On May 10, the U.S. Department of Health and Human Services (HHS) reinstated federal protections from discrimination based on sexual orientation and gender identity in health care. The regulation will provide protection from discrimination for an estimated 13 million LGBT people ages 13 and older, including more than 1.5 million transgender people.
LGBT people experience health disparities compared to non-LGBT people and often lack access to health care. Recent research from the Williams Institute found that many LGB and transgender people have underlying health conditions that could increase their risk for COVID-19-related illness, including asthma, diabetes, heart disease, and HIV.
“Access to health care is critically important, particularly during the COVID-19 pandemic,” said Jody L. Herman, Scholar of Public Policy at the Williams Institute. “Research shows that LGBT people who fear discrimination in health care settings are less likely to seek needed care and more likely to receive poor care.”
Discrimination against LGBT people in health care settings is well documented and takes many forms, including outright denials and substandard care.
According to analyses of data from the Generations Study and the U.S. Transgender Population Health Survey (TransPop), 38% of LGBTQ people worry about being negatively judged when seeking health care because of their sexual orientation or gender identity.
Among transgender people, 62% expressed fear of being judged in a health care setting.Transgender people who had substantial concerns about receiving inclusive and accepting health care were less likely to have a personal doctor or health care provider.
An estimated 483,000 transgender adults were concerned that if they express their gender identity, they could be denied good medical care.Approximately 77,000 transgender adults felt unsatisfied with the care that they have received in the past.
Approximately one in five (21%) LGBTQ people were in poor or fair health. About one-quarter of LBQ women (24%) and transgender people (26%) experienced poorer health.
According to the 2015 U.S. Transgender Survey (USTS), conducted by the National Center for Transgender Equality, 23% of respondents did not seek needed medical care due to fear of being disrespected or mistreated as a transgender person.
The new rule affirms that sexual orientation and gender identity discrimination are forms of sex discrimination as prohibited under federal laws, including the Affordable Care Act. This interpretation is consistent with the U.S. Supreme Court’s holding in Bostock v. Clayton County last year.
The Williams Institute at UCLA School of Law, a think tank on sexual orientation and gender identity law and public policy, is dedicated to conducting rigorous, independent research with real-world relevance.