Pass Equality Act, AAFP and Others Tell Senate

“LGBTQ people need the explicit, permanent protections under our nation’s existing civil rights laws that the Equality Act would provide with regard to access to care, housing, education, federally funded programs and more,” the groups said in their May 13 letter to senators regarding H.R. 5, which passed the House of Representatives on Feb. 25. “Such protections will help to protect LGBTQ people from discrimination that threatens their health and well-being.”

A version of the legislation passed the House in 2019. In 2020, the U.S. Supreme Court ruled that Title VII of the Civil Rights Act of 1964 prohibited employment discrimination on the basis of sexual orientation or gender identity. The bill now before senators would amend Title VII to include “sexual orientation” and “gender identity” in the statute’s definition of “sex.”

The Equality Act, said the Academy and its co-signatories, would be critical to overwriting an inadequate patchwork of existing laws that “leaves many Americans subject to uncertainty and potential discrimination that impacts their safety, their medical care and their day-to-day lives.”

The letter zeroed in on the gaps in medical and mental health care left by that patchwork, particularly given numerous recent state-level threats to gender-affirming care.

“A substantial body of research indicates that LGBTQ populations across the United States encounter significant barriers to health care,” the groups said. “Many LGBTQ people have difficulty finding providers who are knowledgeable about their needs, encounter discrimination from insurers or providers, or delay or forgo care because of concerns about how they will be treated. The Equality Act is needed to help achieve the goal of health equity for all Americans.”

The letter reminded senators that evidence-based medical care for transgender youth is effective and operates within guidelines developed and endorsed by, among other societies, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American College of Physicians and the American Psychological Association.

“Receipt of gender-affirming care has been linked to dramatically reduced rates of suicide attempts, decreased rates of depression and anxiety, decreased substance use, improved HIV medication adherence and reduced rates of harmful self-prescribed hormone use,” the groups added.

The Senate Judiciary Committee heard testimony on the legislation March 17.  

The Biden administration this month announced that it would restore enforcement of Section 1557 of the Patient Protection and Affordable Care Act, reversing an action by the Trump White House to which the Academy objected in 2019.  

Fewer than half of U.S. states have anti-discrimination laws protecting LGBTQ people. Only 42% of LGBTQ Americans live in states with insurance protections that include sexual orientation and gender identity. And just 22 states expressly prohibit such discrimination in housing.

Among the letter’s 138 other co-signatories were the AMA, the American Academy of Pediatrics, the American Psychological Association and nine state AAFP chapters.