SOURCE: AP/ Cheryl Senter

Kim Pollock, 17, goes through college materials in her bedroom in Bedford, New Hampshire. FAFSA will soon start recognizing same-sex parents on their financial aid applications.

When lawmakers first created the Free Application for Federal Student Aid, or FAFSA, in 1992, no state recognized civil unions or domestic partnerships between same-sex couples, let alone the freedom to marry. Ten states and the District of Columbia currently confer the rights and responsibilities of marriage to same-sex couples—and that number is swiftly increasing.

Recognizing this changing landscape, the U.S. Department of Education announced last week a small but significant change to the FAFSA that will make the application a more fair, effective, and efficient tool for students seeking financial aid to help pay for their college education. Starting in 2014 the Department of Education will begin collecting demographic and financial information about families headed by same-sex parents to determine eligibility for and amounts of Pell Grants and federal student loans.

Each year more than 20 million families complete the FAFSA, and these families do not necessarily all have the same family structures that the FAFSA—with its roots in the 1950s—presumes. The announced change from the Department of Education simply brings the FAFSA up to date to reflect the changing nature of the American family. What’s more, because many states, colleges, universities, and other providers of financial aid build out from the information already collected on the FAFSA or are modeled after the FAFSA, the proposed changes will likely have a trickle-down effect such that the entire process will become more fair, efficient, and effective for all families.

Below we take a look at the changes to the FAFSA, what they mean for families with same-sex parents, and remaining issues for lesbian, gay, bisexual, and transgender, or LGBT, applicants.

The FAFSA will include language allowing applicants with same-sex parents to accurately fill out the form

The FAFSA currently uses the terms “mother/stepmother” and “father/stepfather” when requesting information about an applicant’s parents. Applicants with same-sex parents must then either arbitrarily designate one parent as “mother” and the other as “father,” or omit one parent from the form entirely. In other words, the current FAFSA puts these applicants in a lose-lose scenario, forcing them to complete and submit an application that does not accurately reflect their family structure and that is therefore inaccurate.

The department’s proposal will change that. For the 2014-15 FAFSA, the department plans to replace “mother/stepmother” and “father/stepfather” with “parent 1” and “parent 2.” This change means that for the first time the department will collect same-sex parents’ financial information in the same way that it does today for married different-sex spouses. These changes not only accurately reflect—for the first time in the FAFSA’s history—the existence of LGBT families; they also capture the economic situation of these families so that students applying for aid can get the support based on financial need without any bearing on their parents’ sexual orientation.

This change mirrors similar changes made by other federal agencies. In 2011, for example, the U.S. Department of State initiated reforms to give passport application forms a more gender-neutral parental designation. Doing so required minimal changes to federal forms while significantly enhancing the accuracy, fairness, effectiveness, and efficiency of government operations. More importantly, this change effectively protects LGBT families by requiring both parents to ascend to a child’s passport application, ensuring that one parent cannot take the child and leave the country without the other’s permission.

The FAFSA will be a more efficient, effective, and accurate application

At its core, this much-needed change to the FAFSA achieves two important policy objectives.

First, it guarantees that all families are treated fairly and equally in the higher-education financial-aid process. Without accurate language to describe their families, students with same-sex parents are likely to see their application delayed due to often-unavoidable inconsistencies. More concerning is the fact that some children of same-sex couples may not apply for aid at all due to the complexity and confusion caused by the FAFSA’s use of gendered language. What results is inequitable access to financial aid for students with same-sex parents. This change, however, significantly levels the playing field for these applicants. As U.S. Secretary of Education Arne Duncan said in announcing the proposed change: “All students should be able to apply for federal student aid within a system that incorporates their unique family dynamics.”

Second, this change advances the efficiency and effectiveness of delivering aid based on need by not allowing irrelevant characteristics such as sexual orientation factor into the application process. Financial aid should be allocated based solely on financial need. Allowing other factors—such as sexual orientation—to enter the process results in the imprudent use of taxpayer dollars. In this way, the proposed change from the department would be a significant step toward enhancing the efficient use of federal funds.

But that is not to say this is the overarching goal of this change. Importantly, the change was made not to save the federal government money, but instead to ensure greater equity among aid applicants. Without accurate data on the LGBT community, we simply do not know how many families will be impacted by this change. We therefore do not know how this change will impact the budget in aggregate, since some families are likely to see larger financial-aid packages while others may see smaller ones with this change.

In announcing the change, Secretary Duncan said, “These changes will allow us to more precisely calculate federal student aid eligibility based on what a student’s whole family is able to contribute and ensure taxpayer dollars are better targeted toward those students who have the most need, as well as provide an inclusive form that reflects the diversity of American families.” With this change, if both parents are living together, both of their incomes will be considered when determining eligibility for federal aid. This will be true whether the parents are married or not and whether they are the same sex or opposite sex.

Remaining LGBT issues with the FAFSA

While the department’s proposed change is welcome news for students with same-sex parents, problems still exist for LGBT applicants.

First, even with this proposed change, antigay laws will continue to prevent the Department of Education from recognizing same-sex spouses or partners. Passed in 1996 the Defense of Marriage Act, or DOMA, defines marriage for the purposes of federal law as the union between one man and one woman. This law effectively denies more than 1,000 federal benefits and protections to legally married same-sex couples. That includes the ability to name a same-sex partner or spouse—and often their dependents—on the FAFSA. By excluding certain family members, the FAFSA calculates an “expected family contribution” that ultimately distorts the amount of aid these applicants should receive.

Second, transgender applicants face unique obstacles in obtaining financial aid. Transgender applicants often encounter problems when data mismatches occur, particularly with regards to a changed name or the gender markers on government-issued identification. If financial-aid institutions encounter data mismatches on applicants’ identification markers, this could delay the process of transgender students’ applications for financial aid. These data-mismatch issues can significantly impair these students’ ability to access aid. This is particularly problematic for transgender individuals that were identified at birth as male, as these students are required to register with the Selective Service upon turning 18 years old.

Third, accessing federal financial aid poses unique problems for LGBT youth coming from unsupportive or hostile families. The FAFSA requires most young applicants to submit their parents’ or legal guardians’ financial information, as well as provide their signatures to successfully submit an application for aid. This requirement may prove difficult for LGBT applicants who come from homes where they are unloved, neglected, abused, or even kicked out because of their sexual orientation or gender identity.

Luckily, the federal financial-aid system recognizes the difficulties facing youth with uncooperative parents by allowing them to bypass many requirements to submit their application, while asking the aid officer on campus to override the dependency determination. Still, that option is not foolproof. Some aid officers on college campuses are reluctant to do a dependency override in any circumstance and more must be done to ensure all children—estranged or not—receive the aid to which they are entitled.

Conclusion

Federal financial aid represents the gateway to a college education for many students in the United States. Individuals with a college education have higher earnings than those who do not, experience lower rates of unemployment and poverty, and have fewer health issues than those who do not or cannot attain a postsecondary education. Built into the system, however, are inherent biases against families with LGBT members, resulting in the discriminatory misallocation of federal dollars based on sexual orientation or gender identity—and not on an applicant’s financial need. With the upcoming changes to the FAFSA, one of those biases will be removed, which is good news for families headed by same-sex parents.

Because of the Defense of Marriage Act, nearly all government forms fail to recognize the diversity of today’s families. Forms such as the FAFSA continue to use gender-specific language when collecting information about parents and spouses that preclude same-sex couples from being fully recognized.

The U.S. Department of Education’s leadership on this issue, however, shows that even with DOMA, federal agencies can take steps to help families with same-sex parents when the executive branch has the flexibility to modify government forms. It’s an authority that should be leveraged wherever possible.

Crosby Burns is a Policy Analyst for the LGBT Research and Communications Project at the Center for American Progress. David Bergeron is the Vice President for Postsecondary Education at the Center.

