The Washington Free Beacon’s Aaron Sibarium recently reported how the Human Rights Campaign (HRC) is once again pushing gender ideology on hospitals, this time through its healthcare scorecard. 

Sibarium noted that while technically the scorecard carries “no official weight, … as countries around the world pump the brakes on pediatric transition, critics say that the index—bankrolled by the very companies that produce and profit off puberty blockers and cross-sex hormones—is encouraging the sort of no-guardrails approach that has made U.S. gender medicine an international outlier. The scorecard has helped powerful lobbyists seed their ideology across American hospitals, becoming de facto regulators of health care.”

Rachel Morrison, a former attorney at the Equal Employment Opportunity Commission, even acknowledged, “A bad score puts a target on hospitals’ backs. … Even if the index itself is not legally enforceable, hospitals still have an incentive to defer to it.”

This scorecard is the Healthcare Equality Index (HEI), funded in part by Pfizer and PhRMA—no surprise. The healthcare scorecard is similar to HRC’s Corporate Equality Index (CEI), which measures how “inclusive” corporations are to LGBTQ+ employees. 

In 2022, the HEI celebrated its 15th year. There were 906 healthcare facilities that actively participated in the survey, and HRC researched over 1,300 non-participating hospitals for its biennial report. Last year was the 5th year that HEI participants were given a score based on their policies and practices related to “the equity and inclusion of their LGBTQ+ patients, visitors, and employees.” Over 490 participants—most of which were in California and New York—received the top score of 100 points, designated as “LGBTQ+ Healthcare Equality Leaders.”

The criteria for the score are broken into five categories: non-discrimination and staff training, patient services and support, employee benefits and policies, patient and community engagement, and responsible citizenship. Facilities earn points for practices, such as having senior executives complete HEI’s LGBTQ+ training, offering transgender-specific clinical services, having a gender clinic for adults and/or children, asking patients their preferred pronouns, providing gender transition healthcare benefits for employees, having an external LGBTQ+ specific logo, supporting LGBTQ+ events in the area, and supporting LGBTQ+ equality under the law through taking action on local, state, or federal legislation or regulations. 

The 5th requirement deducts points for facilities that revoke LGBTQ+ “inclusive policies” and practices (as defined by HRC) or have policies or practices in place that contradict the HRC’s policies. For example, UT Southwestern and Children’s Health in Dallas received the deduction for ending what HRC describes as “necessary gender-affirming care” to trans-identified youth.

Perhaps most concerning, for the first time in 2022, facilities were penalized for following a religious directive or having a policy in place that prevents them from providing “medically necessary” treatments to patients based on a diagnosis of gender dysphoria while providing the same treatment based on other diagnoses. So a facility that provides hysterectomies for women with cancer of the uterus or ovaries would be penalized for not allowing the same treatment for a physically healthy trans-identified female desiring elective surgery to remove her reproductive organs. This penalty applied to 22 Catholic healthcare facilities that followed Catholic ethical and religious directives. 

Even though the HEI does not carry legal mandates with it, the promise of a better score has incentivized hospitals to change their policies. 

As Manhattan Institute fellow, Leor Sapir, commented

Some hospitals have taken direct steps to improve their HEI score, such as Children’s National Hospital. In response to its less-than-perfect score in 2020, Children’s National created a subcommittee dedicated to “diversity, equity, and inclusion.” The subcommittee at the hospital added gender identity language to the patient and visitation policies, including requiring employees to use a patient’s preferred pronouns. They also made gender transition benefits available to employees and dependents under the age of 18. In 2022, Children’s National earned a perfect score.  

While healthcare facilities should serve all patients who enter their doors, regardless of their sexual orientation or gender identity, the HEI goes much further than this. It denies research that shows most children who suffer from gender dysphoria will grow out of it through puberty. It disregards the experiences of detransitioners—like Soren Aldaco, Prisha Mosley, Daisy Strongin, and Cat Cattinson—who have permanent side effects from social and medical transitioning. Ultimately, it incentivizes health care to push a radical gender ideology that harms the bodies and minds of young people—in direct opposition to its very purpose.