I can’t stop thinking about this week’s news  that the Trump Administration created a new division within the Department of Health and Human Services (HHS) to be focused on “conscience and religious freedom”. Even more ironically, the work of the division will fall under the Office of Civil Rights. This new division is thought to pave the way for healthcare workers to refuse to perform certain types of care such as prescribing/dispensing birth control or performing/assisting with abortions. Also, it’s thought to create space for healthcare workers to refuse to treat certain groups of people based on their religious or conscience objections, which while not saying it outright, is a direct threat to individuals who are LGBTQI.

As someone who spent a considerable portion of my career working in healthcare, both in patient care and as an administrator, I can’t process that our government is providing legal protections for healthcare workers to discriminate against their patients. Understandably, when considering the impact of this new division in HHS, many people focus on the “procedures” component, worried how this might impact a woman’s right to access abortion services. But for all of the job opportunities in healthcare, for providers at every level, I feel confident that most people who have moral objections to abortion have already sought out positions where they are not confronted with the procedure. Those RNs already work somewhere other than the local Planned Parenthood clinic.

I’m more concerned about the providers who won’t treat certain groups of people and pharmacists that won’t fill certain prescriptions. For individuals living in rural areas, there may only be one hospital in the region, one pharmacy. What are your options when the local physician decides they will not treat gay people? When your local pharmacy won’t fill your transition-related prescriptions because the pharmacist refuses to treat patients who are transgender? When your local OBGYN won’t prescribe birth control?

Who’s rights are most important? For me this is quite simple. When I went into exercise physiology because I wanted to work in cardiac rehabilitation, where I would be taking care of heart patients, it never occurred to me that I might choose which patients for which I would care. I would work with the “good” patients, who made every lifestyle change I recommended, and the “bad” ones…even the one who tried-and sometimes succeeded-to sexually assault the staff every time he came to class. I can’t comprehend a situation where I would have denied care to a patient. I went into that profession because I cared deeply about people and wanted to make a difference. I think that same motivation drives many nurses, doctors, and other allied health professionals. But they don’t teach us to only take care of the patients we “agree” with, our job isn’t to pass judgement on who is worthy of care. But that is the new world we are living in, as the oaths that healthcare professionals take now come with a government-sanctioned caveat. As one friend eloquently pointed out (shout-out to Mary!), are you really a healthcare provider if you don’t provide healthcare for all?

And what does it say about us as a society when our government is in the business of sanctioning discrimination? That some of our congresspeople view “freedom” as discrimination against others? (House Majority Leader Kevin McCarthy, R-California, stated regarding the Obama administration’s Office of Civil Rights: “In the past this office sent the message, now is not the time for freedom, it is time for you to conform. What a different one year makes.”) If “conforming” means that all people are treated equally, then I’m all for it.

Every single human should be able to show up to an emergency room and know they’ll be treated with care and dignity. Every single human should be able to get their scrips filled at their local pharmacy, no questions asked. Every single human should have a relationship with their provider that is free from judgement and discrimination. If this is not freedom, then I think we need to reconsider our definition of the term. If a nurse doesn’t want to care for patients, she should not work in a hospital. If a pharmacist does not want to fill scripts, they shouldn’t work in a pharmacy.

And while I haven’t attended church in quite a long time, I regularly attended services while growing up. None of this aligns with the lessons of our little Protestant church.  We were taught not to judge one another, to love each other, and to treat others as we wished to be treated. We learned to care for people who were different from us, to help those in need. Nowhere in our Sunday School lessons did we talk about only certain types of people being worthy of our care. There wasn’t one sermon about discriminating against our fellow humans. While I am deeply suspicious of any religion that denies any human their humanity, I respect an individual’s right to worship what they choose. But to consider that our government is providing such religions power over our access to healthcare is terrifying. A government that stands for the rights of ALL citizens would be ensuring and protecting that very access, not compromising it.

Individuals who are LGBTQI already suffer known health disparities.    For example, youth who are lesbian, gay or bisexual seriously contemplate suicide at three times the rate of heterosexual youth. Also, in a national study 40% of transgendered adults reported having attempted suicide, with 92% of those attempts having been before the age of 25. Transgender women are at an unusually high risk of contracting HIV, and transgender individuals receive an HIV diagnosis at three times the national average. (Sources: The Trevor Project and CDC) The health care system is already failing these individuals. The new policies will only exacerbate these disparities.

While there aren’t any quick or easy solutions, it is one more reminder that our democracy is not a spectator sport. It is incumbent upon all of us to vote and engage with our congresspeople. Our elected officials are a reflection of us, and every election matters deeply. And when someone says to you that politics don’t matter, respectfully engage with them about how it does. Because of this administration, a large number of Americans now wonder if they can go to their local emergency department and be treated. Not treated with dignity, or treated with care, but treated period. It says a lot about who we are.

“Nothing is so essential as dignity…Time will reveal who has it and who has it not.” ― Elizabeth Gilbert