In the Bay Area, medical providers and civil rights advocates are responding to the controversial formation this January of a federal Conscience and Religious Freedom Division (CRF), which would give medical providers the ability to reject service to a person based on the provider’s religion. Advocacy groups say this could allow discrimination, and potentially impede members of vulnerable communities, such as the Lesbian, Gay, Bisexual, Trans, and Queer (LGBTQ) community and people living with HIV, from accessing medical services.
“It can easily become an excuse to withhold services for a lot people, not just necessarily those who are gay,” said Leslie Ewing, executive director for the Pacific Center for Human Growth, which is based in Berkeley. The Pacific Center provides mental health services for LGBTQ youth ages 13 and up.
DK Haas, community liaison of the UC San Francisco Alliance Health Project, said, “Every time a law that discriminates against LGBTQ people gets enforced or upheld—or even if not a law, like this stupid division—it threatens us as people.” AHP provides mental health services to the LGBTQ community and people living with HIV.
Haas said that something like the new division can make the lives of those it works against uncomfortable and can cause trauma. “When there is a law that says you don’t even have to actually treat this person, you can throw them out of your office if you morally object to their queerness, I think that adds another pressure to the patient,” she said. And even if the medical provider may seem to be welcoming, she said, LGBTQ patients may hide their sexual orientation or hesitate to fully disclose who they are. “That is more problematic, the more intersectionality a person is living with,” she said, referring to the idea that a person might identify as a member of more than one minority group.
The new division, which is within the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services, will be charged with overseeing “conscience claims” from medical providers who refuse to perform certain actions for moral or religious reasons. On January 18, Roger Severino, who serves as director for the OCR announced the new division’s formation in a video that was livestreamed on Facebook
“On May 4, 2017, we reached a turning point in America,” he said, referring to President Donald Trump’s Executive Order Promoting Free Speech and Religious Liberty. This order created legal grounds to allow medical providers to opt not to perform certain procedures, such as abortions or euthanasia, that would violate a provider’s religion.
In October, the Trump administration also authorized new regulations that would allow some employers, based on religious or moral beliefs, to deny birth control coverage to employees.
During the January livestream, Severino said, “Times are changing and we are institutionalizing a change within HHS to never forget that religious freedom is a primary freedom.”
“It is these fundamental questions of conscience where the state should not force people to go against their integrated view of humanity,” Severino continued.
National groups like PFLAG (Parents and Friends of Lesbians and Gays), which work to support LGBTQ families and allies and has branches in the Bay Area, were quick to voice their distaste for the CRF and President Trump. In a press release from the group’s national office, executive director Dr. Jamie Grant wrote: “This president needs to return to his doctor and have his head examined again if he thinks the LGBTQ community is going back to the day when anyone, anywhere can turn their backs on our medical needs and out right to be compassionate.”
In the East Bay, Ewing pointed out that LGBTQ community is not the only one at risk of being turned down by a medical provider, and that the issue connects to the civil rights of different types of people. “If you have a business that is catering to the public, you have to serve the public,” she said.
Carlos Villatoro, a spokesperson for the Medical Board of California, said this is not an issue the board “would take a position on. The Board’s main purpose is consumer protection and ensuring that physicians and surgeons are in compliance of the Medical Practices Act. A doctor can terminate his/her relationship with their patients as long as they are following the Standard of Care,” he wrote by email. Those standards include notifying the patient in writing of alternative care providers and telling them how to obtain their medical records.
While Ewing said that she does not foresee this being an immediate issue in California, she noted the importance of speaking out against discrimination. “It kind of is never over,” she said. “For every progressive step taken there is always a backlash, and the pendulum swings back and forth.”