SOURCE: AP/Marcio Jose Sanchez

Rachel Sorrow, a transgender woman, attends a therapy session with Dr. Dan Karasic, a psychiatrist with the Center of Excellence for Transgender Health in San Francisco, California.

Endnotes and citations are available in the PDF version of this issue brief.

*Author’s note: This article has been updated to correct an omission. The California Department of Insurance was the first regulatory entity in the nation to specifically address insurance discrimination against transgender people.

In America’s increasingly expensive health care system, the costs of not having adequate insurance coverage are both financial and physical. Without coverage, many people must choose between struggling to pay exorbitant medical bills or going without the care they need.

Similar to millions of other Americans, many transgender people lack health insurance coverage. But even when they are able to find coverage, the promise of more secure access to care and protection from unaffordable medical bills often rings hollow. This is because the majority of U.S. health insurance plans deny coverage for medical procedures and treatments seen as specific to transgender people.

This brief provides an overview of insurance discrimination against transgender people; the impact of the Affordable Care Act on insurance discrimination; and how some state insurance regulators are taking action to stop gender-identity discrimination in insurance.

SOURCE: AP/ Mel Evans

A high school student and his mother listen to a question about his suffering through bullying at Haddonfield Memorial High School in Haddonfield, New Jersey.

Earlier this month Rep. Jared Polis (D-CO) and Rep. Ileana Ros-Lehtinen (R-FL) reintroduced the Student Non-Discrimination Act in the House of Representatives. If passed, this law would ensure that public elementary and secondary schools would be held accountable for prohibiting discrimination against students on the basis of sexual orientation and gender identity. Specifically, students who are bullied would be able to seek legal recourse, and the federal government could pull funding from public schools condoning this harassment.

The past few years have shed light on the daily injustices faced by lesbian, gay, bisexual, and transgender, or LGBT, students at schools across the country. Earlier this year a Florida school threatened to disband all extracurricular activities in an attempt to dissuade eighth-grade student Bayli Silberstein from starting a Gay-Straight Alliance club. Last year school officials in Ohio ignored a mother who repeatedly reported that her son, Zach, was being harassed at school until a video of him being brutally beaten by another student went viral online. In 2011, 14-year-old Jamey Rodemeyer of New York committed suicide after being bullied for years by his classmates. The stories are endless, and the consequences are immeasurable.

Bullying is not a new problem. But one explanation for this disturbing new trend of harassment and violence against LGBT youth is that Americans are coming out of the closet at younger ages than ever before. Compared to LGBT adults, LGBT youth are extremely vulnerable to the effects of discrimination and stigma because they have not yet had the opportunity to develop networks of support elsewhere if their schools and homes are hostile to them. With nowhere to turn, these youth are often at increased risk for developing mental-health issues, becoming homeless, and entering the juvenile justice system.

When considering the Student Non-Discrimination Act, members of Congress should take into account the ways in which the bill could help prevent other issues affecting LGBT youth that stem from experiencing stigma and discrimination at such a young age. Passing this bill could also underscore the importance of addressing discrimination when it starts—during adolescence.

Here are some of the major issues that LGBT youth face that Congress can begin to alleviate by eliminating bullying and discrimination in public schools.

Bullying negatively impacts a student’s education

A safe and inclusive school environment is paramount to receiving a good education. When students feel threatened, they are less likely to perform well in class or even attend class at all. The latest Gay, Lesbian and Straight Education Network, or GLSEN, School Climate Survey revealed that 6 out of every 10 students who identify as lesbian, gay, or bisexual report feeling unsafe at school, and 8 out of 10 transgender students report the same feelings. Students who were frequently harassed reported lower grade point averages than students who did not experience harassment. Moreover, nearly one in every three LGBT students has skipped class or an entire school day due to feeling unsafe.

Education is a critical determinant of lifetime success, and passing the Student Non-Discrimination Act can remove the barriers that LGBT youth face in performing their best in the classroom.

LGBT youth are more likely to turn to substance abuse to cope with discrimination

LGBT youth have higher rates of mental-health issues and substance abuse than their heterosexual peers because of discrimination and societal stigma. Lesbian, gay, and bisexual youth are four times more likely to attempt suicide than their straight peers. Furthermore, each episode of victimization such as harassment or assault increases the likelihood of self-harming behavior by an average of 2.5 times.

LGBT youth subsequently attempt to cope with stress and discrimination through self-medication by way of tobacco, drug, and alcohol use. These high rates of substance abuse, called the minority stress effect, are linked to high rates of discrimination and family rejection. Researchers have found, for example, that 51 percent of surveyed LGBT youth reported that they were either currently smoking or were former smokers.

By ending bullying in schools, the Student Non-Discrimination Act can begin to address the mental-health and substance abuse disparities that plague LGBT young people.

LGBT youth who have nowhere to turn often end up on the streets

Hostility and harassment at school only exacerbate the problems LGBT youth may experience at home. Although LGBT youth comprise 5 percent to 7 percent of overall youth, an overwhelming 40 percent of all homeless youth are LGBT. Family rejection is unsurprisingly the leading cause of homelessness among these youth, and an additional 26 percent leave home by their own volition because they feel they have nowhere else to turn. Once they hit the streets, the conditions are even grimmer. Homeless LGBT youth face harsher conditions and realities than their heterosexual homeless peers, including higher rates of sexual assault and victimization, depressive episodes, and physical abuse.

Fortunately, local organizations, such as the Alley Forney Center in New York City, provide key services, resources, and support for homeless LGBT youth, but the federal government also has a role to play. Further legislation is undoubtedly necessary, but by passing the Student Non-Discrimination Act, Congress can send a clear message that schools are to be refuges for LGBT youth, not more bastions of discrimination.

Discrimination funnels LGBT youth into the juvenile justice system

LGBT youth are significantly over-represented in the juvenile justice system: Approximately 300,000 young LGBT people are arrested or detained each year. Though they represent 5 percent to 7 percent of the overall youth population, they comprise 13 percent to 15 percent of those currently in the juvenile justice system. These high rates of involvement in the juvenile justice system are a result of family rejection, as well as victimization in their schools. One study suggests that LGBT youth are up to three times more likely to experience harsh disciplinary treatment by school administrators than their heterosexual counterparts.

Passing the Student Non-Discrimination Act would penalize this discriminatory practice and channel LGBT youth away from the juvenile justice system.

Conclusion

On the one hand, the willingness of more and more Americans, including our youth, to openly identify as LGBT is encouraging and reflects a positive shift in our country’s attitude toward LGBT people. On the other hand, however, young people who identify as LGBT are uniquely vulnerable to some forms of discrimination because they are inexorably reliant upon their families and their schools, which are often hostile toward them because of their sexual orientation or gender identity.

The Student Non-Discrimination Act would be an important first step to lessening the stigma and discrimination LGBT students face at school and addressing the host of negative outcomes that stem from discrimination so early in a young person’s life. The Student Non-Discrimination Act, however, is only a stepping stone in what should be a greater commitment to ending discrimination when it starts, unfortunately, at childhood.

Christopher Frost is an Intern with the LGBT Research and Communications Project at the Center for American Progress. Katie Miller is the Special Assistant for the project at the center.

SOURCE: AP/Duane Burleson

Then-Boston Celtics center Jason Collins, left, guards Detroit Pistons center Greg Monroe, right, in the second half of an NBA game in Auburn Hills, Michigan.

In a widely discussed article posted yesterday on the Sports Illustrated website and published in the May 6 edition of the magazine, professional athlete Jason Collins declared, “I’m a 34-year-old NBA center. I’m black. And I’m gay.”

We interrupt this column for other breaking-news developments: The world did not come to an end yesterday, and the sun rose in the east and set in the west. Also, we’re reliably informed by our sources at the Federal Aviation Administration that all airliners departing from U.S. airports landed safely at their destinations. And, closer to home, Fido bit a mailman on Main Street. Back to you, Sam, for more details on the not-so-shocking story about the gay basketball player.

