The Human Rights Campaign, a national LGBTQ rights organization, significantly lowered the ranking of two Dallas hospitals in its scoring system for health care inclusivity after the facilities halted medical treatment for new adolescent transgender patients.
Children’s Health and the University of Texas Southwestern Medical Center are now the two lowest scoring hospitals in Texas in the biennial Healthcare Equality Index 2022, published Monday.
HRC said it applied the “responsible citizenship criteria” penalties because the hospitals stopped providing “necessary and medically approved care” to trans youth while continuing the same care for cisgender patients.
Genecis – which stood for Gender Education and Care, Interdisciplinary Support – was an acclaimed seven-year-old program created by the hospitals to provide comprehensive care to transgender and gender-diverse youth. It was the only such program in the state of Texas before it stopped providing gender-affirming medical care for new patients in November 2021.
“The actions taken by UT Southwestern Medical Center and Children’s Medical Center Dallas are life-threatening for transgender youth and required decisive action on our part,” said Tari Hanneman, HRC director of health and aging.
“Every person deserves to have access to quality healthcare, be respected and heard by their doctor and feel safe in the facility where they are receiving care,” she said. “Which is why it is heartbreaking that transgender kids in Texas are being rejected this life-saving, gender-affirming care.”
The Dallas Morning News reached out to UT Southwestern and Children’s Health for comment on the score changes but has not received a response.
The future of gender-affirming health care access for transgender youth is up in the air as state leaders battle the use of medical treatments to treat gender dysphoria in adolescents in Texas court.
Texas Attorney General Ken Paxton issued an opinion in February that made treatments for minors like puberty blockers and hormone treatments akin to child abuse. On Wednesday, Paxton asked the Texas Supreme Court to allow the state to resume its abuse investigations into the parents of trans adolescents receiving such care after they were paused by a temporary injunction.
All of the major national and state medical groups support age-appropriate, individualized gender-affirming care for trans children and adolescents. Best practices dictate that medical interventions only be explored for adolescents who have experienced the onset of puberty and have undergone mental health evaluation.
At least one health care facility – Texas Children’s Hospital in Houston – paused gender-affirming medical care for its adolescent patients in response to Paxton’s opinion. But the change in care at Genecis began months before the state began investigating parents of trans youth.
HRC suspended UT Southwestern and Children’s Health from both the Healthcare Equality Index 2020 and “top performer” designations in February because of the program’s closure and a lack of public communication on the decision.
Until the suspension, UT Southwestern and Children’s Health were listed as scoring 95 and 90 out of 100, respectively, on the index. UT Southwestern previously pointed to the index “top performer” designation on its website as proof of its focus on equity and access.
UT Southwestern’s score is now a 50, Hanneman said, while Children’s Health’s score is a 75.
The decision to invoke such a significant deduction was not an easy one, she said. “We did not take implementing this penalty lightly. In the end, we prefer not to have to do it,” Hanneman said. “We would prefer that the ship would be righted in providing that care.”
Suspending the hospitals from the 2020 index instead of immediately docking points off was done to buy time for HRC to learn more about the change in care. Jay Brown, HRC Foundation senior vice president, said the organization tried unsuccessfully to hold conversations with the hospitals about Genecis in the months leading up to the suspension.
The Dallas hospitals are now two of only three hospitals to ever receive a 25-point deduction in the biennial scoring system’s 15-year history for “known activities that undermine LGBTQ equality or patient care.”
In the 2018 index, Johns Hopkins Hospital received the deduction for Johns Hopkins Medicine’s “failure to address HRC’s concerns regarding deeply disturbing anti-LGBTQ misinformation voiced and published by faculty members,” according to HRC’s website.
Only 22 Texas health care facilities participated in the 2022 index, a small fraction of the 906 healthcare facilities that participated nationally. Nearly 500 facilities earned the index’s “LGBTQ+ Healthcare Equality Leader” designation by earning an overall score of 100.
One hospital, Methodist Metropolitan Hospital in San Antonio, and three health care clinics, all based in Austin, received perfect scores.