stated ACNM President Susan Stone, CNM, DNSc, FACNM, FAAN. “Further, we specifically affirm the rights of transgender and gender non-conforming individuals to care that is delivered in an unbiased, safe, respectful, and equitable manner. This proposed rollback reverses critical protections and puts countless individuals at risk of continued harm from inadequate and discriminatory health care.”

The HHS proposal, announced Friday, May 24, seeks to limit the scope of civil rights protections established under the Health Care Rights Law that brought transgender and gender non-conforming individuals under the umbrella that prohibits discrimination based on race, color, ethnicity, disability, age, and sex in any health program or activity receiving federal assistance, any program or activity administered by a federal agency and the health insurance marketplaces.(1) The ruling applies both to health insurers as well as to providers such as hospitals, pharmacies, midwives, nurse practitioners, physicians, and others.

Numerous reports, including one by the National Center for Transgender Equality, have documented extensive discrimination against transgender and gender nonconforming individuals in accessing health care as well as significantly higher health disparities.(2)  Moreover, care that is provided is often delivered in a way that is inadequate, disrespectful, or increases distress and trauma. Transgender and gender non-conforming individuals report experiencing lower rates of health insurance coverage than the general population and one-third (33%) of those who saw a health care provider in the past year reported having at least one negative experience related to being transgender, with higher rates for people of color and people with disabilities. Additionally, as many as one-fourth of transgender people avoid health care services due to concerns about discrimination and harassment.”(2) 

ACNM supports access to comprehensive health care for every individual. As ACNM’s related position statement notes, “Everyone has the right to make choices regarding sexual and reproductive health (SRH) that meet their individual needs…. Every individual has the right to safe, supportive, and affirming health care in which providers demonstrate respect for human dignity. ACNM supports each person’s right to self determination, access to comprehensive health information, and active participation in all aspects of an individualized plan of care.”(3) 


1. Trump Administration Plan to Roll Back Health Care Nondiscrimination Regulation: Frequently Asked Questions. National Center for Transgender Equality. https://transequality.org/HCRL-FAQ. Accessed May 28, 2019.

2. James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). The Report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality. http://www.ustranssurvey.org/reports#USTS Accessed May 28, 2019

3. Access to Comprehensive Sexual and Reproductive Health Care Services. American College of Nurse-Midwives. Approved 1991. Reviewed and Revised, October 2016. http://www.midwife.org/acnm/files/ACNMLibraryData/UPLOADFILENAME/000000000087/Access-to-Comprehensive-Sexual-and-Reproductive-Health-Care-Services-FINAL-04-12-17.pdf. Accessed May 28, 2019.

About ACNM

With 6500 members, ACNM is the professional association that represents certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States. ACNM promotes excellence in midwifery education, clinical practice, and research. With roots dating to 1929, our members are primary care providers for women throughout the lifespan, with a special emphasis on pregnancy, childbirth, and gynecologic and reproductive health. ACNM provides research, administers and promotes continuing education programs, establishes education and clinical practice standards, and creates liaisons with state and federal agencies and members of Congress to increase the visibility and recognition of midwifery care.

American College of Nurse-Midwives
409 12th St SW, Suite 600, Washington, DC 20024-2188
Phone: 240.485.1800
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