Why the DOL Changes to Home Healthcare Provide the Perfect Opportunity for the Disability and LGBT Communities to Work Together

Fighting for your rights when you are a person that is intersectional, and living within more than one minority community, ensures there are extra challenges and barriers placed in your way. I happen to be one of those people, as I exist within both the disability community and the LGBT community. I have spent years discussing how important it is for minority communities to work together, to fight systemic oppression. I think most minority communities would be surprised to know how much we actually have in common, when it comes to oppression and discrimination. There is strength in numbers, so why aren’t we working together?

Existing in multiple communities can be lonely, as invariably one or both of the communities will make you feel left out. That is why I’m calling out both of my communities to work together on issues of discrimination. Right now, I don’t think the LGBT community has any idea about what is currently going on in the disability community, particularly when it comes to the Department of Labor and regulations for home care workers, something that impacts anyone with a disability who is reliant on some form of homecare. Impending regulations could have a negative effect on people with disabilities, but there are special considerations for those of us reliant on home care who also identify as members of the LGBT community.

First, I want to make it clear that all of us who depend on home care workers want them to get paid a fair wage. Right now, home healthcare is the only field that is not protected, when it comes to making not just a living, but minimum wage. Those of us dependent on home care want our workers to be paid fairly, but at the same time, we also don’t want to lose our workers if they are working over 40 hours per week. The Department of Labor wants to regulate not only how much money home healthcare workers get paid, but also force states to pay them mandatory overtime.

On paper, this looks great and sounds amazing, but in practice, it has inherently detrimental effects on both the home healthcare worker and their clients, those of us who depend on them for services. You see, most homecare workers work well over the 40 hour work week, with some working more than double the amount of time. In my specific instance, I have three personal care attendants, though I have one primary attendant who does over 80 hours of care per week. She prefers to work this much, and I prefer to have people I’ve known for years doing the intimate level of care she does, for me.

With the forced overtime, states are going to stop allowing home healthcare workers to work over 40 hours per week, which will cut the hours of many home healthcare workers, and also cut their income. In states that already pay more than minimum wage, they will have no choice but to cut down the price they will pay, per hour, if they are forced to pay overtime. There simply isn’t enough money available for states to be forced to pay overtime. This isn’t an issue of states not wanting to pay for overtime. It is an issue of states not having the money to afford to pay for overtime.

Even if these states increase the base amount home health workers will get paid, they are still going to lose significant amounts of money. For my primary home health worker, she was paid well over minimum wage already, so the wage increase would simply remove half of her hours, with no benefit to her income. Losing half of her income would ensure she would not be able to pay her bills, and considering I live in her house, since I cannot be alone at night, I would also lose the place I live.

You’re probably wondering why this would affect the LGBT community, and why they should care? While I believe everyone should care what happens to people with disabilities, the LGBT community should have a vested interest in LGBT people with disabilities, because the problems with this new ruling by the Department of Labor have an even more significant effect on LGBT people with disabilities. It affects more than just the income of home health workers.

I am not only a person with a disability, but I am a transgender man. I have been transitioning from looking like a female to living my life as the male I know I’ve been for much of my life, for well over a decade. I have body scars, which are a telltale sign that I was not born biologically male. My most active home healthcare worker has been working for me for 13 years. She has been with me throughout my entire transition. I am not afraid to have her see me naked, and I do not feel ashamed when she is working for me.

I need someone to help me with all of my activities of daily living (ADLs). This means I need someone to help me go to the bathroom, brush my hair, brush my teeth, get dressed, eat, get in and out of my wheelchair, roll me over in bed, and pretty much any other physical activity a person can do. I spend close to 56 hours a week going to the bathroom, bathing, getting dressed or doing some activity where I am naked. When my home health worker, who knows my body, and will not discriminate against me, is forced to cut down to 40 hours a week that will mean that I will have to entrust, at least, 16 hours of care to a stranger, and that person may not like transgender people as much as they claim.

When I was in college, at the ripe old age of 18, I had my first home care workers, a pair of female college roommates. At that time, I was presenting as female, and I did not quite understand that I was transgender. I knew that I was attracted to women, and like many other transgender people, I thought I must be a lesbian. I was extremely closeted in a small, Midwestern college town, and all it took was one person, a self-proclaimed gossip who decided she did not like me, someone I barely knew who was a neighbor of my friend, to out me to the two women who worked as my home health aides. These two women confronted me, angrily, and immediately put in their resignation for the end of the semester, which was a few weeks away.

I was horrified at being outed, especially by someone I didn’t even know. It wasn’t her right to tell anyone, least of all my home health workers. One of my workers didn’t see it as a big deal, but she was the best friend of her roommate, who had supreme problems with me being LGBT. It wasn’t long before bedtime turned into a lecture hour during those last weeks they worked for me. My worker would wait until she put me in bed, where I was unable to escape the barrage of harassment. She would talk about how “God” was against me, what a big sinner I was, and she would try to force me to renounce my attraction to women. It is not a time I like to remember, but I am unable to forget it as I think about how I will be outed to any person who works for me, especially those who must help me do the most intimate of ADLs.

I like having someone I know take care of my needs, so I can worry about being independent. I like not having to worry about whether my home healthcare workers will discriminate against me, one day. I cannot tell you how many people I know, who have said they had accepted me, only to get angry for some reason, and then call me a transgender slur, in their anger. My real fear with these DOL changes is that it will prevent me from having people I know I’m safe with taking care of me. I deserve to be safe. My friends who are LGBT with disabilities, who rely on home healthcare, deserve to be safe. These regulations put our safety at risk.

We do not often hear about issues that are pertinent to an LGBT community that features people with disabilities. We have unique issues, on both sides, and I know, at least for me, it would mean a lot for both of my communities to come together and fight an issue that not only is causing a great level of anxiety to all people with disabilities who depend on home healthcare, but especially to those of us who also happen to be LGBT. I hope, together, we can fight this issue and get the Department of Labor to see these new regulations will put many of us at risk.

Truthfully, we should be working on the issue of getting our home health workers paid better, because they deserve it, but it should not be done at the expense of all of us with disabilities. We will be the ones paying the price, as we lose workers we trust, so shouldn’t we have a say in these new regulations?