ABC News has picked up a story.
Following the recent EEOC ruling on sex discrimination with regards to transgender people, a coalition of GLBT groups sought clarification from Health and Human Services Secretary Kathleen Sibelius as to whether or not sex-based discrimination includes discrimination on the basis of gender identity and sex stereotypes under the Patient Protection and Affordable Care Act.
HHS replied in July.
We agree that Section 1557's sex discrimination prohibition extends to claims of discrimination based on gender identity or failure to conform to stereotypical notions of masculinity or femininity and will accept such complaints for investigation. Section 1557 also prohibits sexual harassment and discrimination regardless of the actual or perceived sexual orientation or gender identity of the individuals involved.
Consider the case of Jay Kallio, 56, who is disabled with kidney failure, rheumatoid arthritis, and…now…cancer. Kallio, a former EMT, transitioned from female to male at the age of 50. He chose not to undergo reassignment surgery, but rather only hormone treatment. When he discovered a lump in his breast, the surgeon who performed the biopsy was "so shocked" at Kallio's body that he was unsure whether to refer to Kallio as "he" or "she" and could not bring himself to tell Kallio the results of the test.
Kallio only found out that he had breast cancer after a lab technician called to ask how he was doing with the diagnosis. Kallio was horrified. So he went to see an oncologist…who became hostile and refused to advise him on treatments.
Eventually the doctor apologized, saying "I don't think it interfered with the quality of your care." In fact, having to find new doctors delayed the beginning of his chemotherapy beyond the "therapeutic window" for his particular aggressive form of breast cancer.
Our community needs medical providers to know what their obligations are and passing a law is the strongest and clearest way to do that.
--Mara Keisling, National Center for Transgeder Equality
NCTE estimates that between 1/4 of 1% and 1% of the population is transgender.
We are so vulnerable when we are sick. I was at the point where I was going to forgo treatment. I had greater trust in the natural course of my cancer than with my providers. No one should be treated like that when they face a potentially terminal diagnosis.
--Jay Kallio
Kallio does not know what the effect in his long-term helth will be.
I have not been able to go back for follow up checks because I was forced into an HMO that does not accept the oncologist who is willing to treat me, so I will need to find another congenial provider who is willing to treat a transgender person.
Finding an accepting doctor with an accepting staff is not as easy for us as you might think.
In the 1995 case of Tyra Hunter hostile treatment by firefighters and EMTs cost a life. The 24-year-old hairdresser was in a car accident which left her unconscious on a Washington, DC street.
As they removed her clothing, they found the anatomy wasn't what they were expecting and they ceased to provide care.
A jury awarded Hunter's mother $2.9 million in 1998, determining that the non-action of the responders violated the 1977 Human Rights Law.
Now, if a patient divulges he or she is transgender, if the doctor consistently mixes the genders or misnames someone or treats anybody in unkind ways, [the transgender patient] has recourse to file complaints.
--Vincent Paolo Villano, NCTE
There is also the case of Shane Morgan, 37, who last August developed a urinary tract infection on a Friday. Since he couldn't get an immediate doctor appointment, he went to a "grocery store clinic", hoping to score some antibiotics.
I was in an open seating area and the nurse looked at the paperwork and looked at me and she said, 'You don't have a UTI, you have an STI (sexually transmitted infection).
He whispered to her that he was transgender, hoping they could speak privately about his genitals, but the nurse became "very rude and uncomfortable" and refused to treat him.
I am short, stocky, with a beard and am bald, but you can't judge a book by its cover.
Morgan has had his breasts removed and is on hormone treatment. The nurse said, "I am not comfortable with your anatomy" and handed him an OTC product.
I was both shocked and floored.
Medical professionals take an oath to do no harm, and not providing care, regardless of what a person looks like, you could do them harm.
By Monday Morgan had a full-blown kidney infection.
In my own experience my general practitioner sent me to an endocrinologist after I had had my thyroid irradiated in treatment for a metabolic problem. The specialist almost crawled out the window in her office trying to get away from me after she discovered I was transsexual. Needless to say, she refused to treatment. I was given the name of another endo...but I have never since been comfortable making an appointment.
It is very important to me and other people that we don't face those kinds of obstacles. I am medically savvy with a medical background, white and speak English. If I have every advantage, it doesn't bode well for other people.