Gatekeeping in Healthcare
By Anu Sharma
Getting a doctor’s appointment at times can be tricky, however, as a trans individual, it can be difficult and sometimes impossible to receive healthcare let alone an appointment to see a healthcare professional.
Lis Regula, a professor at the University of Akron has faced multiple forms and instances of discrimination in healthcare. Regula had to go through six to eight surgeons in Akron before finding healthcare professions who had diversity training to treat him. It was an attempt to get top surgery that he realized many healthcare professionals did not have diversity training and was being discriminated against.
“Trying to make arrangements for top surgery, multiple surgeons who otherwise performed mastectomies say ‘No don’t do that.’ And actually had one of the offices flat out tell me they don’t work with people like me,” he said.
Regula mentioned there is a heavy presence of gatekeeping targeting specifically the trans community.
“Functionally it plays out as requiring counseling or requiring a note from a health-mental health care provider saying yes you suffer from gender dysphoria, yes you have these symptoms, yes you understand what you feel as gender identity disorder,” he explained.
A recent Kent State graduate, Rhys Winter, who also is a trans man, has experienced healthcare discrimination from the campus health center. Winter had healthcare professionals ask intimate questions, touch him with his consent and misgendered him. He said it felt like constant microaggressions.
‘When was your last period?’
I don’t have periods.
‘Well you should fix that you need to get you know, on hormones to fix that.’
Well I already am on hormones to fix that, so I don’t have to have that problem. ”
Upon getting top surgery, a surgery to remove the breasts, Winter was forced by hospital staff to take a pregnancy test before undergoing anesthesia. Later he found that his insurance would not cover the cost of the pregnancy test because he is a man, however, the staff put “f” on his medical bracelet.
Eventually, Winter found the Pride Clinic in Cleveland, an informed consent clinic with a staff of diversity trained healthcare professionals, who do not discriminate against patients.
“Informed consent means that we don’t need a therapist’s letter to get on hormones. We just need to fill out the work that claims that we are in our right minds, and we understand our decision that we’re making,” Winter said.
His doctor from this clinic put in his chart as hormone imbalanced rather than gender dysphoria so it waives the letter requirement and so Winter’s insurance could cover the cost of hormones. He has Medicaid which covers most of his costs however, Medicaid covers it specifically with requirements.
While there is no federal protection for discrimination in the healthcare system, Kent, Akron, Cleveland and Cuyahoga County all have non-discrimination ordinances that offer some form of protection. There is a new version of the Ohio Fairness act which was reintroduced by Senator Antonio.
Taylor Phillips, a Senior Aide for Senator Antonio said Senate Bill 11, adds LGBTQ individuals as a protected class under the Civil Rights Code of Ohio.
“You are able to you know go to the Ohio Civil Rights Commission, and say this is happening to you and there could be some sort of-some sort of a resolution to that,” Philips said.
She said Antonio has brought up the legislation to every General Assembly and hopes it will pass. Antonio gave sponsor testimony on March 13 and Phillips said there will be more testimonies to come in order for the bill to pass.
“People should be able to feel safe where they work, play, pray and have a home. And you know we think it’s well due time for this legislation,” she said.
