Metro Weekly

Washington State mother sues employer for denying insurance coverage to transgender son

Lawsuit claims Catholic health care organization is breaking law by denying coverage for all transgender services

Cheryl and Pax Enstad – Photo: ACLU of Washington.

The ACLU of Washington has filed a civil rights lawsuit against a Catholic health care organization for refusing to cover the medically necessary surgery required by a transgender son of one of their employees.

The ACLU is suing on behalf of Cheryl Enstad, a medical social worker at PeaceHealth St. Joseph Medical Center in Bellingham, Wash. Enstad decided to file a lawsuit after PeaceHealth refused to cover the medical expenses of her transgender son, Pax, even though the treatments that were denied were recommended to treat his gender dysphoria.

Because PeaceHealth is a Catholic health care organization, it tries to abide by the teachings of the Catholic Church when it comes to issues surrounding sexual orientation or gender identity. It used that as justification for refusing to provide coverage for a recommended chest reconstruction surgery and other treatments for gender dysphoria under its medical benefits plan.

The lawsuit charges that PeaceHealth’s policy of refusing to provide insurance coverage for all “transgender services” violates nondiscrimination protections in the Affordable Care Act and Washington State’s nondiscrimination law.

The lawsuit also argues that the policy is harmful to the health of transgender individuals because denying them insurance coverage may lead them to postpone seeking treatment and, if their gender dysphoria goes untreated, may even lead them to commit suicide.

This is particularly true for Pax, who has suffered from depression and anxiety as a result of his gender dysphoria since entering puberty at age 11. His grades at school fell, he was unable to participate in swimming or athletics, he wore several layers of clothing to hide his chest, and even avoided going outside. His gender dysphoria became so severe that he began wearing a binder 24 hours a day to flatten his chest.

“PeaceHealth’s blanket of exclusion of ‘transgender services’ is not based on standards of medical care,” Lisa Nowlin, a staff attorney for the ACLU of Washington, said in a statement. “This is discrimination, and it is plainly illegal. Under state and federal law, no company is allowed to single out and exclude one group of individuals from medical care that is prescribed for them by their doctors and that the company routinely provides for others.”

The denial of coverage caused distinct and tangible harm to the Enstad family, forcing Cheryl Enstad and her husband to take our a second mortgage on their house and use money from Pax’s college savings fund to pay nearly $10,000 in out-of-pocket costs for the surgery and related expenses.

“We were willing to do whatever it took to get Pax the medical care he needed — as any parent would,” Cheryl Enstad said in a statement. “When your child is singled out and rejected simply for being themselves, it’s heartbreaking, and it isn’t fair. We’re bringing this lawsuit to ensure no family has to go through what we did.”

John Riley is the local news reporter for Metro Weekly. He can be reached at jriley@metroweekly.com