The Final Conscience Rule Is A Direct Assault on the LGBTQ Community

Legal discrimination in healthcare is turning your doctor’s office into a political battleground

Imagine this scenario – you schedule your annual physical with a new doctor and, during the appointment, you discuss your sexual health and request to have blood drawn for a full STD panel. You also ask your doctor about a prescription for PrEP.  But your new doctor says that he can’t provide PrEP for you or proceed with your appointment because treating a queer patient directly conflicts with his religious beliefs.


You’d probably feel angry.  You’d feel violated. You’d feel like a victim of discrimination, which you would be.  And you’d probably be motivated to hold that doctor accountable. Except, under the Department of Health and Human Services’ Final Conscience Rule, your new doctor can deny care under the protection of the law, and there’s nothing you can do.


The Final Conscience Rule

The Final Conscience Rule was announced May 2. According to HHS’s official press release, the regulation “protects individuals and health care entities from discrimination on the basis of their exercise of conscience in HHS-funded programs”. It’s a more formal extension of a May 2017 executive order from the Trump administration, which was created to protect religious liberty.


In other words, if a healthcare provider feels that offering you a certain type of care, or offering you care at all, clashes with their religious ideology, they can deny treatment and send you away.  This rule applies to a wide range of services (e.g. abortions, assisted suicides, etc.) but it also extends to vital LGBTQ services, including gender affirmation surgeries and other procedures for transgender patients.


To some, this might not seem like a big deal.  The Final Conscience Rule is just the latest development in a series of policy enactments or rollbacks that target our community in direct and indirect ways.  And, 56% of LGB and 70% of trans and gender nonconforming people are already experiencing regular discrimination in healthcare facilities around the country.


But it is a big deal.


It’s a big deal to Grayson Russo, who spent three years fighting to have their top surgery approved.  It’s a big deal to the transgender people who regularly avoid the ER out of fear of discrimination, resulting in higher rates of illness and death.  It’s a big deal to anyone who believed a hospital or a doctor’s office was a safe space.


Accessible, Compassionate Care Matters

The Final Conscience Rule has turned America’s healthcare facilities into moral and political battlegrounds.  This is in addition to the many barriers to care that we – black, queer, intersectional people – already face.


HIV infections among black queer men account for 60% of diagnoses in the entire black community, and these cases are often a result of lack of access to affordable healthcare and a lack of knowledge about preventative options.  The tools are there but they aren’t within reach. And now, fear is yet another barrier to stop us from seeking the care we so desperately need.


Access to care, and compassionate care at that, can be lifesaving.  But discrimination in healthcare contributes to a lack of understanding amongst professionals who administer care and creates a lack of trust in the overall healthcare system.   This creates preventable medical issues and even death.  


Discrimination means denial of medically necessary care, like HIV meds.  It means mistreatment, like the case of Kyler Prescott, a suicidal transgender boy who was misgendered and released early from the hospital, only to later commit suicide. This even means LGBTQ parents being denied services for their children.


To make this kind of behavior permissible, under the guise of protecting religious freedom, is phony, dangerous, and dishonest.  The Final Conscience Rule creates a pecking order in healthcare. It gives physicians a right to determine who is worthy of care and who isn’t.  Aren’t all humans deserving of the lifesaving care that we need?


This “rule” doesn’t protect religious freedom so much as it enables bigotry.  It politicizes a space that should prioritize helping others. Care now comes with a caveat; you must see through your sickness and urgent medical needs to read the cultural fine print.  Because you are who you are, you can be denied a wedding cake or an emergency medication.


It seems now that an act as simple as scheduling a doctor’s appointment is a political one.  Healthcare has enough problems without the Trump administration’s misguided meddling – open discrimination doesn’t need to be one of them.


Cover photo: Unsplash Arsney Togulev

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