Raising Women’s Voices

LGBT Inclusion in Health Care Reform

Posted in DC Reform, Health Disparities by raisingwomensvoices on February 16, 2009

The National Coalition for LGBT Health has developed Guiding Principles for Lesbian, Gay, Bisexual and Transgender Inclusion in Health Care Reform, which will be sent to the Obama administration and LGBT-friendly members of Congress.  In the reform efforts to secure guaranteed health coverage for all, these principles serve to remind policymakers that not all groups can be treated the same.  Disparities in access to, and quality of, care faced by marginalized populations require specialized measures of reform to address the cultural discrepancies and discrimination that place them at higher medical risk and leave them underinsured.  The principles outlined in the letter to Obama and DC policymakers are as follows:

1. Cultural competency must be mandatory and practical — There must be systematic effort on the part of the federal government in providing training and funding and distributing best practices and awareness programs about LGBT people and their specialized health needs.

2. Guaranteed access to care — An overhaul of the health care system will need to include an oversight body of some sort to guarantee permanent access to health care for LGBT people and insulate this right from the whims of the political climate and anti-LGBT administrations in the future.

3. Clear definitions in policy and legislation — The federal government’s current definitions of such terms as “family,” “parent,” and “spouse” are exclusive of the LGBT community.  New definitions of family should include a clause along the lines of, “Any individual related by blood or affinity whose close association with the employee is the equivalent of a family relationship.”

4. No exclusions on diagnoses of pre-existing conditions — Fear of anti-LGBT stigma discourages people from seeking routine diagnostic services, causing more instances of late treatment and consequent insurance provider discrimination on the basis of pre-existing conditions.

5. Health care coverage for transgender inclusion is mandatory — Insurance companies routinely refuse to cover transition-related medical expenses, under the “transgender exclusion” clause.  Such care should be a basic benefit.

6. Data collection tools must be appropriate for all populations to facilitate proper planning, clinical care and program evaluation — Health data collection has typically overlooked the issues of LGBT and other marginalized groups, causing a lack of information about their particularized health care needs.

7. Adequate assurances that health information technology will ensure privacy and address the unique health care needs of transgender people — Confidentiality of sexual orientation and gender identity is a crucial element of LGBT health care provision that must never be overlooked or compromised.

8. Reproductive health care services must support all methods of conception for all patients — Any coverage of family planning must include coverage of alternative family creation methods.

9. The HIV/AIDS epidemic must be addressed — Gay men, particularly gay men of color and youth, and transgender women are at elevated risks of contracting the disease.

10. Mental health parity must be included — LGBT people are significantly more likely to suffer from mental health concerns and substance abuse.


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