Transgender-Affirming Hospital Policies

This blog post was co-authored by Dru Levasseur, Director of the Transgender Rights Project at Lambda Legal, and Shane Snowdon, Director of HRC's Health and Aging Program.

Lambda Legal and the Human Rights Campaign Foundation (HRC) are proud to announce the release of a unique, groundbreaking publication that provides much-needed guidance to hospitals on best practices for care of transgender patients. Creating Equal Access to Quality Health Care for Transgender Patients: Transgender-Affirming Hospital Policies is a collaboration among Lambda Legal, HRC and the LGBT Rights Committee of the New York City Bar Association, with pro bono assistance from Hogan Lovells US LLP.

Transgender people are widely recognized as agroup that faces significant barriers to equal, consistent and high-quality health care, as documented by a landmark Institute of Medicine report. Transgender and gender-nonconforming people experience discrimination in health care and barriers to care two to three times more often than lesbian, gay and bisexual people, according to Lambda Legal’s national survey of LGBT health care experiences, When Health Care Isn’t Caring.

In fact, 19 percent of the 6,000+ respondents to the 2011 National Transgender Discrimination Survey reported having been refused health care outright because of their transgender status, while 28 percent had postponed necessary care when they were sick or injured, and 33 percent had delayed or not sought preventive care because of prior health care discrimination. Rather than endure abuse and poor treatment, many transgender people go without care, endangering and worsening their health.

In the last few years, laws have been passed to address discrimination against transgender patients. For example, the Affordable Care Act prohibits discrimination on the basis of sex, including gender identity, in any hospital or health program that receives federal funds. Furthermore, the Joint Commission, which accredits virtually all U.S. hospitals, requires that they prohibit discrimination on the basis of gender identity to maintain accreditation. Additionally, many state and local nondiscrimination laws ban discrimination related to gender identity in public accommodations. Hospitals have long wondered, however, how to honor the letter and spirit of these requirements.

The new publication is designed for all hospitals seeking to comply with legal and regulatory mandates and to align themselves with best practices in the field.  It answers their questions about transgender patients, shows them how to reduce bias and insensitivity, and addresses key issues such as confidentiality, room assignments, bathroom access and admitting/registration procedures.The guidance also includes unique model policies that can be adapted to meet the needs of individual hospitals.

Improvements in policies and practices, together with greater transgender competency on the part of health care personnel, will make hospitals truly welcoming for transgender people, rather than places to be feared. They will encourage transgender patients to seek health care when needed, rather than delaying or avoiding it—and will reduce the costs associated with the complications that arise when careis deferred due to discrimination. This long-awaited publication will play an important role in eliminating health disparities for transgender people, providing them with patient-centered care, and ensuring equity in the nation’s health care system.

Download the publication.