Effects of Trans Bans on LGBTQ+ Health Care: “State of Emergency”

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Speaker 1 ( 00:04 ):
America's LGBTQ+ community says it's living in a state of emergency. The human rights campaign
reports over 500 anti - LGBTQ+ bills have been introduced in 41 states this year, and more than 75 have
become law, and many of them deal with the right to healthcare.
Dr. Marwan Haddad ( 00:24 ):
Just because we do not have all the research done, doesn't mean you ban gender - affirming care
legislatively across the board and increase further barriers for kids and adolescents in particular, but also
adults.
Speaker 3 ( 00:36 ):
Our guests are Dr. Marwan Haddad, the immediate past chair of the HIV Medicine Association, and Dr.
Carl Streed, the research lead for the gender care center at Boston Medical Center, where he helps to
assess and address the health and wellbeing of transgender and gender diverse individuals.
Dr. Carl Streed ( 00:53 ):
I think one thing also to really point out around these bans is they're hyper - focused around access to
medications and surgery, when gender - affirming care is really much more than either of those, and the
care needed for youth is often more focused around educating the family, making sure the youth is
supported, that they have a safe environment, and that their community is safe for them.
Speaker 3 ( 01:14 ):
This is Conversations on Healthcare.
Speaker 1 ( 01:24 ):
Well, welcome Dr. Haddad and Dr. Streed to Conversations on Healthcare.
Dr. Carl Streed ( 01:29 ):
Thanks for having us.
Speaker 1 ( 01:30 ):
Yeah. Good to see you both. Let's start with Dr. Streed. You're on the faculty at Boston University's
Chobanian & Ava Avedisian School of Medicine. In November, you'll become the president of the US
Professional Association for Transgender Health. The Human Rights Campaign says 35% of transgender
youth live in states that have passed bans on gender - affirming care. What harm do you think this will
cause if the bans are fully implemented?
Dr. Carl Streed ( 02:03 ):
Thanks for that question. I feel like it's important to recognize that while the bans themselves are
egregious, they're not evidence - based, they're going to cause direct harm. I think it's important to
recognize that the conversations even around these bans are really harming people even across
different state borders. It's causing significant degrees of distress, anxiety, concerns around depression,
and lots of questions around access, even in neighboring states because a lot of folks are still having to

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travel to different clinics very far away because so few folks are actually able to provide gender -
affirming care for youth and adolescents and honestly, even adults.
( 02:40 ):
Myself as a primary care doctor who provides gender - affirming care for adults, I have patients who are
traveling hundreds of miles to access care because there aren't enough of us who are able to do that. I
think one thing also to really point out around these bands is they're hyper - focused around access to
medications and surgery, when gender - affirming care is really much more than either of those, and the
care needed for youth is often more focused around educating the family, making sure the youth is
supported, that they have a safe environment, and that their community is safe for them. Medications
and surgery, if indicated, are only part of that conversation. They're not the only part of the
conversation.

Speaker 3 ( 03:18 ):
Well, Dr. Streed, as you know, a lot of conversation going on in the country and supporters of these bills
say that they're really just protecting children who are too young to understand the health impacts of
such care. I wonder what you say in response to this issue, particularly of the age of children and what
does it mean to be too young?

Dr. Carl Streed ( 03:41 ):
I feel like this is such a loaded question because we allow folks to make decisions, a variety of life -
changing decisions at different ages, but again, the focus is really trying to make sure that the youth are
supported in whatever decision they make that makes sense for them, and that this is not just
somebody who's made a decision all of a sudden and that the doctor's going to prescribe or going to do
surgery immediately. This is always something that's been in conversation with a multidisciplinary team
for a very long time, honestly, for many folks. So this is not a decision that's made lightly for anyone, and
this is a decision often made in conjunction with a multidisciplinary team and always with the support of
family essentially.

Speaker 3 ( 04:19 ):
If I can just ask you to clarify, and we do hear this a lot about young, are there age, or is there evidence
for certain ages of which it's appropriate to begin having the conversation or is whenever the child and
family are ready to have the conversation?

Dr. Carl Streed ( 04:35 ):
I think it's more about when the child and the family are ready to have the conversation. They're the
ones who should be really... Like the child, the youth, the adolescent are the ones who really should be
dictating their care. That's how we need to be doing it in general. We should be listening to the patient
in front of us. That being said, of course, we have very clear guidelines about when we may consider
medical or surgical interventions, and those are the guidelines we should be following from the World
Professional Association for Transgender Health, of which US Path is part of. So it's again, one of those
things where this is not uncharted territory really. This is really something that has clear guidance, has
expert input, has more and more evidence supporting the provision of this care. So it's more a situation
that I often see where politicians are making policies without evidence and are not seeking the input of
the people affected and not seeking the input of experts who are providing that care.

