How LGBTQ friendly is your health care?
America is growing more dangerous by the day. Do you have nondiscriminatory access to health care? Victoria T. Ferrara has some helpful advice.
Although the Affordable Care Act (ACA) has critical nondiscrimination protections on the basis of sexual orientation and gender identity, such discrimination persists and must be addressed in the efforts to improve the ACA as well as the access to health care for the LGBTQ community.
According to the Human Rights Watch, “lesbian, gay, bisexual, and transgender (LGBT) populations across the United States encounter significant barriers to health care. Many LGBT people have difficulty finding providers who are knowledgeable about their needs, encounter discrimination from insurers or providers, or delay or forego care because of concerns about how they will be treated. In the absence of federal legislation prohibiting healthcare discrimination based on sexual orientation and gender identity, LGBT people are often left with little recourse when discrimination occurs.”
Further, discriminatory practices continue to under the disguise of religious freedom exemptions. People are uncomfortable and even afraid to access health care because they are not sure or have had bad experiences with how some, medical care providers have treated them. This is especially true of transgender people looking for care either with their transitions or just general medical treatment.
The important thing is to look for recommendations of clinics and physicians through organizations that will be helpful and supportive such as the LGBTQ community centers. For example, in Norwalk Connecticut, Circle Care Center describes itself as Fairfield County’s home for LGBTQ-inclusive medical services and sexual health. Its mission is to “provide the highest quality of medical care to our patients in Southwestern Connecticut; specializing in primary care for people living with HIV, the LGBTQ community, as well as HIV prevention (PrEP & PEP), Hepatitis C, and STI testing and treatment.”
Discrimination in insurance is also inherent in family formation for gay men. Although there is some progress being made with insurance legislation in some States, and there are some progressive employment benefits obtainable by gay employees at certain large corporations, there is still a big problem with accessing insurance for IVF treatment to create embryos. As Dan Avery points out in his article for NBC, Gay couples face added hurdle when trying to start a family: Insurance policies, “insurance mandates nationwide define infertility in heterosexual terms: Couples must try to conceive through sexual intercourse for a year before being covered. In most states, a woman without a male partner is mandated to attempt intrauterine insemination up to a dozen times before a plan covers egg donation.”
The anti-discrimination provisions of the ACA are not at all helpful in these matters because the insurance companies can still use a discriminatory definition of infertility. Gay men and gay couples will not be physiologically able to meet the definition of infertility and so any benefits for IVF treatment in their health insurance policies are routinely denied in spite of the fact that they consistently and faithfully pay their insurance premiums and meet their contractual obligations under the health insurance plans.
Sometimes there is misinformation in these areas regarding insurance. Some States in the U.S. actually pass laws called fertility insurance mandates that say there shall not be discrimination in accessing reproductive medical benefits for IVF. People think that they will be able to get benefits for IVF treatment but these so-called fertility insurance mandates still have the issue of the definition of infertility as medical infertility. People have to show that they medically have been unable to conceive. For example, a gay woman who has tried numerous inseminations and is not getting pregnant can now show medical infertility. But gay men cannot show medical infertility because they cannot try to get pregnant in the first place. These laws must be amended and expanded to include social infertility that includes the impossibility of getting pregnant without the assistance of IVF and egg donation.
To sum up, it is important to know what your health insurance policies say about benefits, and to know the limitations of laws that purport to be helpful but, in reality, continue discriminatory schemes. It is also important to seek out employment-related benefits and if there are none or they are limited, to work internally within corporations to enhance benefits for matters such as adoption, IVF, surrogacy, paid work leave, etc. Lastly, when seeking medical treatment, look for recommendations of medical providers who are knowledgeable and affirming about LGBTQ+ health care.
About the author
Victoria Ferrara is the Founder & Legal Director of Worldwide Surrogacy. She has practiced in the courts of Connecticut and New York for the past thirty years. Victoria has remained on the cutting edge of assisted reproductive law issues, representing clients in LGBT-related law proceedings and surrogacy arrangements. One of her greatest achievements is the landmark decision of Raftopol v. Ramey, a Supreme Court case that established a new way to determine legal parentage in Connecticut. Victoria has published numerous articles and lectured and presented as a panelist in surrogacy conferences throughout the world.
