Marchers carry a rainbow flag down University Avenue in San Diego. Photo by Chris Stone

By Thom Senzee

Who could oppose the idea of ensuring patients are never discriminated against by hospitals because of their sexual orientations, their gender identities or their gender expressions?

Sadly, the answer is federal policymakers. High-ranking officials in the executive branch are systematically tearing out even the humblest measures aimed at upholding the basic American values of fairness and equality.

The New York Times recently reported that disturbing new rules are coming out of the Department of Health and Human Services following approval by the U.S. Department of Justice.

“The Trump administration says it plans to roll back a rule issued by President Barack Obama that prevents doctors, hospitals and health insurance companies from discriminating against transgender people,” wrote Times correspondent Robert Pear.

“Advocates said the change could jeopardize the significant gains that transgender people have seen in access to medical care, including gender reassignment procedures—treatments for which many insurers denied coverage in the past.”

Thom Senzee

Some of America’s foremost health-policy experts and the country’s most engaged journalists covering health care — not least among them Politico reporters, Jennifer Haberkorn and Dan Diamond, as well as The Fenway Institute’s health policy director, Dr. Sean Cahill — had all but predicted this dire news months ago.

A casual survey of reporting and research conducted just during the past four months by those three respected authorities reveals a slew of rightfully alarming headlines, including: “HHS Strips Lesbian, Bisexual Health Content from Women’s Health Website;” “Trump Administration Dismantles LGBT-friendly Policies;” “LGBT Community and People with HIV have Much to Lose in Health Debate.”

An extensive review of the past year in the current administration’s attacks on LGBTQ health care was recently published by The Fenway Institute under the title, “One Year in, Trump Administration Amasses Striking Anti-LGBT Record.”

As The Times article pointed out, the current administration has not only declined to fight back against a temporary ruling by a federal judge in Texas that essentially said the Obama Administration had misunderstood Congress’s intent regarding the prohibition of sex discrimination by hospitals and other health care entities accepting federal monies—that’s virtually all of them, by the way. But it has also written new rules to honor Judge Reed O’Connor’s belief that in the Affordable Care Act’s anti-discrimination provisions, Congress specifically intended gender to be a binary construct.

It’s worth noting that Judge O’Connor’s stay need not have been the final ruling. Clearly, longtime foe of LGBTQ equality Attorney General Jeff Sessions jumped on the temporary ruling as an excuse to undo pro-equality regulations at HHS—making them more cruel, more unhealthful and potentially more deadly to transgender people.

It’s also worth noting that the flimsy excuse Sessions’ DOJ has used was a ruling by a judge about whom, writing at Law.com, Miriam Rozen said, “[p]erhaps no federal judge has ruled more often to stall the recent pace of acceptance of the LGBTQ community than O’Connor.”

Why Stop Collecting LGBTQ Health Data?

O’Connor’s actions notwithstanding, the Trump administration had already begun taking apart the very foundations upon which current and future health care policies could have created more equitable and effective health care for LGBTQ people in this country.

As a nation, we recently learned just how deadly it can be to intentionally or even passively allow ourselves to be blindfolded by one-sided political agendas from data. Thanks to the effectiveness of the gun lobby, i.e., the National Rifle Association, the Centers for Disease Control have been prevented by law from gathering data about gun violence as a public health issue. Now, with the March for our Lives and #NeverAgain movements gaining on the NRA’s outsized influence, new light is being shone on the dearth of gun death and injury data for public health policy.

We know that in the 21st century, deeply studied data and widely gathered information is the bedrock for developing effective policy and programs. We also know that finding a way to provide access to quality health care has been one of our nation’s most complex and vexing problems for at least 50 years.

Can someone please explain to me then why, as if fighting on behalf of religious-refusal zealots to empower their desires to deny health care to LGBTQ people was not enough—exactly why would the U.S. Department of Health and Human Services be working so hard to stop gathering data about LGBTQ patients?

Is the federal government intentionally putting on and passing out blindfolds regarding LGBTQ health care? As The Fenway Institute and Dr. Cahill have uncovered, that is exactly what’s happening.

“The government is rolling back essential tools that can determine whether supportive services are reaching all elders and disabled individuals,” Fenway’s Cahill and other authors write in their report about one-year of Trump Administration attacks on LGBTQ health care.

The decision by the Administration on Aging, a unit of HHS, to remove questions that would include LGBTQ seniors as part of an important annual report about older Americans in independent-living facilities is troubling.

“Collecting [sexual orientation and gender identity] data in disability services would be important, as research has shown higher rates of disability among the LGBT population compared to the rest of the general population,” says The Fenway Institute Report.

Taking Action

The good news is that journalists, activists, researchers and regular people who care about health care and LGBTQ equality are not sitting out the current attacks. In fact, Dr. Sean Cahill flew to Southern California from Boston to share some of the invaluable research he’s led the investigating of at The Fenway Institute.

Cahill headlined the most recent engagement of America’s longest-touring live-discussion LGBTQ panel series, LGBTs In The News, which was presented by Radiant Health Centers with support from the SAG-AFTRA LGBT Actors National Committee, Dr. Bronner’s, Mark Wood Entertainment, and The Rage Monthly.

I was proud to moderate as Cahill and his fellow panelist covered topics such as LGBTQ aging, transgender health, the HIV-preventative PrEP pill, as well as a host of other LGBTQ health matters. The engagement was titled, “LGBTQ Community Health: Resolving Disparities, Overcoming Barriers.”

Joining Dr. Cahill on the panel were Dr. Cordula Dick-Muehlke, a leading expert on dementia care with a special focus on LGBTQ aging; Dr. R. Austin Nation, assistant professor California State University, Fullerton School of Nursing; plus Dr. Michael L Krychman M.D., a noted obstetrician-gynecologist, leading author and executive medical director at the Southern California Center for Sexual Health and Survivorship.

While a raft of important topics were covered, perhaps the most interesting of which was Cahill’s statement that “if we’re not counted, we don’t count.”

Explaining just part of the dire impact of Trump administration policies that seek to erase LGBTQ Americans from government studies, surveys, research—possibly even the 2020 U.S. Census, Cahill’s clarion call is not unlike the call to action uttered four decades ago by slain gay civil rights leader, Harvey Milk. Prior to his assassination by his former fellow San Francisco City and County Supervisor, Dan White, Milk famously implored LGBTQ America to “come out, come out wherever you are.”


Thom Senzee is founder and moderator of the “LGBTs in the News” live-discussion panel series, and an award-winning Southern California journalist. A version of this column was previously published by The Advocate.

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