Tennessee Legislators Make Next Move to Deny Mental Health Care to LGBT Patients

The effort to allow counselors to deny mental health services comes a week after Mississippi Governor Phil Bryant signed a law to let counselors escape similar liability and let physicians deny transgender patients access to gender reassignment care.

First it was Mississippi. Now it’s Tennessee legislators who want to let providers deny care—in this case, mental health services—to persons who are gay or transgender.

A bill headed to Governor Bill Haslam’s desk was amended to allow therapists to avoid liability for refusing services based on “sincerely held principles.” This language had been changed from “sincerely held religious beliefs,” according to the Chattanooga Times Free Press.

Haslam has not said whether he’ll sign the bill but recently told Nashville’s newspaper, The Tennessean, that he could “understand” the reasons for it. Critics say the last-minute change only makes the bill murkier. Some say its language could open the door to widespread discrimination in mental healthcare, including refusal of services based on race.

The American Counseling Association (ACA) condemns the bill. In a March statement, the group called it an “unwanted and unnecessary blow to the counseling professionals and those who benefit from the services of a professional counselor.” The counseling group called on Tennessee residents to ask elected officials to oppose it.

The mental health services bill has received less attention than a related “bathroom bill” similar to one passed in North Carolina; the bill to require transgender persons to use facilities based on their gender at birth drew fire from leaders in the music and entertainment industry. Tennessee’s attorney general said it would cost the state Title IX funds.

Both the ACA and therapists who have spoken with news outlets in Tennessee say there’s nothing wrong with referring a patient to another counselor if the person’s needs are outside one’s expertise, but refusing service based on a belief system goes against the organization’s ethics policies and professional training.

The ACA Code of Ethics, which the group said is included in licensing in most states, says professional counselors “may not deny services to a client regardless of the person’s age, culture, disability, race, religion/spirituality, gender, gender identity, sexual orientation, marital/partnership status, language preference, socioeconomic status, immigration status, or any basis proscribed by law.”

A wide-ranging “religious freedom” bill signed into law April 5, 2016, by Mississippi Governor Phil Bryant would allow counselors to deny services based on religious beliefs, and would let endocrinologists and other medical providers refuse to provide services, including prescriptions for pharmaceuticals, to persons going through gender reassignment. These elements were part of an overall law that lets businesses deny a host of wedding-related services to gay and lesbian couples.

Members of the LGBT community are at greater need for mental health services than the general population due to discrimination, rejection from family members, and bullying during their school years. According to a recent report by the American Psychological Association (APA), Stress in America, nearly a quarter of the adults who are LGBT report being unfairly stopped, searched,

questioned, or physically threatened by the police. A third say they have been unfairly not hired for a job. Respondents also report being harassed, threatened or subjected to poor service.

The CDC reports that gay and bisexual men have higher rates of depression, bipolar disorder, and general anxiety disorder, higher rates of drug use, and greater risk of suicide.