The Des Moines Register recently ran a story about a patient, LeQuan Edwards, who was hospitalized with a stroke at Mercy Hospital Medical Center in Des Moines. Edwards, 52, ended up staying in the hospital for 137 days because no nursing home in the area would take her. The story implies the reason was because she is transgender. She is also bipolar and suffers from post-traumatic stress disorder.

She was finally placed at the Norwalk Rehabilitation Center in Muscatine, 2½ hours away from her family. The staff at that facility, the story noted, had been “trained to work with transgender people” (whatever that means).


$142,000 later

Only 2 of the 137 hospital days were covered by Medicaid. The hospital was responsible for the remaining 135 days at an estimated cost of $142,000. But the issue goes beyond the money. According to the story,

“Hospital leaders across Iowa have been saying Iowa’s bottleneck of patients who cannot be released for lack of a place to go is worsening, and they’ve blamed it on a lack of options for mentally ill patients who need supervision short of full hospitalization.”

The story didn’t say whether Edwards mental health conditions required such supervision nor whether that was the reason why 89 facilities rejected her. It did say that the rejection by those nursing homes made her feel hopeless. She said,

“I am being treated like a leper. No one deserves to be treated like this.”

A friend of Edwards, a retired United Methodist minister named Brian Carter was quoted saying that a hospital social worker told him Edwards’ transgender status was “a significant reason they couldn’t find a nursing or rehabilitation facility near Des Moines.” The story went on to state,

“Facilities that were accepting new residents said men didn’t want to room with a person who is biologically male, but identifies as a woman. Neither did female residents.”


So many violations

According to the story, laws were being broken right and left. First, nursing homes and rehab facilities that accept Medicaid are prohibited from discriminating against residents based on gender identity. Next, Iowa’s Civil Rights Act also expressly prohibits such discrimination. Hopefully, some fines will be levied and oversight will be increased.

The violation that wasn’t explicitly discussed is the violation of this patient’s privacy. How could residents of the nursing home facilities object to rooming with a transgender patient they had not met? I can only assume that staff disclosed to the other residents that the hospital was seeking to place a transgender person in their facility. This is a violation of Edwards legal right to privacy as detailed in Health Insurance Portability and Accountability Act (HIPAA) that was signed into law in 1996.

HIPAA privacy rules don’t just apply to hospitals and doctors’ offices, they also apply to nursing homes. Further, a person’s transgender status is a part of their medical history and, therefore, is protected by HIPAA. According to the National Center for Transgender Rights, HIPAA

“…protects the privacy of individually identifiable health information, including information related to a person’s transgender status and transition.”

At the time of her need for a nursing home, Edwards was a woman. That is all any of the nursing residents needed to know. Are nursing homes routinely asking residents if they are willing to room with a person of another race or ethnic group? If so, that is a Civil Rights violation too. When are we going to stop legitimizing discrimination by saying it is the right of the person discriminating to refuse to serve, sit next to, or room with a person different from themselves? When it comes to discrimination, they are not the victims. They are the perpetrators even if the defense of their actions comes wrapped in words like “religious freedom.”

I hope this story receives the national attention it deserves. Donna Red Wing, the executive director of One Iowa, an LGBT advocacy organization says that,

“The problem of finding homes for elderly transgender people is a national one.”

This is not just a “problem,” it is a disgrace.

Kudos to Lee Rood, the journalist at the Des Moines Register who has tenaciously covered this story.


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