The Two Failures We Are Fixing
Self-reporting, and the blended average.
The first problem is obvious once you notice it. A clinic adds itself to a directory, ticks a box saying it welcomes LGBTQ patients, and that is the entire verification process. Sometimes it is true. Sometimes it means one staff member attended a training in 2019. You find out which at the appointment.
The second problem is subtler and does more damage. Directories that do rate places tend to produce one friendly overall score — which means a practice that is genuinely warm to trans patients and has three steps at the front door reads as good. Disabled people learn quickly that a high rating tells them nothing, because the rating was never measuring them.
Affirming and accessible get separate scores here, permanently, and they are never averaged together. A place can be excellent at one and fail the other, and you deserve to see that before you drive there.