That may mean refusing a transgender patient mental health care or gender-confirming surgery. But it may also mean denying patients care that has nothing to do with gender identity, such as a regular office visit for a bad cold or ongoing treatment for chronic conditions like diabetes.
"What it does, from a very practical point of view, is that it empowers bad actors to be bad actors," Mara Keisling, executive director of the National Center for Transgender Equality, told reporters.
The proposal would also eliminate protections based on sexual orientation and gender identity from several other health care regulations, like non-discrimination guidelines for the health care insurance marketplaces.
Does it affect only LGBTQ people?
The proposal goes beyond removing protections for the LGBTQ community and those who have had an abortion.
It appears to weaken other protections, such as those based on race or age, by limiting who must abide by the rules. The Trump proposal would scrap the Obama-era rule's broad definition of which providers can be punished by federal health officials for discrimination, a complicated change critics have said could ease requirements for insurance companies, for instance, as well as the agency itself.
And the proposal erases many of the enforcement procedures outlined in the earlier rule, including its explicit ban on intimidation or retaliation. It also delegates to Severino, as the office's director, full enforcement authority when it comes to things like opening investigations into complaints lodged under the non-discrimination rule.
Why did HHS decide to change the rule?
The Obama and Trump administrations have different opinions about whether a health care provider should be able to refuse service to patients because they are transgender or have had an abortion.
It all goes back to a section in the Affordable Care Act barring discrimination on the basis of race, color, national origin, age, disability or sex. President Barack Obama's health officials said it is discrimination to treat someone differently based on gender identity or stereotypes.
It was the first time Americans who are transgender were protected from discrimination in health care.
But President Trump's health officials said that definition of sex discrimination misinterprets civil rights laws, particularly a religious freedom law used to shield providers who object to performing certain procedures, such as abortions, or treating certain patients because they conflict with their religious convictions.