Oppose HHS Investigation Targeting Transgender Health Care Access

I am writing to urge you to take immediate action against the Department of Health and Human Services investigation announced this week by Office for Civil Rights director Paula M. Stannard. This investigation, framed as protecting religious freedom, is actually designed to restrict access to medically necessary health care for transgender people by targeting state licensing requirements for behavioral health providers. This is the fifth conscience rights investigation announced during Trump's second term, and it represents a dangerous escalation in using federal civil rights enforcement as a political weapon. The investigation examines whether state requirements for providers to participate in or refer patients for what HHS calls "sex-rejecting procedures" violate federal protections for religious objections. By grouping gender-affirming care with female genital mutilation in its language, HHS conflates evidence-based medical treatment with criminal acts. The consequences for transgender people are severe and immediate. Behavioral health professionals serve as the gateway to care for gender dysphoria, depression, and anxiety, conditions that disproportionately affect trans youth and adults. Former HHS deputy assistant secretary for health policy Adrian Shanker, who served under President Biden, explains that public announcements of federal enforcement actions create fear across the medical system, resulting in "compliance in advance" where hospitals and clinics quietly scale back or abandon services before any formal penalties are imposed. Some states strengthened provider requirements after patients were turned away from necessary care, often requiring objecting providers to offer timely referrals. Treating these patient protection measures as unlawful coercion will leave vulnerable people without access to lifesaving treatment during a national shortage of behavioral health providers. I urge you to publicly oppose this investigation and work with colleagues to protect access to gender-affirming care. Transgender constituents deserve the same access to medically necessary health care as everyone else. This investigation prioritizes ideology over patient welfare and must be stopped.