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The work, which analyzed focus group discussions with 22 physicians, adds context to a larger study published February 2021, also in Health Affairs, that showed only 56 percent of doctors strongly welcomed patients with disabilities into their practice. Less than half were confident or very confident that they could provide the same quality of care to people with disabilities as they could to other patients. The studies add to a larger body of research suggesting that patients with a variety of conditions that doctors may deem more difficult to treat often struggle to find quality care. The Americans with Disabilities Act of 1990, or ADA, theoretically protects the one in four adults in the United States with a disability from discrimination in public and private medical practice, but enforcing it is a challenge.

Laura VanPuymbrouck, an assistant professor in the Department of Occupational Therapy at Rush University, said the 2021 survey was “groundbreaking. It was the crack that broke the dam a little bit.” Now, researchers are hoping that medical schools, payers, and the group that accredits hospitals, the Joint Commission, will push health care providers for more equitable care.

He’s far from alone. Many people with disabilities describe challenges in finding physicians prepared to care for them. “You would assume that medical spaces would be the most accessible places there are, and they’re not,” said Angel Miles, a community-based services policy analyst at Access Living, a disability rights advocacy group based in Chicago.

Not only do clinics often lack the necessary equipment—such as scales that can accommodate people who use wheelchairs—but at least some physicians actively avoid patients with disabilities, using excuses such as “I’m not taking new patients,” or “you need a specialist,” according to a paper in the October 2022 issue of Health Affairs.

Ben Salentine’s experience is shared by many patients with disabilities who find physicians unprepared—or sometimes unwilling—to care for them.

In October, Oklahoma Governor Kevin Stitt, signed a bill that bars federal funds earmarked for the University of Oklahoma Medical Center from being used for gender affirming treatments for minors, while calling for the state legislature to ban some gender affirming treatments when it reconvenes in February 2023. Additionally, Tennessee has passed legislation curbing trans healthcare, but it faces legal challenges. Arizona has passed four laws regarding transgender healthcare.

While these pieces of legislation continue to be tangled up in courts, groups like the Human Rights Campaign and AAP say they will continue to fight for medical care for trans youth.

“It is critically important for every child to have access to quality, comprehensive and evidence-based care — transgender and gender-diverse youth are no exception,” said AAP Immediate Past President Lee Savio Beers in a statement earlier this year regarding an increase in laws targeting trans youth. “As pediatricians, we will continue to speak up and advocate for our patients. We also want transgender and gender-diverse youth to know that not only do we care for them, we care about them, we value them and we will do all we can to ensure they have access to the care they need and deserve.”