Kunyange neAACA Chikamu 1557, zvakaoma
Kuenzana kwekodzero dzevanodarika veAmerica vave kwenguva yakareba, asi Mutengo Wakanaka Wechirongwa (ACA) uri kufambira mberi kuhutano muhutano hwehutano . Chikamu 1557 cheAACA chinorambidza kusarudzwa pane zvikonzero zvakasiyana-siyana zve "chirongwa chehutano kana basa" rinogamuchira chero rubatsiro rwezvemari yehurumende.
Asi izvi hazvirevi kuti vanhu vose vehurumende vezvitender iko zvino vanogona kuwana chero nzira ipi zvayo yekurapa yavanoda.
Chikamu 1557 cheAACA
ACA Chikamu 1557 chave chiripo kubvira muna 2010, asi inongova mapoka maviri chete kwenguva yakareba, uye yakawanda kwazvo mumasikirwo. Kujekesa kusarudzwa kwekusarura, Dhipatimendi reHutano neHuman Services (HHS) neHhodhi yeZvikodzero Kodzero (OCR) yakabudisa mutemo wokupedzisira wejiji 362 yekushanda kweChikamu 1557 munaMay 2016.
Chikamu 1557 chinorambidza rusarura rwakawanikwa nemitemo iripo-Civil Civil Act, Chinyorwa IX, Age Age, uye Chikamu 504 cheRehabilitation Act-iyo inowanzozivikanwa kune vakawanda vekuAmerica (kureva, makore, kuremara, rudzi, ruvara, nyika uye zvepabonde). Chikamu 1557 cheAACA chinoshandisa mitemo iyo isina kusarura kune zvirongwa zvehutano nemabasa anogamuchira mari yehurumende.
Mukutonga kwekupedzisira, HHS naOCR vanojekesa kuti hutano huzivi "hunogona kunge huri murume, mukadzi, kana, kana kusanganiswa kwevarume nevakadzi." Uye mutemo wacho unorambidza zvakananga zvirongwa zvehutano nemabasa anogamuchira federal mari kubva pakusarura kune vamwe vanhu zvichienderana nehutano hunhu kana hutsika hwepabonde.
Chikamu 1557 chinoshanda kune chero sangano rinopa rubatsiro rwehutano kana inshuwarhu yehutano (kusanganisira masangano ane zvirongwa zvehutano hwehutano hwevashandi vavo) kana vakagamuchira chero rudzi rwehurumende rubatsiro rwemari yehutano inshuwarano kana mabasa ehutano.
Izvi zvinosanganisira zvipatara nezvimwe zvipatara, Medicaid , Medicare (kunze kweMedarereti B ), zvirongwa zvehutano hwevadzidzi , Child Health Insurance Program , uye vatsigiri vega vega vanogamuchira mari yehurumende (kusanganisira rubatsiro mukutengeserana kwevatengesi vavo vanozvitengesa; kana zvakadaro, mapurisa ose aya anofanira kunge achienderana neChechi 1557, kwete kungoita zvirongwa zvavo zvekuchinjana).
Misangano inofanirwa kutevedzera Chikamu 1557 inonzi "masangano akavharwa."
Zvizhinji zvezvikamu zvekutonga kwekupedzisira zvinotanga kuitwa musi waJuly 18, 2016, asi kana kuchinja kunofanirwa kuitwa kurongwa hwehutano hwerongwa, izvo zvinogona kunonoka kusvikira kutanga kwegore rokutanga rakatanga iro kana kuti mushure meJanuary 1, 2017 Saka urongwa hwehutano hwakarongwa gore hunotangira kubva munaAgasti kusvika munaJuly haufaniri kuita shanduko dzinodiwa mumutemo wokupedzisira kusvika munaAugust 2017.
OCR inotarisirwa kushandiswa kwechikamu chechikamu 1557, uye ivo vave vachiita kudaro kubva muna 2010. Zvinonyunyuta nekugadziriswa zvinotarisirwa pane-case-by-case basis, uye vanhu vanobvumirwa kuuya nechisarudzo chemhosva mumatare ehurumende pasi peChikamu 1557.
IAACA Inoda Inishuwarenzi Kuvhara Gender Reassignment Surgery?
