Will the U.S. finally ban discrimination against LGBTQ+ Americans?

As a preteen in a small Appalachian town, contemplating self-harm as I was strung between my parents’ vicious custody battles, I learned of a privately operated counseling facility in a neighboring county. It was one of few in the area that advertised openings for new patients. I knew that counseling would be a lifeline.

But I also knew the counselor had turned away queer teens, citing her religious opposition to “a homosexual lifestyle.” Once, she had told my family about refusing to work with a young “dyke.” 

“Some patients have problems that I can’t fix,” she said. “Only God can mend a broken, sinful mind.” 

Without help from legislation such as the Equality Act, passed by the U.S. House of Representatives in February, mental health care was beyond my grasp. I thought that counselors were supposed to help broken people. How irreparably broken, how worthless, I felt when I understood that counselors or therapists could reject me based on my sexuality. 

The Equality Act would ban discrimination based on gender identity or sexual orientation in housing, employment, education and other areas of life. It would rein in the ability of an institution or a business owner to claim religious belief as a reason to turn away LGBTQ+ people. The law won’t eliminate hate and bias, of course. A homophobic counselor forced to see LGBTQ+ clients could be detrimental to their well-being, especially if they are seeking support related to their gender or sexuality.

But as an adolescent, I was in crisis. While coming to grips with my sexuality was stressful, I was also struggling with heavy pressures of family dysfunction and addiction. Visiting a counselor (even a bigoted one) might have given me the opportunity to address some of these problems, seek a referral to another practice or, even better, request a recommendation for a psychiatrist. Without access to any mental health care professionals, however flawed, I couldn’t take these steps. 

The House first passed the Equality Act in 2019, but Senators refused to consider the bill. It faces strong opposition again, as Republican Senators argue that it might infringe on business owners’ freedom of speech or religion.

Meanwhile, LGBTQ+ people continue to live out the very real, painful, realities of discrimination and the consequences for health.

Fifteen percent of LGBTQ+ Americans avoid getting health care for fear of discrimination.  Twenty-nine percent of transgender patients have been turned away from health services, and 8% of LGBTQ+ people report that a provider rejected them because of their sexuality. 

Fifty percent of LGBTQ+ people report that discrimination in their personal lives has hurt their mental health. As someone who did not get the therapy I needed at a formative age, I often consider how this discrimination feeds the systemically high rates of depression, drug abuse, and suicidal thoughts  among LGBTQ+ youth in this country.

And I wonder how many young people will be saved if the Equality Act becomes law.

The Affordable Care Act (ACA) prohibits discrimination by health care providers and programs that receive federal funding and by insurance plans that participate in ACA marketplaces. Some private health providers and businesses, including large ones, leverage such policies as the Religious Freedom Restoration Act to assert their right to deny service to LGBTQ+ people on the basis of religious freedom. The Equality Act would expand anti-discrimination protections to parties outside  the jurisdiction of the ACA. 

The next time I considered therapy, I was nearly 20 years old. The years of unaddressed loneliness and self-hatred weighed on my shoulders, metaphorically and literally. I carried tension in my shoulders, and even today I sometimes feel stinging residual shoulder pain. 

That weight also settled into scratches: I cut open the skin on my upper arms and collarbones with a razor as I regularly contemplated suicide.

I finally sought help from a therapist I knew personally — a woman who was accepting of LGBT people and would not turn me away. I was diagnosed with depression and anxiety. Alongside my counselor and a psychiatrist, I finally established what I had long needed: a plan and the resources to survive. After starting on Prozac and working through therapy, I stopped cutting. 

How might the Equality Act lead to a better, healthier future for LGBTQ+ folks? First, the bill could help secure housing options because it would be illegal to reject a prospective renter or home buyer because of their gender or sexual orientation. 

People with consistent access to safe housing tend to report fewer health problems than their housing-insecure peers. LGBTQ+ people face high rates of homelessness and exclusion from domestic violence and homeless shelters. The U.S. Department of Housing and Urban Development has found that same-sex partners often face discrimination when they try to buy or lease property. Housing insecurity can lead LGBTQ+ people to experience various health problems, including physical abuse from living on the streets, anxiety and depression, and hypertension. 

Second, LGBTQ+ patients could not be turned away from hospitals, mental health centers, or doctors’ offices because of their identity. 

Third, the Equality Act would crack down on discrimination in lending. While some states prohibit such discrimination, federal law remains unclear. The Equality Act would set a strong national standard and close loopholes that may be used to deny loans and banking services to LGBTQ+ people. Without access to credit, many LGBTQ+ people cannot hope to cover the out-of-pocket costs of a catastrophic illness or surgery.

The revived debate over the Equality Act has unveiled vicious biases against LGBTQ+ people. As Representatives prepared to vote on the bill, Georgia Republican Marjorie Taylor Greene mocked Illinois Democrat Marie Newman for hanging a transgender pride flag. Newman’s daughter is trans. Greene hung an opposing sign outside her office, which read, “There are TWO genders: MALE & FEMALE.” These personal attacks amid the larger Congressional consideration of the Equality Act illuminate the countless ways that homophobia and transphobia permeate our society, all the way up to Capitol Hill.

The Equality Act can’t change someone’s mind about LGBTQ+ rights. Nor will it solve systemic issues that make health care inaccessible and unaffordable to so many Americans. Nonetheless, the act would go a long way toward helping LGBTQ+ people feel safer, live healthier, and have equal access to the services that their heterosexual and cisgender peers often take for granted.

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