Without Anyone Noticing, D.C. Passed a Remarkable LGBT Bill
On Tuesday, the Council of the District of Columbia, Washington, D.C.'s governing body, unanimously passed B21-168, the LGBTQ Cultural Competency Continuing Education Amendment Act, and once it is signed by Mayor Muriel Bowser, the district will be the first jurisdiction in the nation to require LGBTQ cultural competency training for health care providers. The bills sets a modest but needed floor for such training by requiring any health care professional who is required to receive continuing education to include at least two credits of LGBTQ-related clinical or cultural competency training.
The fact is that even in the district, where LGBTQ people have some of the strongest legal protections in the country, they still have disparate health outcomes and unique health care needs. For example, gay and bisexual men are at higher risk for STIs and anal cancer, lesbians and bisexual women are at higher risk for breast and gynecological cancers, and transgender people may be at risk for behavioral health conditions like depression or cancers not typically associated with their gender presentation. If a medical providers does now know how or feel comfortable asking about a patient’s same-sex sexual contact or their gender-related medical history, they may not screen for important risk factors or know what other questions they should be asking.
Although LGBTQ people make up about 10 percent of the population of the district, most healt hcare professionals receive little or no training regarding the particular health issues these communities face. For transgender people, finding accepting and knowledgeable health care can be especially challenging. While the district has made substantial efforts to clarify that transgender people should have coverage for medically necessary transition-related care, finding knowledgeable health care professiionals who can provide such care is difficult at best. In fact, every transgender person I know, including myself, has had the experience of being turned away by a health care provider or getting inferior care because of transgender status. This new law will help to ensure that providers are educated about and sensitive to this population.
While similar measures requiring training on LGBTQ cultural competency have been proposed in various states, this bill is both the first to pass and unique in that it affects all health care providers in the district that are required to receive continuing education. So will a law requiring mandatory training for health care providers be effective? Well, research about a New Jersey law requiring culturally competency training (for other populations) shows that these laws can have a dramatic impact. After the passage of the New Jersey cultural competency requirement, the number of physicians receiving such training increased 60-fold.
While this measure will not solve LGBTQ health care disparities by itself, it will certainly make a difference for LGBTQ people living or receiving health care in the district. Over time, this new law and others like it will help improve and standardize LGBTQ health care for both patients and providers.
Alison Gill is an accomplished attorney and a nationally recognized expert on LGBTQ law. Alison is a senior partner at the Parallax Group, focusing on policy implementation and compliance, legislative drafting, advocacy strategy, and risk mitigation.