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Opposing Rollback of Healthcare Rights Law

For some examples of comments that have been received from healthcare professionals/healthcare providers, scroll down.

As you may know, HHS has released a new harmful proposed rule that would rollback Obama-era regulations about protections for LGBT patients in the Health Care Rights Law (Section 1557 of the Affordable Care Act).

While it does not change the law, the new proposed regulation would make it easier for healthcare providers and professionals, hospitals and insurers to discriminate against LGBTQ people, turn people away because of who they are, and refuse to provide coverage for medically necessary care, including transition-related care.

HHS is now receiving comments on this proposed rule (the deadline to submit comments is August 13th). As a healthcare professional/healthcare provider, your voice can make a big difference in ensuring that your patients and clients can get access to the care they need.

GLMA urges you to speak out and submit a comment against the proposed rule. Every comment counts!

Go to www.ProtectTransHealth.org and take a few minutes to explain why, as a healthcare professional/healthcare provider, you are against this harmful rule and the impact it would have on your practice and your patients.

Please use your own words in submitting comments. Below are some general guidelines to help get you started. Please also share this with your colleagues and networks!

General provider comment guidelines:

  • Include your name, your credentials, your affiliation, and where you work

o   Example: “My name is Teresa Rodriguez, I am an MD, and work as an internist at General Hospital in Houston, Texas”

  • Say you are against the proposed rule, and explain how rolling back nondiscrimination protections would harm your patients. You can mention, for example, the impact that discrimination can have on the health of your patients, and how strong nondiscrimination protections help ensure that your patients can access health care and insurance.

o   Example: “Along with countless medical and healthcare experts, I oppose the proposed regulation. Promoting discrimination is wrong and could harm millions of people who need access to basic care.”

o   Example: “As a healthcare provider, I am deeply concerned with and oppose the Department’s proposal to weaken nondiscrimination protections for transgender patients under the Health Care Rights Law (Section 1557) of the Affordable Care Act. The ACA protects patients who are medically underserved and vulnerable to discrimination, including transgender people, and helps provide them with equal access to healthcare.”

o   Example: “Stigma and discrimination continue to be the greatest problems facing transgender patients. Decades of research have established the impact of discrimination, isolation and stigma as the primary factors leading to an increased physical and mental health burden for minority populations. For example, transgender patients are already more likely to delay getting necessary medical care and face high levels of discrimination when they seek access to healthcare.”

o   Example: “Nondiscrimination protections like the ones in the Health Care Rights Law (Section 1557) do not prevent the use of professional medical judgment – they simply ensure that patients can access the same care provided to other patients, no matter who they are. These protections are fundamental for LGBT patients to be able to access the care that they need.”

  • Share your story about why as a healthcare professional/healthcare provider this rule impacts you and your practice specifically.

o   If you identify as LGBTQ, share a personal story about when these nondiscrimination protections were important for you as someone in the healthcare industry

o   If you see many LGBTQ patients—or provide transition-related care in particular—you can discuss how nondiscrimination protections impacted your patients and their access to care. This can include, for example, increased insurance coverage for transition-related care, improvement in patient health from having more options of when and how to access care, improvement in the medical field about LGBT competency, etc.

Submit your comments today!

Remember to please use your own words in submitting your comments. To help you develop your own comments, we are providing below some examples of healthcare professional/healthcare provider comments already received:

“I am writing as a provider of mental health care to the transgender community to deeply encourage the Department of Health and Human Services to protect the lives of transgender people and uphold the Heath Care Rights Law. As a provider that knows first hand how vulnerable this population already is to stigma, discrimination and violence, I am against this proposed rule that will make it harder for transgender people to obtain life-saving care. By way of introduction I have been working with transgender youth since 2011 in a variety of contexts, providing individual and group therapy and training at the [X], where I trained and now work as a clinician supporting transgender and gender expansive youth and their families. I also have a private practice in New York City.

To date I have seen hundreds of transgender individuals, and feel qualified to assess issues and make treatment recommendations related to gender identity. I am not sure if you are aware, but a study recently published by the American Academy of Pediatrics revealed alarming levels of attempted suicide among transgender youth -- with the highest rates among transgender boys and non-binary youth. The findings emphasize the urgency of building welcoming and safe communities for LGBTQ young people, particularly for transgender youth. More than half of transgender male teens who participated in the survey reported attempting suicide in their lifetime, while 29.9 percent of transgender female teens said they attempted suicide. Among non-binary youth, 41.8 percent of respondents stated that they had attempted suicide at some point in their lives.

I have many examples of clients that have suffered from profound anxiety, depression and suicidality due to their lack of access to affirming medical treatment. Children and adults I see in my practice avoid going to a doctor when sick or injured out of fear of discrimination and some that did seek out care were harassed, misgendered, and denied care. This official proposed rule from HHS will erase protections for transgender people in accessing affirming healthcare. This proposed rule and others like it, not only seek to erase trans identities and deny them care in the legal sense, but they make TGNC people less safe in our world by emboldening discrimination and violence that is already such a real and regular threat.

All the data and research on best practices for transgender people unanimously emphasize that the more transgender people feel accepted, have access to affirming medical treatment and the less discrimination they face, the more likely they are to live vibrant and productive lives. Please, I implore you to not go through with these proposed changes. The first responsibility of health care providers is to do no harm. These policies will do the opposite and unleash devastating results for this deeply vulnerable population. [X,] Licensed Clinical Social Worker

“My name is [X], and I am against this proposed rule. As a physician in private practice with >1000 transgender patients, I oppose any/all rules or policies that make it harder for my patients to access life-saving care. There are more transgender and non-binary patients than there are prostate cancer patients, and withholding care or enabling providers to discriminate against them is egregious and against the Oath we took to First Do No Harm.

Denying, withholding, discriminating against, or otherwise making it difficult for transgender patients to access health care DOES HARM and ought not be promoted, tolerated, or enacted in policy. While these are among the finest human beings I might ever have the honor of helping in clinical practice, those who refuse to treat them do themselves a disservice, dishonor their Oath, and stain the profession. An administration that promotes discriminatory policies such as this rule is hateful, downright mean, and unAmerican in targeting the most vulnerable among us. The suicide attempt rate for those with UNTREATED Gender Dysphoria is 41%; after treatment, that number falls to 4%, which is equivalent to that of the general population.

Medical intervention is LIFESAVING; denial of such care perpetuates suffering and is far too often LETHAL. Proceed with your rule, and the blood is on your hands. Shame on you for even proposing it. I avail myself to you for further comment and/or if you are interested in a boots-on-the-ground professional evaluation. Please surprise me by taking me up on this offer. Do the right thing, [X], MD”

“My name is Dr [X] and I am against this proposed rule because I believe that It would make it harder for transgender people to obtain life saving care.

I am a family physician in rural [state of X] serving over 500 transgender patients and I hear many stories of discrimination and mistreatment in health care settings regularly. I believe that all humans deserve respectful and loving healthcare, especially those who experience censure, judgement and discrimination for who they are.
Please do not make it MORE difficult for people to get care!

Thank you,
Dr [X]

Many thanks to our colleagues at the National Center for Transgender Equality for developing and sharing these materials and resources.


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