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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

Equal care for LGBT community improving in Missouri

LGBT, pride

  Last month, the Human Rights Campaign called on the Centers for Medicare and Medicaid Services to address LGBT discrimination in healthcare.

Sarah Warbelow is the Legal Director for the Human Rights Campaign, a national LGBT advocacy organization. She said many LGBT individuals are hesitant to seek care based on a history of discrimination by healthcare providers.

“We've even had stories brought to our attention where transgender people go into a hospital for something like a broken ankle and are told by hospital staff, 'You're transgender, I don't know  how to take care of you so please leave.' People are people and ankles are ankles and it doesn't matter, someone's background with regards to their gender identity,” Warbelow said.

She said hospitals on both coasts lead the nation in inclusive healthcare practices, but the rest of the country has some catching up to do.

“Many sections of the Midwest, the South and the Plains states, there still exists an incredible need for consistent, reliable protections against discrimination,” Warbelow said.

Andrew Shaughnessy, Public Policy Manager of the Missouri LGBT advocacy organization PROMO, said his state is stepping up. Thanks to changes at  many urban hospitals, Missouri's ranking in the Human Rights Campaign's Healthcare Equality Index jumped from 37th in the nation to 6th in just one year.

But Shaughnessy said even in his state, much more needs to be done.

“Research has suggested that lesbian, gay and bisexual individuals experience poorer health outcomes than their heterosexual peers," Shaughnessy said. "That's because of the history of discrimination, stigma and really the lack of legal and public policy support that has set barriers for the LGBT community in trying to receive health care.”

Both Shaughnessy and the Human Rights Campaign said the best way to combat discrimination is by educating healthcare providers, many of whom receive little or no instruction on LGBT issues as part of their training.

“The Missouri Foundation for Health in 2012 cited that medical students and providers only receive five hours of education around LGBT issues," Shaughnessy said. "A lot of the time is focused around HIV/AIDS which is only a piece of the huge puzzle which makes up the health of the LGBT community.”

While Missouri might seem like a model state for LGBT health  care, inclusive practices aren’t present in all parts of the state. Of the 19 Missouri hospitals listed as Leaders in LGBT  Healthcare by the Healthcare Equality Index, only 5 are located outside the state’s larger metropolitan areas.

Warbelow said this rural-urban divide is common in other states as well.

"Certainly where there are statewide laws that prohibit discrimination, then you're going to see a greater degree of consistency, regardless of where the hospital is at," Warbelow said. "But in places like Missouri that lack those statewide protections, cities really have been leading the way on LGBT non-discrimination."

Now that hospitals in major metropolitan areas are doing more to guard against LGBT discrimination, Shaughnessy said it’s time to focus on rural healthcare providers.

"LGBT people are everywhere and we access healthcare in every part of this state so we must include these welcoming policies."

Hope Kirwan left KBIA in September 2015.