REBUKE at UVA
Once I heard that the UVA Board of Visitors was scheduling an emergency meeting to consider the decision by UVA Health to resume providing gender-affirming care after a federal court had stayed the implementation of President Trump’s Executive Order, there was no doubt about the outcome.
Governor Youngkin and Attorney General Miyares had been emphatic that the stay on President Trump’s Executive Order had no bearing on their directive to VCU and UVA to cease providing gender affirming medications and surgery.
Whether their position is legally binding is an open question. But the political reality is that the Governor has appointed the vast majority of UVA Board of Visitors members and they were never going to tell him “see you in court.”
The resolution from the UVA Board of Visitors noted that “new patients seeking gender affirming care of the nature described in the Presidential Executive Order should be referred to alternate private health care providers until further notice.” The resolution did make allowance that that UVA doctors should continue “to treat current patients at the University in a manner consistent and compliant with existing law” until it was practicable to refer these individuals to a private provider.
The Board of Visitors’ resolution went beyond the discussion of gender affirming care to an extraordinary rebuke of the University’s leadership. Without mentioning either the President or the CEO of the hospital by name, the resolution directly stated that the original suspension and the subsequent reversal regarding gender affirming care took place without consultation with the Board.
The resolution also noted that the Board should be consulted in the future prior to the “consideration and announcement of any material policy change…, or the creation of any task force or other committee to formulate or evaluate any potential material changes, and the Board of Visitors may determine, in its discretion, the scope, objectives and final membership of any such group or the content of any such announcement.”
Based on the two terms I served on the Board of Visitors at VCU, I’d offer a couple of observations.
First, it is extremely surprising that there wasn’t apparent consultation with at least a subset of the Board. I do not recall it being common practice to consult with the entire Board on time-sensitive decisions, but consultation with the Executive Committee or at least discussion with the Rector (Board Chair) would have occurred on a decision of this import. From reading the resolution, it is evident that physicians providing gender affirming care at UVA Health have legitimate ethical and medical concerns about simply abandoning patients who are presently at some stage of treatment. But it appears that a process for informing the Board about these concerns was never in place.
Second, the Board’s resolution rightfully expresses its role as the policy-making body of the University. Yet it does so in an expansive manner, noting its authority to determine not only over the decision to form a task force or committee to assess a policy change but over its very membership.
The Board may legally possess this authority, but in practice it is almost always delegated. In my time on the VCU Board, we were informed about the task forces or committees that would be evaluating policy changes or we might even have been asked to participate in a strategic planning group (I invariably declined thinking it was a conflict from the policy-making role), but it certainly was not regular practice for the Board to determine the membership of a task force or committee with the exception of a presidential search.
The University of Virginia is widely recognized as one of the nation’s leading public universities- by the faculty who want to teach there, by the students from across Virginia and around the globe who want to study there, and by the law firms, medical practices, businesses, governments and nonprofits who want to hire UVA graduates. I don’t know what will occur with the simmering tensions evident in the resolution. But it’s hard to imagine that everyone is not better off if these are resolved before they are exploited and explode.