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Speaker 1 ( 05:26 ):
Well, Dr. Haddad, we of course know you very well. In the spirit of transparency, you're the director for
the Center of Key Populations at the Community Health Center and the health center is part of the
Moses Weitzman Health System, and I'm wondering what do health systems mean when they say they
offer gender - affirming care and hormone therapy, and what does that involve?

Dr. Marwan Haddad ( 05:52 ):
Yeah. Thanks for that question. I think it's very important to really define what that is because a lot of
times I think people just focus and hone in on exactly what Dr. Streed was saying, it's about medications,
and it's a lot more than that. So for me, it means that these health systems provide a welcoming, safe,
respectful environment for the LGB and transgender and gender diverse communities, and that all the
staff is well - versed, well - trained, and culturally humble, when it comes to interacting with individuals in
the LGBT community, it means, for instance, things like being able to accommodate and appropriately
use people's names and pronouns. It means that we have expertise in providing quality care in issues
and conditions that affect the LGB and transgender populations, including medications like hormone
therapy.
( 06:38 ):
But as a note, there's much more to delivering comprehensive patient - centered care, which is the bread
and butter of primary care health centers like ours, much more than just hormones, and health systems,
I think need to understand and provide this holistic care. And lastly, I think, and ideally, they also have a
resource and referral network that also provides safe and respectful care for the patients.

Speaker 1 ( 07:00 ):
Well, maybe for both of you, are we losing this battle in terms of definition where everything is viewed
only in one context, and what can we do to better educate people across the board about the more
comprehensive view of the work that's going on here?

Dr. Carl Streed ( 07:18 ):
I mean, I feel like it always comes down to actually knowing who's affected and really sharing narratives,
really sharing the stories of who's having trouble accessing care and highlighting the harms that are
happening from this legislation that's already been passed in too many states, but also highlighting the
positive benefits, the joy that we see from youth and adolescents and adults who are able to access
gender - affirming care. I mean, honestly, for me as a clinician, there isn't a week that goes by where a
patient isn't just happy, joyful, or will honestly say like, "You saved my life," by providing very broadly
gender - affirming care. So we have to share that information, we have to share those stories. And then
also, we have to really lean into not backing down from any one of these battles. It's essentially, I
describe it as somebody essentially setting fire in different homes, and we have to go to each one of
them and put out each one of them with the same dedication we would for any others. So it is an
ongoing fight to make sure that people know who's benefiting and who's being harmed by these
egregious policies.

Speaker 3 ( 08:17 ):
Well, that really goes to the recent study that found that transgender children are three times, I think, as
likely as the general population to have anxiety and depression, neurodevelopmental disorders. And we
note that the US Justice Department has said, and I'm quoting here, "No person should be denied access

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to necessary medical care just because of their transgender status, including transgender children."
There's so many questions about this out there, and Dr. Haddad, what about the argument that the
medications used for gender dysphoria lack the FDA's approval for this use? Where does that fit in?

Dr. Marwan Haddad ( 08:54 ):
Sure. So there are a lot of things as we say that we don't have FDA approvals for that we use in medicine
across the board, not just in transgender health. And so I think first, we need to acknowledge
wholeheartedly that we do need more research in gender - affirming care, and we need more funding for
research. We need more active recruitment and inclusion of transgender and gender diverse individuals
in all research across the board. But that doesn't mean that we don't know how to care for transgender
and gender diverse individuals. As Dr. Streed said, in the US, we've got experts in many fields of
medicine and prominent medical organizations that support the gender - affirming care and that we have
these guidance and guidelines. And just because we do not have all the research done, doesn't mean
you ban gender - affirming care legislatively across the board and increase further barriers for kids and
adolescents in particular, but also adults in seeking the care they need and deserve.
( 09:50 ):
So gender - affirming care, truly, as I think Dr. Streed was alluding to, means in many ways supporting the
social transition. What do we mean by that? That means allowing kids to wear the clothes they want,
cutting their hair like they want, playing with the toys that they want, providing that safe support for
families and for the patients to say that, yes, it is okay for you to feel this way, and means providing the
counseling. And at some point through all the shared decision - making with providers, patients, with
families, medications may be prescribed around the time before puberty's going to hit. So puberty
blockers do delay onset of puberty, and so you can start those until such a decision is made, shared,
when they want to go through puberty and which puberty they want to go through based on their
gender identity.
( 10:39 ):
We hear from our patients all the time that if a trans kid is about to go through the puberty of the
gender that you do not identify with, that is a very serious and critical time and a dangerous time for
them. And so I think a lot of these issues are made together with the families, with the providers. What
has to happen though is that we cannot have that interference and being dictated by legislation. These
are decisions that are made in the context of the provider patient relationship, and they need to remain
there. And as we said, the harm in withholding this care to the transgender community is really
detrimental and can be fatal.

