Wi State Journal:Transgender UW researcher denied coverage for gender confirmation surgery, complaint says

A transgender researcher at the UW School of Medicine and Public Health has filed a complaint against the state, the medical school and an insurance company, saying she was unfairly denied coverage of gender reassignment surgery.

The ACLU of Wisconsin filed the complaint Tuesday with the U.S. Equal Employment Opportunity Commission on behalf of Shannon Andrews, a cancer researcher at the medical school. It seeks reimbursement of $21,000 she paid to have the surgery in October.

“Setting aside a separate class of people ... as not being worthy of medical care feels and seems discriminatory to me,” said Andrews, 34, of Madison. “Everyone deserves equal medical treatment. Everyone should be fairly reimbursed for the insurance that they pay into.”

The complaint is against the Group Insurance Board, which oversees health benefits for state workers through the state Department of Employee Trust Funds. It also names the medical school and Monona-based WPS Insurance, one of the companies that provides health insurance to state workers.

Spokesmen for the Group Insurance Board and WPS declined comment. Lisa Brunette, spokeswoman for the medical school, said the insurance board, not the university, determines the scope of coverage for state workers.

The ACLU said in a statement that state worker health benefits exclude coverage of “procedures, services and supplies related to surgery and sex hormones associated with gender reassignment.”

That violates Title VII of the Civil Rights Act and the Equal Protection Clause of the Fourteenth Amendment, the ACLU said.

However, on July 12, the Group Insurance Board approved ending its exclusion of benefits and services related to gender reassignment or sexual transformation, effective January 2017.

The board’s lawyers recommended the change after the federal government issued final regulations in May regarding a portion of the Affordable Care Act related to discrimination, according to a board document.

Andrews said she had no idea the policy change was coming, and it came too late for her.

 

She said she became aware of her gender dysphoria around the age of 15. In recent years, doctors and therapists recommended gender reassignment treatment. She struggled with anxiety and depression, and last year felt she needed to proceed with surgery to transition from male to female.

“It came to a point where this has to change or I’m going to have worse health problems,” she said.

She contacted WPS and learned the surgery likely wouldn’t be covered, so she paid out of pocket. She submitted the bills in a claim, which was denied in February. After losing an appeal, she turned to the ACLU for help.

Though the Group Insurance Board has changed its policy, the state discriminated against transgender workers for a long time, said Larry Dupuis, ACLU of Wisconsin Legal Director.

Andrews “is out $21,000 in a way that was discriminatory,” Dupuis said.

Other public and private employers in Wisconsin continue to discriminate against transgender workers, he said.

“Transgender folks aren’t able to get medically necessary care covered, in the way that their non-trans co-workers are,” he said.

Andrews graduated from UW-Madison in 2003 and has worked as a researcher at the UW Carbone Cancer Center since 2014.

She is represented by Dupuis and John A. Knight of the ACLU’s national Lesbian, Gay, Bisexual, Transgender and HIV Project.

 

Date: 
Wednesday, July 27, 2016