Policy Progress and Setbacks for LGBTQ+ Community During Pride Month

As PAEA celebrates Pride month and reflects on the unique role of PA education in promoting the health and well-being of LGBTQ+ patients, students, and faculty, recent events have illustrated both the substantial progress made in recognizing the dignity of all individuals as well as the long path ahead to fully achieving Health for All.  

On June 15, the Supreme Court issued decisions in two landmark cases, ruling that the prohibition against employment discrimination on the basis of sex established by the Civil Rights Act of 1964 similarly protects LGBTQ+ workers. Prior to the Supreme Court’s decision, only 21 states, the District of Columbia, Guam, and Puerto Rico had comprehensive statutory employment protections in both the public and private sectors for the LGBTQ+ community.

While the Supreme Court decision represented progress on behalf of LGBTQ+ employees, transgender patients experienced a significant setback. On June 12, despite the submission of more than 120,000 public comments in opposition to the proposal, the Trump Administration finalized a proposed rule amending its interpretation of non-discrimination protections under Section 1557 of the Affordable Care Act. In recognition of the impact that discrimination in health care settings has historically had on marginalized patients, Section 1557 prohibits discrimination in certain health programs and activities based on definitions in existing civil rights law. While the Department of Health and Human Services had previously interpreted prohibitions on sex-based discrimination to include gender identity, the Trump Administration has now formally amended this interpretation to exclude transgender patients.

To address disparities in care and outcomes for transgender individuals, PA education has undertaken a robust response. This month, PAEA’s Board of Directors approved the formation of a Gender and Sexual Minority/LGBTQ+ Health Special Interest Group to facilitate the exchange of ideas and information regarding PA education and the health of LGBTQ+ patients.

In addition to resource sharing, effective in September 2020, Standard B2.06 of ARC-PA’s Accreditation Standards will require the curriculum of all programs to include content preparing students to provide care with consideration for gender identity and sexual orientation. Fortunately, according to a recent survey of PA program directors administered prior to the adoption of Standard B2.06, more than 85% of programs already include content on the care of transgender individuals — suggesting that a large majority of PA programs are already taking steps to educate students tasked with providing culturally competent care to transgender patients.

As we support the restoration of legal protections for transgender patients in pursuit of the Association’s vision of Health for All, PAEA remains fully committed to providing member programs and faculty with the resources necessary to prepare all students to provide care that recognizes the inherent value and dignity of all patients.