Had Collins’s admission occurred at almost any other point in our nation’s collective past psyche—say a decade or even a year ago—it might have been a shocking, even frightening moment. But it didn’t, and so it wasn’t.

Sports fans and social observers knew it was only a matter of time before the first professional male athlete jumped out of the closet while still wearing a team uniform. Now that it has happened, however, it feels oddly anticlimactic. No shouts or curses, only cheers and the proud affirmation that something that loomed so fearsome over our cultural landscape could be, in the end, not nearly as disruptive as it appeared just a few years earlier.

In a justice-is-served way, that’s how it should be. Collins isn’t a high-profile basketball player. He’s not flashy. Outside of those who closely follow the game, he might even be considered invisible. He has played for six teams over his 12-year career, averaging a lackluster 3.6 points and 3.8 rebounds per game. Collins doesn’t enter into fantasy-sports conversations.

Yet his fame and fortune as a pro baller is about to change forever. If sports in America are a bellwether for change in our society, Collins is about to add his face to the pantheon of athletic heroes who push us toward our better selves.

Of course, some folks disagree. ESPN’s NBA analyst Chris Broussard, for example, condemned Collins as “openly living in unrepentant sin” in a broadcast yesterday that discussed the announcement.

To be sure, the acid test of Collins’s disclosure will come over time in fan reactions to seeing an openly gay male basketball player. But if the immediate and overwhelming public reaction is a clue, Collins has little to fear and a league full of cheering supporters. ESPN.com reported the social-media world was quick to latch onto Collins, as his Twitter account picked up more followers in the hour after Sports Illustrated posted his story than in his previous 430 days on the site. His followers jumped from 3,700 to more than 9,000 in that hour, and @jasoncollins34 now has more than 89,000 followers a day later.

Fellow Washington Wizard Emeka Okafor told The New York Times that Collins is a great teammate and nothing has changed. “He’s the same guy,” Okafor said. “He’s just let us know more about him.” Other players, including stars such as the Los Angeles Lakers’s Kobe Bryant and the Oklahoma City Thunder’s Kevin Durant posted tweets praising Collins’s courage.

Even President Barack Obama, who admitted to evolving toward supporting marriage equality last year during his presidential re-election campaign, called Collins to personally say that he was “impressed” by his willingness to live and play basketball out of the closet.

Collins wants to continue to play and will seek to sign with a team when his current contract with the Washington Wizards expires July 1. NBA officials say it’s likely he’ll be in uniform because teammates, coaches, and team owners will be far less concerned about what he does off the court and quite eager to have his 7-foot, 255-pound frame snaring rebounds and clogging the lane.

Unlike other gay men who have played professional sports, Collins didn’t wait until retirement to make his sexual orientation public. In 2007 former NBA veteran player John Amaechi became the first professional basketball player to say he was gay but did so four years after retiring from the sport. Amaechi praised Collins’s disclosure but called it “a nonissue” because the public is far more tolerant now than ever before.

“This is a positive,” Amaechi said in a video post on the sports-related blog BleacherReport.com. “When there is this tipping point and there are enough people coming together, deciding that change is necessary, that’s when it happens. I’m hopeful that Jason will be a catalyst in this process, more so than anyone who’s come before him.”

For those who keep track of such things, Collins’s announcement is significant only because he’s the first openly gay male athlete who is an active player on a professional sports team. Surely, that will make him the Jackie Robinson of the LGBT community—something that Collins seemed to welcome, albeit reluctantly, in the Sport Illustrated article.

“I want to do the right thing and not hide anymore,” he said in the article. “I want to march for tolerance, acceptance and understanding. I want to take a stand and say, ‘Me, too.’”

Sam Fulwood III is a Senior Fellow at the Center for American Progress and Director of the CAP Leadership Institute. His work with the Center’s Progress 2050 project examines the impact of policies on the nation when there will be no clear racial or ethnic majority by the year 2050.

SOURCE: AP/Al Goldis

Joanne Polisano, left, Mary Czartoryski, center, and Stephen Eddins join others in a rally outside the Michigan Hall of Justice in Lansing, Michigan, on April 11, 2006, following a state court of appeals hearing on whether governments and public universities can provide health insurance and other benefits to the partners of gay employees without violating the state constitution.

Last month the U.S. Supreme Court heard oral arguments in cases challenging restrictions on the recognition of marriage between same-sex couples. Importantly, one of these cases challenges the Defense of Marriage Act—the federal law defining marriage as the union between one man and one woman—meaning that the justices’ ruling will have a profound impact on federal policy that affects the nearly 650,000 American families headed by same-sex couples.

As the Court deliberates the cases in the coming weeks, however, these couples and their families must carry on with their lives and continue to navigate the numerous social systems that too often threaten their health, well-being, and economic security by denying them equal access to vital programs and benefits.

Thus, while the Supreme Court is at the center of the federal conversation about families headed by same-sex couples, federal agencies can also significantly influence the daily lives of same-sex couples and their children. In particular, policymakers implementing key provisions of the Affordable Care Act have already released rules this year that will help increase access to affordable health insurance coverage for these families, mitigating some of the significant harms posed by discriminatory laws such as the Defense of Marriage Act.

Obamacare makes insurance more affordable for families headed by same-sex couples

There is overwhelming evidence suggesting that LGBT Americans are significantly more likely to live in poverty than the general population. LGBT workers are more than twice as likely to earn less than $10,000 per year, and when sex, geography, and race are factored in, this income disparity widens.

In addition to basic income inequalities, inequalities under the law create additional financial burdens for families headed by same-sex couples. Because of the Defense of Marriage Act, same-sex couples pay higher taxes compared to married heterosexual couples, including an average tax of $1,069 per year on health insurance coverage for their spouse or partner—when they are able to access this coverage at all.

It is no surprise, then, that socioeconomic inequality has put health insurance coverage, and therefore access to many health care services, out of reach for a significant number of LGBT families. Starting next year, however, the Affordable Care Act will ease the financial burden on many American families by opening up doors to health coverage and better health care.

Under the law, individuals and families who buy coverage through a Health Insurance Marketplace will be eligible to receive subsidies for health insurance premiums if their income is less than 400 percent of the federal poverty level—$45,960 for an individual and $94,200 for a family of four in 2013. These subsidy amounts are calculated during the insurance-marketplace application process, and the amount is set based on a sliding-scale percentage of income that goes toward premiums.

Because the calculation of household income is tied to restrictive marriage definitions imposed by the Defense of Marriage Act, or DOMA, same-sex couples will have to have these subsidies individually calculated instead of jointly. Fortunately, however, nothing in federal law, including DOMA or the Affordable Care Act, restricts the ability of same-sex couples to combine their individual subsidies to purchase family coverage.

Health Insurance Marketplace policies can be LGBT inclusive

Even before the passage of the health reform law, insurers have often stepped up to offer family plans that include same-sex couples and their families.

In states that extend some form of legal recognition to LGBT families, laws often also require insurers in the individual and small-group markets to extend family coverage to domestic partners. Even in states where there are explicit prohibitions on the legal recognition of relationships between same-sex partners, insurers still frequently extend inclusive family coverage, and some states give insurance companies the explicit authority to offer benefits to these families.

The widespread nature of inclusive coverage is well demonstrated in the practices of employers: Fifty-one percent of small business offer coverage to same-sex partners of employees, and more than 60 percent of Fortune 500 companies do the same. Federal policy under the Affordable Care Act promotes the expansion of these positive market practices and authorizes the marketplaces to offer coverage that includes same-sex couples and their children in family policies available in 2014.

