Metro Weekly

Baltimore City lifts transgender surgery exclusions in city employee health insurance plan

Board of Estimates finds exclusion violates Title VII and Maryland's nondiscrimination law

Baltimore City Hall – Photo: Smash the Iron Cage, via Wikimedia.

On Wednesday, the Baltimore City Board of Estimates voted to remove an exclusion from its employee health insurance plan that previously prohibited transgender city employees from obtaining coverage for gender confirmation surgery.

The Board of Estimates found that the transgender health care exclusions constituted a form of employment discrimination, under both Title VII of the Civil Rights Act and the Fairness for All Marylanders Act, which prohibits discrimination against people on the basis of gender identity. The board then unanimously voted to remove the exclusion.

The U.S. Equal Employment Opportunity Commission recently found, in a case out of Alaska, that states or municipalities that prevent transgender employees from obtaining coverage for gender confirmation surgery may be violating those employees’ rights under Title VII.

“I’m pleased that the city has done the right thing here,” FreeState Managing Attorney Jennifer Kent said in a statement after the vote. “We will continue to fight alongside employees who are transgender to ensure that all Marylanders are treated equally in their health insurance coverage.”

The issue was first brought to the city’s attention by the LGBTQ advocacy organization FreeState Justice after its client, the Rev. Merrick Moses, the citywide LGBTQ Community Liaison for the Baltimore City State’s Attorney’s Office, was denied coverage for medically necessary transition-related health care.

Historically, state or local governments have instituted bans on gender confirmation surgery because they deemed such procedures as cosmetic and not medically necessary. But over the years, a greater understanding of transgender health care has led people to understand that gender dysphoria is a real medical condition, and that transition-related health care, including hormones or surgery, are crucial to treating it.

Nineteen states and the District of Columbia currently prohibit transgender exclusions in health care. California, Massachusetts, and the District of Columbia also have provisions in place that explicitly transition-related care in Medicaid programs. In recent years, transgender residents in Iowa, Minnesota, and Wisconsin have sued their states over Medicaid exclusions, which were declared unconstitutional in the Iowa and Minnesota cases.

“This issue is about fairness,” Moses said in a statement. “Baltimore City’s transgender employees should be treated fairly and with dignity, including in health insurance matters. These gender confirmation surgeries are not cosmetic procedures. These matters are medically necessary procedures for the well-being of gender diverse persons.

“Baltimore City employees, who happen to be transgender, should be able to get the health care they need to live their best lives,” Moses added. “We are very happy that Mayor Pugh has taken a stand against transgender discrimination in health care. Our community just wants to be treated with fairness, dignity, and respect, like all other human communities.”

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