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Health & Wellness

How the HEI Is Helping Medical Providers Become More LGBTQ Inclusive

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Having a relationship with healthcare providers in which you can speak frankly about your concerns and be treated with compassion and knowledge is an important part of maintaining good health.

Patients who are lesbian, gay, bisexual, transgender, and queer (LGBTQ), however, do not always feel confident that the care they receive will be equitable and free from discrimination.

To address this issue, the Human Rights Campaign Foundation, the educational arm of the largest LGBTQ civil rights organization in the United States, launched the Healthcare Equality Index(HEI) in 2007. The annual HEI survey scores healthcare facilities across the country on policies and practices designed to support LGBTQ inclusion. In 2018, a record 626 facilities participated in the survey, and the number will be even higher in the upcoming 2019 report.

Funded in part by grants from Pfizer, the HEI was developed to give healthcare facilities the information they need to ensure that LGBTQ people have access to “truly patient-centered care.”

GetOld spoke with Tari Hanneman, director of the organization’s Health Equality Project, for an overview of the HEI.

GetOld: What is the Healthcare Equality Index?

Hanneman: The HEI is a national index, or scorecard, of how healthcare facilities are treating their LGBTQ patients, visitors, and employees. We look at a number of policies and practices that impact LGBTQ health, like whether a facility has a patient non-discrimination policy that is LGBTQ-inclusive. That means that, when the facility enumerates their nondiscrimination policy, it includes sexual orientation and gender identity or expression along with categories like race and religion.

We look for a similar nondiscrimination policy when it comes to patients being able to have the visitors of their choice at hospitals. In the past, you used to hear a lot of stories about someone’s LGBTQ partner being turned away.

Those are foundational policies. We also survey and measure a wide range of other policies in patient services and support. For example, are facilities training their staff in LGBTQ patient-centered care? Are they including sexual orientation and gender-identity data in electronic health records? (We strongly support collecting this information.)

GetOld: What do you hope to achieve through the HEI?

Hanneman: Our goal is to help hospitals and other healthcare facilities become more LGBTQ-inclusive. The survey helps facilities self-assess where they are on this issue. The annual report also helps them see what the benchmarks are for the leading facilities, those that earn the designation “LGBTQ Healthcare Equality Leader,” and how they implement policies and practices. For example, what does a marketing campaign look like for a hospital that’s LGBTQ-inclusive? 

GetOld: Why are LGBTQ-inclusion practices so important when it comes to improving health outcomes?  

Hanneman: We know there’s a history of discrimination in healthcare for the LGBTQ community. There are people who have faced this discrimination themselves or who know someone who may fear going to a provider or fear coming out to their provider. That means they may delay or avoid seeking care and, as a result, whatever health issues they’re facing may get worse.

Discrimination is especially problematic for the trans community. Here, you may have outright refusal to offer care. A provider may say ‘I don’t know anything about transgender issues so I’m not going to care for you.’ Or, there may be very inappropriate language and requests of transgender people. Something like, ‘Oh, you’re the first trans person I’ve seen so I want to see it all!’

The most frequent type of discrimination is misgendering, including intentional misgendering. It’s one thing to make a mistake, apologize, correct yourself, and move on. It’s another thing to say, ‘I’m going to call you ‘he’ even though you’ve asked me to call you ‘she.’ 

A lot of the things we do are around helping hospitals and other healthcare centers become more welcoming and inclusive. Simple things can go a long way in putting LGBTQ patients at ease, such as having their nondiscrimination policy posted in the waiting room or having images that are representational of the full community a facility is serving, including the LGBTQ community.

GetOld: How can someone find an LGBTQ-friendly healthcare center for themselves or a family member or friend?

Hanneman: You can search our website for healthcare facilities that are evaluated in the latest HEI report by state or through our interactive map.

GetOld: The Human Rights Campaign Foundation just announced a partnership with SAGE, the world’s largest organization dedicated to improving the lives of LGBTQ older adults. What does this partnership mean?

Hanneman: We have partnered with SAGE to create a Long-Term Care Equality Index (LEI) of how long-term care facilities are treating their LGBTQ residents. This is an effort that is also being supported by Pfizer, and it will be similar to the HEI in the types of things we’re measuring. We expect to release the first LEI report in 2021.

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