The Sexist

How Clear Do Anti-Discrimination Policies Need to Be?

Yesterday, the Human Rights Campaign published its 2010 Healthcare Equality Index, which rates the policies of hospitals around the U.S. on their efforts at LGBT inclusion. This year, the HRC determined that all D.C.-area hospitals it surveyed failed its preliminary test: They don't mention sexual orientation and gender identity in their patient anti-discrimination policies. But for hospitals inside the District line, at least, discriminating on the basis of either of those factors is against the law. So how specific does a hospital non-discrimination policy need to be?

Yesterday, a rep from D.C.'s Sibley Hospital wrote in to argue that its patients non-discrimination policy implicitly covers both sexual orientation and gender identity, so it was wrong for the HRC to flunk them. Sheliah Roy, Director of Public Relations & Marketing for the hospital, notes that hospital policy gives patients the right to "receive Hospital services without discrimination on the basis of any factor to which discrimination is prohibited by law." She adds that the hospital's visitation policy is gender-neutral. It reads: "New fathers or significant others are welcome at any time if the patient has a private room in the Family Centered Care Unit."

Again, District of Columbia's Human Rights Act prohibits discrimination based on sexual orientation and gender identity. So what's the problem?

One possibility: Employees and patients may not be aware of all the  types of discrimination the D.C. Human Rights Act actually prohibits. The act outlaws discrimination based on nearly 20 factors—"actual or perceived" race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, gender identity or expression, familial status, family responsibilities, genetic information, disability, matriculation, political affiliation, source of income, or place of residence or business.

Tom Sullivan, Deputy Director for the Human Rights Campaign Family Project, argues that specificity is key to ensuring that hospitals are actually committed to following each part of that law—and that patients know it. "In the Healthcare Equality Index survey, we asked for specific language—explicit language that policies were inclusive of LGBT families," says Sullivan. "That's not to say that if a hospital does not have that language, LGBT patients will always have bad experiences there. Sibley is a very good hospital. But nationally, we've found that there's enough discrimination against LGBT patients in healthcare to warrant very specific language in the patient's bill of rights to say that gay, lesbian, bisexual, and transgender people will not be discriminated against."

According to the HRC, the Joint Commission—an organization that "accredits and certifies more than 17,000 health care organizations and programs in the United States"—concurs on that point. The HRC says that "The Joint Commission—the largest organization that accredits hospitals nationwide—has announced that, in the future, all hospitals in America will need to have a non-discrimination policy for LGBT patients on their books."

Photo via brykmantra, Creative Commons Attribution License 2.0

  • Eleanor

    I used to work with an organization dedicated to helping LBT women during times of medical crisis, in situations usually involving hospital care. Almost every single one of our clients experienced some level of discrimination including: assumptions about her health behaviors; noticeable negative changes in health practitioner's attitudes toward them after they disclosed their sexual identity or behaviors; practitioners with misinformation or no information about LBT health needs and challenges (yes, LGBTQ heath is more than HIV); practitioners who ignored same-sex partners during consultations, particularly in favor of parents or other relatives; out and out bans on same-sex partner visits, even in facilities or states with non-discrimination policies; etc.

    Remember, most of these discrimination situations occur one-on-one with individual practitioners and staff members. In these cases, it is infinitely useful for patients and their partners to have an explicit, clear-cut, facility-specific policy to point to. We had plenty of DC area clients who were told by biased staff members that local laws didn't apply to visitation rights, only hospital policy did. These cases are rarely reported because, hello, very sick people do not have the time or energy to deal with this kind of bile. Even an evil eyed sneer from a custodian is alarming when you're trapped in a hospital bed.

    Queer folks of all stripes face a lot of fear and discomfort in medical environments, the stress of which often chokes off critical communication channels with medical practitioners and delays patient healing. The last thing sick individuals need is the stress of discrimination exacerbating their illnesses. Even if health care facilities think their staffs are all fully committed to equality (which some, inevitably, aren't), patients need a crystal-clear, spelled-out policy to feel as welcome as possible, for their health's sake.

    Awareness of welcome is critical to both effective care and social justice. In a broad context, LGBTQ people are far less likely to get routine medical care for many reasons, but chief among them are fear of discrimination and lack of access to health insurance. Health care facilities can help address one of these discrepancies, the other is the government's job (Obama, can you hear me?).

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