In response to reports that lesbian, gay, bisexual, and transgender (LGBT) people experience barriers to healthcare, the American College of Physicians (ACP) is calling for policies to support healthcare equality for the LGBT community.
Approximately 9 million people in the United States identify as LGBT, according to the Williams Institute at the UCLA School of Law, which conducts independent research on sexual orientation and gender identity law and public policy.
The ACP’s policy position paper is titled “Lesbian, Gay, Bisexual, and Transgender Health Disparities: Executive Summary of a Policy Position Paper From the American College of Physicians.” It was published today in Annals of Internal Medicine.
Their recommendation came out the same day as the U.S. Department of Health and Human Services released a series of directives on a number of health-related topics. One of them declared that preventative care cannot be limited based on a patient's sex assigned at birth or their gender identity if a doctor determines such a service is medically necessary. That directive includes mammograms and pap smears for transgender men.
In their paper, the ACP offers various recommendations, such as a call for comprehensive transgender healthcare services to be included in public and private health benefits plans. They also recommend that transgender people receive covered services that other people are offered.
In addition, the paper includes a statement that gender identity, independent and fundamentally different from sexual orientation, be included as part of nondiscrimination and anti-harassment policies.
The ACP also supports same-sex civil marriage rights and recommends the definition of family be inclusive of those who maintain an ongoing emotional relationship with a person, regardless of their legal or biological relationship.
Moreover, the ACP states LGBT people should be able to determine who may visit them in healthcare facilities and who may act on their behalf during their stay, without stipulation.
The paper also states ACP’s opposition to the use of conversion therapy, which is a range of treatments that seek to change the sexual orientation of LGBT people.
Challenges Faced by the LGBT Community
Before determining its recommendations, the ACP’s Health and Public Policy Committee reviewed published studies, reports and surveys on LGBT healthcare, and health policy.
The committee concluded that challenges facing the LGBT community range from access to healthcare coverage and culturally competent care to state and federal policies that reinforce social stigma, marginalization, or discrimination.
These challenges are also associated with increased rates of anxiety, suicide, and substance or alcohol abuse.
According to a 2010 study from the National Center for Transgender Equality and the National Gay and Lesbian Task Force, respondents faced hurdles to accessing healthcare.
The study found that 19 percent of respondents reported being refused care due to their transgender or gender nonconforming status, with even higher numbers in the minority LGBT community.
Additionally, 50 percent of the respondents reported having to teach their medical providers about transgender care while 28 percent were subjected to harassment in medical settings and 2 percent said they were victims of violence in healthcare offices.