Recently, the U.S. Department of Health and Human Services released final regulations implementing provisions of the Affordable Care Act that reform health insurance markets across the country. These regulations address the types of coverage that insurers offer to families. In explaining the rules, the agency clearly indicated that all families need access to health coverage and that adopting a narrow definition of “family” could adversely impact the ability of diverse families such as LGBT families to access the coverage and care that they need. Accordingly, the agency explicitly gave states the flexibility to require issuers to include specific types of individuals on a family policy. Current market practices that have promoted expanding coverage for LGBT Americans and their families will thus continue to advance under the Affordable Care Act.

The U.S. Office of Personnel Management, or OPM, has also released rules that will promote access to coverage for same-sex couples and their families. In rules implementing provisions of the Affordable Care Act that establish standards for multistate plans, OPM followed the Department of Health and Human Services in refraining from adopting a definition of family that would restrict the ability of plans to offer inclusive family coverage to households headed by same-sex couples. But OPM also went a step further by indicating that it would use the contracting process to encourage plans to “provide the same benefits for all family compositions, including but not limited to same-sex domestic partners and their children.”

Conclusion

While we wait for the Supreme Court’s historic rulings in a few weeks, state and federal policymakers should continue the important work of ensuring that policies implementing the health reform law provide fair and equal access to health coverage for all Americans, including same-sex couples and their children. And despite all of the sometimes confusing news and misinformation surrounding the Affordable Care Act, LGBT Americans and their families should take heart: Many of the law’s reforms are already making a difference, with even more benefits still to come.

Andrew Cray is a Policy Analyst with the LGBT Research and Communications Project at the Center for American Progress. Kellan Baker is Associate Director of the project.

SOURCE: AP/ Tom Harkin

Senate Health, Education, Labor, And Pensions Committee Chairman Sen. Tom Harkin (D-IA) speaks to reporters on Capitol Hill. Sen. Harkin has promised to bring the Employment Non-Discrimination Act before the Senate for a vote.

* Author’s note, May 14, 2013: This column reflects a clarification regarding the religious exemption language in the Employment Non-Discrimination Act.

It currently is perfectly legal in America to fire someone for being lesbian, gay, bisexual, and transgender, or LGBT. Rather than being evaluated on their skills, qualifications, and ability to contribute to the job, LGBT workers are all too often not hired, not promoted, or, in the worst cases, fired from their jobs solely due to their sexual orientation and gender identity—characteristics completely irrelevant to job performance. And in a majority of states and under federal law, these employees have no legal recourse to challenge this discrimination.

This week, however, a bipartisan group of senators and representatives are planning to introduce a bill to change that. If passed and signed into law, the Employment Non-Discrimination Act of 2013, or ENDA, would prohibit most employers from discriminating against employees based on sexual orientation or gender identity. It would finally put in place uniform and comprehensive protections for the LGBT workforce in all 50 states.

Considering the high rates of discrimination that LGBT workers experience, this law is sorely needed. Discrimination can force LGBT workers into unemployment, leaving them without an income to pay the mortgage, buy groceries, and otherwise make ends meet. Workplace discrimination is not only a problem for workers though; it also presents problems for businesses by introducing inefficiencies and costs that cut into profits and undermine businesses’ bottom lines.

While ENDA has been introduced in every session of Congress save one since 1994, the last time it received a vote in the Senate was in 1996. More than a decade and a half later, there still isn’t a federal law in place protecting LGBT workers from bias and discrimination. Luckily, earlier this year Sen. Tom Harkin (D-IA) vowed as Chairman of the Senate HELP committee—which oversees ENDA’s introduction—to move the bill forward this year. It’s high time the senate takes up this important bill once again for a vote.

With the bill’s introduction this week, here are the top 10 things you need to know about the Employment Non-Discrimination Act.

LGBT workers experience high rates of discrimination

LGBT employees continue to face widespread discrimination and harassment in the workplace. Studies show that anywhere from 15 percent to 43 percent of gay, lesbian, and bisexual people have experienced some form of discrimination and harassment in the workplace. Specifically, 8 percent to 17 percent of LGB workers report being passed over for a job or being fired because of their sexual orientation; 10 percent to 28 percent received a negative performance evaluation or were passed over for a promotion because they were LGB; and 7 percent to 41 percent of LGB workers encountered harassment, abuse, or antigay vandalism on the job. Rates of discrimination are especially high among people of color who identify as LGBT.

Transgender workers in particular experience high rates of employment discrimination. An astonishing 90 percent of transgender people report some form of harassment or mistreatment on the job or report having taken action such as hiding who they really are to avoid it. As with LGB employees, rates of employment discrimination are especially pronounced among transgender people of color.

Employment discrimination is bad for both employers and employees

Employment discrimination is a lose-lose situation for both the employees who are discriminated against and for the employers who allow discrimination to go unchecked.

For employees, discrimination often means being forced into the ranks of the unemployed, leaving them without an income to support themselves and their families. In this way, discrimination is largely to blame for many of the economic insecurities among LGBT families, who, contrary to commonly held stereotypes, report lower annual earnings and higher rates of poverty than non-LGBT families.

For employers, discrimination is an economically unwise business practice. Discrimination cripples a businesses’ ability to recruit and retain the best and the brightest. It diminishes overall job performance and productivity and closes businesses off to potentially profitable consumer markets.

The vast majority of Fortune 500 companies support these policies

When you consider the fact that discrimination hurts businesses, it is not surprising that nearly all Fortune 500 companies have taken steps to protect their workers. Companies that don’t protect and support LGBT workers are increasingly out of step with corporate America. Of the Fortune 500 companies, 87 percent of businesses have established nondiscrimination policies that include sexual orientation, and 56 percent include gender identity. That number increases as you climb the fortune ladder: Of the Fortune 100 companies, 93 percent include sexual orientation and 82 percent include gender identity in their corporate nondiscrimination policies.

No federal law prevents workers from being fired because they are LGBT

No federal law currently exists to prohibit employers from discriminating against LGBT people. Unfortunately, 9 out of 10 voters mistakenly believe LGBT workers already have federal protections against employment discrimination. A majority of states similarly do not offer employment protections to the LGBT workforce. Only 21 states and the District of Columbia prohibit employment discrimination on the basis of sexual orientation; 16 and the District of Columbia do so on the basis of gender identity.

ENDA would provide comprehensive protections to LGBT workers in all 50 states

If passed and signed into law, the Employment Non-Discrimination Act would protect private and public employees from employment discrimination on the basis of perceived or actual sexual orientation and gender identity. ENDA is similar to Title VII of the Civil Rights Act of 1964, which already protects workers on the basis of race, color, religion, sex, and national origin, as well as to the Americans with Disabilities Act of 1990, which protects against employment discrimination based on disability status. ENDA would only apply to employers with 15 or more employees, and the Equal Employment Opportunity Commission, or EEOC, would enforce it.

Small businesses report having LGBT-inclusive nondiscrimination policies

A Center for American Progress poll reveals that many small businesses already have policies in place that prohibit discrimination against LGBT employees. Seven out of 10 small businesses prohibit discrimination on the basis of sexual orientation, and 6 out of 10 small businesses already prohibit discrimination on the basis of gender identity. What’s more, small-business owners report that there were virtually no costs associated with implementing and maintaining these nondiscrimination policies. In fact, most research indicates that nondiscrimination policies are a net positive for large and small businesses.

ENDA enjoys broad public support

In a Center for American Progress poll, nearly three-fourths—73 percent—of the American public supports protecting LGBT people from workplace discrimination. This support cuts across political party affiliation, with 81 percent of Democrats, 74 percent of independents, and 66 percent of Republicans supporting workplace nondiscrimination laws for LGBT people. Looking at key demographic groups, Catholics and seniors solidly favor employment protections based on sexual orientation or gender identity with 74 percent support and 61 percent support, respectively. Even among people who identify themselves as feeling generally unfavorable toward gay people, a full 50 percent support workplace nondiscrimination protections for the LGBT population. The small business community also strongly supports enacting ENDA: 63 percent of small-business owners have voiced their support for the bill.

