Since 2017, the Healthcare Equality Index (HEI) has scored participants based on criteria in four core sections that reflect the number of policies and best practices from each section each participant has implemented. In addition to these four criteria, there is a fifth criteria section called “Responsible Citizenship” that focuses on known activity that would undermine LGBTQ+ equality or patient care. Healthcare facilities will have 25 points deducted from their score for a significant anti-LGBTQ blemish on their recent records, due to either an official policy decision or a public action.
A similar criteria category is also part of the scoring system for the Corporate Equality Index (CEI) and on rare occasions has been utilized during the CEI’s 20-year history. Hopefully, like the CEI, this point deduction will rarely be needed. Prior to 2022, the deduction has only been applied once in the HEI. The penalty will only be applied for this criteria to an HEI score after ample notice has been given to the healthcare facility and the facility has an opportunity to address the HRC Foundation’s concerns.
In the HEI 2022, both UT Southwestern and Children’s Health in Dallas have had this major penalty applied to their HEI scores because they are denying necessary and medically approved care to transgender youth while continuing the same care for cisgender youth.
In late 2021, the GENECIS clinic at Children’s Health, which was operated jointly with UT Southwestern Medical Center, was closed. The GENECIS clinic was one of only a few clinics in the southwest providing comprehensive medically-necessary healthcare to transgender youth. Upon the clinic’s closure, the hospitals said they would cease to offer age-appropriate, medically-necessary, gender-affirming care by stopping all new prescriptions for puberty blockers and hormone therapy for transgender patients. In addition, the hospitals have publicly confirmed that they will continue to provide similar treatments for cisgender youth, which amounts to discrimination against transgender youth and a clear violation of their own internal Patient Non-Discrimination Policy.
The Human Rights Campaign Foundation has attempted numerous times to engage in dialogue with representatives from UT Southwestern and Children’s Medical Center Dallas but has been unsuccessful. Requests for meetings and answers to written questions about the closure and the services provided to transgender youth have gone unanswered. However, UT Southwestern officials have acknowledged in public statements that political pressure was a factor in their decision to close GENECIS and cease providing new prescriptions to transgender patients.
Every credible medical organization calls for affirming care for transgender and non-binary people. Sexual orientation and gender identity are real concepts recognized by major medical and mental health associations — including the American Medical Association, the American Academy of Pediatrics, the American Psychological Association and the American Academy of Child and Adolescent Psychiatry — as part of the normal spectrum of human experience. Health care providers who work with transgender and non-binary people — including young people — are providing life-saving care, with many patients driving hundreds of miles just to get to their doctor’s office.
Gender-affirming health care is lifesaving. For transgender people, being denied critically necessary transition-related care can extend and exacerbate the stress and discomfort caused by gender dysphoria, leading to increased incidences of depression and substance abuse, as well as health complications caused by delaying care. Ensuring that transgender and non-binary people have access to trans-affirming health care is lifesaving. A recent study from the Trevor Project provides data supporting this — transgender youth with access to gender-affirming hormone therapy have lower rates of depression and are at a lower risk for suicide. Another study, published in the Journal of the American Medical Association, agreed, saying, "receipt of gender-affirming care, including puberty blockers and gender-affirming hormones, was associated with 60% lower odds of moderate or severe depression and 73% lower odds of suicidality over a 12-month follow-up." Additionally, the Trevor Project study shows that parental support is vital in ensuring transgender youth’s mental and physical health. In fact, in a statement made to the Dallas Express, just a couple of months prior to closing the GENECIS clinic, an official from Children’s Health acknowledged the importance of this treatment, “Given the significant suffering and extraordinarily high suicide rate in these children, offering a comprehensive, multidisciplinary approach is needed to help treat this medical problem.”
The HRC Foundation encourages UT Southwestern and Children’s Health to resume providing age-appropriate, medically necessary care to transgender youth. The care that they provide to all of their patients should be driven by established medical standards and best practices, not by politics.
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