Though it's difficult to get accurate numbers, it's believed there are about 700,000 transgender people in the United States. Like many groups who don't conform to societal norms and expectations, the transgender community is subjected to discrimination from others on a daily basis. However, the Affordable Care Act (ACA) has made seeking medical care a tiny bit easier for transgender individuals by making it illegal for medical professionals to discriminate against them.
About ACA Non-Discrimination Language
Passed in March 2010 and effective starting January 2014, the ACA is designed to make healthcare more affordable for and accessible to all Americans. Among other reforms, each state was required to set up insurance exchanges through which citizens who were not covered by employer plans or public insurance programs such as Medicare could buy medical insurance without worry about being discriminated against because of pre-existing conditions, sexual orientation, or gender identity or expression.
The ACA also includes Civil Rights language that bars any healthcare program or activity receiving federal funds from discriminating against people because of their protected class and this includes gender identity and expression. Since healthcare providers and medical facilities are direct beneficiaries of the insurance plans people purchase through the ACA exchanges, this discrimination prohibition applies to them. This means a doctor cannot refuse to treat a patient or otherwise discriminate against a person based on a class protected by the law.
A recent decision by the Minnesota federal court confirms the protections offered by the ACA to transgender individuals. In 2013, a transgender man received substandard care during his stay at an area hospital that was directly the result of the staff's disapproval of his gender identity and expression. Among other things, one doctor performed an exam that was characterized as assaultive. Another doctor failed to adhere to infectious disease containment procedures by using the same gloves to examine the patient's eyes and mouth that he used to examine the individual's genitals. The man later developed sores on his face.
The hospital attempted to have the case dismissed, but the judge determined the man had sufficient evidence to substantiate a sex discrimination claim under the ACA. The judge also allowed the case to go forward based on the Minnesota Human Rights Act.
Poor Quality Care Still a Problem
While the ACA guarantees equal treatment for transgender individuals on paper, the real world still has a lot of catching up to do. A study conducted in 2011 found 19 percent of transgender individuals were refused medical care and 28 percent were harassed by healthcare providers because of their gender identities. This discrimination often prevents transgender people from getting much-needed medical care and has even proved fatal to members of the community on more than one occasion.
In 1995, a young African-American transgender woman died because she did not receive adequate medical care due to transphobia. The woman was in a car accident, but the EMTs who arrived on the scene to assist her refused to provide care when they discovered she was biologically a man. The doctors who treated her at the hospital did not properly diagnose or treat her internal bleeding and she died as a result. The woman's mother sued for medical malpractice and received over $4 million in damages.
More recently, a doctor failed to give a transgender man his breast cancer diagnosis because the healthcare professional couldn't handle the man's gender identity and expression. The patient only found out he had breast cancer when a lab technician called to check on his condition. Unfortunately, the man had a difficult time finding doctors willing to treat him and, as a result, it appears to be too late to effectively treat the disease.
Pursuing Compensation for Damages
Unfortunately, sometimes the only way to get people and institutions to make meaningful changes is to sue them for damages resulting from medical malpractice stemming from discriminatory treatment. If your healthcare provider violates the ACA and/or state protections against discriminatory medical treatment and you suffer harm as a result, it's best to consult with a personal injury attorney or a firm like Arrington Schelin & Munsey PC who can help put together a case that lets you collect compensation for damages and maybe improve healthcare for others in the transgender community.