Asking a favor…

This afternoon I went to a workshop on trans healthcare at Wash U. I didn’t learn much I didn’t know, and I surprised myself by tearing up while listening to a lecture about insurance. I mean, it really triggered some deep stuff. If you’ve known me for very long you’ve heard about my experiences with doctors and the like. (If you haven’t, buy me a beer and I’ll weave a tale of woe.) For a long time – even now, if I’m honest – I felt like I was getting away with something by transitioning.. like I was exercising some unfair advantage. I’ve attacked the journey in fits and starts, one day an activist, the next a hermit. Personal demons.

Today though, this moment, I’m an activist. And I need you.

The Problem:

If you are insured, you know your plan is complicated and boring, so you probably haven’t looked at your certificate of coverage (long, long document telling you what’s covered and what’s not).  I’ll skip the bulk of it and come right to the point.  In every insurance plan, there is a list of exclusions in this certificate of coverage – stuff that’s NOT covered- and it almost always has an entry that says something like this:  Sex Change Services and supplies for a sex change and/or the reversal of a sex change. (from my own insurance plan)

This may seem pretty simple, but it’s life changing.

Here’s how:

I had a large cyst on my ovary that had to be removed a several years ago. I hadn’t started transitioning, so my insurance company didn’t blink when I claimed the surgery to remove it.  Fast forward to now.  If I had the same problem and walked into the doctor’s office with a beard and “male” on my documents, the insurance company can (and would absolutely) deny my claim.

Need another example?

Some insurance companies won’t pay for anything that happens to a trans person because they say literally everything that happens to that person is trans-related because they have a trans body – meaning that if a trans person with that insurance falls and breaks their arm, the cast and er visit aren’t covered because the broken arm happened to a trans body. Trans benefits aren’t allowed. I’m not exaggerating.  This actually happens.


I have to pay out of pocket for my prescription for Testosterone (no small cost). If my son, a cis gender male, had the same prescription and was on the same plan, his hormones would be covered.  Also, my partner, who has gone through menopause, is able to obtain her hormone replacements using the same prescription plan as I have.

When the Affordable Care Act became law, so did this:

Section 1557 is the civil rights provision of the Affordable Care Act.  Section 1557 prohibits discrimination on the ground of race, color, national origin, sex, age, or disability under “any health program or activity, any part of which is receiving Federal financial assistance … or under any program or activity that is administered by an Executive agency or any entity established under [Title I of ACA]….”   Section 1557 is the first Federal civil rights law to prohibit sex discrimination in health care.  To ensure equal access to health care, Section 1557 also applies civil rights protections to the newly created Health Insurance Marketplaces established under the Affordable Care Act.

Which means that the exclusion on my plan, which is an ACA plan (and millions of other people’s – including possibly yours if you signed up on the healthcare exchange) should go away.

But the insurance companies have left them on there because, well, nobody’s making them take it out.  This is the part where I need your help.  The Department of Health and Human Services is getting ready to issue guidelines pertaining to Section 1557 according to Andre Wilson, the fellow who presented tonight’s workshop.  Email them, he said to me. Make a complaint to the HHS Office for Civil Rights, but do it right now -tonight.  So I did.  And I’m asking you to write to them too even if – maybe especially if – you’re not a trans person.  If you’re an ally, if you’re a family member, if you’re a friend to anyone who is transgender this affects you. It affects your family. It affects your friends. It affects your workplace.

Trans Rights are Civil Rights.

I don’t know – maybe nothing happens. Maybe sending these messages does nothing right away or at all. But I can say with absolute certainty that nothing good will happen if nobody says a word.

*One note, please form your messages to the office as actual complaints instead of commentary so that they don’t see this as spam.  We want this to be as real, genuine and effective as possible.

Here is the contact information for the Health and Human Services Office for Civil Rights


Email address:

More information:

WPATH (World Professional Association for Transgender Health)

Metro Trans Umbrella Group (local trans education group)