Speaker 1 ( 11:24 ):
Dr. Streed, let me just pull the thread on Dr. Haddad's statement about more research needing to be
done. Critics say, instead of offering puberty blockers, clinicians should understand children could just
be going through a phase and that watchful waiting and talk therapy should be used for gender
dysphoria. I'm wondering if that's an area of research and also what's your reaction when you hear
comments like that?

Dr. Carl Streed ( 11:52 ):
My general reaction is, I'm getting tired of us having to try and chase the moving finish line as it were in
terms of, oh, this is the evidence that we need or this is the research question that people should be
focusing on. We should be focusing less on whether gender - affirming care actually is good or bad, and

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focus more on how can we do it better and how can we make sure that we reduce any potential risk
from any intervention just like we do for any medical or surgical intervention. We have to really
understand and characterize it. Right now, we're fighting the battle of is it good or not? And honestly,
anybody who's actually providing gender - affirming care can see it firsthand within their own patient
population. Any researcher who does this seriously can also see at a population level that there is
significant benefit from the provision of gender - affirming care, including medicine, surgery, as well as
broader additional services.
( 12:37 ):
So my general response is exasperation, when people are asking for more research to prove that it is
beneficial or not. But overall, there's so much within medical and surgical care that yes, we need more
research. We always need more research to better characterize the care we're providing. Just because
we need more research, that does not mean we stop providing the care, honestly, just because we have
issues with regards to potential adverse outcomes, that does not mean we stop providing the care
because we then find ways to actually reduce the adverse outcomes. We then find ways to make sure
who's going to benefit the most from the interventions and so on and so forth. Too much do people
focus on very small numbers of adverse outcomes for only apparently gender - affirming care, rather than
looking at adverse outcomes for anything else, that, again, this just for me highlights the ideological and
political motivations around these bans rather than the actual evidence or care about youth and
children or the constituents of these elected officials.

Speaker 1 ( 13:39 ):
We just had on from NYU Legon, the lead researcher for our long COVID study, which is the first in the
nation. And obviously we've been treating long COVID in many different ways without the results of this,
but it's a work in progress. Any research that you're keeping a watchful eye on that's going on that some
of our listeners might want to also be aware of?

Dr. Carl Streed ( 14:04 ):
So there's already great publications from a multi - site longitudinal study of youth and adolescents
receiving gender - affirming care. This is actually an NIH funded study. They've published in the New
England Journal of Medicine, highlighting a number of psychological and mental health benefits of
gender - affirming care. I'm always eager to see what they're going to keep churning out because this is a
multi - year process. They're going to be the leaders honestly, in terms of what can we expect around
gender - affirming care for youth and adolescents. Again, though, what I like about the study is they're
not focused on whether this is good or bad. They're focused on who's benefiting, who could benefit
more, and what do we need to understand about any outcomes from that. I think that's what people
should be keeping an eye out for.
( 14:44 ):
I also want to highlight that there's more research focused around conversion therapy or essentially the
harmful attempts to try and change somebody's gender identity to make it either be cisgender or
cisgender with a sexual minority identity and more research is really highlighting the harms of that
approach. And that has often been the response to, we don't do gender - affirming care, we actually
really try and convince people that they are actually the gender that they were assigned at birth, and we
know that that practice is harmful and really needs to be continued to be banned, and more research
will continue to show that more likely.

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Speaker 3 ( 15:15 ):
Well, I know that both of you are probably equally expert at the one - on - one relationship with the
patient in the exam room and the family, but also in the national circles where the policies are being
made and dialogue is happening. The American Medical Association and the Academy of Pediatrics both
support gender - affirming care. The Pediatrics Academy just authorized and expanded a set of guidance
based on the systematic review of the evidence. But we have this pushback. Florida says, not enough
scientific evidence to prove that treatments improve health. And the United Kingdom I understand is
largely stopping the use of puberty blockers, reciting this gap in evidence. That's a lot I know to unpack,
but I am curious if you're finding that the support from your professional associations is clear and strong
enough that you feel you have that backing of the professional associations going forward or any
concerns in that area that there's going to be a push on professional associations to move in a different
direction?

