For the third year in a row, 19 Bay Area Kaiser Foundation hospitals were ranked amongst the nation’s leaders in healthcare equality for their lesbian, gay, bisexual or transgender patients, according to a report released last month by a national LGBT civil rights organization.
In its fifth year administering the survey, the Human Right’s Campaign Foundation considered hospital policies that protect patients and employees from discrimination based on sexual orientation, in addition to ensuring equal visitation for same-sex couples and training staff to deal competently with LGBT health issues. Kaiser’s performance was considered along with that of 87 other hospital systems in 375 facilities through out the United States.
Kaiser’s Oakland Medical Center was one of the facilities that received perfect scores. “We’re not surprised at this recognition,” said Dr. Jennifer Slovis, Assistant Physician-in-Chief at Kaiser Medical Center in Oakland. “It’s in our DNA. Our physicians have always been committed to the highest quality of healthcare for all of diversities of populations.”
The nationwide index found that only 49 percent of the hospitals that participated had visitation policies that granted equal access for same-sex couples. Similarly, 52 percent granted same-sex parents equal visitation rights for their children.
“The beauty of a report like this is that it drives other institutions to make sure that they enact non-discriminatory policies and to train their physicians to treat LGBT patients no different than any other person walking through that office door,” Slovis said.
With headquarters in Oakland, Kaiser Permanente is one of the nation’s largest not-for-profit health plans serving 8.8 million members through their 35 hospitals, 454 medical offices, and a health insurance plan that covers over 3 million people in Northern California alone.
Tiffany Woods, a male-to-female transgender person, applauds Kaiser’s recent high marks in LGBT healthcare equality. She’s the program coordinator and co-creator of TransVision Tri-City Health Center in Fremont, the only such program serving transgender women in Alameda County. Woods also serves on the advisory council at UC San Francisco’s Center for Excellence in Transgender Healthcare, a national organization that provides medical facilities with research related to transgender healthcare issues.
She and her wife used Kaiser’s fertility care in Fremont to help conceive all three of their children through in vitro fertilization. They were their doctor’s second-ever trans couple, but Woods said that didn’t affect the quality of care and compassion they received. “They became like family,” Woods said about Kaiser’s staff and physicians, who even attended their daughter’s first birthday party.
Wood’s wife gave birth to all three children—who were conceived using sperm from the same sperm donor—at Kaiser Hospital in Fremont. From the fertility clinic to the hospital, Woods said, “We never encountered one problem that would even be construed as discrimination or homophobia.”
But that’s not always the case in other healthcare settings. Last year, Lambda Legal, another national LGBT civil rights organization, released a report on the healthcare experiences of LGBT people and people living with HIV. Nearly 56 percent of LGB respondents and 70 percent of transgender patients reported that they had experienced some form of discrimination while accessing healthcare.
Transgender people face some additional challenges. Wood said a common problem transpeople experience is inconsistent medical files that continually show names from a person’s previous gender despite requests to be updated. Woods said this can cause confusion in the waiting room when a medical staffer calls one name and instead someone of the opposite gender appears. “It can be embarrassing and just terrible, especially when you are sick and in pain,” Woods said.
Transpeople, especially transgender women, also risk HIV infection by sharing needles for hormone therapy, Woods said. This risk is exacerbated when people share needles because their healthcare providers do not cover the treatment, or because they refuse medical due to negative experiences with medical staff in the past.
Woods said negative experiences often prevent LGBT people from accessing care in the future and that when they do, they may be less likely to discuss their sexual orientation or gender identity with their healthcare providers. “You step outside of the San Francisco and there’s such a need for competent transgender health care,” Woods said. “It’s not just about hormones or treating the whole body but it’s really about understanding who your transgender client is.”
Slovis said that the majority of healthcare providers want to be make sure that they are aware of LGBT care needs but don’t always know how to proceed. “I think that the majority of folks don’t know where to get that information and how to make sure they are up to date,” she said, referring to policies that could be implemented in medical settings.
Last year, President Obama ordered hospitals receiving Medicare and Medicaid payments to allow patients to choose who can visit them and help make medical decisions, with special emphasis on the LGBT community.
Businesses, colleges and universities are also increasingly providing broader health coverage, according to research by the Human Rights Campaign, allowing domestic partners—regardless of marriage status—to be included in health insurance plans and in many cases covering hormone therapy and sex-reassignment surgeries for transgender people.
This year, 39 percent of Fortune 500 companies offered transgender-inclusive health benefits that covered transgender people’s domestic partners and sex-change operations. That’s up from 1 percent in 2004, HRC’s research showed. (At least a dozen colleges also had employee health plans that offered similar coverage.) The cities of San Francisco, Berkeley and most recently Portland have agreed to pay for city workers’ sex reassignment operations.
Because of these new policies, Woods said, “More and more trans people are going to be coming out and healthcare facilities starting at the front desk reception down to the doctors need to know how to take care of them.”
Kaiser physicians stay current with LGBT health needs by working with UCSF—which has a specific department that studies LGBT health— along with the Alameda County Department of Public Health and other community venues. Slovis said that Kaiser wants “to make sure that we’re not working in a silo and to make sure that all LGBT patients—whether they are Kaiser members or [on] other health insurance plans—have access and information about what their care rights are.”
KP Pride, Kaiser’s LGBT employee group, also helps keep the hospital network in check with its mission of providing quality, equal healthcare. Marina Coleridge, senior manager of Kaiser’s Northern California Revenue Assurance & Integrity, said as the co-chair for KP Pride, she advocates internally for both Kaiser employees and their members.
“We really want to be able to do some work on tracking health care disparities in the LGBT community,” Coleridge said. Just as the medical community has long tracked how, for example, a disease like diabetes might disproportionately affect one community, she said, “We want to do the same thing with the LGBT community.”
Woods, who said she believes it’s important to start teaching LGBT healthcare issues at medical schools, regularly lectures to students in medical care professions at Cal State University. “We’re looking at 10 years down the road, there should be no excuses,” Woods said. “Somebody at your staff at your community clinic or big institutional hospital, somebody there should be trained in transgender healthcare.”
To find out more about the Healthcare Equality Report, visit the Human Right’s Campaign Foundation’s website.