Federal Attack on LGBT Health Care Is Real and Dangerous

Thom Senzee

Who could oppose the idea of ensuring patients are never discriminated against by hospitals because of their sexual orientation, their gender identity, or their gender expression? Sadly, the answer is federal health and justice policymakers. High-ranking officials are systematically tearing out even the humblest measures aimed at upholding the basic American values of fairness and equality.

The New York Times reported Saturday that disturbing new rules are coming out of the Department of Health and Human Services, following approval by the U.S. Department of Justice.

“The Trump administration says it plans to roll back a rule issued by President Barack Obama that prevents doctors, hospitals and health insurance companies from discriminating against transgender people,” writes Times correspondent Robert Pear. “Advocates said the change could jeopardize the significant gains that transgender people have seen in access to medical care, including gender reassignment procedures — treatments for which many insurers denied coverage in the past.”

Some of America’s foremost health-policy experts and the country’s most engaged journalists covering health care — not least among them Politico reporters Jennifer Haberkorn and Dan Diamond as well as the Fenway Institute’s health policy director, Dr. Sean Cahill — had all but predicted Saturday’s dire news months ago.

A casual survey of reporting and research conducted just during the past four months by those three respected authorities reveals a raft of rightfully alarming headlines, including "HHS Strips Lesbian, Bisexual Health Content from Women’s Health Website," "Trump Administration Dismantles LGBT-Friendly Policies," and "LGBT Community and People with HIV have Much to Lose in Health Debate."

An extensive review of the past year in the current administration’s attacks on LGBTQ health care was recently published by the Fenway Institute under the title "One Year in, Trump Administration Amasses Striking Anti-LGBT Record."

But Saturday’s NYT article pointed out how the current administration has not only declined to fight back against a temporary ruling by a federal judge in Texas that essentially said the Obama administration misunderstood Congress’s intent regarding the prohibition of sex discrimination by hospitals and other health care entities accepting federal monies (virtually all of them, by the way). But it has also written new rules to honor Judge Reed O’Connor’s belief that in the Affordable Care Act’s antidiscrimination provisions, Congress specifically intended gender to be a binary construct.

It’s worth noting that Judge O’Connor’s stay need not have been the final ruling. Clearly, Attorney General Jeff Sessions, a longtime LGBTQ rights foe, jumped on the temporary ruling as an excuse to undo pro-equality regulations at HHS, making the department more cruel, unhealthful, and potentially deadly to transgender people.

It’s also worth noting that the flimsy excuse Sessions’s DOJ has used was a ruling by a judge about whom, writing at Law.com, Miriam Rozen said, “Perhaps no federal judge has ruled more often to stall the recent pace of acceptance of the LGBTQ community than O'Connor.”

Why Stop Collecting LGBTQ Health Data?

But the current administration had already begun taking apart the very foundations upon which current and future health care policies could have created more equitable and effective health care in this country.

We recently learned just how deadly it can be to allow ourselves to be blindfolded by one-sided political agendas regarding data. Thanks to the effectiveness of the gun lobby, i.e., the National Rifle Association, the Centers for Disease Control and Prevention has been prevented from gathering data about gun violence as a public health issue. Now, with the March for Our Lives and #NeverAgain movements gaining on the NRA’s influence, new light is being shone on the dearth of such information.

We know that in the 21st century, deeply studied data and widely gathered information form the bedrock for developing effective policy and programs. We also know that finding a way to provide access to quality health care has been one of our nation’s most complex and vexing problems.

So why would the U.S. Department of Health and Human Services be working so hard to stop gathering data about LGBTQ patients? Is the federal government intentionally putting on blindfolds regarding LGBTQ health care? As the Fenway Institute and Dr. Cahill have uncovered, that is exactly what’s happening.

“The government is rolling back essential tools that can determine whether supportive services are reaching all elders and disabled individuals,” Fenway’s Cahill and other authors write in their report about one year of Trump administration attacks on LGBTQ health care.

The decision by the Administration on Aging, a unit of HHS, to remove questions that would include LGBTQ seniors as part of an important annual report about older Americans in independent living facilities is troubling.

“Collecting [sexual orientation and gender identity] data in disability services would be important, as research has shown higher rates of disability among the LGBT population compared to the rest of the general population,” reads the Fenway Institute report.

Taking Action

The good news is that journalists, activists, researchers and regular people who care about health care, equality, and LGBTQ people are not sitting out the current attacks. In fact, Dr. Cahill will share some of his invaluable research and insights about the subject next week in Southern California. 

A public discussion headlined by Dr. Cahill happens May 1 from 11:30 a.m. to 2:30 p.m. in Costa Mesa, Calif., as part of the panel series LGBTs in the News With Thom Senzee. As founder and moderator of America’s longest-running live-discussion panel series, I urge you to join us. Presented by Radiant Health Centers and with support from the SAG-AFTRA LGBT Actors Committee, Dr. Bronner’s, Mark Wood Entertainment, and The Rage Monthly, the event is free and includes lunch. RSVPs are required and can be made at LGBTSInTheNews.com.

Topics such as LGBTQ aging, transgender health, PrEP and PrEP bias, and a host of other LGBTQ health matters will be discussed. The engagement title, "LGBTQ Community Health: Resolving Disparities, Overcoming Barriers" requires a slate of panelists with unique insights and authoritative perspectives.

Joining Dr. Cahill will be Dr. Cordula Dick-Muehlke, a consultant, University of California, Irvine, faculty member, and leading expert on dementia care with a special focus on LGBTQ aging; Dr. R. Austin Nation, Ph.D., RN, PHN, assistant professor at California State University, Fullerton, School of Nursing; plus Dr. Michael L. Krychman, MD, a noted obstetrician-gynecologist, leading author, and executive medical director at the Southern California Center for Sexual Health and Survivorship. Visit LGBTSInTheNews.com for more information.

THOM SENZEE is founder and moderator of LGBTs in the News and author of the "All Out Politics" syndicated column.

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