- Oncology nurse-patient relationship (https://voice.ons.org/topic/oncology-nurse-patient-relationship)
- Cancer health disparities (https://voice.ons.org/topic/cancer-health-disparities)
- Patient advocacy (https://voice.ons.org/topic/patient-advocacy)
- Clinical practice (https://voice.ons.org/topic/clinical-practice)
HHS Solidifies Protections for LGBTQ Patients
In a May 2021 expansion to Section 1557 of the Affordable Care Act and the Title IX civil law, the U.S. Department of Health and Human Services (https://www.hhs.gov/) (HHS), through the Office for Civil Rights (https://www.hhs.gov/ocr/index.html), increased protections for lesbian, gay, bisexual, transgender, or queer (LGBTQ) people from discrimination. The revisions now prohibit discrimination (https://www.hhs.gov/ocr/index.html) based on sexual orientation and gender identity.
“Fear of discrimination can lead individuals to forgo care, which can have serious negative health consequences,” Xavier Becerra, HHS secretary, said (https://www.hhs.gov/ocr/index.html). “It is the position of HHS that everyone—including LGBTQ people—should be able to access health care, free from discrimination or interference, period.”
Scrolling through federal regulations is cumbersome and requires an interest in the minutia of law. However, that is where the details to discrimination have been codified for years.
The updates were made in light of the U.S. Supreme Court’s decision in Bostock v. Clayton County (https://www.law.cornell.edu/supremecourt/text/17-1618) and subsequent court decisions, in which long-time employees were fired for being LGBTQ. Changing the acts requires presidential oversight. Highlighted sections include (https://www.federalregister.gov/documents/2021/05/25/2021-10477/notification-of-interpretation-and-enforcement-of-section-1557-of-the-affordable-care-act-and-title%22%20/):
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Section 533 of the Public Health Service Act, (https://www.govinfo.gov/content/pkg/USCODE-2010-title42/html/USCODE-2010-title42-chap6A-subchapIII-A-partC-sec290cc-33.htm) which prohibits discrimination on the basis of age, race, color, national origin, disability, sex, or religion in Projects for Assistance in Transition from Homelessness.
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The Family Violence Prevention and Services Act (https://www.govinfo.gov/content/pkg/USCODE-2009-title42/html/USCODE-2009-title42-chap110-sec10406.htm), which prohibits discrimination on the basis of race, color, national origin, disability, sex, or religion in programs, services, and activities funded under the act.
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The Low-Income Home Energy Assistance Act of 1981 (https://www.govinfo.gov/content/pkg/USCODE-2006-title42/html/USCODE-2006-title42-chap94-subchapII-sec8625.htm), which prohibits discrimination on the basis of age, race, color, national origin, disability, or sex in programs, services, and activities funded under the act.
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The Communications Act of 1934 (https://www.govinfo.gov/content/pkg/USCODE-2009-title47/html/USCODE-2009-title47-chap5-subchapIII-partIV-subparte-sec398.htm), as amended by Equal Employment Opportunity provisions, which prohibits employment discrimination on the basis of age, race, color, religion, national origin, or sex by federally funded public telecommunication entities.
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The Community Services Block Grant Act (https://www.govinfo.gov/content/pkg/USCODE-2010-title42/html/USCODE-2010-title42-chap106-sec9918.htm), which prohibits discrimination on the basis of age, race, color, national origin, disability, or sex in programs, services, and activities funded under the act.
Clinicians should be educated to provide safe spaces for LGBTQ patients with cancer and alleviate disparities by having routine and respectful conversations (https://voice.ons.org/news-and-views/nurses-can-provide-safe-spaces-for-lgbtq-patients-with-cancer) that take into account gender and sexual orientation along all points of the care continuum.