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Just how well are gay, lesbian, bisexual and transgender patients and employees treated in America’s hospitals?

The Human Rights Campaign Foundation and the Gay and Lesbian Medical Association decided to find out, and on May 13, the organizations released the results of a nationwide hospital survey. Those results, called the Healthcare Equality Index, will be used to set a “gold standard of national policies that are going to improve the treatment and prevent discrimination of GLBT Americans and their families,” HRCF President Joe Solmonese said during a press conference. Of the 88 hospitals in 21 states that responded to the survey, two were in Tennessee: Vanderbilt University Medical Center and Williamson Medical Center.

“The absence of federal protections, inadequate state laws and inconsistent hospital policies often result in discrimination and inadequate healthcare for GLBT patients and their families,” Solmonese said. He cited examples, such as a gay man barred from comforting his partner or a lesbian mother barred from her child by hospital personnel. Transgender people have been “ridiculed instead of treated” in American hospitals, he said, adding, “These are real-life situations that we hear about every day and that play out every day in healthcare settings across the country with devastating consequences”

The survey included 23 questions, 10 of which pertained to GLBT-specific policy criteria. Those are the answers highlighted in the index. Divided into five categories, the policy questions were:

1. Does the hospital’s patient bill of rights and/or nondiscrimination policy include sexual orientation? Does it include gender identity and/or expression?

2. Does the written visitation policy allow GLBT domestic partners the same access as spouses and next of kin? Does it allow same-sex parents the same access as opposite-sex parents for visitation of their minor children?

3. Does the written policy recognize advance healthcare directives granting GLBT domestic partners decision-making authority for their hospitalized domestic partner? Does the same hold true for same-sex parents?

4. Does diversity or cultural-competence training address issues related to GLBT patients and their families?

5. Does the equal-employment-opportunity policy include sexual orientation? Does it include gender identity and/or expression? Are domestic partner health insurance benefits offered?

Tom Sullivan, one of the authors of the index and an HRCF project manager, said 45 of the hospitals responded “yes” to all 10 of the questions. “When we look at the answers from all respondents, we see that the highest number of “yes” answers came in response to the question about the inclusion of sexual orientation in the hospital’s patient bill of rights or nondiscrimination policy,” he said. That number was 86 out of 88. Conversely, the question about the inclusion of gender identity and/or expression in these policies elicited just 58 affirmative responses. “This is the type of disparity to which the Healthcare Equality Index will draw attention and will work to change,” he said. “This is just a starting point from which we can increase participation and start to focus on the more specific parts of agency policies.”

Vanderbilt answered seven of the 10 questions with a” yes,” while Williamson Medical Center had five “yes” answers.

“Vanderbilt is pleased to have met the criteria in seven of the 10 areas that are outlined in the report,” said Jerry Jones, VUMC regional news director and a participant in the press conference. “Areas which we will seek improvement on include modifying our admission and discharge forms to better reflect the needs of our GLBT patients; additional diversity training for faculty and staff so that they better understand what the needs of our GLBT patients are; and, finally, work with university officials to add gender identity to our nondiscrimination and equal-employment clause.” Noteworthy is that VUMC has 180 employees who participate in its domestic-partner benefits program.

In the press conference, Jones brought up the point that GLBT patients must be aware of state law — and ensure that their relationships and healthcare intentions are clear. “In Tennessee, same-sex partners are seen by the state much like a close friend would be viewed — secondary to any other family member who may be available. If the same-sex couple does not take the time to have an advance designation for each partner to be their decision maker, such as a healthcare power of attorney, then the partner could very well be left out of any important healthcare decisions made on behalf of their loved one,” he said.

Sullivan noted that the statistics presented in the index are the result of participation from a voluntary sample of hospitals, and many of those that participated did so because of their “solid history of working on GLBT cultural-competency issues.” Thus, the results don’t reflect the percentages of America’s entire hospital industry. “However, the results can be seen as benchmarks,” he said. “We will mark progress in the coming years by an increase in participation and through policy changes. …

“As this project moves forward, we will be reaching out to the full range of healthcare agencies, including nursing homes, assisted-living facilities, home healthcare, hospice and community health centers, to identify the best practices in making these services welcoming to GLBT clients and their families.”



June 2008

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