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U.S. Hospitals Show Progress on Gay Rights—With Room to Improve

By L.K. Regan

The Human Rights Campaign (HRC) has completed its annual survey of U.S. healthcare facilities, assessing their protections (and lack thereof) for LGBT patients. Mere weeks after President Obama ordered Medicare recipient hospitals to implement anti-discrimination policies for LGBT patients and their families, the HRC finds much improvement—and a lot more that could be done.

The HRC's Healthcare Equality Index is, as they describe it, "an annual survey of healthcare policies and practices related to lesbian, gay, bisexual and transgender patients and their families." The new report assesses data from 178 healthcare facilities located in 21 states and the District of Columbia. This included 13 healthcare networks as well as 37 individual, non-network facilities. The study identifies the hospitals and networks that have made the most improvement, and those that still have a long way to go.

The individual facilities attaining "Top Performer" status for 2010 were those that "ensure LGBT patients and their families are welcomed, respected and given culturally competent care;" in particular, these were facilities that instituted policies protecting patients from discrimination based on sexual orientation and gender identity. The winners: Baystate Medical Center (Springfield, Ma.); Dana-Farber Cancer Institute (Boston, Ma.); and, lest you think it's only Massachusetts that is making progress, The University of Texas MD Anderson Cancer Center (Houston, Tx.).

The biggest movement overall was in the Kaiser Permanente Network in northern California, which received the first ever perfect score on the Healthcare Equality Index. That's because Kaiser has just this week implemented a complete non-discrimination policy for LGBT patients at all of its 36 hospitals (31 that were included in the HEI). These policies cover both sexual orientation and gender identity. Kaiser is the first hospital network to implement such a comprehensive policy. "Kaiser Permanente is deeply committed to providing equitable, compassionate and high-quality care to our lesbian, gay, bisexual and transgender patients and their families, a level of care that is standard across our diverse patient population," said George Halvorson, Kaiser Permanente chairman and chief executive officer. "In the Healthcare Equality Index report, we are proud to be able to highlight our commitment to these high standards of care, as well as our efforts to promote a supportive work environment for all our employees."

Overall, however, there is much room for improvement. While 83.7 percent of the facilities rated in the study (149 of 178) have policies protecting sexual orientation (whether in a Patients' Bill of Rights or a specific non-discrimination policy), less than 30 percent (52 of 178) include gender identity. As the study points out, the situation is probably even worse than that. "Since participation in the HEI is voluntary," the authors write, "it is expected that responses from HEI-rated hospitals actually tend to be more LGBT-inclusive than the U.S. hospital industry as a whole." And independent research conducted by the HRC parallel with the Health Equality Index found that, among 200 of the largest hospitals in the country, only 58 percent have anti-discrimination policies protecting sexual orientation.

Clearly, these numbers need to come up further. As the HRC's report says, there are rippling consequences to ignoring this issue: "All patients deserve care free of discrimination, but the reality is that lesbian, gay, bisexual and transgender people face discrimination daily in healthcare settings. These experiences of discrimination often prevent LGBT patients from accessing care in the future and, when they do, they may not discuss their sexual orientation or gender identity with their healthcare providers for fear of another negative encounter."