So this is part two of my previous blog post. I've been disputing with my health insurance for almost a year now and although I've convinced my HR representative that it would be foolish to deny coverage and she asked me to put my argument in the form of a letter. That way she can present the points to the policy makers that are also employed in the same company.
Below is a copy/paste of the letter I wrote. If you'd like to borrow the whole or part of the letter, feel free to do so. I am the original author of this, and I hold nobody to plagiarism charges if someone were to use any part of the letter or the whole thing. In short, feel free to use if you need to. Just remember to proof read what you plan on presenting first to check for spelling and grammar errors.
Anyways, here's the letter:
____________________________________________________________
Hello. This is Kris, you asked me to send you an email regarding the
confusion with [company name] healthcare policies. I'm going to try to
refrain from using inflammatory language if possible. This whole year
long ordeal has left me quite upset with [company name]
healthcare policies and those who write said policies.
So to start, I am transgender (male to female) and I'm having
difficulty with receiving equal coverage under [company name] health plan. I
understand that not all companies have experience or knowledge in
working with transgender employees, but I think we can
reach an acceptable solution.
Transgender definition, information, and terminology clarification can be found here:
http://en.wikipedia.org/wiki/Transgender
There is another term that needs to be clarified at that is Intersex
(or Klinefelter syndrome for a more accurate name). People who are
intersex are born with physical and/or mental characteristics that
aren't exclusively male nor female, but somewhere in
between and to varying degrees.
Intersex definition, information, and terminology clarification can be found here:
http://en.wikipedia.org/wiki/Intersex
Though it is still unknown at this time if the intersex condition is
what causes the transgender condition, there is strong correlation
between the two. Many intersex people go through gender transition, but
not all who go through gender transition are intersex
to any measurable degree. The field of medical science is still
actively working on these issues.
The current issue I'm having with [company name] health plan is that it
fails to include policies that address specific healthcare needs of
transgender and intersex clients. I attribute that to two causes.
The first is that the population of transgender and intersex people
is rather small. Not many people have encountered us nor understand our
situations and issues. It's just not common knowledge to hear about or
even meet someone who does not fit into the
standard male/female gender binary.
The second is that persistent misinformation and social bias surround
the issue. It is a common myth that LGBT (lesbian, gay, bisexual,
transgender) people are the way they are because it is their "lifestyle"
or choice. It's repeated so often in media that
it almost sounds to be true. However, doctors and psychologists agree
that it is in fact not a lifestyle nor a choice. To claim that is a
lifestyle choice is demonstrably false based on all the evidence at
hand.
The issue we ran into today is one of sex discrimination. What I mean
by that is some medically necessary preventative treatments are
exclusively for either males or females, and crossover is denied. This
is especially problematic when a patient has the
physical anatomy of both sexes.
What is a transgender or intersex person supposed to do with a
healthcare policy that discriminates away half of their body? It doesn't
make a lot of sense to only cover half of a human being and leave the
other half of that same person to fend for themselves.
Currently, I am legally classified as male, but by tomorrow that
should be changing to female. Sometime in the future, I will need
prostate exams, mammograms, and once I can afford the surgery I will
need gynecological exams. I will need preventative treatment
for all aspects of my body, not just the ones that [company name]
healthcare policy feels like covering.
If I ever receive an illness or injury to the half of my body that's
not covered, it won't be an isolated thing. That illness or injury
affects my whole body and that preventative treatment that would have
saved the company money would end up costing the
company far more in general health treatment. An ounce of prevention is
worth a pound of cure, and by denying parts of my body preventative
treatment, the company runs the risk of having to pay for expensive
illnesses or injuries down the road.
To put it in metaphor, it doesn't make sense to maintain the wheels
on the left side of a car and neglect the wheels on the right side of
the same car. Any catastrophe the neglected wheels suffer, the entire
car suffers the catastrophe and the cost to repair
the car is dramatically higher than if both sets of wheels were
maintained.
By denying me coverage because half of me is one gender and the other
half is another gender, [company name] opens itself to potentially paying for
much higher medical expenses than it would have cost if preventative
treatments were not sex exclusionary.
I would even argue that all the time, energy, lost man/hours, effort,
and resources that have gone into this dispute have ended up costing [company name] more than what the bill would have cost on its own.
Having the main issue addressed, I would like to shed some light on
other issues, specifically transgender exclusionary language in the
healthcare policy and related care.
SRS (otherwise known as Sex Reassignment Surgery) is widely
considered to be, in the field of medical science, a medical necessity.
Few doctors and psychologists would disagree with the necessity of the
procedure:
http://jurist.org/paperchase/2012/09/federal-judge-rules-sex-reassignment-medically-necessary-for-inmate.php
http://www.wpath.org/site_page.cfm?pk_association_webpage_menu=1352&pk_association_webpage=3947
http://www.lambdalegal.org/know-your-rights/transgender/transition-related-care-faq
http://www.aetna.com/cpb/medical/data/600_699/0615.html
Anthem BC/BS even agrees that it is medically necessary in other states where they offer their services:
http://www.anthem.com/medicalpolicies/guidelines/gl_pw_a051166.htm
There are also many instances of healthcare coverage denying medically necessary treatment and being taken to court over it:
http://transgenderlawcenter.org/archives/11285
http://lexiecannes.com/2013/01/30/lawsuit-prompts-state-of-oregon-to-provide-sex-reassignment-surgery-insurance-coverage-for-state-employees/
http://www.washingtonpost.com/national/health-science/ban-lifted-on-medicare-coverage-for-sex-change-surgery/2014/05/30/28bcd122-e818-11e3-a86b-362fd5443d19_story.html
http://kaiserhealthnews.org/news/transgender-lgbt-health-care-michelle-andrews-090412/
I bring these examples up because there is strong legal precedent for
overturning these bans on medically necessary treatments. I don't mean
to imply any sort of threat of any kind, that isn't my goal here. My
intent on presenting this information is to
highlight an opportunity.
There is an organization called Human Rights Campaign, I'm sure
you've seen their bumper sticker on the road. It's the square blue
background with a yellow equal sign. Here is their website:
http://www.hrc.org/
They have what's called Corporate Equality Index, where businesses
and companies are given a score based on equal treatment and equally
administered benefits for all employees.
http://www.hrc.org/campaigns/corporate-equality-index
Many of the corporations on the list are major fortune 500 companies,
as well as others who wish to boast their CEI score to customers and
clients. [company name] could easily make the grade if it weren't for its
arbitrary and exclusionary healthcare policies.
Healthcare equality is starting to sweep across the country, often
either voluntarily or through the judges gavel. It doesn't make any
sense to have doctors and psychiatrists say a treatment is medically
necessary, yet the health insurance claims it's not
medically necessary. One has got to give, and the current legal trend
is going in the right direction towards equality.
In conclusion, I hope that this email will help with future policy
writing, and that hopefully [company name] will be able to one day claim they
are an equal opportunity employer with equal benefits for all employees.
Currently we're not there, but it would be
nice to be there.
