By Tari Hanneman, Associate Director, Human Rights Campaign Foundation’s Health and Aging Program, and author of HRC’s Healthcare Equality Index

LGBT advocates are cheering a court ruling this week that has important implications for transgender people seeking competent and appropriate healthcare.  A federal district court in Minnesota confirmed that a section of the Patient Protection and Affordable Care Act (ACA)  specifically prohibits gender identity discrimination in healthcare under the umbrella of sex discrimination.  

In this case, Rumble v. Fairview Health Services, a young transgender man alleges he was badly mistreated while seeking emergency medical treatment in a Minnesota hospital.  In his lawsuit against the hospital, the man said he was repeatedly misgendered, received delayed and insensitive care, and was ridiculed. 

The court found that, because the hospital receives federal funding through Medicare and Medicaid reimbursements, like the overwhelming majority of hospitals in the U.S., it is subject to the non-discrimination provisions of the ACA, including gender identity non-discrimination.

While this is a promising legal development, the case highlights an unfortunate reality that many transgender people face when seeking medical care.  Fear of receiving harassment or insensitive treatment often leads transgender people to delay seeking care, which can compound many health issues.

Through HRC Foundation’s Healthcare Equality Index (HEI), we are working to change the experience of transgender people in healthcare settings, particularly in hospitals where people are the most vulnerable.  The HEI evaluates healthcare facilities on their policies and practices towards their LGBT patients, visitors and employees.  As part of the HEI we provide facilities with training and resources, including the report Creating Equal Access to Quality Health Care for Transgender Patients: Transgender-Affirming Hospital Policies, so that they can implement best practices.  

To receive accreditation, hospitals are required to prohibit discrimination based on sexual orientation and gender identity. Yet in our ongoing work on the HEI we have found that many hospitals have failed to incorporate these terms into their patient non-discrimination policies.  Not surprisingly, Fairview Southview Hospital -- the subject of this case -- does not include gender identity in its patient non-discrimination policy.

This court ruling provides further evidence that hospitals must treat all patients, including LGBT patients, with the dignity and respect that they deserve. 


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