With the implementation of the Affordable Healthcare Act, the Obama administration determined that its anti-discrimination measures included matters of gender identity, which it defined as “male, female, neither, or a combination of male and female.”

In 2019, the Trump administration eliminated the provision, allowing for gender discrimination by federal law. The same week, the Trump administration also eliminated anti-discriminatory measures based on gender for federal housing.

The new healthcare rules were finalized in 2020, amid the COVID-19 pandemic.

MSNBC – Trump administration rolls back Obama-era health care protections for transgender people
The Wall Street Journal – Trump Administration Issues Rule to Roll Back Transgender Protections in the Affordable Care Act
NPR – Transgender Health Protections Reversed By Trump Administration
Politico – Trump finalizes rollback of LGBTQ patient protections
HHS.gov – HHS Finalizes Rule on Section 1557 Protecting Civil Rights in Healthcare, Restoring the Rule of Law, and Relieving Americans of Billions in Excessive Costs