“It took my breath away,” said Director of Specialty Training and Programs at Planned Parenthood of Greater New York Sue Wendelgass. She had learned what a parent of a transgender child had said about Planned Parenthood’s services. According to this parent, the resources Planned Parenthood provided were not “life affirming,” but instead “life saving.”
“[This story] shows how vital health services are to the LGBTQ+ community,” Wendelgass explained. However, a recent change to the Affordable Care Act slashes health care protections for people who identify as LGBTQ+.
The Trump administration recently reversed Section 1557 of the Affordable Care Act, thus removing nondiscrimination protections for LGBTQ+ people. This move changes the definition of sex discrimination to include only discrimination based on biological sex, effectively allowing discrimination based on gender identity or sexual orientation. This decision leaves LGBTQ+ people, especially transgender patients, particularly vulnerable when seeking health care.
Wendelgass condemned this decision: “It takes us back to an era when it was acceptable for a [general] medical professional to refuse to treat someone or treat them poorly solely because they didn’t like who they were or how they identified.” The Obama administration implemented rules to prevent the discrimination of LGBTQ+ patients. This led to many US federal agencies imposing regulations that established discrimination based on gender identity as included in sex discrimination, and illegal under federal law. However, the Trump administration has taken steps to reverse these regulations.
Wendelgass continued, “There is no logic to why the federal government would withdraw protections from people who have a history of being discriminated against and under-served. This is solely government-sanctioned discrimination and it is wrong.”
Proponents of this change argue that it will reinforce the idea that biological sex is most important for health care. “We are hopeful that this rule will help steer consideration of gender issues in health care back toward science and away from politics and ideology, back to the protection of professional medical judgment and the freedom to adhere to long-observed ethical and moral standards,” said Christian Medical Association’s Executive Vice President for Bioethics and Public Policy Dr. Jeff Barrows. The Trump administration stated that this pushback will ensure that doctors will not be forced to perform surgeries that counter their religious beliefs, such as gender-affirming surgery.
Local and national medical experts disagree with this ruling. “The federal government should never make it more difficult for individuals to access health care—during a pandemic or any other time,” said President of the American Medical Association Dr. Susan Bailey. Wendelgass cited studies that found over a third of transgender people have experienced discrimination in a healthcare setting and explained that LGBTQ+ individuals have struggled to find accessible and safe health care for years. She predicted this will create a fear of seeking medical assistance, such that individuals will wait longer to manage their health care needs. Additionally, she found it likely that people will feel unable to be honest with doctors about their sexuality or gender identity.
“There is nothing good that comes out of this for the LGBTQ+ community, particularly anyone in the community who is an immigrant, a person with limited English proficiency or a person of color,” she said.
Health care institutions throughout New York State are working to combat the potential discrimination permitted by this ruling.
Vice President of Medical Affairs at Vassar Brothers Medical Center Dr. William Begg shared that although the new ruling allows for potential discrimination against LGBTQ+ individuals, it is the hospital’s policy that they do not discriminate against any patient, regardless of their sexual orientation or gender identity. He explained that their hospital policy states that anyone who enters Vassar Brothers receives a basic medical screening exam and basic medical care. Vassar Brothers is also in the midst of updating its policies to ensure there are ample resources for LGBTQ+ patients.
“When we see anything less than [equality] in the national media or legislation, we do everything we can to make sure we treat everyone respectfully and have equal access to everyone, regardless of orientation,” said Begg.
Planned Parenthood of Greater New York also affirmed their commitment to providing resources to assist LGBTQ+ patients in finding access to safe healthcare. Planned Parenthood offers many services for LGBTQ+ patients in their own facilities, and when they can’t provide a service, their policy is to help patients find the care they need. One such resource is “Out With Cancer,” an organization that connects patients with LGBTQ+ friendly cancer care providers. Additionally, Planned Parenthood of Greater New York is hosting Summer of Pride: a series of webinars focused on celebrating the resiliency of the LGBTQ+ community and providing necessary resources. Many of these resources will be aimed at assisting transgender indidivuals.
While the future of health care is currently unclear for many LGBTQ+ individuals, Begg believes that most medical providers are dedicated to helping all patients, regardless of their status. “People that go into medicine go in for the right reasons, and we want the best for everyone in society,” said Begg.
He continued, “What [this decision] does is it represents a mindset in our country, and in my estimation there are small pockets where it may make a difference. For me, it’s also symbolic that we need to do a better job of referencing every person that needs health care.”