On Nov. 26, the American Cancer Society Cancer Action Network (ACS CAN) and the American Cancer Society along with 24 groups representing millions of health care professionals and patients with serious and chronic health conditions filed an amicus curiae (also known as friend of the court) brief, in the case of State of Tennessee et al. v. Becerra in the U.S. Court of Appeals for the Fifth Circuit. The amicus brief supports maintaining nondiscrimination protections in the Affordable Care Act (ACA) for Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) patients receiving health care services.  

At the core of the case is whether the nondiscrimination provision in the ACA should be interpreted broadly to include protections against discrimination based on gender identity or sexual orientation, or narrowly based on the sex a person is assigned to at birth, as a lower court ruled in July 2024. 

In the amicus brief, the groups note that LGBTQ+ patients already face major health disparities, and if upheld, the lower court’s decision would reduce protections for LGBTQ+ individuals against discrimination and further exacerbate these disparities, resulting in even worse health outcomes.  

Following is the groups’ joint statement:  

“As organizations that represent millions of health care professionals and people with serious and chronic health conditions and disabilities, we ask the court to reverse the U.S. District Court ruling and preserve the anti-discrimination protections against LGBTQ+ individuals that Congress adopted when it passed the ACA. Rolling back these protections would undermine the ability of LGBTQ+ people to get timely medical care and preventive screenings, which are critical to better health outcomes. Discrimination on the basis of sex, sexual orientation or gender identity can be particularly harmful for people with chronic conditions and disabilities, who often must rely on health care professionals for access to lifesaving treatments. 

“LGBTQ+ people face distinct challenges in obtaining health care due to discrimination and the fear of discrimination. A report released earlier this year noted that the greatest health disparity faced by LGBTQ+ people is perhaps the presumption-of-care gap, which is the fear that a health care provider will refuse care because of gender identity or sexual orientation. LGBTQ+ cancer patients and survivors have reported delaying or forgoing care because of fears and concerns about discrimination. 

Additional research has shown that transgender men and women especially are more likely to report postponement of health care utilization due to fear of discrimination, as well as to have experienced discrimination in a health care setting. LGBTQ+ people also experience higher rates of mental health disorders, rates that are at least partly due to the excess stress they experience because of discrimination. Moreover, increased levels of stress related to discrimination have led to worse health outcomes among LGBTQ+ people and can directly contribute to increased risk of chronic diseases like heart disease or cancer. 

“Everyone deserves to have timely access to health care without fear of discrimination. We urge the court to protect patients as intended by the health care law.”