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The index, which uses a 100 point scale, is funded by Pfizer and PhRMA, the trade association that lobbies on behalf of large pharmaceutical companies. And, Rempe noticed, it awards points for all of the policies Children’s National implemented.

To earn a perfect score, hospitals must display LGBT symbols, solicit and use patients’ preferred pronouns, and conduct trainings on LGBT issues approved by the Human Rights Campaign, according to the scoring criteria.