Dr. Carl Streed ( 16:22 ):
I'm personally grateful for our professional associations for actually, again, sticking to the evidence and
not caving to any pressure. As somebody who is actively involved in organized medicine through the
American College of Physicians, Society for General Internal Medicine, the American Medical
Association, these are all associations that have really focused on trying to make sure that we
understand the evidence, that we acknowledge where there are gaps, and really try and push the
science forward and make sure that clinical care is based on that. There of course, has been political
pressure.
( 16:49 ):
The American Medical Association, when they really stood up against any legislation around the
provision of gender - affirming care, received very targeted threats, and the AMA has not backed down.
And I think that's what we really need to see from our professional associations is that we are clinicians,
we are based in the provision of care for our patients, and we are focused on the evidence to do well by
that. And these organizations I do not think are going to be caving to any kind of political pressure based
on ideology, based on any kind of ill will towards a group of people who honestly have been targets for
far too long.

Speaker 1 ( 17:23 ):
Dr. Haddad, do you want to add anything to that or...

Dr. Marwan Haddad ( 17:25 ):
I mean, sure. I think our associations have really been great at stepping forward and pushing back
against these legislations, but I think we cannot let our guards down. And to this point, I think we were
always going to get pushback. From my position at the HIVMA, we've been hearing about threats of
pulling funding for pediatric residencies who actually teach gender - affirming care. So all of a sudden, it's
coming at all levels. And I think we need to constantly be very vigilant at the advocacy piece, at really
truly honing it back down to what is that we really want to do. At the end of the day, we want to protect
our children, our communities, and to do that, we truly need to engage all our communities in care. And
it's not by banning care and treatments, it's by investing in this care. It's investing in the research that
we need to further the betterment of the care, investing in the holistic care, improving the access and
decreasing barriers to care and building on what we know from experts as well.
( 18:36 ):

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Instead, like what we said, what we're seeing is almost the complete opposite of what's happening. We
need to continue to push back. You mentioned at the top of this, over 520 anti - LGBT bills and state
legislatures this year alone. There are 22 states that have banned the medical and surgical care for trans
youth, with five states making it a felony crime to provide this medical care to youth. So you can imagine
the impact not only on the patients of the communities, but on the medical teams, on the recruitment
of we're talking about the workforce and the lack of the workforce. It's affecting recruiting good
physicians and clinicians to these states to be able to provide this good care to patients. And we just
need to continue to really focus on the advocacy and the voices and really push back. And so far, I feel
that our associations have really been doing that.

Speaker 1 ( 19:34 ):
And Dr. Streed, you were talking a little earlier about gender at birth and you've written the following,
"As clinicians, we strive to be accurate. The evidence shows that using male and female is the only
options in birth certificates that is not consistent with scientific reality." Wondering, you can explain why
you think the medical profession needs to do a better job of understanding and accepting this issue. And
is it only in the medical arena but also in the public health, the health departments and others who are
really probably in control of what gets put in a birth certificate?

Dr. Carl Streed ( 20:12 ):
Absolutely. I mean, you're bringing up this notion of how we are trying to provide population statistics
on who are we trying to take care of essentially. But, the notion of binary sex is something that has been
only really recent in medical history in terms of from the late 1800s onwards. And it is not an accurate
representation of all the ways in which people, in which bodies are actually created as it were. There are
people with differences in sex development or intersex characteristics that do not fit neatly into our
notions of a binary sex categorization. Oftentimes, there's a lot of harm in trying to push people into
those boxes. So there's been a significant movement to try and understand ways to update our medical
training, update our public health, essentially use statistics and data structures, to try and avoid these
potential harms, both intentional and unintentional.
( 21:05 ):
So there's been a lot of efforts to remove, for example, as you've alluded to, the sex designation on the
public portion of the birth certificate because birth certificates are something that we carry with us for a
number of issues, even though it makes no sense that I have to show my birth certificate for
employment, it's there. And for trans individuals or people born with differences in sex development,
that can be a very harrowing experience. It can be an experience where they are effectively outed and
could be discriminated against based on that information. So we're trying to find ways of reducing
unintentional harm from essentially government use of information around people's bodies, as it were.
So there's much more we could talk about this. I do think this is a little, it's related to what we're talking
about, but it's also a much bigger can of worms as it were because I'm talking about trying to break
down binary categories and the medical profession is so focused on binaries and we are really trying to
update that.