Kunyange zvazvo mutemo wokupedzisira weChikamu 1557 unonyatsotsanangurwa uye unonyatsorambidza kusarura kunoenderana nehutano hunozivikanwa, hahurevi utano hwehutano hwehutano hwe "kuvhara chero nzira ipi zvayo kana kurapwa kwehutano hwakabatana."
Mitemo hainawo kudzivirira chinamato chakavharidzirwa kubva "kusashandisa mitemo isingatauri iyo inotungamirira mamiriro ezvinhu ayo ichapa kugoverwa kune vose vanyoresa maitiro nenzira isingazivi." Mune mamwe mazwi, kurapwa uye kurapwa kunofanirwa kupiwa nenzira isiri yekusarura, asi hapana zvidikanwi zvakajeka zvekuti inshuwarisi inobata chero humwe hutsika hwehutano hunobata-tanana, kunyange kana ivo vachionekwa semuviri unokosha.
OCR yakatsanangura kuti kana sangano rakavharidzirwa richiita kana kuti richibhadhara imwe nzira yevamwe vayo nhengo dzaro, haringashandisi chizivo chepabonde kana kusagadzirisa zvepabonde kudzivisa kupa mutemo iwoyo kune mumwe munhu wechitsika. Nokudaro, somuenzaniso, kana inshurenzi inobvisa hutachiona hwekudzivirira kana kubata chirwere muvakadzi veCisgender , inofanira kushandisa nzira dzisiri dzekusarura, dzisina kusarura kuti dzione kana dzichavhara hutachiona hwekutarisa dysphoria .
Uye hutano hunhu hahugoni kushandiswa kuramba urongwa hunodiwa mune zvehutano, pasinei nokuti hunoenderana nehutano hwomunhu.
Semuenzaniso, murume we transgender haagoni kukanganwa kurapwa kwekenza yevana vanokonzerwa neicho chaanozivisa semurume.
Asi nyaya yacho inoramba ichinetseka. Isati yatungamirirwa nenyaya yeChishanu 1557 yekupedzisira, paive nemitemo 17 yakanyatsodzivirira vatsigiri vehutano kubva pakusanganisira kubvongodza zvikwereti nokuda kwekuchengetedza kwakasiyana-siyana, uye 10 zvinyorwa izvo zvakadzivisa kubvongodza kwakadaro muMedicaid. Pasi pemutongi wokupedzisira, masangano akavharwa mumamiriro ose enyika anorambidzwa kushandiswa kwekuvhara mabhoti kuti arambe kuchengetedza zvepabonde dysphoria, uye anofanira kushandisa nzira dzisiri dzekusarura paanosarudza kana chirongwa chizofukidzirwa.
Asi kana Chikamu 1557 chiri danho guru kune kuenzana mune zvehutano hwevanodarika veAmerica, hazvirevi kugoverwa kwekugadzirisa zvekuita zvechikadzi pamwe nekuchengetwa kwehutano hwakafanana.
Saka Iko Utano Inishuwarenzi Mazano Akavhara Gender Reassignment?
Kunyange zvazvo Chikamu 1557 chave chiri munzvimbo kubva muna 2010, mutemo wekupedzisira hauna kuuya kusvikira makore matanhatu gare gare, uye vashandi vehutano nevanopa vese vachiri kushanda kuti varongedze mashoko acho. Kunyanya yakapiwa chokwadi chokuti mutemo wokupedzisira weChikamu 1557 haudi kuti mabhizimisi avhare chero mararamiro chaiwo-kunyange kana achionekwa semudiwa-kune zvakawanda zvemajeri nzvimbo.
Healthcare.gov inopa ruzivo rwokuti ungaudza sei zvepabonde zvekunyora pamusangano wekugoverwa muhutano hwehutano hwehutano muhurumende dzinoshandisa Healthcare.gov, uye inotsanangura kuti ungaita sei pamusoro pekuzivisa kusarura.
Kubvira muna 2014, Medicare yakavhara chirwere chepamutemo chinotarisirwa kuti chirwere chekuita zvekuita zvekuita zvepabonde , pamwe nekugadzirisa zvisarudzo zvakaitwa pachiitiko-ne-case based zvichienderana nezvido zvekurapa. Dhipatimendi reVeterans Affairs (VA) rakarongawo kubvisa kurambidzwa kwaro kwenguva yakareba pakubhadharwa kwepabonde reassignment chirwere chemaAmerican veterans.
