VOLS Opposes Proposed Rule That Would Eliminate Protections for LGBTQ Seniors

January 28, 2020

On December 19, 2019, Volunteers of Legal Service (VOLS) submitted a public comment, with the assistance of Kramer Levin Naftalis & Frankel LLP, opposing the adoption of a proposed rule* by the United States Department of Health and Human Services (HHS) removing nondiscrimination protections for LGBTQ patients. This proposed rule will only exacerbate the discrimination that these individuals already face when they seek out healthcare. Research demonstrates that many older LGBT Americans fail to disclose their sexual orientation and gender identity to healthcare professionals for fear of discrimination, being judged, and receiving compromised medical treatment.


VOLS opposes the adoption of the proposed HHS rules because it would worsen health outcomes for many Older LGBT People. The proposed rule would:  

  • Eliminate the prohibitions on HHS grant recipients that prevents them from discriminating on the basis of gender identity and sexual orientation in choosing who to provide services to; and
  • Eliminate the language explicitly requiring HHS grant recipients to treat same-sex marriages valid.


The elimination of these protections will worsen overall health outcomes for LGBT seniors who will be unable to access medical care provided by HHS grantees and/or sub-grantees. Prejudice and discrimination against the LGBT community in our healthcare system, as well as a lack of awareness and attentiveness to the needs of LGBT patients, is particularly harmful to older LGBT individuals. For instance, 36% of LGBT older Americans report that their primary healthcare providers are unaware of their sexual orientations. Nearly one in four LGBT older people are reluctant to discuss certain issues for fear that their healthcare providers will judge them. 20% of LGBT older people and 44% of transgender older people worry that their relationships with healthcare providers, such as hospital or nursing home staff, would be adversely affected if their sexual orientations or gender identities were known. Further, two-thirds of transgender older people feel that there will be limited access to healthcare as they grow older and more than half feel that they will be denied medical treatment as they age.


Equal access to healthcare is of critical importance for older LGBT Americans. LGBT individuals face significant health disparities with respect to HIV/AIDSand substance abuse, both of which are issues that HHS funded programs address.Older LGBT Americans in particular face significant challenges that include elevated levels of depression and a higher risk of suicide than non-LGBT elders.Additionally, because older LGBT individuals are more likely to report being financially insecure than non-LGBT elders,options for access to healthcare and other services may be more limited.


Because it harms the clients and the communities we serve, we strongly urge HHS to withdraw this notice of proposed rulemaking in its entirety.

Click here to download the full VOLS public comment (PDF).


* The public comment by VOLS is in response to FR Doc. 2019-24385; HHS Docket No. HHS-OS-2019-0014; RIN 0991-AC16