With the Affordable Care Act (ACA) under siege by the new U.S. president, many people in the U.S. are worried about changes in their healthcare, especially LGBT communities for whom access to competent and affordable healthcare can sometimes be more problematic than for most people.
Of concern to Catholics is the unclear position that church leaders and church-affiliated providers will take towards LGBT people in this unfolding situation. A closer look into one transgender man’s experience with a Catholic hospital reveals just what is at stake in the coming months.
Bondings 2.0 reported last month about the lawsuit filed by Jionni Conforti against St. Joseph’s Regional Medical Center in New Jersey. You can read an initial report by clicking here. The suit alleges that the hospital refused to perform a hysterectomy which was a “medically necessary as part of [Conforti’s] gender transition.” Conforti’s lawyer, Omar Gonzalez-Pagan of Lambda Legal, told the progressive media outlet Rewire:
“‘For them to say, in writing, we’re not going to do this service, or provide the ability to have these facilities available for this service, because it has to do with your gender identity, and it has to do with the medical treatment for your gender dysphoria, really is discrimination at its core. . .And for them to use religion as an excuse for this discrimination, I think, is something that cannot be accepted.'”
Conforti said the alleged discrimination has been especially painful because St. Joseph’s was his “neighborhood hospital,” where family members have been treated and “where I feel comfortable.” For this reason, though he underwent the hysterectomy elsewhere, Conforti remains troubled:
“[He said,]’My main concern right now is that I still live in Totowa and I’ve lived here my entire life, so in the event of an emergency, the only place that an ambulance would take me is to St. Joseph’s. . .And, you know, I worry that, God forbid something happened, what would I do, how would I be treated? So it’s a constant fear.’
“In October 2016, that fear partly came true. Conforti was in a car accident in Wayne, New Jersey, and suffered minor injuries. The emergency service technicians recommended he get emergency care, but said they could only take him to the two St. Joseph’s locations nearby. If he wanted to go elsewhere, he would have to hire a private ambulance. Afraid to seek care from St. Joseph’s, Conforti instead asked his wife to drive him about 25 minutes away, to another hospital in Montclair, New Jersey.”
Sadly, Conforti’s circumstances are not unique. Many trans people cannot access competent and affordable healthcare, or may even avoid healthcare fearful of discrimination. Rewire cited data from the National Center for Transgender Equality that reveals “23 percent of trans people avoided going to the doctor because they feared discrimination; one-third of respondents had at least one negative experience with their provider, including having to educate the provider on trans people in order to receive appropriate care.”
The Affordable Care Act of 2010 helped to improve healthcare for trans communities, especiallly since Section 1557 established non-discrimination protections based on sex, a class that was interpreted by the Obama administration to include gender identity. It is unclear whether such protections would still hold if the ACA is repealed and replaced by an as yet uknown program devised by Republican legislators. Even if the ACA is not repealed, it is uncertain whether the Trump administration will interpret the non-discrimination protections in the same way as the Obama administration did.
Even if the ACA and its non-discrimination protections remain in place, will religiously-affiliated providers be allowed to discriminate under existing or even expanded exemptions? St. Joseph’s cited the U.S. Conference of Catholic Bishops’ “Ethical and Religious Directives for Catholic Health Care Services” to justify its refusal to provide care for Conforti, guidelines which dictate care for “one in six hospital beds nationwide,” according to Rewire.
Just two weeks after Inauguration Day, efforts to repeal the ACA are well underway. There are more questions than answers about what comes next. But church leaders and Catholic providers do not have to wait and see what happens nationally. They can decide right now to provide high-quality, lifesaving care for LGBT patients.
Catholic hospitals and health systems can choose freely to adopt non-discrimination protections inclusive of gender and sexual minorities. They can train providers to be informed about the unique health needs of LGBT patients, and to provide additional services and programs that may be required. The complexities of law, ethics, and institutional bureaucracies are real, but there is wisdom, too, in Conforti’s statement:
“If there is a procedure that is medically necessary, there should be no question whether or not they will do it. . .No one should be rejected or denied care, especially just for being who you are.'”
Nothing in church teaching restricts more inclusive policies and practices from being enacted in church-affiliated healthcare. Indeed, the Catholic identity so often cited to deny care to patients like Jionni Conforti is the very mandate for why such actions must be now taken. With LGBT communities under attack, this is a moment in history for Catholic hospitals to state decisively that transgender lives, and the lives of all LGBT people matter immensely.
And if inspiration is needed, Catholics can look to St. Vincent’s Hospital in New York City which, in 1973, adopted a non-discrimination policy inclusive of sexual orientation.
To get started on an LGBT-inclusive nondiscrimination policy at your Catholic parish, school, hospital, or social service agency, contact New Ways Ministry at firstname.lastname@example.org or (301) 277-5674. You can also find more information on making this change here.
—Robert Shine, New Ways Ministry, February 6, 2017