Uye muchidimbu ichi kubva kuAetna muenzaniso wakanaka wekuti vatsigiri vehutano vega vega vanogona sei kuvhara zvimwe zviitiko zvekuchinja kwehutano, asi kwete zvose.
Sezvo kutonga kwekupedzisira kweChikamu 1557 kuchigadziriswa, pane zvimwe zvirongwa zvehutano zvichiri kusarudza kupotsa kune rumwe rutivi rwekuvhara chirwere chekuita zvekuita zvepabonde. Vanderbilt University yakashuma muna June 2016 kuti vaizotanga kuvhara chirongwa chekuchinja kwehutano pane chirongwa chehutano hwevadzidzi, uye guta rePortland, Maine rakatanga kuvhara kuchengetedza kwehutano hwakasiyana-siyana kubva munaJanuary 2017.
Asi zvakare muna June 2016, bhodhi reWatch Library yeCincinnati rakasarudza pamwe chete kuti risati rawedzera chero vatasvi vayo muraibhurari yemainishuwarenzi yemazuva ano. Vatasvi vechirwere vaifungidzirwa vaisanganisira nhepfenyuro yehutendender, chirongwa cheBaratric, uye nekushaya vana. Iri raibhurari rine chinyorwa kuburikidza neAnthem, uye mutakuri anopa mumwe munhu anotasva mabhiza iyo raibhurari inogona kutenga kuti igone kutarisira utano hwe transgender.
Asi reraibhurari haifaniri kuonekwa sechinhu chakavharidzirwa pasi peChikamu 1557 cheAACA, nokuti bhizinesi ravo rekutanga haisi iro rehutano hwehutano, hutano hwehutano, kana hutano hwakabatana. Sezvo vakadaro, ivo muenzaniso we sangano iyo inogona kunge isingafaniri kutevedzera Chikamu 1557 chisina kusarura muvashandi vehutano hwehutano.
Mumwe muchengeti wemadzinza anonzi transgender anoshanda kuSan Francisco-based Dignity Health akatambudza mushandi wake muna June 2016 pamusoro pekusarura nzvimbo, nokuti chirongwa chehutano hwechipatara hachirevi kurapwa kwehutano hwechikadzi. Zvinenge zvipatara zvose zvinowanikwa pasi peChechi 1557, asi chipatara chinotaura kuti chirongwa chehutano hwehutano hachisi chisarudzo nokuti hachivhenekidzi "hutano hwehutano" zvachose (asi zvinopesana nekusarura zvakananga kuvashandi ve transgender).
Mhosva yacho inotaura kuti zvepabonde dysphoria haisi manzwiro ehupenyu, asi nyaya yacho inoratidza kuti Chikamu 1557 chinoramba chichibvumira kuti zvive nekutonga, nyaya-ne-nyaya kududzirwa.
Nyaya iyi inogona kutarisana nharo huru yepamutemo pamakore anoverengeka anotevera, kunyanya ichitaura kuti maAACA anokosha emarapirwo ehutano haatauri zvakananga nezvehutano hwevana, uyewo kuti mutemo wekupedzisira weChishanu 1557 hauiti kuti zvirongwa zvehutano zvive zvakajeka zvirongwa zvezvehutano zvine chokuita nekudzorerwa kwevakadzi, pasinei neutano hwekurapa.
> Sources:
Dhipatimendi reZvipatano neHuman Services, Nondiscrimination in Health Health Programs and Activations , yakabatana naJuly 18, 2016. Yakasvika 6/22/16.
National Centre for Transgender Equality, Ziva Kodzero Dzako: Medicare. Yakasvika 6/22/16.
United States Dhipatimendi reRubatsiro, Musoro weChechi IX yeChidzidzo cheZvondo zveEngamire 1972, Yakasvika 6/22/16.
US House of Representatives, Kubatanidza Murwere Muchengetedzo uye Affordable Care Act, Sekugadziridzwa Nhasi 1 Chivabvu 2010 . Yakasvika 6/22/16.