CLEVELAND — Ohio is home to an estimated 389,300 lesbian, gay, bisexual, and transgender (LGBT) adults. These individuals face discrimination in almost every aspect of their lives. Thirty-four percent of respondents to a 2014 Dayton LGBT community survey said they had been denied an employment opportunity because of their sexual orientation or gender identity. Twenty-nine percent said they had been treated differently at a place of public accommodation.
Ohio is also home to an estimated 72,300 LGBT youth. They are stigmatized, as well. A 2017 Youth Risk Behavior Surveillance Survey found that LGB students in Cleveland were more than twice as likely to report being bullied at school and electronically bullied in the previous year than heterosexual students. A whopping 73% of respondents to a 2017 GLSEN National School Climate Survey of LGBTQ middle and high school students said they had experienced verbal harassment based on their sexual orientation at school.
All this stigmatization and discrimination can lead to increased health problems. The research suggests a relationship. Discrimination against LGBT persons has been associated with high rates of psychiatric disorders, substance abuse, and suicide.
Ideally, we would have a health care system that was responsive to these health disparities within the LGBT community. Sadly, we do not. We have a system which tends to exacerbate those disparities by further discriminating against LGBT individuals.
Eric Foster is a columnist for The Plain Dealer and cleveland.com.
In 2010, Lambda Legal released the results of a nationwide survey of almost 5,000 LGBT people and persons living with HIV on their health care experiences. Almost 56% of LGB respondents had at least one of the following types of discrimination in care: being refused needed care; health care professionals refusing to touch them or using excessive precautions; health care professionals using harsh or abusive language; being blamed for their health status; or health care professionals being physically rough or abusive. That number went up to 63% for respondents living with HIV. It peaked at 70% for transgender respondents.
Discrimination against LGBTQ individuals in health care is clearly a problem. But that is apparently not so in the eyes of the Ohio General Assembly and Gov. Mike DeWine. Their belief is apparent from the addition of the following provision to the Ohio budget bill for 2022-2023:
“Notwithstanding any conflicting provision of the Revised Code, a medical practitioner, health care institution, or health care payer has the freedom to decline to perform, participate in, or pay for any health care service which violates the practitioner’s, institution’s, or payer’s conscience as informed by the moral, ethical, or religious beliefs or principles held by the practitioner, institution, or payer.”
You might be wondering what this provision has to do with the LGBTQ community, as it does not mention the group specifically. I understand the question. You might have a better idea if this provision was presented in its own separate bill instead of as part of the budget bill. In that case, there would have been multiple public hearings where proponents of the law could have made their intentions clearer. Also, opponents of the law could have had an opportunity to present their case. Instead, we are left to speculate.
But here’s what we know: Ohio law does not prohibit discrimination in health care based upon sexual orientation or identity. This law allows a medical provider to decline to provide health care services where he or she believes doing so would violate his or her moral, ethical, or religious beliefs. Therefore, what this law does is codify a method of discrimination against LGBTQ individuals based upon a medical provider’s personal beliefs.
Gov. DeWine sees this differently. According to him, “People are not going to be discriminated against in regards to medical care.” I am unsure of which reality the governor lives in. A 2019 national survey conducted by researchers at the University of Michigan Medical School and School of Public Health found that 1 in 5 of all U.S. adults reported that they had experienced discrimination in the health care system. In other words, people of all backgrounds are already being discriminated against in regard to medical care. The problem is that, in Ohio, LGBTQ individuals, unlike seniors or racial groups or religious groups, have no legal protection.
Suppose a pediatrician said his religious beliefs precluded him from evaluating the children of same-sex couples? That would be legal under this law. How about a therapist refusing to counsel LGBTQ persons due to his moral beliefs? Legal. What if a lab worker refused to test the blood of an LGBTQ person for ethical reasons? Legal. Or perhaps a hospital administrative assistant refusing to schedule the check-up of an LGBTQ person on religious grounds? No way. They are not “medical practitioners.” Sorry, but under this law, yes, they are. Legal.
You might be thinking, “Why would anyone want service from someone who doesn’t want to serve them?” I understand the sentiment. I would rather not have a racist doctor. And if I’m being honest, I don’t want my wife cooking for me when she’s mad. The food doesn’t taste the same.
But that’s a question of consumer behavior versus producer behavior. I think we can agree that a business which refuses to serve seniors has greater negative impact, both on the economy and the moral fabric of our nation, than an individual consumer who refuses to purchase goods from Black-owned businesses. That is why you can be racist, but you cannot start a business and refuse to serve persons of other races.
In the context of the provision of health care services — where options are already limited — refusals cause harm to any patient, but they cause a particularly burdensome harm to LGBTQ patients. A 2017 national survey of LGBTQ people conducted by the Center for American Progress found that 18% of them said it would be “very difficult” or “not possible” to find the same type of service at a different hospital. That number jumps up to 41% for LGBTQ people living outside of a metropolitan area.
Gov. DeWine said that he respects medical providers’ rights to decide whom to treat. But what about the rights of LGBTQ persons? Don’t they have a right to adequate health care? Or more specifically, don’t they have the right to the same health care that non-LGBTQ persons get? If the governor had a child who was LGBTQ, wouldn’t he want that child to receive the same health care that he receives? I would think that he would.
I would think most people would. But the problem is that too many of us must be personally affected or be close to someone personally affected by an issue to care about it. That inability to consider the world from another’s vantage point is a key factor perpetuating many of our nation’s greatest flaws. But that’s a column for another week.
In February of this year, Gov. DeWine said, “Ohio is a welcoming place. I don’t care who you are, we want you to come to Ohio. It’s a progressive state.” Four months later, he signed a bill which enshrined into law a method of discrimination against the approximately 462,000 LGBTQ persons living in the state.
Actions speak louder than words, governor.
Eric Foster, a community member of the editorial board, is a columnist for The Plain Dealer and cleveland.com. Foster is a lawyer in private practice. The views expressed are his own.
To reach Eric Foster: ericfosterpd@gmail.com
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