Last week U.S. Department of Health and Human Services' Office of Civil Rights moved to roll back protections for transgender people under Section 1557 of the Affordable Care Act, which bans discrimination in healthcare. Then on Monday, the U.S. Supreme Court ruled that sex-based discrimination (both gender identity and sexual orientation) is prohibited.
Providers fear that LGBTQ patients, especially so for transgender people, will still withhold from sharing information regarding how they identify with their doctors out of fear of still being discriminated against.
"Whenever you think that identifying yourself is going to cause problems for you or put you at risk, it creates a culture of fear," said Heather Hitson, SOGI Project Manager at UCLA Health, "It's absolutely what we don't want.”
Hitson and colleague, Dr. Amy Cummings have been working on a several years long project to be able to include more information on both sexual orientation and gender identity into their EHR. Dr. Cummings, who is the Informatics Chair of the Equitable Care Committee at UCLA explained, "I was on the health staff at UCLA back before we had the ability to capture any kind of information about LGBTQ status. I remember realizing how difficult it must be to not have your identity aligned with your electronic health record when you're being cared for."
Transgender people have suffered significant health differences in multiple areas, leading to misunderstandings and discrimination in some areas. Cummings and Hitson’s idea to include gender identity within the patient’s EHR can lead to better experiences, less discrimination, and improved patient retention.
With that, it’s been shown that if a patient is not identified by the correct gender it can have a negative impact on their quality of care. Dr. Cummings explained that, “if a patient doesn't feel comfortable sharing their identity, it could affect that individual's access to the correct preventive health screenings. It makes interpreting labs more difficult," if patients are using hormone replacement therapy, she added, "Both of these issues are serious medical concerns."
Eliminating stigma and discrimination can help alleviate fear and advance care for the transgender community. Heather Hitson explained how and why reaching this ‘goal’ is important, "If we're not collecting data and asking these questions" about transgender people and healthcare, "it's going to delay research," Hitson said. "There's limited research in the healthcare community around trans people, and this is going to increase the barrier."
No doubt there are gender related differences within the healthcare community all across the country. Dr. Cummings expressed that providers should be visibly supportive, ask questions around sexual orientation in a private place to decrease fear in their patients. All patients should be entitled to the same quality of care that is personalized to their needs. The more researchers can learn about transgender persons, the more they can receive better treatment and care, which can lead to a decrease in generalizations that lead to discrimination. If we can do that, it will lead to much more accurate and unbiased data, allowing clinicians to be able to treat all patients and help to reduce the care gap that exists in healthcare today.
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About the Author: Taylor Genter
Taylor is the Marketing Specialist at Extract with experience in data analytics, graphic design, and both digital and social media marketing. She earned her Bachelor of Business Administration degree in Marketing at the University of Wisconsin- Whitewater. Taylor enjoys analyzing people’s behaviors and attitudes to find out what motivates them, and then curating better ways to communicate with them.