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Ask Lambda Legal: Transgender Health Care

By M. Dru Levasseur, Esq., Transgender Rights Project Director for Lambda Legal

Dear Ask Lambda Legal,
I have put off going to the doctor's office for a long time out of fear of mistreatment because I am trans. I have had terrible experiences in the past, so I avoid seeking care at all costs. I hear that I won't have coverage for the health care I need because of exclusions in my Medicaid plan, so why bother? What are my rights when I'm at the doctor's office?

While the past year has seen quite a few promising changes in health care settings for transgender people, we have a long way to go until transgender people don't have to worry about whether or not they'll be treated with respect at the doctor's office. The statistics reveal that trans and gender-nonconforming (TGNC) people, particularly people of color, are frequently subjected to humiliating and degrading treatment in health care settings. The Affordable Care Act prohibits discrimination on the basis of sex, including gender identity, in any hospital or health program that receives federal funds. Additionally, many state and local nondiscrimination laws ban discrimination related to gender identity in public accommodations. If you have been mistreated in a health care setting, please contact Lambda Legal's Help Desk. Also, be sure to bring a copy of Creating Equal Access to Quality Health Care for Transgender Patients: Transgender-Affirming Hospital Policies to your health care provider as a resource.
Discrimination also rears its ugly head when transgender people seek coverage for health care. While many doors have been opened by the Affordable Care Act for those who are uninsured, the majority of plans still contain exclusions. Over the summer, we saw some exciting progress on this front with the Medicare ruling and now a growing number of states removing Medicaid exclusions – OR, CA, MA, VT and Washington, D.C. Last week, we received word from Connecticut officials that they are also amending that state's regulations to provide coverage. There has been a growing trend of state insurance commissioners taking a stand for transgender equality by issuing clarifying bulletins to remind private insurers that they cannot discriminate against state policy holders. In July, the Illinois Department of Insurance became the ninth jurisdiction to issue such a bulletin, joining CA, CO, OR, WA, MD, CT, VT and Washington, D.C.
These recent gains are a sign that there is a growing understanding of transgender people's health care needs. Lambda Legal will continue to fight to end discrimination against transgender people in health care settings, but in the meantime, we urge you to seek preventative care. You have the right to competent, respectful care at the doctor's office.
To learn more about navigating health care, read our Transgender Rights Toolkit here.

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