A transgender state employee in Alaska is suing the state for denying her health care benefits, thereby forcing her to pay out-of-pocket expenses for medically necessary surgery.
Alaska’s current health insurance plan for state employees prohibits coverage for the same surgical procedures used in transition-related surgery that would otherwise be covered had the patient been cisgender instead of transgender.
Jennifer Fletcher, a 36-year old Juneau resident who works as a state legislative librarian, was diagnosed with gender dysphoria in 2014. Consulting with her doctors, Fletcher started hormone therapy and was advised to pursue gender confirmation surgery as well.
Because AlaskaCare has contained a blanket exclusion on transition-related surgery since 1979, Fletcher was denied coverage for the surgery and had to pay out of pocket. Beginning in 2018, AlaskaCare began covering hormone therapy for transgender employees, recognizing it as medically necessary, but continues to deny requests for surgical-related expenses.
Fletcher subsequently enlisted the help of Lambda Legal and sued the state.
“Jennifer Fletcher was denied coverage for medically necessary treatment specifically because she is transgender,” Lambda Legal Senior Attorney Peter Renn said in a statement. “This is unlawful and stigmatizing discrimination that jeopardizes the health of hardworking state employees. The state employee health care program — AlaskaCare — covers medically necessary treatment for all state employees except transgender employees. That’s textbook discrimination by any standard.”
In its lawsuit, Lambda Legal argues that the State of Alaska is violating Title VII of the Civil Rights Act, which prohibits sex discrimination. In March 2018, the U.S. Equal Employment Opportunity Commission found that there was reasonable cause to believe the State of Alaska violated Title VII when it refused to cover Fletcher’s medical expenses.
“All that I am asking is that the State of Alaska stop discriminating against people like myself,” Fletcher said in a statement. “My coworkers are able to receive coverage for their care, but coverage for transition-related care is denied. This sends a clear message that the State does not value me, and does not consider me equal to its other employees, by forcing me to pay out of pocket for my medically necessary care. How is this not discriminatory, when equivalent care is routinely provided to other state employees?”
Most mainstream medical associations, including the American Medical Association and the American Psychological Association, recognize that transition-related surgical treatments are often considered medically necessary for transgender people who have been diagnosed with gender dysphoria. As such, they have called for an end to discriminatory exclusions like those in AlaskaCare.
“Whether your insurance will cover medically necessary treatment should not depend on who you are,” Lambda Legal Counsel Tara Borelli said in a statement. “The State itself recognizes that transition-related care is medically necessary, which is why it covers hormone therapy. The only reason for this lingering blanket exclusion against surgical treatment is irrational discrimination.”
A federal judge in Oregon issued a blistering ruling against the U.S. Department of Health and Human Services and Secretary Robert F. Kennedy Jr., blocking their efforts to yank federal funding from providers of gender-affirming care for minors.
At the center of the case is the so-called "Kennedy Declaration," in which the HHS secretary claimed that gender-affirming care does not meet accepted medical guidelines, lacks evidence of benefit for treating gender dysphoria, and may cause long-term harm.
At the time, critics said Kennedy based the declaration on an HHS review of gender-affirming care that was anonymously produced and rushed through in 90 days without peer review, in order to comply with President Trump's executive order limiting minors’ access to such treatments.
Republican lawmakers in Tennessee are pushing a bill that critics warn could effectively create a registry of transgender residents, raising fears it could be used to surveil or harass them.
House Bill 754, sponsored by State Rep. Jeremy Faison (R-Cosby) and Sen. Brent Taylor (R-Memphis), would require all gender clinics in Tennessee to report monthly health data on patients who have received transition-related care to the Department of Health. The department would then publish aggregated annual reports.
FCC Chair Brendan Carr is seeking public comment on proposed changes to the parental ratings system that would flag content related to gender identity.
Federal Communications Commission Chair Brendan Carr is seeking public input on whether television programs that address transgender issues or feature trans or nonbinary characters should carry warning labels.
The FCC oversees broadcast and cable TV companies and helps shape the ratings system that guides parents on whether shows are appropriate for children.
In 1996, Congress gave TV companies the option to create their own voluntary ratings system or adopt one imposed by the FCC. The companies chose to create their own system, forming the TV Oversight Management Board, which developed the TV Parental Guidelines still used today for cable, satellite, and streaming services.
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