New Law Would Extend Civil Rights, Ease Health Disparities for LGBT Community

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ACP champions Equality Act as a means to prevent discrimination and protect health and well-being

The American College of Physicians is getting behind new legislation that extends a host of federal anti-discrimination protections to lesbian, gay, bisexual and transgender (LGBT) individuals and helps shore up health disparities in this at-risk population.

The Equality Act, which was introduced in the U.S. Senate and House of Representatives in early March, would expand protections from the 1964 Civil Rights Act to LGBT people by banning discrimination on the basis of sexual orientation, gender identity and sex in employment, housing, public education, credit and the jury system. It also prohibits such discrimination in federally funded programs and facilities used by the public, including retail stores, restaurants, and transportation services.

Currently, at least 30 states have no laws in place to protect the rights of LGBT people, and even the states that do offer some types of protection are lacking in other aspects, explained Hilary Daniel, an ACP health policy associate. “It's a big patchwork of non-discrimination laws at the state and local level,” she said, “and the new legislation would fill in the gaps.”

More than 11 million adults identify as LGBT today, according to the most recent Gallup Poll.

“LGBT individuals are more likely to experience depression or develop substance abuse disorders compared to the rest of the population,” Daniel said, adding that, once you factor in discrimination at work, it's a recipe for disaster.

“In states without these protections, someone can be fired for their sexual or gender identity, and when you are fired, you lose your health care if your insurance is through your employer.”

These individuals may already be reluctant to seek health care services for fear of being judged or misunderstood, and lack of coverage will only create a wider gap between LGBT people and the health care system, she said.

As the proposed legislation makes its way through the House and Senate, ACP members can and should advocate at the state and local level to make sure that LGBT individuals are adequately protected from discrimination in their communities, Daniel said.

For instance, practicing physicians should “create a welcoming, non-judgmental, inclusive environment where someone feels safe and protected, and make sure you and your staff are culturally and clinically competent to care for LGBT patients,” she said, noting that that's part of what's addressed in ACP's policy paper on LGBT health disparities, published in 2015. “Use the appropriate pronouns and provide the needed care. And, if someone has not yet undergone gender- transforming surgery, they still need to be treated or screened for conditions related to the sex organs they were born with.”

As Dr. Ana María López, ACP's president, said in a letter to congressional leaders, “inclusive policies such as this legislation will enhance the health and well-being of LGBT individuals, their families and communities by ensuring that nondiscrimination policies are in place across the spectrum of policy areas that affect the daily lives of Americans.”

Other LGBT advocates are equally enthused about the new legislation, including Richard Burns, interim chief executive of Lambda Legal, a nonprofit group committed to achieving full recognition of civil rights for LGBT individuals.

“This bill is a belt and suspenders that ensures these protections reach every member of our community nationally,” Burns said of the Equality Act. “Today's bill takes a giant step forward towards that goal.”

More Information

ACP's policy paper on LGBT health disparities is available on the Annals of Internal Medicine website.

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Back to the April 5, 2019 issue of ACP Advocate