The hypocritical oath: come out to your doctor, and you may be told to go elsewhere. Now some lawmakers want to legalize religious discrimination.

When Jamie Beiler went to a Florida doctor's office seeking treatment for bronchitis last year, she never imagined the staff would also try to cure her homosexuality. After she was examined by a physician's assistant, Beiler, 36, was handed a packet of materials from an organization that promises "reparative therapy" for gays and lesbians. "I felt like I had been violated," Beiler says. "To this day, I dread the thought of ever having to go to a doctor's office again."

What happened to Beiler is not uncommon. She recently filed a legal complaint--not a lawsuit, since it is apparently not yet possible to do so in the state of Florida--against the doctor, the state health department, and CIGNA Healthcare. In recent years, doctors and pharmacists across the country have been fighting for the right to incorporate their religion into their practice, often at the expense of gays and lesbians. And they are finding support in high places. Some judges have ruled in favor of the idea, and more than a dozen state legislatures are now considering bills that would allow medical professionals to refuse treatment to individuals based on religious and moral objections.

The "conscientious objector policy act," a bill that has been stalled in Michigan for several years, would attempt to give medical professionals the right to discriminate against LGBT people. "Ultimately, physicians would be able to refuse to provide medical care based on personal disapproval of [an individual's] sexual orientation," says Lois Uttley, director of the MergerWatch Project in New York City, a group that works to protect hospital-based services from being restricted by religiously sponsored health systems.

The legislative trend is part of the efforts by a conservative religious movement with increasing political clout, says Jennifer C. Pizer, senior counsel for the gay legal advocacy group Lambda Legal. "We have a lot of hard work ahead of us to persuade mainstream medical organizations, public health organizations, and other health policy experts to speak up forcefully in defense of LGBT patients," she says.

That happened in the case of Guadalupe Benitez, who was refused fertility treatment by the North Coast Women's Care Medical Group in Vista, Calif., in 1999, when Christine Brody, MD, cited religious objections in refusing to help Benitez and her partner, Joanne Clark, become parents. Benitez sued, and the California Medical Association (though not at first) eventually supported the claim that doctors should not have the right to discriminate on religious grounds.

A state appellate court didn't, though, ruling in December that doctors could argue in some circumstances that their "religious beliefs" prevent them from providing treatment; the court has, however, agreed to rehear the case and review new legal briefings. "They thought I would go away and not do anything," says Benitez, who after finding a new physician became a mother to a son, now 4, and eventually, twin girls. "But I'm doing this for everyone else."

Pizer, who is representing Benitez, says doctors who specialize in certain forms of treatment but refuse to provide that treatment to all patients risk running afoul of state and federal laws. "The right of religious liberty does not create a right to ignore laws that apply to everyone else," says Pizer. "Our Benitez case has shown that many health care professionals have been unaware that civil rights laws can apply to them."

But David Stevens, MD, executive director of the Christian Medical and Dental Associations in Bristol, Tenn., says civil rights should include allowing doctors to decide what is and is not in line with their own moral judgments. "An infertility specialist asked to assist in the creation of embryos for unmarried couples may violate the tenets of his or her religious beliefs," he says.

Some lawmakers agree. In 2005, Indiana state senator Patricia Miller put forth a proposal to bar unmarried couples, including gays and lesbians, from using medical procedures to conceive a child. Miller, a Republican from Indianapolis, eventually withdrew the measure but hasn't ruled out resurrecting it this year.

The growing presence of religious discrimination in medicine worries Kathleen DeBold, executive director of the Mautner Project, a national lesbian health organization in Washington D.C. "I am still shocked by the horror stories we hear from our clients," she says. One lesbian diagnosed with breast cancer received a packet of information that included a "virulently antigay comic book called The Gay Blade," says DeBold. Other lesbians have complained that when they came out, their doctors advised them to find another health care provider.

"Discrimination never comes at a good time, but to have it happen when you are sick and at your most vulnerable is absolutely devastating," says DeBold. "The doctor-patient relationship is based on trust. Having a provider judge and condemn us and prescribe homophobic reading materials is an abuse of power and complete betrayal of that trust. And that betrayal leads LGBT people to avoid or delay getting the healthcare we need---often with devastating consequences."

Matt Kraljev, 33, was afraid to come out to his longtime doctor. But after he was diagnosed with HIV and hepatitis C, the Philadelphia resident needed to talk about being gay. So he moved on to a doctor at Philadelphia's Mazzoni Center, medical facility that specializes in caring for LGBT patients. "Many doctors just don't understand gay health care," he says. "I don't believe that straight doctors in general are aware of the ins and outs of taking care of gay men."

Kraljev's doctor, Robert Winn, says he is still surprised by the need for gay-specific treatment facilities. "I'd like to think in 2006 [homophobia] wouldn't be a problem," says Winn, who also serves as vice chair of the policy and advocacy committee for the Gay and Lesbian Medical Association. "But doctors are still saying, 'I can't take care of your kind.'"

In a big city like Philadelphia there are more options for gay patients, Winn says. But many of his patients end up at Mazzoni only after being turned away or finding unsatisfactory treatment at a hospital right down the street.

In addition to the obvious risks that medical discrimination imposes, there are emotional effects that can take an ongoing toll. Since Benitez was told by her doctor that she and her partner were not qualified to be parents, she has sought counseling. "It was very painful," she says. "I never thought I would encounter this. I never expected that my life would be exposed."

McDonald is an editor and a writer in Philadelphia.