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Cori Agarwal, M.D,. Medical Director & Plastic Surgeon of the Transgender Health Program at U of U Health discussed the significance of the HRC designation to the program’s patients, stating, “Coming out to a provider can be an intimidating process. Our providers and staff are prepared to have these sensitive conversations with patients. Considering our patient’s sexual orientation and gender identity is essential in providing whole-person care.” Agarwal continued, “Our providers and staff are trained in best practices and to ask patients about their pronouns and chosen name. Providing patients with a safe environment to access care is critical to ensuring the best health outcomes. Our teams promote safe spaces for patients where they can talk about their identities. We let our patients tell us about their gender journey and how our clinical teams can best help them meet their goals of affirming their gender.”

Every year, HRC recognizes the health care facilities that participate in the HEI for their dedication and commitment to LGBTQ inclusion. HRC also extends its deepest gratitude to these facilities for their courageous fight against COVID-19 and their commitment to addressing racism and injustice. As the final HEI surveys were submitted in March, health care facilities were kicking into overdrive to meet the challenges of COVID-19. Many faced a lack of equipment, staffing shortages and surging demand. Two months later, as the fight against COVID-19 continued, the murders of George Floyd and Breonna Taylor by police officers thrust America’s structural racism into the spotlight. HEI participants issued strong statements on racial justice and equity, participated in White Coats for Black Lives demonstrations and announced new programs to address racial inequities in their institutions and their communities.

“From the previously unimaginable impact of the COVID-19 pandemic to the horrific incidents of racial violence targeting the Black community, the events of the past year have brought about so much pain and uncertainty. Yet, even during this moment of profound unrest, we are seeing more of our humanity and resilience come to life. For me, nowhere is that more true than through the tireless dedication of our health care providers and the intrepid support and administrative staff members by their sides that show up every day to ensure this life-saving work continues,” said HRC President Alphonso David. “The health care facilities participating in the HRC Foundation’s Healthcare Equality Index (HEI) are not only on the front lines of the COVID-19 pandemic, they are also making it clear from their participation in the HEI that they stand on the side of fairness and are committed to providing inclusive care to their LGBTQ patients. In addition, many have made strong statements on racial justice and equity and are engaging in efforts to address racial inequities in their institutions and their communities. We commend all of the HEI participants for their commitment to providing inclusive care for all.”

In the 2020 report, an impressive 495 facilities earned HRC’s “LGBTQ Health Care Equality Leader” designation, receiving the maximum score in each section and earning an overall score of 100. Another 193 facilities earned the “Top Performer” designation for scoring from 80 to 95 points. With 90% of participating facilities scoring 80 points or more, health care facilities are demonstrating concretely that they are going beyond the basics when it comes to adopting policies and practices in LGBTQ care.

The progress reflected in the 2020 HEI includes:

• 92% of participants met the HEI's training requirements, completing more than 150,000 hours of staff training in LGBTQ patient-centered care.
• 99% of HEI participants documented that they include both “sexual orientation” and “gender identity” in their patient non-discrimination policy.
• 99% of HEI participants documented that they include both “sexual orientation” and “gender identity” in their employment nondiscrimination policy.
• 53% of HEI participants indicated that their facility has a policy or policies that specifically outline procedures and practices aimed at eliminating bias and insensitivity, and ensuring appropriate, welcoming interactions with transgender patients.
• After many years of trailing their corporate counterparts in the provision of transgender-inclusive health care benefits for employees, HEI participating healthcare facilities are nearly on par with the HRC Foundation’s (CEI) participants as 80% have at least one health care plan that offered this benefit. The latest CEI noted 85% of participants having such benefits.

In addition to active survey participants, the HRC Foundation proactively researched the key policies at over 1,000 non-participating hospitals. The adoption rate at these researched hospitals stands in stark contrast to the near-perfect adoption by active participants. Among the researched hospitals in which we were able to find or obtain enumerated patient non-discrimination policies, only 67% have policies that include both “sexual orientation” and “gender identity,” and only 63% were found to have an LGBTQ-inclusive employment non-discrimination policy. The equal visitation policy, at 93%, is the only one that comes close to matching the rate of the participating facilities.