Access to Quality, Affirming, and Inclusive Health Care

The Affordable Care Act went a long way to ensure that LGBTQ people have access to better care, but the law doesn’t guarantee that our community will receive access to quality, affordable, inclusive, and often life-saving health care.

Why is this important?

The Trump Administration’s Department of Health and Human Services has proposed new regulations gutting existing protections for sexual orientation and (especially) gender identity.  Meanwhile, pending cases at the Supreme Court of the United States could further undermine the application of all federal nondiscrimination laws to LGBTQ individuals.  Thus without state level protection, LGBTQ Marylanders may soon find themselves without any remedy when discriminated against in access to healthcare. Currently, Maryland only has scant protections offered by Health-General Section 19-355, where hospitals and “related institutions,” like skilled nursing facilities and similar, “may not discriminate in providing personal care for an individual because of the race, color, or national origin of the individual.”  It does not prohibit discrimination by healthcare providers outside of a hospital or nursing facility context, nor by health insurers in any context. Nor does it prohibit against discrimination based on sex, age, creed, marital status, disability, sexual orientation, and gender identity.

Discrimination against LGBTQ people can take many forms in a healthcare setting: doctors may refuse to provide care for LGBTQ patients because of their sexual orientation or gender identity, may refuse to recognize the family of LGBTQ couples, and may use harsh or abusive language when treating them. This discrimination disproportionately affects transgender patients. In fact, a 2017 study by the Center for American Progress demonstrates that 29 % of transgender patients were excluded from healthcare service by a provider because of their actual or perceived gender identity.

This discrimination leads LGBTQ people to avoid seeking care. In fact, 23% of transgender people reported not seeking care for fear of being mistreated and 29% reported having at least one negative interaction with a health care provider in the prior year. This persistent discrimination causes many LGBTQ Marylanders, especially those outside of the Baltimore and Washington, D.C., metro areas, to drive between 45 to three hours to access inclusive healthcare services. 

Even if LGBTQ people are able to find an affirming provider, services can still be denied by provider or insurance company policies that discriminate against LGBTQ patients. In one recent case, for instance, a hospital in Baltimore cancelled a transgender man’s hysterectomy the night before surgery, despite allowing cisgender patients to receive hysterectomies in the same facilities. It is also all-too-common for insurance companies to deny coverage for transition-related care, in violation of federal law and often their own policies.

Discrimination like this negatively impacts the wellbeing of LGBTQ Marylanders by decreasing their access to healthcare providers and to medical care, especially for those living in rural areas or seeking specialized treatments.

What are the Issues and What Can We Do?       

Discrimination by Healthcare Providers and Institutions