New Mexico state Sen. Gregg Schmedes, R-Tijeras, introduced the “Health Care Workers Protection Act" (SB 323) as a way to give health care professionals the power to discriminate against their patients, although the bill stalled soon after its proposal.
The bill was heard in the Senate Health and Public Affairs Committee on March 10, where it was tabled. The only motion to oppose the move to table the bill came from the bill’s sponsor, Schmedes.
SB 323 would have allowed health care workers and institutions to refuse any health care service that violates their “ethical, philosophical, moral or religious beliefs or principles.”
The bill would have also given practitioners, institutions and health care payers the “the right not to participate in or pay for any health care service that violates the medical practitioner’s, health care institution’s or health care payer’s conscience.”
Sponsored by Schmedes and Rep. Rebecca Dow, R-Truth or Consequences, SB 323 would have impacted both reproductive health care, say if a provider objected to serving a patient who was on birth control, and LGBTQ patients.
Marshall Martinez, the interim executive director of Equality New Mexico, said: “(The bill) allows any individual involved in any health care institution to refuse service under any conscientious objection.”
Martinez provided a hypothetical example of a transgender person whose appendix is about to burst going to the ER and everyone, including the hospital’s receptionist, nurse or surgeon, refusing to serve them based on a moral objection that the patient is trans.
Martinez said the bill would be especially harmful toward New Mexicans who live in rural cities, who may not have as many choices as to where they go for health care.
According to a New Mexico Department of Health's report published in 2018, “Addressing the Health Needs of Sex and Gender Minorities in New Mexico," nearly 33% of New Mexico’s “sexual minority population” lives in rural areas, where there are fewer services than there are in larger metro areas like Albuquerque and Santa Fe.
Sexual and gender minorities face a signficiant amount of health-related disparities compared to their heterosexual and cisgender counterparts, which in older community members includes a higher likelihood of disability, according to the report.
In addition, men who have sex with other men “are affected by disproportionately high rates of HIV infection and other sexually transmitted infections compared to other groups,” according to the Department of Health.
Adrien Lawyer, co-founder of the Transgender Resource Center of New Mexico, saw significant problems with SB 323.
“Transgender and non-binary people already are rejected by providers who don’t have a legal right to do it,” Lawyer said.
Lawyer has been teaching courses titled “Transgender Cultural Fluency” statewide at various institutions in hopes of educating New Mexicans about the existence and humanity of transgender people for more than ten years.
Lawyer said it can be easy for someone who doesn’t know a transgender person to create a narrative of what trans people are like, particularly based on how they're portrayed in the media.
Lawyer said the media represents trans people as “diabolical murderers" and “sexually deviant," specifically citing the example of Buffalo Bill from “The Silence of the Lambs.”
Lawyer said the rhetoric that people proposing bills such as SB 323 use is that transgender people are bullying health care providers into caring for them, instead of approaching it as a life-or-death access issue for trans people.
“The modern U.S.-based trans civil rights movement ... is maybe 30 or 40 years behind the gay and lesbian modern civil rights movement,” Lawyer said. “I’m a transgender man, but I came out in ‘85 at 15."
He said further that during that era, LGBTQ+ icons like the Indigo Girls and Ellen Degeneres weren’t yet out of the closet. Once those icons came out, people became educated, which led to the road of marriage equality.
Martinez said LGBTQ+ people already find significant amounts of difficulties in finding health care providers who are respectful of their identities, and said he has countless friends who have been misgendered by their providers.
“My physician said to me, ‘There is no such thing as homosexuality, and you will grow out of this and begin to have normal sex with men,'" Martinez said of an encounter he had with his physician when he was 16 years old.
He didn’t visit another health care provider until he was 24.
Lawyer said an important facet of improving access to health care for transgender people is increasing education to the public about trans people.
The state Department of Health says that health care providers, when serving sexual and gender minorities, should value diversity, avoid stereotypes, manage the “dynamics of difference,” learn about and institutionalize cultural understanding, and adapt to diversity and cultural contexts.
Lawyer said all of his cultural fluency courses are taught by transgender people because, even if the students don’t know another transgender person, they get to know the instructors, which increases education and visibility.
According to the NMDOH report, “Community-based providers must be empowered to establish trusting, affirming relationships, through which (sexual and gender minorities) can develop resilience and self-acceptance.”
Community-based providers building those relationships with their patients who are sexual and gender minorities is “consistent with evidence-based” practice for ensuring improved outcomes for the health of the patients, according to the NMDOH.
According to a 2018 survey from the Center for American Progress, 23% of transgender patients said a health care provider intentionally misgendered them, and 29% said a health care provider refused to see them based on their gender identity.
“Do we want a state where doctors, nurses, etc., are doing the best thing to provide the best care and service for the health and safety of all of their patients, or are they doing the best they can to teach moral lessons to people?” Martinez said.
Sarah Bodkin is a freelance reporter at the Daily Lobo. She can be contacted at email@example.com or on Twitter @sarahbodkin4