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Transgender Librarian Sues for Reassignment Surgery Insurance Coverage
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A lawsuit was recently filed in federal court by a transgender legislative librarian for the state of Alaska.   She is challenging denial by the state health insurance plan of her request for reimbursement  for gender reassignment surgery .  The complaint alleges that Alaska is discriminating against her and other transgender people in violation of Title VII of the Civil Rights Act.  That federal law prohibits discrimination against a job applicant or employee because of race, color, religion, sex, national origin, age (40 or older), disability, or genetic information. 


The plaintiff, Jennifer Fletcher, age 36, argues that denial of insurance coverage is discrimination based on sex.  She seeks to bring the case as a class action, meaning a lawsuit with many plaintiffs, all of whom are similarly situated (experiencing the same problem or loss due to the issue being litigated).


The lawsuit asserts that because the only people who require medically necessary care to treat gender dysphoria (state of unease, dissatisfaction, unhappiness) are transgender, denying coverage discriminates against transgender people.


The state employee health care program, called AlaskaCare, covers “medically necessary treatment” for all state employees.  Fletcher argues the surgery she seeks is medically necessary.  The American Medical Association (AMA) and the American Psychological Association, both mainstream professional organizations, recognize that transition-related surgical treatment can be medically necessary for a transgender individual  The AMA and other medical associations have advocated for ending the exclusions for transition-related treatments.


Said the plaintiff, “My coworkers are able to receive coverage for their care, but coverage for care transition-related is denied.”   Said her attorney, “The state employee health care program covers medically necessary treatment for all state employees except  transgender employees.  That’s textbook discrimination by any standard.”


The exclusion dates back to 1979 when understanding of transgender people was far more limited.  A senior attorney with Lambda called the policy “antiquated, irrational, and downright cruel.”


The case was first heard by the United States Equal Employment Opportunity Commission (EEOC) in March, 2018. The EEOC is a federal agency that enforces Title VII of the Civil Rights Act of 1964.  Before a person can sue for a violation of that Act, s/he must first file a charge of discrimination with the EEOC.  In Fletcher’s case, the agency found reasonable cause to believe that the State of Alaska had violated Title VII.


Fletcher works in Juneau.  She was diagnosed with gender dysphoria in 2014. She is being represented by Lambda Legal, an organization dedicated to achieving full equality for lesbian and gay people.


Similar lawsuits are pending in a few other states, including Wisconsin and Minnesota.