ENDA contains an exemption for religious organizations*

Section 6 of ENDA provides religious organizations, which are broadly defined, with a substantial exemption that allows them to continue to take sexual orientation and gender identity into account when making employment decisions. In this way, ENDA’s religious exemption is broader than other laws that provide exemptions to religious organizations with respect to employment—and in fact is broader than any religious exemption in our federal civil rights laws. Given this, claims that ENDA harms religious liberty are misplaced.

ENDA explicitly prohibits quotas, preferential treatment, and federal data collection

Looking technically at the bill, Section 8 of ENDA explicitly prohibits employers from giving preferential treatment to LGBT workers. It similarly prevents employers from establishing quotas for employment based on sexual orientation and gender identity. It simply protects LGBT workers from unfair or biased decision making in matters of employment, which would level a currently very uneven playing field.

ENDA also prohibits the EEOC from collecting data about employees’ sexual orientation or gender identity. It’s worth noting, however, that the bill does not prohibit employers from collecting data about their LGBT employees themselves. Should they choose to do so—as some businesses in the private sector already do—they can then provide those statistics to the EEOC.

President Obama can sign an executive order prohibiting federal contractors from discriminating against LGBT workers

While the Senate can and should vote on ENDA in this session, it is unlikely that the conservative House of Representatives will take up this critical piece of legislation, let alone put it to a vote. Given ENDA’s dismal chance of becoming law in the near future, President Barack Obama can and should issue an executive order prohibiting federal contractors from discriminating against LGBT workers. Presidents from both political parties have issued similar executive orders that prohibit federal contractors from discriminating on the basis of race, color, religion, sex, or national origin. As the chief executive of the federal government, President Obama should make it clear that discrimination against LGBT workers will not be tolerated if you want to do business with the government.

At its core, ENDA’s premise is simple: Nobody should be denied employment or forced out of a job due to their sexual orientation and gender identity. Americans from all demographic and political backgrounds support this bill. It’s time for Congress to take action and finally turn it into law.

Winnie Stachelberg is the Executive Vice President for External Affairs and Crosby Burns is a Policy Analyst at the Center for American Progress.

SOURCE: AP/Carolyn Kaster

Gabriela Fore, 6, of Upper Darby, Pennsylvania, holds a sign with her moms in front of the Supreme Court in Washington, Wednesday, March 27, 2013 as the court heard arguments on the Defense of Marriage Act.

The connection between marriage equality and cell phones is not immediately apparent, but Justice Samuel Alito made the link during a Supreme Court argument on California’s Proposition 8 last month.

As Justice Alito said to Solicitor General of the United States Donald Verrilli:

Traditional marriage has been around for thousands of years. Same-sex marriage is very new. There isn’t a lot of data about its effect. And it may turn out to be a good thing; it may turn out not to be a good thing, as the supporters of Proposition 8 apparently believe. But you want us to step in and render a decision based on an assessment of the effects of this institution which is newer than cell phones or the Internet?

From his line of questioning, Justice Alito clearly seemed worried about replacing a venerable institution with a “newfangled” one that could turn out to be bad for society. And he wasn’t the only one with concerns. Cardinal Timothy Dolan, head of the U.S. Conference of Catholic Bishops, speaks for many Catholic leaders when he insists that marriage between a man and a woman is God’s intention for humankind. The Mormon Church holds a similar view, as do thousands of evangelicals and Orthodox rabbis. Even some young conservatives, unlike most of their contemporaries, are standing up for their belief that “traditional marriage” is inherently natural and good.

But here’s the problem: The notion of traditional marriage that these conservatives are so vigorously defending is not historically accurate. Pundit Bill Kristol recently fell into this trap when he complained that supporters of marriage equality want to overthrow “thousands of years of history and what the great religions teach” about marriage.

In actuality, traditional marriage—as it existed centuries ago—is not worth defending.

Let’s start with concubines—also known as mistresses—who were owned by husbands in ancient cultures and are mentioned without disapproval throughout the Hebrew Bible. Then there’s the practice of polygamy, which was the norm in biblical times. Back then, tradition forced rape victims to marry their rapist. Tradition also called for victorious soldiers to make female war prisoners their wives and concubines.

In the Middle Ages, marriages were arranged for political and financial reasons, and girls could be forced to marry when they were as young as 12 years old. British Common Law held a man to be “lord and master” of his wife who was subject to “domestic chastisement.” Wife beating was legal and common in England until the late 1800s.

In colonial America, wife beating was illegal, but marriage equaled patriarchy. A wife had no legal rights or existence apart from her husband. Any money or property she inherited belonged to him. Their children were his as well. Wife abuse was not uncommon.

In 1864 a North Carolina court heard the case of a woman abused by her husband because she had called him names. The court ruled that:

A husband is responsible for the acts of his wife, and he is required to govern his household, and for that purpose the law permits him to use towards his wife such a degree of force as is necessary to control an unruly temper and make her behave herself; and unless some permanent injury be inflicted, or there be an excess of violence, or such a degree of cruelty as shows that it is inflicted to gratify his own bad passions, the law will not invade the domestic forum, or go behind the curtain.

It wasn’t until the 20th century—when women fought for and won the right to vote, to sign contracts on their own, to obtain financial credit, to have access to contraception, and more—that these earlier notions of traditional marriage began to crumble, and something resembling the institution we recognize today began to emerge.

But each of the advances for women’s equality was fought by forces that considered them an invasion of the sacred private realm of the home and an assault on the family. Even so, these advances became part of law and culture and are now the norm. In fact, they are embedded in the institution that conservatives are now so fiercely defending.

Marriage has always been dynamic. For the most part, its evolution has been positive. Marriage today is far more mutually supportive, egalitarian, and secure for children than it was centuries ago. Take heart, conservatives. The institution of marriage does change and adapt over the years, and that is what makes it endure.

Sally Steenland is Director of the Faith and Progressive Policy Initiative at the Center for American Progress. Steenland, a best-selling author, former newspaper columnist, and teacher, explores the role of religion and values in the public sphere.

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Transcript

See also:

• “Living in Dual Shadows: LGBT Undocumented Immigrants” by Crosby Burns, Ann Garcia, and Philip E. Wolgin
• “Infographic: The LGBT Undocumented: By the Numbers” by Crosby Burns and Ann Garcia

For more information, please visit http://www.out4citizenship.org/.

Katie Miller is a Special Assistant for the LGBT Research and Communications Project at the Center for American Progress.

SOURCE: AP/ Nick Ut

A line of undocumented immigrants wait outside the Coalition for Humane Immigrant Rights in Los Angeles offices. The path to citizenship is often most difficult for gay and transgender women.

March is Women’s History Month—a time not only to celebrate women’s contributions to history and society, but also to reflect on the injustices and persecution that too many women continue to face across the globe. Among the most vulnerable members of our global society are gay* and transgender women who are victimized and mistreated in their home countries because of their sexual orientation or gender identity. A lack of financial means to escape persecution and seek asylum in the United States often exacerbates their plight. Even if these women arrive on U.S. shores, they face unique challenges filing for asylum. As Congress and the Obama administration move forward on comprehensive immigration reform, they must take into account the barriers that prevent gay and transgender women from fleeing persecution and pursuing more secure and safe lives as U.S. citizens.

Many gay and transgender individuals face persecution in their home countries

In many countries around the world, gay and transgender people are targets of violence and discrimination. In nearly 80 countries, sexual activity between men is illegal, and about half of these nations also outlaw sexual activity between women. Some of these countries use the death penalty to punish gay men and women, while others resort to imprisonment, forced labor, and even corrective rape.

In addition to the persecution of gay and transgender individuals through laws, repressive societies may also threaten the safety of gay and transgender people when their sexual orientation or gender identity does not conform—or is viewed as not conforming—to prevailing cultural, political, or social norms. As a result, many gay and transgender individuals flee their home countries in search of safer and more tolerant countries.

