New hot trend: “Asking”

You will be relieved to know that the University of California system is looking to join pioneering Elmhurst College of Elmhurst, Illinois in asking students to state whether they are lesbian, gay, bisexual, or transgendered (LGBT) on school administrative forms.  The self-identification will be voluntary, but policy advocates have big plans for the resulting data.

Lest you think the UC system thought this up all by itself, be assured that the idea of a public requirement for this data was approved by the state assembly.  In October 2011, Governor Jerry Brown signed Assembly Bill 620, which seeks to have the higher-education systems in California

… collect aggregate demographic information regarding sexual orientation and gender identity of staff and students within other aggregate demographic data collected, and … require annual transmittal of any report to the Legislature, as specified, and posting of the information on the Internet Web site of each respective institution.

The idea has been around for a while, of course, and the leaders of higher education in the Golden State have been discussing it.  The California Post-Secondary Education Commission (CPEC) in June 2009 adopted an official posture urging institutions to “collect and report LGBT data to CPEC in the same manner as gender, race, ethnicity, and disability data.”  According to CPEC, “Sexual orientation and gender identity should be considered its own demographic.”  Page 3 of the CPEC document makes a fleeting reference to pushing for student health insurance to cover gender-reassignment surgery, and we’ll come back to that.

(We should also note, for completeness, that California has mandated a survey inquiring into state judges’ sexual orientation.  According to Democratic State Senator Ellen Corbett of San Leandro, who authored the 2011 legislation, “It’s essential that a state as diverse as California has judges that reflect that diversity.” H/t: Ed Whelan at NRO.)

In the spring of 2011, the Academic Senate for California Community Colleges (ASCCC), citing the CPEC document, resolved to support collecting sexual-orientation and gender-identity data on students.  In February 2012, the chairman of the UC Academic Senate communicated via letter the approval of the Senate’s Academic Council for collecting LGBT data on college students. The groups recommending this were the University Committee on Affirmative Action and Diversity (UCAAD) and the Board of Admissions and Relations with Schools (BOARS).  The original UCAAD and BOARS letters urging approval are included in the PDF file with the chairman’s letter; all three cite AB 620.  BOARS forwards the following statement:

BOARS is sympathetic to the view that students should have the right to identify themselves as LGBT…

I suppose it would be tiresome and pedantic to point out that students have that right today, and in fact have never lacked it.  At any rate, these proposals never spring unmidwifed from the brow of Zeus; there is always something else at work, and in this case, one of the things appears to be national and state health policy.

You may or may not be aware that the US Department of Health and Human Services (HHS) has an initiative called Healthy People 2020, which has its own website and all kinds of opinions, programs, and plans relating to your health.   (Here are the Vision, Mission, and Goals of Healthy People 2020.)  You might not have known that the Affordable Care Act of 2010, better known as ObamaCare, provides funding to collect data for the study of health care disparities (Section 4302).  (You may not have been aware that the United States has an Office of Minority Health, when it comes to that.)  As part of the effort to flesh out disparities, HHS has a plan to improve federal data collection on the LGBT community, by asking people via national health surveys to self-identify as to sexual orientation and gender identity. 

Citing “health disparities in insurance coverage” – a phrase whose meaning is not clear, even though it appears in a federal policy document – HHS outlines its LGBT data collection program here.  While “health disparities in insurance coverage” may not have an intelligible meaning, the words forming the expression appear together in other places, like this Center for American Progress (CAP) article and an LGBT activist document entitled “Healthy People 2020 Transgender Fact Sheet.”  (See also the same activist group’s comments on sexual orientation and gender identity as “health disparity” factors in 2009.)  In these documents, as in the CPEC document above, one of the key issues cited is that health insurance doesn’t routinely cover gender-reassignment surgery or the other health needs of the transgendered.

