Recently, an employee of an East Coast LGBT health organization was asked to assist in preparing one of the organization's trans-related grant proposals. Just weeks before, he said, a male co-worker was denied insurance coverage for a medically necessary procedure that is routinely covered for other subscribers. The reason for the denial was that the man has a transsexual history, and the insurance policy excluded anything that could be construed as related to sexual reassignment – in this case, a hysterectomy, a procedure often sought by transsexual men for nonfunctioning organs and related pelvic pain, and typically covered for women without question.
The man, who was in dire need of the procedure, eventually had to hire an attorney to help him secure proper care. But the irony of such an exclusion was not lost on the man's co-workers, whose organization is known for providing healthcare to the transgender community.
"I had to write back to my organization and say I was sorry, but I could not help to bring in more funds for a place that makes a lot of its money on the perception that it's trans-inclusive,� said John, an HIV prevention worker for the organization. "I would hate to have to find a lawyer before I found a doctor."
John was one of several people who declined to give his last name and asked that his organization not be identified for this article. Many LGBT organizations are currently grappling with how to handle transgender health benefits, and identifying these groups could upset the delicate nature of negotiations, advocates said.
Six years after the city of San Francisco passed its groundbreaking transgender healthcare benefits package, progress across the country has been somewhat slow to follow. As a result of the 2001 legislation – which mandated trans healthcare and sexual reassignment coverage for all transgender city employees in need – regional private insurance companies such as HealthNet, Blue Cross, and Kaiser developed the infrastructure that would allow them to offer such benefits to other employers' healthcare plans, and some employers – like the entire University of California system – quickly adopted packages with full coverage. Other employers – from the Washington, D.C.-based Human Rights Campaign to corporate entities like Microsoft have offered full hormonal and surgery coverage to their employees through "self-insuring," or what amounts to a separate fund for employee health costs.
But unlike the surge in domestic partner benefits that was seen nationwide after San Francisco passed its landmark 1996 equal benefits ordinance – which mandated that companies doing business with the city provide equal health benefits to their employees with same-sex partners – the issue of transgender healthcare remains misunderstood – both in terms of medical necessity and potential cost. And even employees who do have trans-related healthcare may find that adequate care remains difficult to secure.
The biggest problem, according to Assemblyman Mark Leno (D-San Francisco), who authored San Francisco's legislation when he was a city supervisor, is that the insurance industry itself remains broken. Discriminatory exclusions and exorbitant costs mean "so many small employers have a problem trying to give any of their employees coverage," though he added that San Francisco has proved that transgender benefits as part of an existing health plan need not be cost-prohibitive. . . .
| Posted on Thu, Jun. 21, 2007 |  | ||||||
| Hartford Courant
A disgruntled playboy becomes a female fashion magazine editor. A rock star born biologically male finds her true self. A boy is scripted freely adding a pair of girl’s shoes to accessorize his outfit. Transgender people have become the new go-to characters on TV shows including “Ugly Betty” (on which supermodel Rebecca Romijn plays an erstwhile man), “All My Children” and the “The Riches.” They also have become the topic of more news reports in recent months. A Florida city manager is fired seemingly for disclosing his plans to have a sex-change operation. A male sports reporter in Los Angeles decides it’s time everyone learns who she really is. A sibling in the famous Arquette family has brought the struggles that a transgender person faces to the big screen in the documentary “Alexis Arquette: She’s My Brother,” which made its debut this year at the Tribeca Film Festival. The documentary follows other indie favorites, such as “Boys Don’t Cry” and “Transamerica,” to bring lesbian, gay, bisexual and transgender stories to the forefront. Fiction and reality have brought an increasing presence in the media of transgender people in the past six months. This is all positive for transgender people and society, say those who are active in the transgender community. Mara Keisling, executive director of National Center for Transgender Equality, partly credits the Web and medical advancements with allowing people to express themselves physically. That outlet, she says, has created a domino effect. “There’s so many trans people out that more and more people do have trans people in their lives, and that’s going to cause more trans people in the media,” she says. “... When the entertainment media stories happen, they really have a dramatic impact. When they’re done sympathetically, they make people feel safe and more willing to come out. When they’re done maliciously, that has a chilling effect, makes people feel less willing. It’s really that simple.” The country saw both sides in recent months when, in February and March, the Largo, Fla., city commission voted to fire Steve Stanton as the city manager after 14 years on the job. Commissioners have said it was Stanton’s judgment and not his decision to have a sex-change operation to become Susan Ashley Stanton that cost him his job. When Los Angeles Times sportswriter Mike Penner wrote a first-person story in April, formally coming out to readers and co-workers about what his life had been like and what it would turn into by becoming Christine Daniels, the reaction was mostly favorable, says Daniels. Since coming out in the article headlined “Old Mike, New Christine,” Daniels has been inundated with supportive e-mails and phone calls, received a promotion and keeps a blog at latimesblogs.latimes.com/womaninprogress/. “For some reason there’s an acceptance or openness right now that wasn’t there a year ago,” Daniels says. During the years that Daniels, 49, waited to come out, the Jerry Springer phenomenon – as she refers to it, where transgender people are portrayed as freak shows – caused her to grind her teeth in frustration. Daniels says so many people are closeted because of years of that kind of media portrayal. But high-profile outings and more positively portrayed characters on television are all beginning to push the stigma aside, she says. “It’s just created a lot of discussion. There’s a curiosity right now; it’s opened the door for people. Between the e-mails I’m getting and the interview requests I’m getting, people want to know about this. I think that’s what people can take away from 2007,” Daniels says. Damon Romine, the entertainment media director for the Gay & Lesbian Alliance Against Defamation, agrees that increased visibility creates an increased acceptance, he said, of “a community which has been misunderstood and misrepresented for far too long.”. . . | |||||||
Do you have questions about the coming out journey? The Human Rights Campaign has a set of resources to help you along the way. Download a copy of our newly released Resource Guide to Coming Out, or read it online. Or download our Resource Guide to Coming Out for African Americans, the Spanish-language Guía de Recursos Para Salir Del Clóset or our guide to Living Openly in Your Place of Worship.