Women have greater difficulty seeking asylum because of cultural and economic inequality in their home countries

Arriving on U.S. shores often presents the greatest obstacle for women seeking asylum. Unlike an immigrant applying for refugee status, an asylum applicant must be within the borders of the United States—a requirement that poses a significant challenge for women who suffer from cultural and economic inequality within their home countries.

Women often lack the resources to pay for the cost of travelling to the United States and its promise of asylum. Despite the fact that women are half of the world’s population, they comprise 70 percent of the world’s poor, own just 1 percent of property, and earn only 10 percent of global income. For impoverished women in faraway lands looking to the United States for sanctuary, a journey overseas is simply not an option.

Even women with the financial wherewithal to travel to the United States, their asylum may still encounter cultural barriers impeding their escape. Women in some Middle Eastern countries must be accompanied by a male family member when they journey outside the home. Women violating this law may be particularly vulnerable to violence and other forms of severe punishment. For these women, the chances of fleeing their home countries unescorted and undetected are bleak at best, and often dangerous.

The situation becomes even more complicated when a family discovers a female family member is gay or transgender. In that situation a family will often assign more domestic responsibilities to her and limit her movement outside of the household. This is a way of isolating women and depriving them of the opportunity to develop a support network, which would be a valuable resource if they ever choose to flee their home country.

Gay and transgender women seeking asylum in the United States continue to face barriers

Since 1994 the United States has recognized persecution based on sexual orientation as grounds for attaining asylum status. To be granted asylum, U.S. immigration law states that individuals seeking asylum based on their sexual orientation must prove that they are indeed gay or transgender, and that they have or will face persecution by their home country’s government because of their sexual orientation.

Unfortunately, for gay or transgender women nearly all of the precedent-setting court cases that have established standards for successful gay and transgender asylum seekers are based on the experiences of gay men. Gay and transgender women have vastly different experiences than gay men, and current guidelines may not be helpful to them as asylum applicants. Some women, for example, may have been married in their home countries, which often include nations where the government and society exercise extensive control over a woman’s relationship status and family formation. A woman in this situation may have even been forced into a marriage in order to “cure” her of her attraction to women. The fact that a woman is or has been married, nonetheless, may cast doubt on her sexual orientation or gender identity, and as a result her claim for asylum.

Moreover, since a woman’s sexual orientation and gender identity is not always readily apparent, gay and transgender asylum seekers are at risk of having their cases dismissed because they fail to conform to stereotypes of gay or transgender women. In one particular case, which was documented by Immigration Equality, a leading organization working with gay and transgender asylum seekers, an Albanian lesbian, who had been threatened with gang rape to “cure” her of her lesbianism, was denied asylum because she was young, attractive, and single. With no precedential cases about gay and transgender women, establishing grounds for asylum becomes a more daunting task for female gay and transgender asylum seekers.

The Obama administration has already taken several steps to improve the experiences of gay and transgender immigrants and asylum seekers. Specifically, the U.S. Department of Homeland Security created and mandated a training module on gay and transgender issues to educate asylum interviewers on how to properly assess individuals seeking asylum due to persecution related to their sexual orientation or gender identity. The Obama administration must nevertheless ensure that the Department of Homeland Security incorporates an understanding of gay and transgender issues that is neither based exclusively on the experiences of men or on those of gay American women.

The one-year filing deadline presents yet another obstacle to successful asylum claims. This is particularly problematic for gay and transgender women because many of them are not open about their sexuality, or have not “come out” when they first arrive in the United States. Moreover, some women live within immigrant communities where being gay or transgender is still unacceptable. These women could be forced to return to their home countries if they do not file for asylum to avoid persecution in their home countries within one year of stepping onto U.S. soil. The one-year filing deadline is arbitrary, does not reflect the psychological reality of “coming out,” and, if repealed, would largely benefit gay and transgender asylum seekers.

Conclusion

In addition to the general inequalities plaguing women worldwide, the pervasive antigay and antitransgender bias in many countries highlights why many gay and transgender women turn to the United States for asylum. While the U.S. government cannot immediately and singlehandedly end the persecution of gay and transgender women across the globe, Congress and the Obama administration can move forward with a plan for comprehensive immigration reform that takes into account the challenges faced by gay and transgender women.

Christopher Frost is an intern for the LGBT Research and Communications Project at the Center for American Progress.

* In this column the term “gay” is used as an umbrella term for those who identify as lesbian, gay, or bisexual.

Dr. Hamsakumari Ramasubramaniam, left, examines patient Fabian Vasquez at Camillus Health Concern in Miami. Camillus is a private, non-profit organization that provides health care to the homeless, poor, and uninsured in Miami-Dade County.

Reforming America’s health care system is a massive undertaking. The sheer scale of the effort means that the Affordable Care Act will touch the lives of every American—including millions of Americans who are frequently excluded from vital health insurance coverage and denied health care services. Gay* and transgender people and people living with HIV or AIDS are two of the groups whose access to coverage and care has the potential to change dramatically under the health reform law.

On March 18, 2013, CAP hosted an event, “A New Era of Inclusion,” to highlight this important issue. In her introductory remarks CAP President and CEO Neera Tanden stated that:

Here at CAP, we are leveraging the implementation of the Affordable Care Act to eliminate barriers that keep gay and transgender people and people with HIV from achieving the high attainable health care that they need. The LGBT State Exchange Project is working across the country for better data collection, better consumer protections, comprehensive and reliable insurance benefits, and the successful implementation of the Medicaid expansion.

Following Tanden’s introduction, Kellan Baker, the Associate Director of CAP’s LGBT Research and Communications Project, discussed the health and health care access disparities that gay and transgender people face, including the following concerns:

• There are more than 9 million Americans who identify as lesbian, gay, bisexual, or transgender, but federal and state governments do not routinely collect data on the health needs or experiences of this population.
• Gay and transgender people face discrimination and violence that are both structural and physical in employment, housing, education, health care, and other areas of daily life.
• Many U.S. states and the federal government do not recognize same-sex relationships, which deprives many of these couples of social support, economic and health insurance benefits, and legal protections that are available to heterosexual couples.
• Many transgender people have difficulty changing their identity documents to accurately reflect their name and gender after gender transition, putting them at high risk of discrimination and even physical violence.
• Most health care providers do not receive training about working with gay and transgender patients, and may intentionally or unintentionally provide worse care as a result.
• Gay and transgender people—especially those who are parents, women, transgender people, or people of color—are more likely than the general population to live in poverty.
• Many gay, transgender, queer, or questioning young people are kicked out of their homes for their sexual orientation or gender identity, and an estimated 40 percent of the U.S. homeless youth population is gay or transgender.

As a result of these and other factors, gay and transgender people tend to have worse insurance coverage, have less access to health care, and get diagnosed with conditions such as breast cancer, depression, and HIV more often.

Baker highlighted several aspects of the Affordable Care Act that have particular potential to address these disparities, including better data collection on sexual orientation and gender identity, new gay and transgender-inclusive nondiscrimination protections, insurance market reforms that promote access to more comprehensive benefits, and the extension of insurance coverage to more than 30 million Americans through the expansion of the Medicaid program and the establishment of the state-based health insurance marketplaces.

Dr. Jennifer Kates, vice president and director of global health and HIV policy at the Kaiser Family Foundation, gave a presentation on the Affordable Care Act and its effect on people living with HIV/AIDS. She noted that gay and bisexual men comprise 66 percent of new infections, and that only one-quarter of people living with HIV are in regular care. In her remarks Kates underlined several provisions of the health reform law that are particularly important for those with HIV, including an end to annual and lifetime coverage limits, the elimination of pre-existing condition exclusions, and the closing of the “donut hole” in prescription drug coverage under Medicare Part D.

Kates also highlighted the importance of the Medicaid expansion for those living with HIV. According to her presentation, “people with HIV are more likely to be low-income and uninsured than the U.S. population overall and have a heavy reliance on Medicaid,” but only about 68 percent of people living with HIV live in states that plan to expand their Medicaid programs as the Affordable Care Act requires. A Supreme Court decision in June 2012 has effectively rendered this requirement optional for the states.

