Jamie Bruesehoff remembers the first time she took her daughter, Rebekah, to the gender and sexuality development clinic at the Children’s Hospital of Philadelphia.

They drove for nearly three hours from their home in New Jersey to see a knowledgeable specialist — someone who would know the latest research and cutting edge care for transgender patients, like Rebekah.

A psychologist at the clinic spoke one-on-one with 8-year-old Rebekah during that first visit, and when she came back to Jamie and her husband, Jamie says she was teary-eyed.

She told them she asked Rebekah what it meant to be transgender.

Rebekah’s response was, “Being transgender means being who God made me to be.”

The Bruesehoffs are a religious family. Jamie holds a degree in theology, her husband is a pastor, and Rebekah and her two siblings were raised in the church.

“I know there are faith communities where she will never be welcome. I don’t have to like it but that’s religious freedom,” Jamie says.

When she heard about the Trump Administration’s creation of a new division at the Department of Health and Human Services dubbed Conscience and Religious Freedom, she was upset. Organizations like the Human Rights Campaign say that a division like this one can lead to discrimination in health care against LGBTQ patients by protecting “people from being coerced into participating in activities that violate their consciences.”

“Denying my daughter access to medical care — refusing to cast her broken arm or fill her cavity because of who she is — that’s not religious freedom. That’s discrimination,” Jamie says.

Jamie spoke about her family’s experiences at a Human Rights Campaign event in Philadelphia, where the HRC released its annual Healthcare Equality Index on Monday. The index scores health-care facilities on their policies and practices regarding the inclusion of LGBTQ patients, visitors and employees.

This year’s index is especially crucial because of the political climate, says Sarah McBride, the national press secretary at the Human Rights Campaign. The launch of the HEI coincided with the deadline for public comment on the Trump Administration’s division of Conscience and Religious Freedom.

“Despite these legislative or political attacks that we’re seeing from anti-LGBTQ politicians, hospitals are increasingly adopting best practices when it comes to supporting and caring for LGBTQ people,” says McBride.

More than 600 health-care facilities voluntarily reported their policies for the survey this year. They were rated on criteria like whether their patient non-discrimination policies included both sexual orientation and gender identity, or if they allowed equal visitation for same-sex partners.

Another criteria focused on treatment of transgender patients, identifying them as a particularly vulnerable patient population.

Four hundred and eighteen health-care facilities earned perfect scores. States including California and New York have the highest number of perfectly rated hospitals, according to the index.

Sarah McBride (Getty for Human Rights Campaign)
Sarah McBride (Getty for Human Rights Campaign)

“Hospitals, clinics, doctors, health-care facilities in general are stepping forward and adopting inclusive policies within their own walls, but also speaking out for equality in their communities,” McBride says.

The survey shows that health-care facilities are making strides in areas like electronic health records — more facilities indicated that their health records offer an explicit way to capture a patient’s sexual orientation and their gender identity. Hospitals also reported more than 70,000 hours of training in LGBTQ patient-centered care across the country.

“This year’s report underscores both the incredible strides we have made,” McBride says. “But it also underscores the work that remains.”

Keisha Michaels is intimately familiar with the strides and the pitfalls of health care — she’s both the mother of a transgender teenager, and a pediatrician.

“As a parent, the thought that my child could be denied the medical care that she needs because she is transgender saddens, angers and terrifies me,” she says. “As a pediatrician, it is also categorically unethical.”

She says that parents of LGBTQ children are all looking for the same thing — equal care without question.

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