Obama's Cautious Gay Strategy

Extending medical rights to same-sex partners is another incremental step for LGBT issues. When will the president commit to the bold leadership he promised?

Gay rights advocates march by the White House in Washington, on Sunday, Oct. 11, 2009.

It is no secret that lesbian, gay, bisexual, and transgender Americans have a taxing relationship with Barack Obama. We supported his candidacy with great enthusiasm, but our high hopes have been dashed by the slow pace of change on a variety of issues important to our community. It is fitting, then, that the president’s latest incremental move toward full and equal rights for LGBT Americans came on April 15, “Tax Day.” But this time, as we wrote our annual checks to the government, we got a little bit more bang for our buck.

Bill Clinton loved us and left us; Obama wants to date a while longer before he commits.

On Thursday, President Obama issued a memorandum on hospital visitation to Kathleen Sebelius, Secretary of the Health and Human Services. In it, he committed his administration to taking “steps to ensure that patients can receive compassionate care and equal treatment during their hospital stay.” He acknowledged that LGBT people are “uniquely affected” whenever hospitals deny visitation rights and medical decision-making authority to individuals who are not biologically or legally related to us. Specifically, the memorandum asked Secretary Sebelius to “initiate appropriate rulemaking… to ensure that hospitals that participate in Medicare or Medicaid respect the rights of patients to designate visitors.” It also provided a six-month window to allow Sebelius to make additional recommendations “on actions the Department of Health and Human Services can take to address hospital visitation, medical decision-making, and other health-care issues that affect LGBT patients and their families.”

This week’s presidential order was inspired, in part, by the tragic case of Janice Langbehn and Lisa Pond. Three years ago, Langbehn and Pond, a lesbian couple who had been together for nearly 18 years, were preparing for a family cruise with their three adopted children. Just before the cruise ship left its Florida port, Pond collapsed from a cerebral aneurysm, was rushed to the trauma unit at Miami’s Jackson Memorial Hospital, slipped into a coma, and died eight hours later. The tragedy lies not only in the 39-year-old Pond’s premature death, but also in the fact that Jackson Memorial staff refused to let Langbehn and the couple’s children have access to Pond as she lay dying, despite the fact that Langbhen provided the hospital with medical Power of Attorney documentation. Last fall, a federal court dismissed their lawsuit, filed by Lambda Legal, on the grounds that the hospital has no obligation to allow visitation rights to families, visitors, or even health-care surrogates. The court’s harsh ruling illustrates how LGBT families are indeed “uniquely affected” whenever hospital policies fail to honor the basic right of patients to determine their own medical care. In a country where LGBT relationships and families are far more often rejected than respected, such inequities in the health-care system only add further insult to our injuries.

President Obama’s call for greater compassion and equity in health care offers overdue consolation to Janice Langbehn and the children she adopted and raised with Lisa Pond. It signals a growing recognition that LGBT people and families face discrimination and suffering every day—within America’s health-care system and way outside of it. And it also moves us closer to a world where no patient or family—gay, straight, or otherwise—will have to suffer indignity and uncertainty during times of medical crisis. In this sense, it is a victory not only for LGBT Americans, but for all Americans.

Still, what does this week’s memorandum have to say about President Obama’s larger commitment to LGBT equality? Many of us in the LGBT community are frustrated that the president has not moved more swiftly to ensure passage of the bold policies he promised during the campaign—for instance, the repeal of the indefensible Defense of Marriage Act and the discriminatory “Don’t Ask, Don’t Tell” policy, the passage of an LGBT-inclusive Employment Non-Discrimination Act, and federal recognition and support of same-sex relationships, to name just a few. Instead of bold leadership and policy-making on LGBT issues, we have gotten incremental reforms, often done under the radar (as with the many openly LGBT appointments to his administration) or smuggled into unrelated pieces of legislation (as when the Byrd-Shepard Hate Crimes Prevention Act was passed as part of a recent defense authorization bill). President Obama has rarely, if ever, risked significant political capital to advance the cause of LGBT equality, and this week’s call for more compassion and equity, though certainly a sign of progress, is no different. With the midterm elections on the horizon, this pattern is unlikely to change anytime soon.

President Obama has learned some important lessons from his Democratic predecessor, Bill Clinton, whose early support of LGBT issues during his first term led to bitter disappointments, including the passage of “Don’t Ask, Don’t Tell” and DOMA, both of which he signed into law. Clinton’s embrace of our community got him into trouble—especially with conservative Republicans who have used the LGBT community as a scapegoat for their own fear and loathing for more than a generation—and Obama is not about to follow the same script. Bill loved us and left us; Barack wants to date a while longer before he commits.

Still, in a world where our political choices as LGBT people are never ideal, it’s probably better to wait for the bus than get thrown under it. That said, Obama’s approach will never fully satisfy those of us who are more progressive and less patient than he is. I count myself in this camp. But my own frustrations cut both ways (so to speak). On the one hand, I wish the president would come out more forcefully as a strong ally for our community. I wish he would abandon his incremental approach and repeal or veto any law that coddles prejudice and codifies discrimination—and this goes for all people who are maligned or marginalized in this society, not just queer folk. On the other hand, I wish the LGBT community would rethink its relationship with the president. I wish we would stop seeing him as either the prophet who will deliver us or the pragmatist who will deny us. Politics will never be our Promised Land.

Instead, we would do well to follow the example of Lisa Pond and Janice Langbehn—by loving ourselves and each other, by caring for and protecting our children, by living life on our own terms regardless of the homophobia that surrounds us, and by demanding justice whenever and wherever we are denied it. In other words, as we continue to struggle to change laws and enact policies, let us also work to change hearts and minds through the power of our example. Lisa Pond and Janice Langbehn did not ask Barack Obama to value or validate their relationship, but this week, because of them, he did something significant to show the nation that he does. No one should have to die for equality, but sometimes, sadly, that’s what it takes.

Timothy Patrick McCarthy is core faculty and director of the Human Rights and Social Movements Program, Carr Center for Human Rights Policy, at the Harvard Kennedy School. Dr. McCarthy was a founding member of Barack Obama’s National LGBT Leadership Council. His latest book, Protest Nation: Words That Inspired a Century of American Radicalism, will be published this month by the New Press.