Aisha Moodie-Mills, CAP’s advisor on LGBT policy and racial justice and the director of the FIRE Initiative, moderated the subsequent discussion panel. This panel included Jeffrey Crowley, distinguished scholar and program director of the National HIV/AIDS Initiative at the O’Neill Institute for National and Global Health Law at Georgetown University; Mayra Alvarez, director of public health policy in the Office of Health Reform at the U.S. Department of Health and Human Services; Kali Lindsey, director of legislative and public affairs at the National Minority AIDS Council; Susan T. Sherry, deputy director of Community Catalyst; and Kellan Baker.

Moodie-Mills opened the panel by noting that discrimination and socioeconomic inequality continually push gay and transgender people and people with HIV toward the margins of our country’s health care system. When asked why it was important to talk about gay and transgender people and people living with HIV as part of the implementation of the Affordable Care Act, Baker replied that:

First, it is because gay and bisexual men, particularly men of color, are the population where new infections are still rising. LGBT populations are still overwhelmingly disproportionately affected by HIV. The other reason is that the Affordable Care Act has some of the tools to change a health care system that isn’t working for LGBT people and people living with HIV.

All panelists agreed that implementing the health reform law will require new partnerships between federal and state governments, consumer health advocates, gay and transgender health advocates, and advocates for people living with HIV. As Alvarez noted, “The federal government won’t be able to reach everyone, and we need to take a train-the-trainer approach.” Baker echoed the concern that more than two-thirds of those who will benefit most from the Affordable Care Act don’t actually know anything about the law. Sherry discussed examples of partnerships in states such as New York and Maryland, where health reform advocates, communities of faith, and gay and transgender advocates are working together to address the needs of marginalized communities.

As several panelists emphasized, health reform must fundamentally be about the principle of universal design. In taking this historic opportunity to build a health system that works better for gay and transgender people and people living with HIV, we are helping to build a system that will work better for everyone.

Kellan Baker is the Associate Director of the LGBT Research and Communications Project at American Progress. Christopher Frost is an intern with the Project.

* The term “gay” is used in this column as an umbrella term for those who identify as lesbian, gay, and bisexual.

Crosby Burns is a Policy Analyst for the LGBT Research and Communications Project at the Center for American Progress. Christopher Frost is an intern at the Center.

SOURCE: AP/Jacquelyn Martin

Sen. Tom Coburn (R-OK) walks toward the Senate chamber on Capitol Hill in Washington, December 31, 2012.

Bipartisan legislation introduced this past Valentine’s Day in both the House and the Senate gave public-health advocates something extra to love. The HIV Organ Policy Equity, or HOPE, Act, introduced in the House by Rep. Lois Capps (D-CA) and in the Senate by Sens. Barbara Boxer (D-CA) and Tom Coburn (R-OK), replaces outdated organ-donation policies with a pathway to hope for HIV-positive patients who are on waiting lists for life-saving organ transplants.

HIV-positive individuals can currently receive organ transplants, but legislative roadblocks prevent organ donation by HIV-positive donors. The HOPE Act would strike provisions of the National Organ Transplant Act that prohibit the donation of organs from HIV-infected deceased donors, and it would establish a regular review process in which the secretary of health and human services would evaluate the progress of medical research into these procedures. If research shows that organ transplants between HIV-positive donors and HIV-positive recipients are safe and successful, the secretary of health and human services would then have the authority to direct the establishment of procedures to begin such transplantations.

This legislation represents a positive step forward for sensible HIV and health policy by removing outdated barriers to common-sense, data-driven procedures for the donation of life-saving organs. These changes have the potential to change the lives of thousands of individuals in need of organ transplants, demonstrating a shift in the dialogue around donation policies for individuals with or at risk for HIV infection.

Here are the top three reasons public health advocates can—and should—get behind the HOPE Act.

The HOPE Act would replace discriminatory stereotypes with data-driven science

The National Organ Transplant Act of 1984, which established standards for organ donation, was passed at the height of antigay rhetoric and widespread misunderstanding surrounding HIV/AIDS. Reflecting the concerns of the time, the law requires the adoption of standards preventing the acquisition of organs from individuals known to be infected with HIV. While at the time of its passage there may have been rationale for this policy in light of limited understanding of HIV transmission, the effect of the law now is that it prohibits the acquisition of organs from HIV-positive donors, while hundreds of HIV-positive people in need of donated organs languish on long transplant waitlists.

Unfortunately, these organ-donation restrictions have endured despite significant advances in testing, screening, and transmission prevention; are vestiges of antiquated bias and misinformation; and no longer align with the progress made in medical technology and public health policy.

The lack of medical rationale for this ban is underscored by the fact that current policies regarding HIV are significantly more restrictive than policies addressing other infections that can also be transmitted during the transplantation process. Individuals who test positive for hepatitis C, for example, are permitted to donate organs to patients who also have hepatitis C. Furthermore, while no transplants of HIV-infected organs into HIV-positive patients have been done in the United States because of the ban, researchers say that such procedures have been performed in South Africa with excellent clinical results.

By shifting organ-donation policy away from outdated assumptions about risk, the HOPE Act would reflect the fact that “our scientific understanding of AIDS is much better than when this research ban was established,” permitting “sound science” to guide federal standards.

The HOPE Act would help save on Medicare spending

Basing organ-donation standards on research-based science makes sense from more than just a standpoint of principle. Removing barriers to the donation of safe, viable organs is also good fiscal policy. Fortunately, care for patients with kidney failure is covered as part of the Medicare End Stage Renal Disease Program. This program makes up slightly less than $20 billion of the overall Medicare budget. Transplantation can prevent some of these costs, however, by providing healthy transplant organs to these patients. If restrictions on organ donations between HIV-positive individuals were lifted under the HOPE Act, these costs would be cut by $500,000 per patient. With recent studies suggesting that 500 HIV-positive people in need of replacement kidneys could receive them if the ban on donation by HIV-positive donors was lifted, the potential cost savings for the Medicare program are significant. In the current fiscal climate, it makes sense to increase options for safe transplantation practices where—in addition to saving lives—it saves taxpayer dollars.

The HOPE Act could help save thousands of lives

Most importantly, the HOPE Act would open up pathways to research and transplantation policies that could save thousands of lives. There are currently more than 74,000 active waiting-list candidates on the Organ Procurement and Transplantation Network registry. This is not a fast-moving list, with some patients waiting as long as 10 years to receive a transplant. Many die waiting. Removing outdated restrictions on organ donation could ease the strain on our country’s organ-transplant system and create pathways to transplants both for patients who are living with HIV and those who are not.

First, using organs from HIV-positive donors for HIV-positive recipients would result in HIV-positive patients receiving transplants faster. Approximately 500 HIV-positive people in need of replacement livers and kidneys could receive them each year if organ donations by HIV-positive donors were permitted. This change could potentially provide transplanted organs to every HIV-positive transplant candidate on the waiting list. In addition, these transplants would likely take place faster. Research on a comparable policy permitting organ donation between individuals infected with hepatitis C shows that wait times are significantly reduced and that patients are more likely to survive while on the donation waiting list.

Additionally, patients who are not living with HIV would also receive transplants faster because HIV-positive patients would be able to draw from a supply of organs that would be otherwise discarded under current policy. Although organs from HIV-positive donors may not be appropriate for transplantation to individuals who are not living with HIV, permitting the use of a unique supply of organs that is appropriate for a subset of patients on the waiting list would benefit all individuals waiting for life-saving transplants.

Conclusion

Medical science and public health policy have come a long way in the past several decades, and legislators on both sides of the aisle—along with numerous medical and advocacy groups—have voiced their support for legislation that would allow organ-donation policy to reflect this knowledge. The shortage of donor organs is a matter of life and death for thousands of Americans, and the HIV Organ Policy Equity Act is a positive first step toward safe and effective transplantation policy that would live up to its name and give these patients and their family hope for a healthier future.

