Donald Trump stated on July 26, 2024 in remarks at Turning Point USA summit:
Kamala Harris “wants to forcibly compel doctors and nurses against their will to give chemical castration drugs to young children.”
By Grace Abels
Since Democratic Vice President Kamala Harris announced her presidential candidacy, her opponent, Republican former President Donald Trump, has attacked her stance on gender-affirming care.
"Harris wants to forcibly compel doctors and nurses against their will to give chemical castration drugs to young children," Trump said at a July 26 Turning Point USA event in West Palm Beach, Florida.
PolitiFact contacted Trump’s campaign for comment and received a reply from Republican National Committee spokesperson Anna Kelly, who pointed to instances in which the Biden-Harris administration supported access to gender-affirming care. Kelly provided no evidence to support Trump’s specific claim.
Although neither Trump nor his team specified which policies he referred to, we identified one connected to Harris that has faced similar criticism.
Harris has supported anti-discrimination protections for LGBTQ+ people. But PolitiFact found no evidence that Harris has advocated for doctors to be forced against their will to give medical care to children.
LGBTQ+ discrimination protections under Biden have faced similar criticism
An antidiscrimination regulation the Department of Health and Human Services formalized in 2024 has been similarly described by critics as forcing medical professionals to provide care.
Section 1557 of the 2010 Affordable Care Act is a nondiscrimination clause that prohibits discrimination based on race, color, national origin, disability, age and sex in federally funded health programs and activities.
The scope of one of those definitions, "sex discrimination," has varied across presidential administrations. During the Obama administration, sex discrimination included gender identity and sex stereotypes. The Trump administration’s regulations did not define sex.
In April 2024, during the Biden-Harris administration, the Department of Health and Human Services formalized regulations that again said sexual orientation and gender identity would be included as part of sex discrimination. The change meant that LGBTQ+ people are again included in the Affordable Care Act’s prohibition on sex discrimination.
This means that refusing to treat patients solely because they are gay or transgender could be considered discriminatory.
A 2023 survey by KFF, a health policy research center, showed that LGBTQ+ adults report higher levels of health care discrimination, including disrespect and unfair treatment from providers.The report also found that negative experiences can lead to worse health outcomes among LGBTQ+ patients, and discourage people from seeking medical care.
The inclusion of LGBTQ+ identities under Section 1557 followed a 2020 U.S. Supreme Court decision that determined that discriminating against employees based on sexual orientation and gender identity is a form of sex discrimination. Since the decision, the Biden administration has sought to extend this LGBTQ+-inclusive understanding of sex discrimination to other civil rights laws and agency regulations, but is facing lawsuits from conservative groups and states that seek to stop the expansion.
Trump’s statement could have been referring to this Affordable Care Act rule change. Following the announcement, critics such as the Alliance Defending Freedom, a conservative legal group, expressed concern that doctors would be forced to provide care they disagreed with.
But HHS’ page of frequently asked questions about the rule change says otherwise. It addresses the question: "Does the final rule require the … provision of treatment (e.g., hormone therapy, surgery, etc.) for children and/or adults with gender dysphoria if prescribed by a doctor?"
The answer says providers are not obligated "to offer any health care, including gender-affirming care, that they do not think is clinically appropriate or if religious freedom and conscience protections apply."
Elana Redfield, federal policy director at the Williams Institute, an LGBTQ+ research and policy center at the UCLA School of Law, said, "In my reading, it's really extremely unlikely that a provider would be unable to get an exemption from Section 1557 if they had any kind of religious or moral objection to providing gender affirming care."
"The Section 1557 rule is very explicit," said Ma’ayan Anafi, senior counsel at the National Women’s Law Center, "Providers can't discriminate against transgender patients, but they're not required to provide any care that is contrary to their judgment or their expertise."
Lawsuits have been filed by states and clinics challenging the rule and arguing that clinicians could be obligated to provide care.
With the lawsuits pending, enforcement of the rule is paused nationwide following a federal district court ruling in Mississippi.
Trump inaccurately characterizes gender-affirming care
In his comment, Trump referred to "chemical castration drugs" given "to young children."
"Chemical castration" is a phrase people who oppose access to gender-affirming medicine often use to describe puberty blockers.
Gender-affirming care supports transgender and nonbinary people’s gender identity and can go beyond medical interventions. For the small population of transgender youth, this mainly involves support through social transition, puberty blockers and hormones as children become adolescents. Gender-affirming surgery is rarely performed on minors.
Puberty blockers are medications that pause or suppress the release of hormones that lead to bodily changes that accompany puberty.
A lowered sex drive is normal when an adolescent is taking them. But these effects end when adolescents stop taking the medications.
The most common medication for pubertal suppression is gonadotropin-releasing hormone agonists (GnRHa), which signals the pituitary gland to slow production of sex hormones such as testosterone and estrogen.
GnRHa have been FDA-approved since 1985, and they are used in adults to treat prostate cancer and endometriosis. Since 1981, they have also been used to treat "precocious puberty," which is when kids start going through early puberty, around ages 6 or 7.
Use of GnRHa in transgender kids is considered an "off-label" use because the U.S. Food and Drug Administration didn’t approve the medication for that purpose. Physicians first started prescribing blockers to this population in 1997 in the Netherlands.
Experts say that after puberty blockers are stopped, sex hormone production and puberty resumes. For this reason, numerous major medical organizations in the U.S. consider these treatments reversible. Puberty blockers by themselves do not affect fertility.
But if a teen decides to go directly from blockers to cross-sex hormones, which can affect fertility, they can risk not having mature eggs or sperm to preserve, depending on their age when they started treatment.
Surgical interventions in minors are rare and are evaluated on a case-by-case basis.
Trump said, "Harris wants to forcibly compel doctors and nurses against their will to give chemical castration drugs to young children."
An RNC spokesperson provided information about the Biden-Harris administration’s general support for access to gender affirming care for youth, but did not specify what Trump was referring to or a policy that would "force" doctors to provide care.
During Harris’ vice presidency, the Department of Health and Human Services passed a rule that included LGBTQ+ people in the Affordable Care Act’s prohibition on sex discrimination. Medical providers can still object to providing gender-affirming care if it goes against their clinical judgment or religious beliefs. The rule is being litigated and is paused nationwide.
There is no certainty Trump was referring to this policy. Trump’s characterization of puberty blockers also is misleading.
At PolitiFact, the burden of proof is on the speaker. We rate the statement False.
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