Speaker 3 ( 22:03 ):
Well, we may have to come back and revisit the issue in another conversation because it's certainly a
fascinating one that I know I did not have on my radar. So I appreciate your comment there. And if I can,
I want to turn to the issue of HIV and AIDS for a moment. It was 42 years ago that the reports came out
from CDC on the clinical evidence of a disease that would later become known to all of us as AIDs. A

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question to both of you. Where do things stand today in terms of diagnosis of people having access to
testing and to being diagnosed if they're at risk and also treatment?

Dr. Marwan Haddad ( 22:46 ):
Sure. So I mean, I think as we've talked about, we do have the tools to end the HIV epidemic. We've got
great tools for that. Yet overall, we're still seeing over 36,000 new infections each year in the US. And
these are preventable. And the majority are still among men of sex with men. Majority are in black
African - Americans followed by Hispanics. And then transgender women are also disproportionately
affected, also majority in black and Hispanic trans women. And we have excellent treatment for HIV. So
if we're able to diagnose everyone with HIV and engage them in care and on treatment, first of all, their
lifespan themselves will approach the expected lifespan of those without HIV. But if they're on
treatment, they would also not transmitting HIV to the sexual partners, regardless of the condom. The
whole concept of u equals u, undetectable equals untransmittable.
( 23:37 ):
And then for those who do not have HIV but continue to be exposed, we have pre - exposure prophylaxis
or PREP, and that can prevent someone from acquiring HIV also regardless of condom use. And so we
can end the HIV epidemic and we can stop the new infections from occurring with these tools. Yet in the
US, one in three people with HIV are not on treatment, and three out of four people who could benefit
from PREP are not on PREP. So we have made major strides in the last four decades, and yet it's that
implementation of these tools that we are failing in reaching everybody.

Speaker 1 ( 24:16 ):
Well, I want to go to an area where there was incredible success in this area, and Dr. Haddad, you wrote
a piece in the Journal of the American Medical Association with the title Ending the HIV Epidemic, We
Have the Tools, Do We Have the Will? We had the great opportunity where you're out at the Aspen
Ideas Health Initiative and had the opportunity to talk with Dr. Fauci. He and former senate majority
leader, Bill Frist, were on stage talking about the work that happened with PEPFAR initiative and that
really reduced AIDS in underdeveloped countries. I'm wondering, given that that was so powerful a
message that with the right will, with the right economic incentives, that we really can make
transformational change, I'm wondering what kind of willpower is missing now.

Dr. Marwan Haddad ( 25:22 ):
To continue that thread that I started talking about in terms of just now, and within this piece, it's really
about not the tools, because we have the tools, but it's really about the context that these tools are
trying to be implemented in the US. And you mentioned PEPFAR, and as you know, I've worked in some
of the PEPFAR countries as well in that front. And I will have to say that the PEPFAR countries, many of
them are doing much better than the US in terms of really achieving the viral suppression rates that we
need to be doing in order to truly end the HIV epidemic here in the US. And a lot of this is, I mean, it's
also multifactorial as to what we need to be doing in the US. One, I think we need to concentrate on the
workforce. We have a dwindling HIV workforce, and we need to build not only more, but we need to
build a more diverse one that reflects the patients we're trying to reach and engage. The stigma and
discrimination and the structural racism, that needs to be addressed.
( 26:23 ):
And it's not being addressed by passing these laws and policies that not help but further embed the
structural racism, the anti - women, anti - gay, anti - trans laws that are happening, that are pushing the

