"Get to the emergency room immediately."
"He's receiving IV and oxygen."
These three fragments keep playing on a loop in my head. They were part of a longer phone conversation I had with a medical attendant earlier this month at a marathon in Frederick. I'm sure the attendant said other things to me, but those three sentences are what have stuck.
My husband, Trevor, was running in the marathon. It was his first, and he had trained hard since the previous November for this day. Unfortunately, he trained in this year's cold and snowy winter, so his body was simply not ready for the 90 degree temperatures, strong sun and high humidity that hung over the 26.2 mile course.
The medical attendant had very little information for me, so I assumed the worst. But as I raced to the ER, I was not just worried about Trevor's well-being — although that was my paramount concern. In the back of my head, I was distracted by another worry: how the hospital staff would treat us, since we're a same-sex married couple.
Maryland's attorney general this year issued a legal opinion that instructed the state to recognize the rights of same-sex couples married in other jurisdictions, and Trevor and I were married in Massachusetts in July 2006. But we were in a conservative part of Maryland, and I've learned to expect the worst in these situations. It's a survival instinct that many gay people share. Plus, I didn't have any documentation with me to prove that we are legally married. We should know better and always have this documentation — but would a straight, married couple ever even have to think about carrying this paperwork everywhere they go?
Even having the right documents wasn't enough for Janice Langbehn. Ms. Langbehn had the right legal papers but was still denied access to her same-sex partner, who lay dying in a Florida hospital in February 2007. A hospital employee allegedly told her that legal documents don't matter if you're in "an anti-gay city or state." Ms. Langbehn's story prompted President Barack Obama to ask the Department of Health and Human Services to issue new rules that would require visitation policies in hospitals and other health care facilities to include sexual orientation and gender identity nondiscrimination language.
President Obama's actions are most welcome and very important to the overall movement toward LGBT equality. However, his administration must make sure that hospitals and other facilities not only adopt these policies but actually enforce them. Advocates need to work with HHS to make sure that the new rules include enforcement and sanction mechanisms that clearly signal to health care facilities that there will be real — i.e. financial — consequences if this new policy is not fully and fairly implemented.
Some marriage-equality advocates worry that these incremental changes reduce the urgency for full marriage rights. I understand this concern, but it would be highly unethical not to pursue changes that will benefit people's lives in the short term, all for the sake of a larger goal that could be years in the future. Full marriage for gay couples should be our ultimate goal, but achieving small victories that have real impact must also be a priority.
As a political realist (my euphemism for "pessimist"), I do not believe gay couples will have full federal marriage rights in our country in the next few years. Lesbian, gay, bisexual and transgender Americans and their allies need to work on advancing that goal, but we must also do everything we can to secure incremental rights such as hospital visitation, or marriage or civil union rights in individual states.
I would also argue that these smaller victories strengthen and improve our chances of securing full equality. Hospital visitation policies highlight how the current legal system often prevents gay couples from being able to care for each another, especially for people who don't see the challenges facing LGBT families firsthand. It shows that marriage equality is common sense, which most Americans don't yet know. Teaching this lesson in very tangible terms is critical to achieving full equality.
There will almost certainly be cases where — even after HHS announces and implements the new medical visitation guidelines — same-sex couples will encounter resistance or ignorance from the people and institutions that implement these policies. The only policy that will permanently and totally erase this resistance and ignorance is full marriage recognition, coupled with the public education that will get us there.
It's not an either/or strategy for relationship recognition — it's a both/and.
We need to work toward the ultimate goal of full marriage equality and full social acceptance so that no frontline hospital staff thinks it strange or wrong that a man would rush into an ER and ask about the condition of his husband, as I did a few days ago in Frederick.
I remember being grateful at the time that the hospital staff allowed me to be by his side without a hassle. But I am still angry that this has to be a consideration for me or anyone else in a similar position. And that's why this (not-so) radical gay agenda of ours not only needs to become law, but also needs to become part of our society's basic values, ethics and norms.
Jeff Krehely is director of LGBT research and communications at the Center for American Progress. His e-mail is firstname.lastname@example.org.