Dallas hospitals receive the lowest scores in Texas in the latest health care equality rating system

The Human Rights Campaign, a national LGBTQ rights organization, has significantly downgraded the rank of two Dallas hospitals in its healthcare inclusivity rating system after the facilities stopped providing medical treatment to new teenage transgender patients.

Children’s Health and UT Southwestern Medical Center are now the two lowest-scoring hospitals in Texas in the 2022 biennial Healthcare Equality Index released Monday.

HRC said it imposed the “responsible citizenship criteria” because hospitals stopped providing “necessary and medically-approved care” to transgender youth while continuing to provide the same care to cisgender patients.

Genecis – which stood for Gender Education and Care, Interdisciplinary Support – was an acclaimed 7-year program created by the hospitals to provide comprehensive care for transgender and gender-biased youth. It was the only such program in the state of Texas before it stopped providing gender-affirming medical care to new patients in November 2021.

“The actions taken by UT Southwestern Medical Center and Children’s Medical Center Dallas are life-threatening to transgender youth and have required decisive action on our part,” said Tari Hanneman, HRC director of health and aging.

“Every person deserves to have access to quality health care, to be respected and listened to by their doctor, and to feel safe in the facility where they are treated,” she said. “That’s why it’s heartbreaking that transgender children in Texas are being denied this life-saving, gender-affirming care.”

UT Southwestern and Children’s Health issued a joint statement Monday night reiterating that care for existing patients will remain unchanged. New patients continue to receive psychiatric care and are referred to outside providers unaffiliated with the hospitals for other medical treatments, they said.

The hospitals said the Genecis brand has become a “lightning rod for controversy” over the past year, prompting changes to avoid a full shutdown of the program.

The future of gender-affirming access to health care for transgender youth is up in the air as state leaders fight in a Texas court against the use of medical treatments to treat youth gender dysphoria.

Texas Attorney General Ken Paxton issued an opinion in February making treatments for minors, such as puberty blockers and hormone treatments, comparable to child abuse. On Wednesday, Paxton asked the Texas Supreme Court to allow the state to reopen its abuse investigations into the parents of trans youth who receive such care after being stayed by an injunction.

All major national and state medical groups support age-appropriate, individualized, gender-affirming care for trans children and youth. Best practices dictate that medical interventions are only explored for adolescents who have experienced the onset of puberty and have undergone a mental health assessment.

At least one health care facility – Texas Children’s Hospital in Houston – stopped providing gender-affirming medical care to its teenage patients in response to Paxton’s opinion. But the shift in care at Genecis began months before the state began investigating parents of trans kids.

HRC suspended UT Southwestern and Children’s Health from both the 2020 Healthcare Equality Index and the Top Performer award in February due to the closure of the program and the failure to publicly communicate the decision.

Prior to the suspension, UT Southwestern and Children’s Health were ranked 95 and 90 out of 100 on the index, respectively. UT Southwestern previously noted the “Top Performer” index designation on its website as evidence of its focus on equity and access.

UT Southwestern’s score is 50 in the latest index, Hanneman said, while Children’s Health’s score is 75.

The decision to invoke such a significant deduction wasn’t easy, Hanneman said. “We did not take the implementation of this penalty lightly. In the end, we prefer not to have to do it,” she said. “We would prefer the ship to be legitimate in providing that care.”

The suspension of hospitals from the 2020 index rather than snapping points immediately was done to give HRC time to learn more about the change in care. Jay Brown, senior vice president of the HRC Foundation, said the organization tried unsuccessfully to hold discussions with hospitals about Genecis in the months leading up to the suspension.

Dallas hospitals are now two of only three hospitals to have ever received a 25-point deduction for “known activities that undermine LGBTQ equality or patient care” in the 15-year history of the biennial rating system.

In the 2018 Index, Johns Hopkins Hospital received the deduction for Johns Hopkins Medicines “failure to address HRC’s concerns about deeply troubling anti-LGBTQ misinformation expressed and published by faculty members,” according to the HRC website.

Only 22 health facilities in Texas participated in the 2022 Index, a small fraction of the 906 health facilities that participated statewide. Nearly 500 institutions received the Index’s LGBTQ+ Healthcare Equality Leader award by achieving an overall score of 100.

One hospital, Methodist Metropolitan Hospital in San Antonio, and three health clinics, all located in Austin, received perfect scores.

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