Gay and Transgender Discrimination Outside the Workplace

From the Center For American Progress, a good review of the issues:

Gay and Transgender Discrimination Outside the Workplace: "Gay and Transgender Discrimination Outside the Workplace
Why We Need Protections in Housing, Health Care, and Public Accommodations"

More US companies covering transgender surgery

More US companies covering transgender surgery

This is a welcome trend, and it indicates the importance that more major employers are giving to inclusion of trans employees in their diversity efforts.

LGBT Employees at Credit Suisse Benefit from Enhanced Offerings -- NEW YORK, Jan. 19, 2011 /PRNewswire/ --

Credit Suisse, a major financial firm, is not only offering benefits for same-sex relationships, but specifically including appropriate benefits for their transgender employees.

LGBT Employees at Credit Suisse Benefit from Enhanced Offerings -- NEW YORK, Jan. 19, 2011 /PRNewswire/ --:

"The revised benefits package, effective January 1, 2011, includes new transgender benefits including sex-reassignment surgery and related prescription drug treatment will be covered under the medical plan."

Goldman Sachs covers transgender health benefits

NEW YORK (Fortune) -- Wall Street is typically considered a pretty conservative place to work. But the classic white-shoe investment bank is loosening things up by adding health benefits that cover sex-change operations.



Not only is Goldman Sachs ranked No. 9 on Fortune's list of 100 Best Companies to Work For, it also appears on what could be a list of transgendered job-seekers' ideal employers as well.

Goldman added health-insurance coverage of sex reassignment surgery as part of a push last year to attract top talent and recruit and retain a more diverse workforce, the company said.

The surgery alone could cost an individual anywhere from $5,000 to $150,000 if they paid out of pocket, depending on their particular situation, said Pauline Park, chair of the New York Association for Gender Rights Advocacy, a group that campaigns for transgender rights. That figure doesn't include hormone and other drug treatments.

Goldman Sachs (GS, Fortune 500)' plan covers the actual surgery, as well as transgender-related prescription drugs, such as testosterone injections, said spokeswoman Gia Morón. It does not cover electrolysis and other cosmetic treatments, she said.

The surgery is free under the company's HMO and PPO plans as long as patients are screened and diagnosed with transsexualism and see an in-network doctor. Drugs are subject to regular prescription copays that are typically $5 to $30 a month.

Goldman is not the only financial firm that offers such benefits. Bank of America (BAC, Fortune 500), Deutsche Bank (DB) and Wachovia (WB, Fortune 500) also offer some level of coverage for transgender treatments, according to a poll by the Human Rights Campaign - a gay, lesbian, bisexual and transgender advocacy group.

The HRC asked Fortune 1000 corporations, large law firms and other companies to volunteer information on their policies and benefits; 519 employers responded. But companies on its list may cover just hormone therapy and related prescription drugs, and not the sex reassignment surgery, as Goldman does.
Best Companies to Work For: 25 Top-paying companies

For example, Wachovia's health plan deems sex reassignment surgery "elective," and not medically necessary, so it doesn't pay for actual operations. But the bank does allow transgendered employees to take short-term disability leave for surgery and covers some related prescriptions, such as painkillers and antidepressants, said a company spokeswoman, Megan Roberts.

Wachovia also offers post-operative counseling and provides diversity and sensitivity training for the "transitioning" employee's officemates, allowing the person to "feel like they can come back to some sort of normal work environment," Roberts adds.

Meanwhile, Bank of America covers the surgery, and related treatments such as hormone shots and prescriptions, as long as they're deemed by a doctor to be medically necessary.

Besides banks, other large companies including Microsoft (MSFT, Fortune 500) and General Motors (GM, Fortune 500) cover transgender treatments, according to the HRC survey.

Even in the aerospace and defense industry, as well as among law firms and consulting firms, more employers are adding non-discrimination policies that include sexual orientation as well as providing additional insurance coverage for transgendered staff, said Samir Luther, manager of the Workplace Project at the Human Rights Campaign foundation.

