Clinics fall short in treatment of transgender patients, doctors

Even gay-friendly health care organizations often lack nondiscrimination policies.

By Kevin B. O’Reilly — Posted June 4, 2009

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Only 10 in 166 outpatient clinics and hospitals got a perfect score on a set of model equal-treatment policies for gay, lesbian, bisexual and transgender patients and health professionals, according to a May report released by the Gay and Lesbian Medical Assn. and the Human Rights Campaign advocacy group.

Most of the organizations that participated in the survey listed sexual orientation in their nondiscrimination policies, allowed equal visitation access for same-sex partners and parents, had cultural competency training on sexual orientation and offered health benefits for employees with same-sex partners. But even among these gay-friendly hospitals and clinics, only 7% pledged in writing not to discriminate against transgender patients.

"This means that in the other 93%, a transgender patient may be addressed by an incorrect name or incorrect pronouns, perhaps even placed in a room with other patients of their birth gender," GLMA President-Elect Rebecca A. Allison, MD, said in a news conference. "A clearly stated policy that forbids discrimination on the basis of sexual orientation and gender identity or expression is an important first step in encouraging openness, and in creating a climate for delivery of quality care. Transgender patients face health care discrimination every day -- a fact that makes the disparities identified in this report a call to action."

Gay, lesbian, bisexual and transgender patients are four times more likely than other patients to withhold medical information from their physicians for fear of discrimination, according to a 2004 Witeck-Combs Communications/Harris Interactive survey.

"This lack of openness can lead to missed opportunities in identifying individual health risks and the failure to provide appropriate screening," said Dr. Allison, a Phoenix cardiologist who chairs the American Medical Association's Advisory Committee on GLBT Issues. "Discrimination, or the fear of discrimination, undermines the delivery of quality care."

The 93 hospitals and 73 clinics that responded to the survey did so voluntarily, and the results are not a representative sample of industrywide practices. In 2007, the AMA modified its policies to specifically prohibit discrimination against transgender physicians, medical students and patients.

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