Doctors like Dr. Vesna Roi keep gay parents awake at night.
The now little-known, little-remembered case (at least by mainstream America) happened in Michigan in 2015. A lesbian couple, Krista and Jami Contreras, had vetted pediatricians and decided on a Dr. Vesna Roi, who knew their sexual orientation, says the Washington Post. But when they brought a 6-day-old Bay in for her postpartum checkup, they were informed they’d be seeing another doctor.
“The first thing Dr. Karam said was, ‘I’ll be your doctor, I’ll be seeing you today because Dr. Roi decided this morning that she prayed on it and she won’t be able to care for Bay,’” Jami told WJBK.
While the American Medical Association takes a “strong stance” against discrimination for reasons like sexual orientation or gender identity — or, one presumes, the sexual orientation or gender identity of one’s parents — it’s just that: a guideline. Doctors aren’t bound by it. And without a national law codifying “sexual orientation and gender identity” as illegal reasons for discrimination, Dr. Roi wasn’t doing anything against the law.
Now Trump’s Health and Human Services top civil rights official is creating a Division of Conscience and Religious Freedom (sounds like something straight out of a dystopian novel, doesn’t it?). According to NPR, the purpose of the agency is to “to protect doctors, nurses and other health care workers who refuse to take part in procedures like abortion or treat certain people because of moral or religious objections.” Read: Gay people. Lesbians. Transgender people. And possibly, their children.
In other words, the new policy seeks to protect doctors, nurses, and healthcare providers who choose to discriminate based on sexual identity.
An Obama-era policy barred healthcare workers from refusing to treat transgender people, at least on paper, but this agency and its objectives roll back that protection. Louise Melling, deputy legal director at the American Civil Liberties Union, told NPR, “This administration has taken a very expansive view of religious liberty. It understands religious liberty to override antidiscrimination principles.”
And some parents are terrified.
Joseph, a husband and father, says that without nondiscrimination protections in their state, they have had to vet every important caretaker of their children, including their daycare provider and their pediatrician. Joseph also said that they felt their family is “in a very small bubble of safety that could pop at any moment” when it comes to health care, “so it’s a constant anxiety in the back of my mind.”
Emergency care worries them most of all: “This decision opens the door to that. It tells people who are ‘pretty convinced’ of our undesirability, ‘go ahead, run with that, we’ll protect you.’ I mean, this is the state where Ken Shupe was able to claim ‘God’ commanded him not to help a stranded, disabled motorist on the side of a desolate highway because they had a Bernie Sander’s sticker on their car… can you imagine what this sort of permission will do to people who have to do more than tow our car?”
As a result, Joseph’s family has plans to avoid mentioning their marriage for fear of their children being denied care. “We have accepted that part of reality may mean needing to lie,” they say.
Transgender people are already refused healthcare more often than we realize. According to Vice, after a traumatic procedure during which a provider repeatedly and rudely misgendered transmasculine teen Julian, the health care provider called a week later to inform them that the shot was no longer available and suggested they try another clinic.
These actions were legal under Georgia state law, but recent laws don’t distinguish between not being willing to provide a service and not being willing to serve a certain person, says Vice, which allows healthcare providers to refuse to serve people based on their sexual orientation — and mostly commonly, their gender identity.
As pregnant daddy John, a freelance artist and disabled person, says, “Statistics are sobering and ugly when you’re trans.” Indeed they are. According to a Center for American Progress survey, 29% of transgender people have been refused healthcare in the previous year “because of their actual or perceived gender identity.” 23% were intentionally misgendered or had the wrong name used; 21% were subject to harsh or abusive language. 23% have avoided “seeking needed health care” because of fears about of discrimination or mistreatment. About 30% can’t just hop to another doctor or clinic for the same care, and 18% can’t use a different pharmacy.
John has had a difficult time as a pregnant dad. He was told at the ER that “only women have babies.” He eventually found a doctor who treats trans men. “There’s probably a handful,” he said. “But it’s like Cheers, we all know each other and all see the same [person].”
But before his pregnancy, John had a miscarriage. He and his husband ended up in the ER with his bleeding, and they told John to come back in two days. Two days later, John was treated to this: “The ER doctor was clueless and tried to tell me attempting to get pregnant during transition was a bad idea … That is not how any of this works. Transition is not a destination.” John was not on hormone replacement therapy at the time of his pregnancy.
“Part of the trans experience is knowing more about your health than your own doctor does most of the time,” he says.
But as a lesbian gynecologist, Dr. Athena H. — a married mother of three — says, she worries most about her LBGTQ patients obtaining needed reproductive care, because she lives in a conservative area. Most troubling, however, for Dr. H. is that, like many other LBGTQ parents, she has “always worried” about her children being denied or refused care because of her sexual identity.
“We have always worried about this and went out of our way to directly ask our pediatric practice about it,” she said. “It’s eased somewhat for us because the majority of our kids are out of the house and fairly independent. I do worry that we could both be refused access to them if something happened, especially since I am not on their birth certificates.” Under Trump, these worries could get even worse.
In the end, as Allyn Jensen, trans queer mental health worker and activist said, if doctors were forced to treat everyone, regardless of their personal beliefs about a patient’s lifestyle, “Doctors would stuff down their prejudices and successfully treat folks they secretly kind of despise– like almost every doctor everywhere has done at least once in their career because they knew it was the right thing to do and they knew they were qualified for the job. [They] deserve to be doctors in spite of any prejudices. They are still committed to taking a go at medical professionalism and actually doing their job. The [others] have opted out of acting like doctors and, therefore, do not deserve to be doctors, and should not be treated as if they do.”
Amen, Allyn. Amen. If only the Trump administration would listen.