Since employers don't want to discourage diverse candidates from applying to their firms, said Luther, "it's a trend that's going to continue even in conservative industries."

"Because we have a system of employer-based insurance, any employer that does not clearly include gender identity in their employment policies may send a signal that they're not supportive," added Park, of the New York Association for Gender Rights Advocacy.

And even though sex reassignment surgery can be expensive, a company covering the procedure won't break the bank, according to Park.

"With companies that do provide coverage, it actually doesn't affect their bottom line significantly," Park said. She added that of the few transgendered employees there may be at any given company, most don't actually want a surgical sex change.

"It's simply a myth to think that providing coverage for sex reassignment surgery is going to bankrupt a company," Park added.

http://money.cnn.com/2008/02/08/news/companies/gender.fortune/index.htm?postversion=2008020809

AMA Opposes Denial of Health Insurance Benefits

The American Medical Association house of delegates met in Chicago the weekend of June 23/24, passing a number of historic trans-positive policies for all physicians to follow or be in violation of acceptable professional ethics. These will, of course, have the most impact in workplaces employing physicians. One of these policies, however, which opposes denial of health insurance benefits based on gender identity, will affect all workplaces

The policy to which I refer is the following:

Policy H-180.980
Sexual Orientation and/or Gender Identity as Health Insurance Criteria.
The AMA opposes the denial of health insurance on the basis of sexual orientation or gender identity. (Res. 178, A-88; Reaffirmed: Sub. Res. 101, I-97)

This issue is definitely making great strides. As I've discussed before, most benefit plans contain an exclusion for "transsexualism." This means that mental health counseling, hormone replacement therapies and surgical procedures will not be covered if they are associated with transsexualism. As I read it, the AMA is opposing this type of exclusion. As noted in my previous discussions, the reasons for the exclusion no longer apply, and the Human Rights Campaign has changed its Corporate Equality Index to measure coverage of transgender health benefits. Kodak, Microsoft and other employers have now included many transgender health benefits, including surgical benefits. A transgender employee recently won a lawsuit against an insurer, Highmark Blue Shield, that refused to cover the costs of her sex reassignment surgery. However, there are still major problems experienced by transgender employees trying to access coverage. Employers should look to see what health benefits they offer transgender employees, and consider how they might communicate with insurers to avoid problems that may turn into litigation.


To read the full AMA report,click on: http://www.ama-assn.org/ama1/pub/upload/mm/467/bot11a07.doc

Update on Transgender Employment Issues

So many interesting things have happened in the last month on transgender employment issues, I'm going to make a list. The most important news is about the signing of legislation in Iowa, Vermont, Colorado and Oregon. But not all is rosy...

- The Governor of Iowa signed the bill including gender identity into the state's antidiscrimination law, as did the Governor of Vermont, the Governor of Colorado, and the Governor of Oregon.

The Governor of Ohio by executive order restored a ban on discrimination against state employees based on gender identity and sexual orientation, which had been removed by his predecessor in 1999 However, the Governor also noted his opinion that any Ohio legislation purporting to outlaw discrimination based on sexual orientation or gender identity would be rendered unconstitutional by the state's constitutional ban on same-sex marriage It is difficult to understand the connection, and I note that federal court opinions already cover all transgender employees in Ohio.

A transgender employee won a lawsuit against an insurer, Highmark Blue Shield, that refused to cover the costs of her sex reassignment surgery This comes on the heels of reports that more employers are covering the costs of such surgery

However, not all is rosy for transgender employment rights:

The Connecticut legislature failed to pass legislation adding gender identity to the state's non-discrimination law (I note that all transgender employees in Connecticut are covered by a state administrative ruling.)

