A transgender state employee in Alaska is suing the state for denying her health care benefits, thereby forcing her to pay out-of-pocket expenses for medically necessary surgery.
Alaska’s current health insurance plan for state employees prohibits coverage for the same surgical procedures used in transition-related surgery that would otherwise be covered had the patient been cisgender instead of transgender.
Jennifer Fletcher, a 36-year old Juneau resident who works as a state legislative librarian, was diagnosed with gender dysphoria in 2014. Consulting with her doctors, Fletcher started hormone therapy and was advised to pursue gender confirmation surgery as well.
Because AlaskaCare has contained a blanket exclusion on transition-related surgery since 1979, Fletcher was denied coverage for the surgery and had to pay out of pocket. Beginning in 2018, AlaskaCare began covering hormone therapy for transgender employees, recognizing it as medically necessary, but continues to deny requests for surgical-related expenses.
Fletcher subsequently enlisted the help of Lambda Legal and sued the state.
“Jennifer Fletcher was denied coverage for medically necessary treatment specifically because she is transgender,” Lambda Legal Senior Attorney Peter Renn said in a statement. “This is unlawful and stigmatizing discrimination that jeopardizes the health of hardworking state employees. The state employee health care program — AlaskaCare — covers medically necessary treatment for all state employees except transgender employees. That’s textbook discrimination by any standard.”
In its lawsuit, Lambda Legal argues that the State of Alaska is violating Title VII of the Civil Rights Act, which prohibits sex discrimination. In March 2018, the U.S. Equal Employment Opportunity Commission found that there was reasonable cause to believe the State of Alaska violated Title VII when it refused to cover Fletcher’s medical expenses.
“All that I am asking is that the State of Alaska stop discriminating against people like myself,” Fletcher said in a statement. “My coworkers are able to receive coverage for their care, but coverage for transition-related care is denied. This sends a clear message that the State does not value me, and does not consider me equal to its other employees, by forcing me to pay out of pocket for my medically necessary care. How is this not discriminatory, when equivalent care is routinely provided to other state employees?”
Most mainstream medical associations, including the American Medical Association and the American Psychological Association, recognize that transition-related surgical treatments are often considered medically necessary for transgender people who have been diagnosed with gender dysphoria. As such, they have called for an end to discriminatory exclusions like those in AlaskaCare.
“Whether your insurance will cover medically necessary treatment should not depend on who you are,” Lambda Legal Counsel Tara Borelli said in a statement. “The State itself recognizes that transition-related care is medically necessary, which is why it covers hormone therapy. The only reason for this lingering blanket exclusion against surgical treatment is irrational discrimination.”
A federal judge issued a nationwide order blocking a pair of executive orders from President Donald Trump seeking to criminalize the provision of gender-affirming health care to transgender youth.
U.S. District Judge Brendan Hurson, of the District of Maryland, granted a preliminary injunction to the families of several transgender young adults and adolescents whose access to gender-affirming care was disrupted by Trump's orders. Those families are joined by the pro-LGBTQ advocacy group PFLAG National and GLMA, the country's largest organization of LGBTQ and allied health professionals.
President Donald Trump used his address to Congress on Tuesday, March 4, to attack transgender individuals, calling transgender identity a "lie" and railing against transgender athletes, gender-affirming care, and trans visibility in the military and more broadly within society.
At one point during the speech, Trump switched from speaking about a child who was diagnosed with cancer to claim his administration was protecting children from "toxic ideologies" in schools.
He brought up the story of January Littlejohn, a Florida anti-transgender activist who sued the Leon County School District in Tallahassee, Flordia, in 2021, alleging that her child's school had discussed restrooms and name change requests with the child, assisting her in "socially transitioning" without informing Littlejohn or her husband of their efforts.
The Pentagon will start forcibly discharging transgender service members within 60 days unless an individual can obtain a special waiver to allow them to continue serving.
On Wednesday, February 26, the Pentagon issued a policy memo outlining how the U.S. Department of Defense is complying with an executive order by President Trump to prohibit transgender individuals from serving openly in the U.S. military.
Trump's executive order claims that allowing transgender people to serve in the Armed Forces threatens military readiness and undermines unit cohesion.
It contradicts a 2016 RAND Corporation study, commissioned by the Pentagon, that found allowing transgender members to serve openly had no negative impact on unit cohesion, operational effectiveness, or readiness.
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