Thursday, January 23, 2020

Two State of Florida Employees Sue for Coverage of Gender Confirmation Surgery

Meet Jami Claire. Ms. Claire is a senior biological scientist at University of Florida College of Veterinary Medicine. She has worked there for 32 years. She also happens to be a motorcycle enthusiast.

Kathryn Lane is also an employee of the State of Florida. Ms. Lane is an attorney with the appellate division of the Office of the Public Defender in the Second Judicial Circuit of Florida in Tallahassee.

The State of Florida determines what its health insurance policy for employees will cover and what is excluded from coverage. The plans explicitly exclude coverage of “gender reassignment or modification services or supplies.” Just to be clear, the absence of gender-affirming care is not a gratuitous denial on the part of the insurance carriers. It is the result of a deliberate decision by the state.

In 2016, in the process of soliciting competitive bids, the State explicitly excluded gender-affirming care. Presumably that not only affects State employees but also the children of state employees. These two women require medically necessary care that is being denied — I would speculate — for other than economic reasons.

Taking it a step further, care that is not medically necessary or deemed experimental is already excluded from coverage. Therefore, the State is essentially admitting that gender-affirming care is medically necessary and is not experimental. Indeed it is recommended by virtually every medical professional organization.

Consider Ms. Claire's case. She has been gender incongruent since the age of seven. In severe distress she transitioned in 1997. Her wife divorced her. The Mormon Church excommunicated her. Her entire family, including her children, want nothing to do with her. All because of a medical condition. Five years later, she had to cease gender affirmation because she could not afford the hormones after the huge financial toll of her divorce.

In 2016, with crippling anxiety and depression, Ms. Claire re-transitioned. She did not sign up for this. Moreover, as Christian conservatives relish pointing out, hormones come with risks and undesirable side effects. Surgery to remove her testicles would allow Ms. Claire to cease or significantly reduce her hormone consumption. She simply cannot afford the surgery out-of-pocket.

I am focusing on Ms. Claire's situation because she has been a loyal and productive employee of the state for over three decades and because she is 62 years of age. She is at heightened risk for life-threatening blood clots.

The University of Florida is a $5 billion enterprise with over 40,000 employees. Inclusive gender affirming care of about 200 employees would be statistically insignificant.

According to lawyers for Ms. Clair and Ms. Lane:
The State’s categorical exclusion of medically necessary gender- affirming care in all State Plans constitutes unlawful sex discrimination in violation of Title VII and the Equal Protection Clause.
Why does the State of Florida have to be sued to do the right thing for what is probably fewer than 1,000 employees (out of about 200,000)? How can state officials be this obtuse? The answer is politics and religion. People should not have to be sick because of religious beliefs.

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