IACHR Press Office
Washington, DC - The Inter-American Commission on Human Rights (IACHR) warns against the wave of laws and policies in the United States of America (USA) that seek to restrict access to health care for LGBTI persons. The Commission is particularly concerned about the differentiated impact of some of these laws on the rights of trans and intersex children and youth.
The Commission notes that at least 30 states in the USA have passed laws and policies that restrict gender-affirming healthcare for trans youth. Among other things, these laws and policies restrict access to puberty-blocking medication and hormone therapies for trans individuals who request these treatments. Additionally, in the State of Missouri, restrictions also apply to gender-affirming treatments for adults.
The IACHR is also concerned about public reports that the State of Florida has approved a law that allows healthcare providers, including doctors and insurance companies, to refuse medical services based on religious beliefs. Human rights defenders focused on the human rights of LGBTI persons have pointed out that this law lacks protections in cases where services are refused based on sexual orientation or gender identity.
The IACHR is also concerned about the impact that some of these measures have on the rights of intersex persons. Civil society organizations have noted that while some states in the USA prohibit gender-affirming healthcare for trans individuals, a number of these legal schemes simultaneously introduce an explicit exception for harmful non-emergent procedures performed on intersex children. These provisions aim to ensure that doctors who perform medical interventions including irreversible surgeries on intersex children, even where the treated person does not consent to these, are immune to prosecution, thereby adding additional barriers for intersex persons to seek justice.
In its report on Trans and Gender-Diverse Persons and Their Economic, Social, Cultural and Environmental Rights (2020), the IACHR stated that trans and gender-diverse persons see their rights related to health severely limited mainly due to the pathologization of their identities, as well as the high rates of violence and discrimination they experience when seeking medical care. The lack of access to gender-affirming healthcare has a severe impact on trans youth, who become aware of their gender identity at an early age. The Commission has observed that not only is their physical health affected by discrimination, but their mental health as well, leading to increased isolation, depression, self-harm, and suicide risks.
Concerning intersex persons, in its report on Violence against Lesbian, Gay, Bisexual, Trans and Intersex Persons in the Americas (2015), the IACHR warned against invasive medical treatments for purely cosmetic purposes that seek to "normalize" the diverse sex characteristics of intersex persons without their full, prior and informed consent. The Commission considers such treatments as a form of medical violence based on prejudice against bodily diversity and against intersex persons' bodily integrity and personal autonomy.
The Commission reiterates that states must guarantee access to healthcare services for LGBTI persons without the fear of violence or discrimination. Furthermore, States should ensure that health protocols and services, including gender-affirming treatments, respect human rights and address the specific needs of individuals.
The IACHR is a principal and autonomous body of the Organization of American States (OAS), whose mandate stems from the OAS Charter and the American Convention on Human Rights. The Inter-American Commission has the mandate to promote the observance and defense of human rights in the region and acts as an advisory body to the OAS on the matter. The IACHR is made up of seven independent members who are elected by the OAS General Assembly in their personal capacity, and do not represent their countries of origin or residence.