California comes by the LGBT data-collection approach honestly, of course.  Besides the 2011 law requiring a sexual-orientation inquiry into the state’s judges, California has pioneered LGBT data collection with its California Health Interview Survey (CHIS), which is another thing you may not have known existed.  As the CAP article points out, CHIS is the only operation in the United States that has collected this kind of information in its health surveys.  In 2011, the congressionally chartered Institute of Medicine published a study, The Health of Lesbian, Gay, Bisexual, and Transgender People, based on data from the CHIS survey of 2009.

So, to recap: the pedigree of LGBT data collection is extensive in California, but as the HHS initiative indicates, the US federal government is also on the hunt for ways to collect data on sexual orientation and gender identity.  Its pretext for doing so is that the LGBT demographic is associated with minority health disparities – and HHS isn’t the only agency that has thought of that.

Back at Elmhurst College, the dean of admissions points out the following incentives for having students identify themselves as members of the LGBT community:

Those who answer “yes” may be eligible for a scholarship worth up to one-third of tuition, not unusual because about 60 percent of incoming students receive some type of scholarship aid, Rold said. More importantly, he said, knowing students’ sexual orientation will help officials direct incoming students toward services or groups that might help them make an easier transition to college life.

Q***r Alliance Board member Luis Roman puts it a little differently, referring to the UC system proposal:

Roman … believes it will bring badly needed services for lesbian, gay, bisexual, and transgender students.

Some members of that community believe it would show that there are many more LGBT students than university officials realize.

“I think the numbers are way bigger than we really imagine or know,” Roman said.

The “badly needed services” do not, of course, refer to dry-cleaning or bicycle maintenance.  The CPEC document specifies, along with an itemized list of necessities (page 4), the following:

Meet needs of LGBT students in student housing, health insurance coverage for gender reassignment surgery, and recordkeeping when students or staff change gender.

The theme of health insurance coverage for LGBT issues recurs often.  The Healthy People 2020 Transgender Health Fact Sheet points out these discrepancies:

Health insurance coverage for … transgender-specific health services continues to be commonly excluded by most U.S. health care insurers. These blanket exclusions in health insurance policies present barriers to access to all types of health care. While many transgender people cannot afford the expensive out-of-pocket costs of the transgender-specific services, coverage denials can extend to even basic health care services unrelated to sex reassignment. For example, transgender men who have a lifelong need for ongoing gynecological care find their insurance policies will not cover it after they transition to male.

It would be one thing if these various comments and appeals about insurance coverage were sentiments expressed in a private – that is to say, non-governmental – context.  All things being equal, we can rejoice that other people’s gender-reassignment surgery is none of our business.  But all things are not equal, and the boundary on our rejoicing is drawn right where public policy may require that the surgery be made available to 18-year-olds at third-party expense (e.g., through insurance).  Clearly, the policy on insurance coverage at a state university is public policy.

With ObamaCare, meanwhile, it is increasingly possible – in the absence of an originalist Supreme Court ruling at some future date – that even in the realm of private institutions’ policies, the era of privately-contracted, elective insurance coverage is entirely behind us.  Never again will it be possible to say that people can pick and choose insurance based on a company’s coverage policies, and that no one is forced to cover anyone else’s gender-reassignment surgery or gynecological services for transgendered males.  As the HHS contraception mandate has made clear, that is no longer our choice.  With ObamaCare’s mandates, we have passed from the basis of tolerance, as regards what other people choose to do with their bodies, to a basis of enforced subsidy.

So when a state university system proposes to collect data on the LGBT student population, while proposals for special health “services” for those students are published, and HHS wants, coincidentally, to collect the same data on the population at large to redress “health disparities” – it matters.  Questions about why this is being done are worth asking.  There is no credit remaining in the big-government Left’s “benefit of the doubt” reserve; if it looks like another end-run on health insurance, mandates, and conscience, it’s a good bet that that’s what it is.

J.E. Dyer’s articles have appeared at Hot Air’s Green Room, Commentary’s “contentions,” Patheos, and The Weekly Standard online.