By Abigail Painchaud and Megan Greig

For four decades, America’s Essential Hospitals and its members have championed care for marginalized and underserved communities, including LGBTQ people. As we celebrate Pride Month, the association reflects on our members’ efforts to improve care for this population and recent administration actions to support this goal.

Nearly as soon as President Joe Biden took office, he swiftly released executive orders related to health equity and nondiscrimination, including one focused on preventing and combating discrimination on the basis of gender identity or sexual orientation. This action was just the beginning of the new administration’s commitment and dedication toward inclusive health policies. In May, the Department of Health and Human Services announced it will interpret and enforce section 1557 of the Affordable Care Act’s prohibition on discrimination “on the basis of sex” to include sexual orientation and gender identity, which previously was narrowed under a rule finalized in 2020.

Meanwhile, states are engaging in policymaking related to LGBTQ health care issues. So far, 26 states have banned health insurance exclusions for transgender individuals. However, some states are actively pursuing legislation to limit LGBTQ access to health care, particularly for transgender patients.

The Human Rights Campaign in 2007 developed its Healthcare Equity Index (HEI) to identify health care facilities that go above and beyond in their policies and practices to be inclusive and affirming toward their LGBTQ patients, visitors, and employees. Dozens of essential hospitals made the most recent list in 2020.

Member Initiatives for LGBTQ Care

Essential hospitals have made significant progress in creating innovative, wide-reaching policies and practices to improve LGBTQ health care. Many members have gone so far as to establish entire divisions of care dedicated to providing services for LGBTQ people, including gender-affirming care, affordable testing and treatment for sexually transmitted infections (STIs), and access to community resources.

  • NYC Health + Hospitals/Woodhull Medical and Mental Health Center’s Pride Health Center is North Brooklyn’s first clinic dedicated to providing gender-affirming services that prioritize the needs of LGBTQ patients. The center offers obstetric and gynecological care, dental care, hormone therapy, primary care, behavioral health care, and testing and treatment for HIV and STIs.
  • The MetroHealth System, in Cleveland, established its Pride Network to provide a variety of services to LGBTQ patients, from primary care to STI screenings and more. The Pride Network also houses MetroHealth’s KIDz Pride Clinic, which focuses solely on LGBTQ youth.
  • Santa Clara Valley Medical Center, in San Jose, Calif., in 2019 opened its Gender Health Center, making it the first all-ages clinic specialized in caring for transgender, gender-nonbinary, and gender expansive people in the South Bay. The health center provides gender-affirming surgeries, mental and emotional health care, and other important services to the LGBTQ community.
  • Cooper University Healthcare’s Center for LGBTQ+ Health offers services to protect and affirm the experiences of LGBTQ patients and educate the local community on the most pressing issues related to these patients’ experiences.

In addition to clinical care, many essential hospitals serve as resource centers for their LGBTQ patients and staff, connecting them with community organizations and offering opportunities to advocate for greater equity.

  • University of California San Francisco Medical Center’s Lesbian, Gay, Bisexual, and Transgender Resource Center provides information, education, advocacy, and support to LGBT patients, staff, and supporters. The center includes a mentorship program connecting LGBTQ students and staff and an active LGBTQ Committee.
  • Temple University Health System created the Temple Health LGBTQ Alliance Task Force in response to the Pulse nightclub shooting in Orlando, Fla. The task force comprises about 170 hospital employees and takes action to support the LGBTQ community through hospital policy and procedure development.
  • University of California Davis Health in 2013 became the first academic health system in the nation to include sexual orientation and gender identity as standard demographic information within its electronic health record. This year, the health system will host the Improving OUTcomes Conference, exploring how health professionals and community partners can improve quality of and access to care for LGBTQ patients and their families.
  • University of New Mexico Health Services Center has used its Project ECHO telehealth learning model to expand physician knowledge of the needs of LGBTQ patients.
  • University of New Mexico Hospitals founded the Office of Diversity, Equity, and Inclusion and fostered creation of a separate LGBT Collaborative dedicated to changing hospital policies, training, and perspective to ensure a safe, caring environment for LGBTQ patients and staff.