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HHS Progress Report and HRC Health Equality Index Shed Light on LGBT Health Care


Coinciding with Gay Pride month, the Department of Health and Human Services (DHHS) this week released a progress report on health issues for gay, lesbian, bisexual, and transgender people in the U.S. In addition, the Human Right Campaign (HRC) released its latest Health Equality Index, a survey of how well health care facilities serve LGBT patients.

"Today LGBT Americans face numerous barriers to health from providers who just don’t understand their unique health needs, to difficulty getting health insurance because they can’t get coverage through a partner or a spouse," Health and Human Services Secretary Kathleen Sebelius said at a press conference at Howard University Hospital. "And unfortunately way too many LGBT individuals face discrimination and bigotry in the health care system."

Among the accomplishments listed in the report, HHS is now collecting health data broken out by sexual orientation. In 2011 the Institute of Medicine released a report on the state of research regarding the health needs of LGBT people. The Substance Abuse and Mental Health Services Administration created "Larkin Street Stories," a video series about best practices for providers serving homeless LGBT youth. And the Fenway Institute received a federal grant to create a National Training and Technical Assistance Center to help more than 8500 community health centers improve LGBT health.

The federal government's Centers for Medicare and Medicaid Services (CMS) now requires hospitals to allow patients to choose their visitors regardless of sexual orientation, gender identity, or legal marriage status, and to enable same-sex partners to make decisions about the care of incapacitated patients. The Joint Commission, a health care accreditation group, requires that facilities prohibit discrimination based on sexual orientation and gender identity or expression.

Objectives for 2012 include grants to support timely entry and retention in HIV care for transgender women of color, initiatives to reduce smoking among LGBT youth and reduce obesity among lesbian and bisexual women, a CMS training video to educate long-term care providers about the needs of older LGBT people, and release of CDC sexual and domestic violence data broken out by sexual orientation

"I am proud to be part of an administration that has a historic record of accomplishment for the LGBT community," Sebelius stated. "We will continue to take action to ensure that LGBT Americans get equal treatment in healthcare settings and that all patients are treated with the dignity they deserve."

"Each of the policy changes listed affects real people and real lives, and we commend HHS Secretary Kathleen Sebelius and the Obama administration for their efforts supporting the health and well-being of LGBT people and families," said National Gay and Lesbian Task Force executive director Rea Carey. "These victories are just the beginning -- not the end -- of what needs to be done to eliminate disparities and ensure optimal health for LGBT people."

HRC Survey

The Health Equality Index survey consisted of 24 questions on issues such as employee non-discrimination policies, regulations regarding visitation by same-sex partners, and training personnel to understand LGBT people and their concerns.

A total of 407 hospitals, community health clinics, and other institutions participated in the voluntary survey -- a small proportion of the thousands that see LGBT patients, but a 40% increase over the previous year (the survey started in 2007).

Among the participating institutions, 71 achieved the status of "Leader in LGBT Healthcare Equality" -- those that meet the minimum requirements "essential for equitable and inclusive LGBT care" -- a 162% increase over the 2011 percentage.

While more than 95% of surveyed institutions include sexual orientation in their employee non-discrimination policies, the figure drops to about 75% for gender identity (up from about 50% in 2010). About two-thirds said they provide employee training about LGBT-sensitive care. About 75% have written policies that allow visitation by same-sex partners and parents.

The self-selected nature of the survey makes it likely that facilities with favorable policies were more inclined to participate. In 18 states there were no institutions that completed in the survey.

"Just a few short years ago the healthcare industry wasn't having conversations about LGBT healthcare equality," said HRC president Chad Griffin. "Now, thanks to advocacy by the LGBT community and some standout leaders, growing numbers of healthcare providers are making an explicit commitment to treat all patients with dignity and respect."

One area that requires substantial improvement is full insurance coverage of care for transgender people, including sex reassignment surgery. Only 9 participating institutions said they offer a transgender-inclusive health plan.

Another area that needs attention, said HRC's Shane Snowdon, is aging and the concerns of older LGBT communities. Future surveys will include long-term care facilities and other institutions that serve LGBT elders.



DHHS. HHS LGBT Issues Coordinating Committee 2012 Report. June 19, 2012.

Human Rights Campaign. Healthcare Equality Index. 2012.

Human Rights Campaign. HRC Report: 2012 Sees Great Progress Toward LGBT Healthcare Equality. Press release. June 19, 2012.

National Gay and Lesbian Task Force. Health and Human Services report details progress and new goals on lesbian, gay, bisexual and transgender health issues. Press release. June 20, 2012.