Andrew Cray is a Research Associate for the LGBT Research and Communications Project at the Center for American Progress.

Download a printable version of this infographic (PDF)

This infographic contains a correction.

Crosby Burns is a Policy Analyst for the LGBT Research and Communications Project at the Center for American Progress. Ann Garcia is a Policy Analyst for the Immigration Policy team at the Center.

SOURCE: AP/J. Scott Applewhite

House Speaker John Boehner (R-OH), accompanied by fellow GOP leaders, meet with reporters on Capitol Hill in Washington, February 26, 2013, to challenge President Barack Obama and the Senate to avoid the automatic, across-the-board spending cuts that could take effect.

See also: Caught in the Budget Battle: How the ‘Fiscal Showdown’ Impacts Gay and Transgender Americans

If Americans thought the so-called fiscal showdown was over, they should think again. Unless Congress strikes a deal today, a series of across-the-board cuts to the federal budget will go into effect that would reduce funding for federal programs by a whopping $85 billion by the end of the year. These automatic spending cuts—which would occur under a process known as sequestration—were intended to force both parties to agree on an alternative deficit-reduction plan out of a mutual desire to avoid swallowing such a painful pill.

Millions of hardworking Americans, however, once again find themselves at the precipice of a fiscal showdown that, if left unresolved, will impose real and significant financial harm. Among those Americans who will be hit hardest by sequestration are gay and transgender Americans.[1]

Last November the Center for American Progress, the National Gay and Lesbian Task Force, and a coalition of 23 national gay and transgender advocacy organizations released “Caught in the Budget Battle,” a groundbreaking report examining how the sequester would cut funds from federal programs that are crucial to the health, wellness, and livelihood of gay and transgender Americans and their families.

Revisiting the report, here are six reasons why sequestration still poses a significant threat to gay and transgender Americans.

Sequestration hurts gay and transgender workers

Studies have confirmed that gay and transgender workers face extraordinarily high rates of discrimination in the workplace—for example, 42 percent of gay people report having experienced discrimination on the job at some point in their lives. Remarkably, 90 percent of transgender people report some form of harassment or mistreatment on the job or report having taken some action such as hiding who they are to avoid it. While gay and transgender workers continue to be forced out of their jobs and into the ranks of the unemployed, it remains perfectly legal in a majority of states and under federal law to be fired for being gay or transgender.

Sequestration turns a precarious situation into a dire one for gay and transgender workers. Broad cuts to nondefense discretionary spending, for example, weaken the Equal Employment Opportunity Commission’s ability to investigate claims of discrimination against gay and transgender workers.[2] With reduced and severely limited budgets, the commission may be forced to delay or even halt investigations of employment discrimination, exacerbating the problems facing these Americans.

Sequestration compromises gay and transgender health and safety

Gay and transgender Americans suffer from a greater number of health disparities compared to their straight and nontransgender peers. They also disproportionately lack access to health insurance and culturally competent health care services, further worsening these health disparities and obstructing access to life-saving preventive care.

Fortunately, a number of federal programs are in place to support the physical and mental health of gay and transgender Americans. Those programs, however, will be slashed by sequestration. Severe cuts to Medicare-provider reimbursements may result in limited access to care to gay and transgender elders, and programs that help gay and transgender youth such as antibullying initiatives will also be on the chopping block. Moreover, sequestration could reverse progress on addressing the HIV/AIDS crisis by cutting funding to programs that help prevent the spread of HIV/AIDS and treat those living with the virus.

Sequestration exacerbates homelessness among gay and transgender youth

Gay and transgender Americans already experience higher rates of homelessness compared to the general population. Though gay and transgender individuals comprise 5 percent to 7 percent of all youth in America, they represent up to 40 percent of all homeless youth. Sequestration limits the progress toward fighting gay and transgender homelessness by reducing grant funds to community organizations addressing the issue and by limiting the government’s ability to fight housing discrimination.

One of these grant recipients is the Ali Forney Center, an organization that helps gay and transgender homeless youth in New York City. Under sequestration, the federal agencies that provide financial assistance to the Ali Forney Center would see their budgets slashed, which would severely limit the capacity of the center to help gay and transgender youth who are desperately in need of its services.

Sequestration makes higher education less accessible for gay and transgender students

Higher education is viewed as one of the premier pathways to economic prosperity in the United States. It is also a significant financial investment that many would not be able to achieve without the help of federal assistance. In short, many students, including gay and transgender students, regard federal financial aid in the form of loans, grants, and work-study programs as a lifeline to accessing higher education.

Sequestration, however, would result in significant cuts to federal work-study programs for gay and transgender students and a reduction in supplemental educational opportunity grants for low-income gay and transgender students. This would further intensify inequalities in accessing higher education and may disproportionately disadvantage gay and transgender students.

Sequestration limits the ability to prevent violence against gay and transgender people

Across-the-board cuts and spending caps will tremendously undermine the government’s ability to tackle the disproportionate levels of abuse, harassment, and violent crime suffered by gay and transgender Americans. Sequestration limits resources available to investigate, prosecute, and prevent hate crimes. Limits on the Department of Justice’s ability to investigate bias-motivated crimes would be caused by four main reasons:

• The Federal Bureau of Investigation will have fewer resources to investigate violent crimes committed against gay and transgender people.
• The Department of Justice’s Civil Rights Division will have restricted resources to federally prosecute bias crimes.
• Sequestration will impede the Department of Justice’s ability to collect data on hate crimes.
• Strained funding will make it far more difficult to train state and local law enforcement to help prevent hate crimes based on sexual orientation and gender identity.

Sequestration limits U.S. capacity to protect the human rights of gay and transgender people worldwide

The Department of State has taken the lead in promoting a comprehensive human-rights agenda aimed at protecting the human rights of gay and transgender people around the world. Eighty countries have laws or other legal provisions criminalizing sex between people of the same gender, and being gay is punishable by death in five countries. Sequestration will be detrimental to the public diplomacy efforts conducted by U.S. embassies to promote gay and transgender human rights and would deal a significant blow to support for global gay and transgender equality.

No time for games

If we are to cut spending, what we need is a scalpel, not a meat cleaver. Only then can we spare the most vulnerable communities—including those in the gay and transgender community—the pain and hardship that would come with sequestration.

It’s time for politicians in Washington to stop playing games and agree on a rational solution to reduce the federal deficit. Though the odds are slim that Congress will come to an agreement today and avert sequestration, developing an alternative plan to deficit reduction must remain a top national priority. It is only a matter of time before the effects of sequestration are felt in every household across the country.

Christopher Frost is an intern with the LGBT Research and Communications Project at the Center for American Progress. Crosby Burns is a Research Associate with the LGBT Research and Communications Project. Katie Miller is a Special Assistant with the LGBT Research and Communications Project at the Center.

Endnotes

[1] In this column the term “gay” is used as an umbrella term to describe people who are lesbian, gay, or bisexual.

[2] Last spring the Equal Employment Opportunity Commission issued a watershed decision determining that discriminating against transgender individuals based on gender identity falls within Title VII of the Civil Rights Act’s prohibition of “sex” discrimination, as does discrimination against gay people who break gender norms or sex stereotypes. Thanks to this ruling, gay and transgender people now have a resource when they are denied a job or fired based on their sexual orientation or gender identity.

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Lauren Santa Cruz is a Videographer for the Center for American Progress. Katie Miller is a Special Assistant for the LGBT Research and Communications Project at the Center.

The opinions expressed in this video do not necessarily reflect the views of the U.S. Marine Corps or the Department of Defense.

See also:

• Collateral Damage: How the Defense of Marriage Act Harms the Troops and Undermines the U.S. Military by Katie Miller

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