Health Care: Health Provider Discrimination
Nakoa & Barbara

Barbara: “We finished at church and Nakoa was eating some cookies and he just started turning red and coughing non-stop. We drove to the fire station because it was five minutes away. I thought, ‘Oh, thank God, they’re going to help us.’”

Nakoa: “I’ve been living as a man for almost three years and I always wear a binder, but I took it off [that morning] because I was having trouble breathing.”

Barbara: “When we got to the fire station, the Emergency Medical Services guys unbuttoned Nakoa’s shirt all the way [and then stopped helping when they realized he was transgender.] They said there was nothing they could do.”

Nakoa: “When I realized they were not going to help, the only thing I could think of is, ‘We have to leave.’ That’s a real sensitive situation—with a bunch of guys standing around and my shirt wide open. We were lucky and found a doctor nearby who gave me steroid shots to help me breathe.”

Barbara: “The doctor said Nakoa could have died [because of the delay]. I don’t care if you don’t like us, but to turn someone away in a life-threatening situation…I couldn’t believe it.”

Nakoa: “I filed a complaint later with the Fire Commission, but it came down to my word against five reputable firemen.”

Health Provider Discrimination

Ambulance workers jeered at and refused to treat Tyra Hunter, a transgender woman seriously injured in a car accident outside Washington, DC who later died from her wounds. The same kind of hate-fueled medical negligence killed Robert Eads, a transgender man with ovarian cancer whom 20 separate doctors wouldn’t treat; one said the diagnosis should make Eads “deal with the fact that he is not a real man.”

It’s stories like these that scare many transgender people away from routine checkups and other needed care, and cause them to suffer disproportionately from untreated medical conditions. There’s also reason to fear a provider will share your transgender status with people who have no need to know; ask invasive and irrelevant questions; or purposefully use the wrong name or pronoun. Seventy percent of the transgender or gender-nonconforming (TGNC) people polled in a 2009 Lambda Legal survey experienced some sort of health care discrimination or harassment.

Yet individual mistreatment is just part of the problem; the health care system neglects TGNC people as a matter of policy. For instance, most insurance companies refuse to cover transition-related health care even when a doctor considers it medically necessary. This is true despite medical consensus on the “efficacy, benefit and medical necessity” of transition-related treatment, as the American Psychological Association described it in 2008.

For more about that, see our FAQ on accessing transition-related care.

Everyone deserves to be treated with respect in health care settings; good experiences do more than treat illness or injury. Studies show that suicide rates drop significantly when transgender people are able to access appropriate medical care.

Our FAQ on overcoming health provider discrimination offers tips for accessing basic, quality health care, whether from your family doctors or from one of the LGBT community health clinics stepping in when mainstream doctors and facilities fail to meet the needs of TGNC patients.



Transgender people so often experience discrimination or incompetence when they go to the doctor that many feel uncomfortable seeking the range of health care that they need. This includes check-ups for cancer prevention such as pap tests for transgender men, for instance, or prostate exams for transgender women. Insurance coding systems that cover certain medical treatments only for one gender or the other also create barriers to care. For example, carriers typically deny uterine fibroid treatment to transmen who are enrolled as male.



There is continued reluctance among most insurance companies to cover transition-related health care such as hormone therapy or gender-affirming surgery, which can put these treatments out of reach even when a doctor affirms they are medically necessary for a particular patient. The insurance landscape is gradually changing, however, with a growing number of U.S. localities that cover transgender medical services, including gender reassignment surgery, as a standard benefit in their government health plans for lower-income and disabled persons. And the trend in private workplaces is such that companies hoping to score 100% on the Human Rights Campaign’s annual Corporate Equality Index must now offer trans-inclusive health insurance.Lambda Legal and other legal advocates are challenging discriminatory exclusions of transgender health care in the courts. (For more about insurance coverage of transition-related health care, please see our fact sheet, “Transition-Related Health Care,” at



Forty-one percent of the 6,450 transgender and gender-nonconforming respondents in the 2011 National Transgender Discrimination Survey (NTDS) said they had attempted suicide (compared to 1.6% of the general population). But suicide risk seems to fall significantly once transgender people are able to access appropriate medical care. The rate of self-reported suicide attempts among participants in a 2006 study dropped from 29.3 to 5.1 percent when they were given access to transition-related treatment.

FOR MORE INFORMATION: Contact Lambda Legal at 212-809-8585, 120 Wall Street, Suite 1900, New York, NY 10005-3904. If you feel you have experienced discrimination, call our Help Desk toll-free at 866-542-8336 or go to