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Indiana hospital refuses to treat transgender woman

by Joseph Erbentraut
Contributor
Thursday Aug 12, 2010
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When Erin Vaught went to Ball Memorial Hospital in Muncie, Ind., last month, she was coughing up blood and seeking treatment for a lung condition. After reportedly facing ridicule and transphobic remarks-"he-she," "transvestite" and "it"-staff eventually refused to treat her after she waited two hours.

Activists both in the Hoosier State and across the country were not about to let Vaught’s experience go unnoticed. After the Bilerico Project, Change.org and other media outlets broke the story, Ball Memorial received some 2,000 e-mails. And the response caused hospital president Mike Haley to issue a strong statement indicating the facility will begin to work with area-LGBT groups to improve its policies.

"Ball Memorial Hospital is engaging with Indiana Equality [and] Indiana Transgender Rights Advocacy Alliance to assist with review of [our] care policies, employee benefits, and diversity training," wrote Haley. "[We are] committed to providing preeminent health care services for all our patients, and to continue [our] tradition of treating all patients and families with dignity and respect."

Both Vivian Benge, president of INTRAA, and Doug Whitinger of Indiana Equality were impressed with the swift action the hospital, which is part of Clarian Health, the largest health care provider in the state, took. At press time, the groups and hospital administration were already set to begin their conversation about new, LGBT-inclusive policies in a meeting on Wednesday, Aug. 11, a little over two weeks after the story original broke.

"The hospital is being very forthcoming and there’s been really great progress made already. This is a major step forward," Benge told EDGE. "I’m hopeful we can turn this into something that can help the whole community."

Whitinger added he was proud Vaught had the courage to step forward and approach both groups after she said Ball Memorial staff refused to treat her.

"Erin has really brought the issue to light that there are areas of the state and country where people are experiencing this discrimination," said Whitinger. "And it’s happening in locations close to people here, not far away in some intangible place. I think that’s motivating people to act."

According to data Lambda Legal released earlier this year, incidents such as the one that took place at Ball Memorial are far too common-particularly for trans people. In its survey of more than 5,000 respondents, Lambda Legal found 70 percent of trans or gender non-conforming people had experienced discrimination in health care settings-ranging from harsh or abusive language to denial of care due to their gender identity, compared to 56 percent of LGB people who suffered mistreatment due to their sexual orientation. A higher proportion of low-income respondents or those who identified themselves as people of color reported similar discrimination.

Further, more than half of trans or gender non-conforming respondents were generally concerned of being mistreated or refused health care. And more than 90 percent of trans respondents believed there are not enough medical personnel who are properly trained to care for them.

Michael Silverman, executive director of the Transgender Legal Defense and Education Fund, said Vaught’s story is an all-too-common experience that carries dire consequences. These include trans individuals pursuing self-care or avoiding routine health care altogether.

"The health care system simply has not progressed to meet the concerns of the transgender community and it shows up in ugly incidents like what happened to Erin," said Silverman. "Transgender people have largely checked out of the mainstream health care system, which often results in some really bad health outcomes."

Hector Vargas, executive director of the Gay and Lesbian Medical Association, a group that works to combat homophobia within the medical profession and promote quality health care for LGBT people, offered further insight.

"When an individual LGBT person doesn’t feel like the health care professionals are welcoming or inclusive of their particular needs, that individual’s actual health is put at risk," he said. "Good health is one of the most important things a person can have and that’s at risk if we don’t address this sort of discrimination in the health care setting in a global way."

A global fix-up of health care providers’ treatment of LGBT patients will prove a large undertaking. According to the latest Healthcare Equality Index, created by the Human Rights Campaign in conjunction with GLMA, only 58 percent of the nation’s 200 largest hospitals had non-discrimination policies in place for patients’ sexual orientation.

When it comes to gender identity and expression, this number shrinks to only seven percent.

While Ball Memorial and other facilities may have good intentions to improve their services for LGB and specifically trans patients, efforts to enact patient-specific non-discrimination policies and create LGBT cultural competency training sessions for hospital staff often come with a price tag. Some financially-strapped providers may be hesitant to take on the additional cost of overhauling databases previously geared to only two gender options, as one example.

Despite the work that lays ahead in countering what he describes as a "failure of the system to address the needs of transgender people," Silverman emphasized progress is a two-way street requiring heightened advocacy similar to the way Indiana activists responded to the Ball Memorial controversy.

"We have to be willing to step up and say this is what we need and these are the barriers we face in our community and see how the system can work for us," he said. "We have to be prepared to partner with health care providers to ensure equal access to care."

Joseph covers news, arts and entertainment and lives in Chicago. He is the assistant Chicago editor for The Huffington Post. Log on to www.joe-erbentraut.com to read more of his work.

