(NEW YORK) -- Jay Kallio, a former EMT who is disabled with kidney failure, rheumatoid arthritis and now cancer, has struggled to get good medical care, but being transgender stood in the way.
At the age of 50, Kallio transitioned from female to male but never had gender reassignment surgery, only hormone treatment.
When a suspicious lump was found in his breast and tested positive for cancer, the surgeon was so shocked that Kallio's body didn't match his gender identification -- not knowing whether to address him as "he" or "she" -- that he couldn't bring himself to tell his patient the grim biopsy results.
Now, the U.S. Department of Health and Human Services has said that under the Affordable Care Act, it is against the law to discriminate against transgender and LGBT patients in federally funded healthcare programs.
The policy follows a landmark 2010 U.S. Equal Employment Opportunity Commission ruling on sex discrimination in the workplace. LGBT and transgender advocacy groups pursued a clarification from HHS for harassment and gender stereotyping in healthcare settings.
Kallio, who is now 56 and lives in New York City, learned "accidentally" that he had breast cancer when the lab technician called to ask how he was doing with his diagnosis.
"Which diagnosis?" Kallio asked, horrified.
And it happened a second time, when the medical oncologist was "hostile" and refused to advise him on treatments.
Later, said Kallio, the doctor apologized, stating, "I don't think it interfered with the quality of your care."
In fact, it did. Having to find new doctors delayed the start of chemotherapy beyond the so-called "therapeutic window" for Kallio's particularly aggressive form of breast cancer.
"Our community needs medical providers to know what their obligations are and passing a law is the strongest and clearest way to do that," said Mara Keisling, director of the National Center for Transgender Equality (NCTE).
The U.S. Census and other federal agencies do not keep track of data pertaining to gender identification and many who are transgender do not go public. But NCTE estimates that between .25 and 1 percent of the population is transgender.
Copyright 2012 ABC News Radio