What does healthcare equality look like?

Photo by Matt Popovich on Unsplash

Earlier this year, my coworker and friend Mike asked me to join a committee on healthcare equality. I didn’t really understand what it was, but I knew it had something to do with LGBTQ rights, so I joined. Plus, hanging with Mike is good for the soul.

The Human Rights Campaign Foundation (with the yellow and blue “=” logo) started an initiative called the Healthcare Equality Index, or HEI. HEI measures how healthcare organizations work to include their patients who identify as lesbian, gay, bisexual, transgender, and questioning. Healthcare companies ask to be rated using HEI. Then they’re given a status — ours is proud to be a HEI Leader — and identified and mapped out online.

If someone who is LGBTQ has a healthcare need, they can go to the HEI web site and they can find out how their local hospital system measures up. Or they can seek out another hospital nearby to get better service.

Each year, HEI changes the criteria to “raise the bar” for healthcare companies to continue to improve their inclusion practices. HEI recognizes that culture change takes time and effort, but also knows that no progress can be made without lofty goals.

I’ve been a passionate supporter of LGBTQ rights and equality for a little more than a decade. As a child, I was taught that homosexuality was evil, but as an adult, I have come to realize that human beings are complex organisms, and gender has its own complexities, too. Sexual identity and orientation are on a spectrum; they’re not just black and white. Maybe that’s why the LGBTQ symbol is the rainbow.

Anyway, back to the HEI committee. Being on the committee has been an enlightening experience, and not a wholly positive one. It’s scary to see where we’ve come from and how much farther we need to go… and not just in healthcare.

For many LGBTQ people, finding the right healthcare provider can be a challenge. Unless a person lives in a metropolitan area, appropriate choices are often few and far between.

I offer this fictional perspective to show you how complex [and personal] the issue can be:

You’re a transgender male, which means you’ve made the transition from being born female to living as a male today. As a child, you knew you were different. As an adult, you made the decision to set things right for yourself. Completing the transition meant countless hours of research, counseling, filling out a million forms, getting your medical and academic records updated, and going through a myriad of different hormonal therapies and surgeries to become who you always knew you were. You’ve done it. There’s some refining and maintenance to be done, but you’re through the hardest part.

When you develop pain in your groin, you think it must be a kidney stone. It definitely involves the part of your body that’s been altered. Do you go to an OB/GYN or urologist? Which will be able to treat you? Will that physician have the experience they need to care for your unique physiology? What if you have to be admitted to the hospital? Will you room with a male patient or a female? Passing a kidney stone at home seems more and more appealing by the minute.

In its 2018 report, the HRC cites some pretty disturbing HEI statistics. About 70% of transgender or gender non-conforming patients and about 56% of lesbian, gay, or bisexual patients have experienced some type of discrimination in healthcare. The data shows that they expect to be the victims of discrimination. If that’s not disturbing enough, many LGBTQ patients have had experiences that had nothing to do with their orientation. Here are some of the real scenarios provided by HEI on page 6:

“I went to the ER because I fell and broke a rib. Once the doctor found out I was transgender, he wanted to do a genital exam on me. When I refused, they refused to treat me.” — A transgender woman seeking treatment for a broken rib

“I transitioned ten years ago and have a full beard. But after learning I was born female, the doctor kept calling me ‘she’ in front of all the staff and other patients, no matter how many times I corrected him — and kept asking when I’d be having ‘the surgery.’” — A transgender man seeking care for a dislocated shoulder

“I couldn’t believe it! As I walked back to see my partner and our newborn, an employee stopped me and asked who I was. When I said, ‘The other mom,’ she rolled her eyes and walked away saying, ‘I don’t believe this.’” — A lesbian mother after the birth of her first child

When I read these accounts, I thought, You’ve got to be kidding. This is 2018. This is America. But they’re true. And because healthcare is a microcosm, you can rest assured every level of discrimination is still rampant in our society. (In case you needed to be reminded.)

HRC Foundation President Chad Griffin wrote, “Over the past year, the LGBTQ community has faced all-out assaults on our most fundamental civil rights from the highest levels of government. Basic decency and fairness have been flung out the window, and some of our bedrock American principals are being tested. Among the [present] administration’s numerous attacks have been efforts to promote a license to discriminate against LGBTQ people in every aspect of daily life, including healthcare… But even as we fight back against these attacks, it is especially remarkable that this year has ushered in a new high watermark in LGBTQ inclusion in healthcare.”

Let me sum that up for you: the expert on healthcare equality says that we as an industry have done well to rise above society’s standards for inclusion of LGBTQ people. Although that makes me damn proud, I know we’re still not where we need to be, because society’s standards are total crap.

The title of this article is, What does healthcare equality look like?

The answer to that question is:

When we attain healthcare equality, we will provide everyone with the same high quality healthcare, no matter their identity.

We will remember that medical care is a necessity for human beings. We will care for those who would otherwise be victims of discrimination.

We will respect each patient’s choice by using their chosen name and pronouns.

We will believe with our whole hearts that no one should be denied quality healthcare or be discouraged because of their experiences to seek medical treatment when they need it.

We will remember that true compassion knows no color, shape, size, age, or orientation.

Arthur Ashe wrote, “Start where you are. Use what you have. Do what you can.”

Right here at work, I can be an agent of change.

I can be a staff member offering a smile instead of a stare. I can push for a culture change and encourage others to be respectful of other lifestyles and personal choices.

I can help define ways for our company to be more inclusive for patients, family members, and employees. I can ask for more inclusive employment practices.

I can do research on what other healthcare companies are doing and push to adopt those practices.

What will you do?

Esther Hofknecht Curtis, BSOL, MSM-HCA, is a writer living in Dover, Delaware. Follow her on Facebook — go to https://www.facebook.com/TheArdentReader19977/

Book nerd and freelance writer finding gold in ordinary places. Email me at ejhcurtis@gmail.com Visit https://www.facebook.com/TheArdentReader19977/

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