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people who are at the highest risk, who are getting infected right now with HIV, away from healthcare
rather than bringing them into healthcare. We need to really be looking at... And by the way, all of this
structural racism and these disproportional effects that've been having, we've known for decades in the
HIV epidemic, but it took the COVID pandemic to truly highlight these inequities on a scale that now
couldn't be ignored like it was being ignored in the HIV epidemic. And so fundamentally, we need to be
focusing on these as basic civil and human rights issues. This is not an issue of HIV, this is not an issue of
anything else but the basic fundamental civil and human rights.
( 27:23 ):
And so we mentioned other things like mental health, substance use treatments, harm reduction
approaches to all of this. This is a holistic approach. We need to be treating the endemics of HIV and STIs
and viral hepatitis and substance use and mental health. We're shutting down syringe services
programs. So in West Virginia and Indiana where we had outbreaks secondary to injection drug use of
HIV and viral hepatitis, and we knew that syringe services programs were working, they shut those
down. And now we're seeing resurgences of infections that are driven by injection drug use. And we
need to, as we said, create these safe and respectful environments for the LGBT community. We need to
build the trust with racial and ethnic minoritized populations. And so near and dear to your hearts, I
know, right? Ensuring affordable and comprehensive healthcare for all, and we need new innovative
care models.
( 28:21 ):
The current care models that we have have done so much and great stuff, but there's still this gap that
we're missing. And so we really need to look at these new innovative care models that are going to
address the social determinants of health, they're going to address the stigma and the discrimination,
and really try to bring in these populations. Not even bring in, actually, I recently heard this, that we
need to stop thinking about bringing people into healthcare. We need to go out and meet the people
where they're at, and that's what we need to be.

Speaker 1 ( 28:52 ):
Do you think there are models that we should learn from in what's called the developing world? And Dr.
Fauci reminded us when he went to Africa to figure out whether or not people could manage all of the
dosages, the dosing that was required. He came back and said, "My God, they're way ahead of us. They
can manage all of this." I'm just wondering, do we have a similar situation where there's an intervention
model that we can embrace? And of course in the Community Health Center world, Dr. Geiger comes
out of South Africa with that community oriented model that he brings back to America. So where might
we learn from?

Dr. Marwan Haddad ( 29:38 ):
I think there's a lot to learn. The differentiated service delivery models that are implemented in all the
PEPFAR countries, are exactly what we need to start doing here in the US, looking at those who are
doing really well, don't need to come in and those who need more support to get more support on that
front. So looking at this, looking at street medicine and being able to get reimbursed and find ways to be
able to go out into the streets and meeting people where they're at, the use of community health
workers and peers, which has been a big backbone of success in a lot of the PEPFAR countries, that we
are just starting to talk about here in the US. So there's definitely a lot of things that we can learn from
the PEPFAR countries and bring them back to the US for us to improve our care.

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Speaker 3 ( 30:26 ):
Well, you point to so many great examples, and I know you're a big fan of the mobile vans as well as
vans that can go anywhere in the community where there are people we might need to reach, but we
remember those early days of the HIV epidemic. We also remember quite a few people in healthcare
who were not willing, ready, or able to step up and in provide the kind of care that both of you do. And I
understand I maybe need clarification on it, that there are a number of states, they say more than one in
eight states where LGBTQ+ people are living where doctors, nurses, other healthcare providers can
legally refuse to treat them. This is according to the Movement Advancement Project. Now, I don't know
whether that's refused to treat for anything from your dental care to your routine primary care, or it's
specific to gender - affirming care and the care we've been talking about. But how much of a problem is
this getting to be in terms of healthcare providers who perhaps have a very different view of all this, just
refusing to see people at all?

Dr. Carl Streed ( 31:38 ):
I think it goes... I've gotten to the point where I tell my students and trainees that if you have any deeply
held moral beliefs against the provision of any care to people you don't agree with, you're probably in
the wrong profession. And if you are against the provision of gender - affirming care, that's all well and
good, but you need to know who's going to be able to provide that care for your patients. And again, if
you are against the provision of care based on deeply held moral beliefs, I'm very curious as to why
you're in a caring profession where you need to be able to care for everyone who's coming to your door.
( 32:09 ):
The kind of legislation you're describing is providing inappropriate protection to discriminate essentially
for healthcare professionals and includes a number of professions, including pharmacists who won't
provide, for example, Plan B or won't dispense hormone therapy for trans individuals. And what it gets
down to is that happens more often in what is "seen as not an emergent situation." Definitely is not
allowed in ERs or surgical emergencies and such. But, again, those laws are allowing clinicians to
discriminate when they shouldn't be.

Speaker 1 ( 32:43 ):
Thank you both for joining us and thanks to our audience. Be sure to go online to CHCradio.com to sign
up for emails and updates. And again, thank you both for the important work that you're doing.

Dr. Marwan Haddad ( 32:55 ):
Thank you for having us.

Speaker 1 ( 32:55 ):
Good.

Speaker 3 ( 33:01 ):
This copyrighted program is produced by Conversations on Healthcare and cannot be reproduced or
remitted in whole or in part without the express written consent from Community Health Center, Inc.
The views expressed by guests are their own, and they do not necessarily reflect the opinion of
conversations on healthcare or its affiliated entities.

Transcript by Rev.com