Today, the Human Rights Campaign Foundation released the 10th edition of the Healthcare Equality Index (HEI), reflecting on a decade of progress in LGBTQ healthcare. In the face of the state’s anti-LGBTQ HB2 law, 28 hospitals in North Carolina participated in the HEI, with 22 earning the coveted “Leader in LGBTQ Healthcare Equality” designation. North Carolina is third nationwide in the number of facilities achieving Leader status, behind only California and New York.

“While North Carolina’s state legislature fails to stand up for the LGBTQ community -- especially the transgender community -- North Carolina hospitals are providing life-saving medical treatments to this too-often marginalized community every day,” said Tari Hanneman, Director of the Health Equality Project at the Human Rights Campaign Foundation. “HB2 has stained North Carolina’s reputation, but it is heartening to know that these medical professionals put their patients over politics and continue to give LGBTQ people the best treatment in an affirming environment.”

In the wake of HB2, many North Carolina hospitals and healthcare systems reassured their employees of their commitment to LGBTQ diversity and inclusion, and some spoke out publicly against the discriminatory bill. Duke University, a longtime participant in the HEI and a Leader in LGBTQ Healthcare Equality, called for the bill’s repeal. Throughout this controversy, several hospitals in North Carolina committed to LGBTQ inclusion by participating in the HEI for the first time, and many of them achieved the Leader in LGBTQ Healthcare Equality designation. Novant Health, based in Winston-Salem, helped fuel this surge in participation by having all 13 of their hospitals, including 10 in North Carolina, participate in the survey this year and become Leaders.

This year’s HEI features a profile of the Center for Child and Adolescent Gender Care at Duke Children’s Hospital, founded by Dr. Deanna Adkins who recognized the need for a dedicated, comprehensive gender center in North Carolina. As the first center of its kind in the state, Dr. Adkins reflects on impact the center has had, including serving as a resource for the transgender community and their loved ones looking for support after HB2 was signed into law a year ago.

“Since HB2 passed, our patients are more anxious and afraid. They are immediately targets for harassment and bullying when they use a public restroom. More and more withdraw from school and society,” said Dr. Adkins. “I am really concerned because this self-isolation escalates their depression, which increases their risk of suicide even more."

The 10th edition of the HEI includes new criteria that raises the bar on what it takes to earn HRC’s “Leader in LGBTQ Healthcare Equality” designation. For the first time, HEI participants are awarded numerical scores for their implementation of LGBTQ-inclusive policies and practices in four areas;  LGBTQ patient-centered care, LGBTQ patient services and support, fully-inclusive employee benefits and policies, and LGBTQ patient and community engagement. Participants receiving the maximum score in each section, for a total score of 100, earn the coveted status of “2017 Leader in LGBTQ Healthcare Equality.”

In the 2017 report, an impressive 303 facilities -- 51 percent of those actively participating in the survey -- met this year’s more challenging criteria to earn the Leader designation. Another 144 facilities earned a “Top Performer” designation for scoring between 80 and 95 points. With three quarters of actively-participating facilities scoring 80 points or more, it is clear that healthcare facilities are going beyond the basics in adopting policies and practices in LGBTQ care.

In addition to the positive scoring criteria, the 2017 HEI includes a fifth section focusing on responsible citizenship, and calling out activity that would undermine LGBTQ equality or incusive patient care. Healthcare facilities may have 25 points deducted from their score for a large-scale official or public anti-LGBTQ blemish on their recent records. This year, Johns Hopkins Hospital became the first and only facility to receive this deduction.

Of the hospitals who did not participate in the 2017 HEI but were scored based on HRC’s research, only 61 percent have nondiscrimination policies that include both “sexual orientation” and “gender identity,” and only 52 percent were found to have an LGBTQ-inclusive employment non-discrimination policy. However, 95 percent of these facilities are committed to equal visitation, close to the rate of the facilities that actively participated in the survey.