A tale of transgender victory

Dear trans friends and allies,

The last year has been hard, no doubt. Many have suffered under unfair laws and treatment, risking their lives to simply be who they were meant to be. That journey is never easy. In this time of madness and disarray, I’d like to tell you a story.

Not a story of struggle, but a story of victory, and how I got there.

The year was 2010, and I had been full-time in my new gender for a few years now. I felt the time was right for SRS (sexual reassignment surgery, or “the surgery”), and worked on the numerous details that need to be handled before such a thing can happen.

As any trans person can attest, the hardest part about the surgery is paying for it. I was lucky enough to work at a very large software company, which was quite progressive for the time, and had some limited coverage for transgender surgeries, with a lifetime cap of $15,000.

That may sound like a lot, but for a typical FtM surgery, it is barely a portion of it. For my MtF surgery, it was barely enough. I had never been under the knife before, and I asked my insurance what would happen if there were any surgical complications. Would they be covered? They didn’t have an answer for me.

Picking my battle

It’s never a good sign when your insurance company doesn’t have an answer for you. It then occurred to me that if there was a problem, I could easily be overwhelmed with medical costs that my insurance would not pay for. Uninsured medical expenses is one of the chutes toward poverty.

Considering the health insurance (widely renown as one of the best perks in the industry at the time) covered any other surgical procedure at 100% without a co-pay, I decided that I shouldn’t be treated any differently.

Preparations

The general who wins a battle makes many calculations in his temple before the battle begins. — Sun Tzu

First, you have to do your research. I read all the documents involving our medical plan, and contacted the insurance company multiple times asking for clarification. I prepared a spreadsheet based on the cost of care (which I had to pre-approve with the insurance company). I read the employee handbook and often quoted a phrase saying the company doesn’t discriminate based on gender identity, which was present right there in their own handbook.

I read and learned about health care law, and insurance law. One key concept was the concept of “medical necessity,” which is a catch phrase in coverage insurance where they won’t cover procedures that aren’t “medically necessary.”

I contacted the HRC and the Transgender Law Center, both excellent resources for these types of cases.

Most important, you need to know what you’re prepared to do. When you start something like this, it is a combination of coming out to everyone you meet, becoming a lightning rod for statements you find offensive, and risking your employment tied up in one neat package. Then again, so is coming out as trans.

Aim at the head

The first step to all of this was formally notifying my company of all I had found, and asking what they were planning on doing to remedy the situation.

You have to present the problem directly to the people that can do something about it. Don’t bother presenting it to your direct manager, as it will never make it up to a person who will care. Aim at the head. They will deflect and get their subordinates on it, but they will be aware of the problem, which is the most important part.

I emailed the head of HR, our Gay and Lesbian employees alliance, the person in charge of diversity, and the EEOC compliance officer. I laid out the facts, and asked some hard questions.

I let them know that some of our FtM transgender employees were even more unfairly treated than I was. I let them know that specifically calling out surgeries as “transgender surgeries” in the policy is in itself a troubling concept, because by definition transgender surgeries are only for transgender people, and transgender surgeries were the only ones that were capped, but there was no list of what might be considered a “transgender surgery.” I made my point that not only was this possibly a discriminatory ban, but it was hurting our employees.

At this point, things were mostly stalled. I was told that it would be looked into, but was not told at what level, any time frame, or invited to any participation about my needs. It was the classic brush off.

Don’t give up the mic

Don’t ever let them brush you off. Let it be so obvious to them that you aren’t leaving until the problem is solved. This is how you gain priority.

I picked my venue for a public expression of my problem. We had a conference with all the LGBT community of our company and the senior HR director, regarding benefits involving same sex domestic partnerships. The time came for questions, I took the microphone, and I asked some very basic questions:

Why do you cap transgender care at $15,000 lifetime? 
Is it appropriate to be capping transgender benefits? 
Is a cap on benefits because I’m transgender discriminatory?

The question I kept asking was: “Why am I being treated differently?” This is the key question for LGBT people fighting for equal rights.

Be prepared for whatever reason they come up with. When I was told that my medical care “wasn’t as urgent”, I was able to retort immediately that it was medically necessary care, and we should be covering all the care that our employees, and that is what the purpose of our insurance was. Why should I be forced to wait or pay more?

When I was told that it would be “too expensive,” I let them know that this cost is far below the cost of dealing with a heart attack, which they were very nearly giving me. The biggest costs of health care plans are by far obesity related problems like heart attack and diabetes.

I was also told by senior management that I should be grateful for these great benefits I have, because the last company they worked for didn’t offer anything to transgender employees. I told them we do things a little different here, and our focus should be on the company we work for now.

There aren’t a lot of transgender people out there. It’s just a simple fact. We’re not going to win by democracy, we have to influence others and build support by sharing our story. By sharing my story with the rest of the gay and lesbian community at our company, they were clapping and agreeing with me to the top members of our HR benefits team, showing this was a real issue.

For me, I couldn’t stop my leg from trembling and I even felt a little lightheaded. But that’s when I got traction.

Traction

I received an email from the VP of HR wanting to hear more about my situation. He had received my previous email weeks before, but had to my knowledge, done nothing. Only after asking these questions in public did he care. He knew I wasn’t going away.

He told me about how many issues he had on his plate, and how important each of them was, and that he can’t deal with everything. I told him that I understand that’s how things work in a company and that’s why I’m going to make it a priority for him, so that he can help me solve this.

I would occasionally go by his office near the end of the day and ask him how things were going. I made sure he understood I wasn’t going away.

It wasn’t long after that when I was told next year’s health plan would be getting rid of the cap on transgender surgeries.

Victory

I had my surgery in January of 2011, with no complications and a speedy recovery. Overall this was a small victory, but being able to help out some of my fellow coworkers afford their surgeries was a great victory for us.

I believe that rights are not something someone is given. Rights are something someone asserts. They are rarely asserted when times are easy.

The formula I’ve had great success with is:

  1. Know what you want.
  2. Know your rights, and know the law regarding your issue.
  3. Formally protest the injustice in writing.
  4. Get the word out there, and gather your supporters.
  5. Relentlessly assert your rights, and keep asking questions.
  6. Prove you’re not going away, that they need to deal with the situation.

If you ever think you are too small, or too alone to do something like this, it’s okay. Doing something like this is biting off something more than anyone can chew, but you somehow chew your way out of it. One person can take on the system and win. Sometimes, it is actually about being right.

If you think one person can’t make a big change, just look at the record of US supreme court cases (recent example, Roe v Wade). Many times the people represented in the cases were specifically picked for their individual circumstances.

And if you’re transgender, you already know this isn’t the easiest road, so you might as well enjoy the bumps along the way. Good luck Gavin.