This survey is the first to examine refusal of care and barriers to health care among LGBT and HIV communities on a national scale. We hope that these data will influence decisions being made about how health care is delivered in this country now and in the future.
Over the last decade, hospitals throughout the United States have recognized that some groups of people face significant barriers to health care because of historic bias and discrimination against them. Many efforts have been launched to identify these groups, learn more about the challenges they face in health care, and welcome them into the nation’s hospitals. To reach out to these long overlooked groups, hospitals have examined their policies and practices to ensure that discrimination is clearly prohibited, recommendations for equitable and inclusive care are being followed, and staff are trained to provide knowledgeable, sensitive care.
The federal 1987 Nursing Home Reform Law requires nursing homes to “protect and promote the rights of each resident” emphasizing individual dignity and self-determination in the provision of long-term care. Every nursing home accepting Medicare and/or Medicaid must meet federal requirements, including those regarding residents’ rights.
Ambulance workers jeered at and refused to treat Tyra Hunter, a transgender
woman seriously injured in a car accident outside Washington, DC who later
died from her wounds. The same kind of hate-fueled medical negligence killed
Robert Eads, a transgender man with ovarian cancer whom 20 separate doctors
wouldn’t treat; one said the diagnosis should make Eads “deal with the fact that
he is not a real man.”
The kinds of health care associated with gender transition have too
often been misunderstood as cosmetic, experimental or simply unnecessary.
Yet there is medical consensus that hormone therapy and sex reassignment
surgery (SRS) are medically necessary for many transgender
people. It’s quite clear now that a person’s gender identity—one’s inner
sense of being male or female—is deep-seated and cannot be changed,
and therefore that this transition-related health care can be crucial.