A Texas directive regarding healthcare access for transgender youth has sparked an ideological battle over gender identity and the new role that Obamacare could play in making procedures and medications such as hormone therapy, surgery, and puberty blockers more accessible.

The Biden administration has taken steps to reverse Trump-era policies limiting transgender people’s legal recourse for fighting discriminatory treatment. The administration also aims to include healthcare, which includes things such as medically necessary mental healthcare and surgical treatments, as essential health benefits in Obamacare plans.