The Medical Case against Anti-LGBT Laws in Texas

Legacy Policy Paper | June 2016

It’s possible, if not likely, some elected officials will again try to move legislation early next year that singles out and targets gay and transgender Texans. This year we’ve seen such proposals become law in a number of southern states. Texas should not join them, given the significant medical implications of such laws.

“Bathroom Bills”

Because six of Legacy Community Health’s 22 locations in the Houston area are in KIPP Academy schools, Legacy is concerned about the mental health consequences of the political battle over bathroom use for transgender students. The concern comes following the negative reaction by some elected officials in Texas to the Obama Administration guidelines encouraging public schools nationwide to allow transgender students to use the bathrooms that match their gender identity. Lt. Gov. Dan Patrick has confirmed a discriminatory “bathroom bill” will be a priority issue in 2017. One Denton parent said Patrick was putting her transgender child right in the middle of a “pissing contest.”

Some mental health concerns for policymakers to consider:

  • The mean-spirited rhetoric around bathroom usage is incredibly damaging to transgender youth. They are eight times as depressed and much more likely to attempt suicide as the rest of the population. The bathroom is already a dangerous place for transgender youth, more so now with the heightened attention.
  • More than 40% of transgender Americans try to kill themselves at some point in their lives, compared with 4.6% of the general public, according to the American Foundation for Suicide Prevention and the Williams Institute.
  • A study earlier this year correlates the high suicide rates of transgender teenagers with bathroom bans.

Legacy has built one of the few transgender practices in Texas and sees about 1,000 transgender patients of all ages per year. It is our responsibility to our patients to advocate against harmful bathroom exclusions in policymaking.  In addition, whether Texas schools follow the Obama Administration’s guidelines around bathrooms – or not – is up to the local school boards, not the government.

Religious Freedom Legislation

Texas has had a strong, effective religious freedom law on the books since 1999. But similar to what lawmakers did in North Carolina this year, where the business-led backlash to its “religious freedom” law was been swift and severe, Texas officials might push for a more explicit version targeting gay and transgender Texans.  Texas is home to more than 50 Fortune 500 companies, many of which are on record opposing LGBT discrimination last legislative session because it’s bad for their bottom line.

In other states, medical exemptions have become part of newly-minted laws this year.  Tennessee’s Governor approved legislation allowing therapists to refuse treatment to clients who violate their personal principles. The Mississippi Governor signed a similar law, making it legal for doctors and psychologists to refuse service to certain patients if it violated their beliefs.

What any potential religious freedom bill (s) might look like in the Lone Star State is unknown.  But inclusion of medical professionals is unnecessary and redundant. Texas health care providers already have the right to refuse service, as explicitly stated by Texas Medical Association’s code of ethics. “A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve.”

The market is working. The government doesn’t need to step into the exam room.