Comments

  • Bill Blazak, 2010-08-12 07:56:20

    You can all the politically correct non-discimination policies in place you like, but when the majority of hospital workers come from Third World cultures that find all this stuff just plain crazy, you’re going to have problems. Too much of LGBT "solutions" are designed bring white people into compliance with political correctness. ("failure of the system to address the needs...). You see, it’s not a "system," it’s people and people from cultures that will never view transgendered as anything but freaks. Implementing new "policy" isn’t going to do a damned thing. Not really.


  • Michael K. Lavers, 2010-08-12 09:18:39

    With all due respect to your comment BB, what do you suggest these hospitals do to improve the quality of health care for their transgender specifics? I’m particularly interested to read any specific recommendations you may have in mind.


  • Anonymous, 2010-08-12 10:48:53

    Actually, BB non-discrimination is a policy that carries massive consequence when violated. Hospital Risk Managers will be all over this if there is a threat to it impacting the bottom line. So, whether US or foreign-born healthcare professionals discrimination can cost a bundle and the policies for that a longstanding. The how to effectively deliver care to trans people is how you mitigate risk.


  • Bill Blazak, 2010-08-12 14:02:07

    There is no doubt that firing such individuals will cow the rest into obedience - up to a point. The cultural taboos which surround this strange phenonemon will probably never be overcome. My point is broader than the context of the article, and my objection is to the notion that enforcing political correctness through coercive means mitigates the actual problem. It only drives it underground. By all means, use force of law to end this kind of discrimination, but don’t succumb to the delusion that the problem has been seriously addressed. There are some prejudices that simply will never be overcome and men turning themselves into women is one of them, especially in Third World cultures - where the majority of American hospitals now find their skilled and semi-skilled healthcare workers.


  • Michael K. Lavers, 2010-08-12 14:21:50

    With all due respect (once again) BB, you’re using the phrase "strange phenomenon" and "men turning themselves into women" in your description of someone who is transgender?


  • Michael K. Lavers, 2010-08-12 14:24:09

    I meant to say ’transgender patients’ and not ’transgender specifics’ in my previous post. My apologies...


  • Bill Blazak, 2010-08-12 16:44:53

    Yes, Mr. Lavers, I find transgenderism exceedingly strange. As a lover of penises and of the people who have them, I am unable to process the desire to cut off one’s own and scoop out a vagina in its place. Not being down with it, however, does not equate to being hostile to it, which I believe is implied by the passive/aggressive nature of your response. This LBGT thing is a political construct designed to bring wildly incongruous communities together in a manufactured solidarity in order to effectuate political change. That is fine, but the problem with such inventions is that in the hands of zealots, which the gay left has in legion, less than blind devotion to the construct is heretical. Would I ever do anything that would discomfort or even disturb a transgendered person. God forbid, but I do retain the right to find it all very curious, regardless of how much opprobrium I risk for having opinions not in lockstep with political correctness.


  • Anonymous, 2010-08-12 18:27:44

    "issue a strong statement indicating the facility will begin to work with area-LGBT groups to improve its policies." The hospital doesn’t need to work with anyone. They simply need an order from the top to treat everyone equally. A statement like that means that hospital management condones and wishes to continue disparate treatment. The GLBT community has money that is the same color as everyone else. If the hospital really wants that money, no dialog is required.


  • Bill Blazak, 2010-08-12 21:14:18

    18:27 I quite agree with you. This notion of "working" with local groups to do this or that is complete left wing drivel. I have not disagreed with anyone who has said that the way to overcome this issue is not to send people to sensitivity training and dialogue with groups - my God what impotent crap - the solution is to establish policy and bring down the wrath of God on those who do not follow it. My point all along has been that one should never assume that the iron hand of policy actually deals with the undrlying problem.


  • Anonymous, 2010-08-18 02:42:00

    The ethnic group I’ve seen flocking to American healthcare jobs for years (at my mother’s workplace and every hospital or care facility I’ve visited) is Filipinos. While the Catholic church has huge influence there, I think trans people do have a peculiar kind of visibility in Filipino culture (and don’t get me started on Thailand). In Iran (speaking of third-world cultures, whatever their technology), the government actually pays for gender reassignment. The Iranian interpretation of the Quran’s teachings on trans women in particular seems to view them as either a legitimate third sex, or as women with a medical condition that makes them look like men. Unfortunately, the de facto solution in most care settings is for patients themselves to ’educate’ their care providers as best they can. Even professional standards among trans-specific advisory groups vary, and most caregivers aren’t even aware such groups exist. On my therapist’s shelf sits a copy of "Transgender Care" that I purchased myself. Obviously nobody in an emergency room is going to read a 180-page book on request. But I’d advise anyone with an unusual medical history (trans or otherwise) to make a habit of carrying some basic information about their medical history. This along with standing orders and legislation to provide the same care to trans people as to anyone else, with serious consequences and criminal liability if those orders aren’t followed. Sucks that so many conflicts between individuals and organizations are automatically steered into civil court (IF that). Of course, any problem between patients and hospitals or HMOs is often part of a larger dysfunction in the American healthcare industry.


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