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Telehealth ensures that you can easily access care when you need it. Anchor Health Initiative offers a welcoming, supportive and safe environment for the lesbian, gay, bisexual, transgender and questioning LGBTQ community. For many, simply knowing that allies exist can be a big source of support. There is a notary available in both locations. Get all of the medications you need delivered to you through Anchor Health Pharmacy! Call our office to transfer your prescriptions to our pharmacy.
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The decisions to roll back the rule protecting transgender people and to expand protections for those who refuse to provide healthcare services based on religious beliefs strengthen the ability of insurers and providers to refuse care to LGBT people, and particularly transgender people. Between the fall of and the fall of , the Office of Civil Rights OCR received more than 30, complaints alleging civil rights or privacy violations in healthcare settings. In a roughly similar period, OCR received just 34 complaints alleging violations of existing federal laws that permit religious refusals.
In addition to these federal developments, three US states have enacted laws or regulations that give wider latitude to discriminate in the provision of healthcare services. As the research in this report illustrates, many LGBT people in the United States face significant obstacles when seeking healthcare services. Retreating from antidiscrimination protections while expanding exemptions that permit insurers and providers to deny care based on their moral or religious convictions is a dangerous combination. The withdrawal of antidiscrimination protections and expansion of religious exemptions is occurring in a climate in which LGBT people already face significant barriers to accessible and inclusive health care.
LGBT people in states that enacted exemptions described four major obstacles, independent of the proposed federal changes, to obtaining the care they need: lack of accessible services, discrimination by insurers and providers, refusals by providers, and reluctance to seek care. As discussed in this section, each of these obstacles is exacerbated where legal protections against discrimination are absent or unclear and where the expansion of religious exemptions allows providers to refuse care.
Even before approaching healthcare providers, LGBT people can encounter difficulty finding the specific services they need.
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If they experience discrimination, they may not have alternative providers available. In part, this is because there may be few providers who are known to provide care to LGBT individuals without passing judgment on their sexual orientation or gender identity or are equipped to provide certain types of care, especially in more rural areas.
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The creation of LGBT competency modules in physician training programs is a relatively recent development; a survey of US medical schools conducted in found that only 16 percent of respondent institutions had comprehensive LGBT-competency training, and 52 percent had no LGBT-competency training at all. Even where there are multiple providers in an area, material and logistical barriers may prevent LGBT people from being able to access them.
When providers are not trained on LGBT issues or services are scarce in an area, LGBT people may have few options when a provider discriminates against them or turns them away. Huge, huge, huge swathes of our state not only have no pediatricians, but have as few as two or three physicians per county. The lack of providers was especially acute in rural areas, but certain services were difficult to find in metropolitan areas as well. As one mother of a transgender child noted:.
While some of the scarce services were related to sexual orientation or gender identity, others were general medical services that providers denied to LGBT people. Interviewees described how one transgender man in East Tennessee had to travel three hours to obtain a hysterectomy, [54] and others noted that breast surgeries that were available to cisgender individuals were not similarly available to transgender individuals.
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Many interviewees told Human Rights Watch that some services were available only from a small number of providers. A survey by the National Center for Transgender Equality found that 29 percent of transgender people who are able to access transition-related care have to travel more than 25 miles to obtain it. Several providers and LGBT individuals noted that they knew of very few providers in their areas who would prescribe PrEP, a medication that significantly lowers the risk of HIV infection by preventing HIV from taking hold in the body. Other interviewees identified a limited number of fertility and reproductive health providers who worked with same-sex couples.
A lesbian woman in Mississippi recalled that, when she and her wife sought a fertility doctor in , they were unable to find options in their area and contacted a clinic in Alabama. When that clinic informed the couple that they only treated heterosexual, married couples, they did not find an LGBT-friendly provider for a year. And these are the ones who have been somewhat vetted as being LGBT friendly. And a lot of those, the T is silent, most of the time. In some instances, services existed but were not advertised to the community.
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One doctor in a rural state noted that her hospital had extensive services for transgender youth, but they were not allowed to market or advertise those services because administrators were concerned about repercussions from the state legislature. When a limited number of providers were known to the community to be competent and welcoming, they could be overwhelmed with demand. For many LGBT people, unemployment and poverty combine with other barriers to care to make particular types of care virtually unattainable. A study examining data collected from to found that households headed by same-sex couples are more likely than those headed by demographically similar heterosexual couples to live in poverty.
Transgender Survey indicated that 15 percent of transgender respondents were unemployed and 29 percent were living in poverty. In early , an estimated 25 percent of transgender individuals were uninsured. Transgender Survey, a third of the transgender respondents indicated that they had foregone medical care they needed in the past year because of concerns about cost. Interviewees described how cost and distance made certain services unattainable.
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Sandra R. The nearest in-state surgeon she could find who would do the procedure was located in Ann Arbor, an hour away, which was prohibitively difficult because she did not have her own transportation. She was told that to obtain surgery from that provider, she would have to undergo electrolysis. Although she was able to find a surgeon in Pennsylvania who did not require electrolysis, her insurance would not cover out-of-state procedures, and she had thus far been unable to navigate her insurance to determine how she could proceed.
People might be 40 miles, 50 miles, from the nearest therapist who takes their health insurance…. When LGBT people did access healthcare services, many encountered discriminatory language or treatment related to their sexual orientation or gender identity. As noted above, a nationally representative survey released in January found that 9 percent of lesbian, gay, and bisexual respondents and 21 percent of transgender respondents had experienced harsh or abusive language from a medical provider in the previous year.
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Multiple interviewees noted that they not only encountered discrimination from their medical provider, but from administrative staff. Beyond the intake, some interviewees faced humiliation or discrimination from providers themselves. Renae T. Although many interviewees described negative experiences in hospitals, discrimination occurs in counseling and therapy as well, as described elsewhere in this report.
KT Hiestand, a therapist in Memphis, observed:. These discriminatory incidents can deter LGBT people from returning for medical care. As Carla B. In many instances, this discriminatory treatment was overtly moralistic. Trevor L. This kind of overt discrimination can be especially damaging to those seeking mental health care. Shane Bierma, who provides psychological services at Positively Living in Knoxville, underscored the tenor of the discrimination that many LGBT people encounter from mental health professionals:.
In recent interviews, mental health professionals in Tennessee said they continue to see new clients who have been turned away by other providers. Jessica Shea, a clinical social worker in Memphis, described how one transgender child was turned away from a religiously affiliated psychiatric practice:. Refusals occur in other aspects of health care as well. Probably over a hundred. Practitioners who have witnessed the effects of healthcare refusals stressed that these are not without consequence.
Your Pride is our Pride. Daisy J. Transgender students interviewed by Human Rights Watch said that being made to use facilities that did not correspond to their gender identity made them feel unsafe at school or exposed them to verbal and physical assault. Some students told Human Rights Watch that all-gender facilities, introduced as an option available to all students, would be their preferred solution, and lessen the stress of gender policing by peers and teachers. But they also provide physical and mental health resources, library materials, access to the internet, extracurricular and noncurricular activities, and opportunities to socialize. In , the Youth Risk Behavior Survey found that
Activists have observed wider social effects of religious refusal laws. Interviewees expressed concern that people did not understand the scope of the laws and assumed they permitted a much wider range of religious refusals.