The transgender experience in the job market: The American Lawyer publishes a letter, by one of the few transgender lawyers in a large law firm, discussing its article on strides made by gay lawyers in overcoming employment discrimination in large law firms, and noting that transgender lawyers have not been included in the largesse

ENDA: An editorial published in the Washington Blade, an important gay newspaper, suggests that the inclusion of transgender people in anti-discrimination legislation threatens gay people

Identification records: At a "Town Meeting" held on the newly released regulations under the Real ID Act, two witnesses testify about the negative effects on the transgender community, with one noting that "you don't know what it's like to get carted off the security line by a couple of burly cops" (comments at 41:00 and 1:15)

ENDA: The Concerned Women of America suggest that the federal legislation to ban employment discrimination based on gender identity and sexual orientation, the Employment Non-Discrimination Act, would be an unconstitutional infringement of employers under the First Amendment rights to freedom of speech and freedom of religion

Corporate Diversity: Micron Corp., after a shareholder resolution requiring protection of employees based on gender identity and sexual orientation, adds sexual orientation but refuses to add gender identity

And here are some other notable transgender tidbits:

The National Center for Transgender Equality and the Human Rights Campaign release a groundbreaking guide for transgender people about coming out as transgender

Identification records: Transgender passengers are having more and more passport problems because of federal rules written by people who don't understand transgender identities

A transgender police officer on the Kansas City police force came out, and things are going well for her so far

The San Francisco police commission elected a transgender woman as its president

Schools K-12: A Texas transgender high school student, suspended from school for dress code violations, is reinstated after intervention by a pro bono lawyer

Transgender experience in the job market: The Transgender Economic Empowerment Initiative, aimed at reducing chronic unemployment and underemployment in the transgender community, established in San Francisco, and a similar program in Los Angeles, the Transgender Job Placement Program

Trans culture: Executives at Frameline, San Francisco's LGBT film festival, made the unprecedented decision to yank a film, The Gendercator, from this year's schedule due to community outrage over its satirical portrayals of transsexuals in a mythical future

A transgender woman, Jenny Bailey, has been chosen mayor of Cambridge, England, as it celebrates its 800th anniversary

Kodak updates trans health benefits

Kodak has updated its health plan coverage to include health benefits specific to transgender employees. Most U.S. benefit plans contain an exclusion for any health services related to transsexuality, but qualifying transgender employees at Kodak will be able to receive benefits including psychotherapy, hormone replacement therapy, and sex reassignment surgical procedures on or after July 1, 2006, provided it is part of a medically supervised treatment.

I previously blogged about health benefits for transgender employees. This issue is of increased relevance for all companies because the Human Rights Campaign, which issues the Corporate Equality Index (CEI), a measure of corporate diversity, is reviewing health benefits for transgender employees beginning with the 2006 rankings. A company cannot get 100% on the CEI unless there is "parity in at least one transgender wellness benefit."

On another note, this blog has now had over 5,000 visitors since I started it 5 months ago. Thank you for making it successful.

Issue: Health Benefits

Although many companies have included "gender identity" as a protected category, the relationship between such a policy change and health benefits are poorly understood. Most benefit plans contain an exclusion for "transsexualism." This means that mental health counseling, hormone replacement therapies and surgical procedures will not be covered if they are associated with transsexualism. Since employers negotiate insurance benefits for their employees, the inclusion of "gender identity" as a protected category may make it appropriate to revisit this issue with the insurer. For example, Microsoft not only recently added "gender identity" to its EEO policy, but also announced increased coverage of transgender-specific health benefits.

This issue is of increased relevance for all companies because the Human Rights Campaign, which issues the Corporate Equality Index (CEI), a measure of corporate diversity, is reviewing health benefits for transgender employees for the 2006 rankings. A company cannot get 100% on the CEI unless there is "parity in at least one transgender wellness benefit."

The exclusion for "transsexualism" began appearing in insurance contracts in the 1960s, after media publicity about new treatments for transsexuality. There were generally three reasons for the blanket exclusion for transsexualism: the experimental nature of medical treatments, the lack of evidence of medical necessity, and the onerous costs. This reasoning may no longer be as persuasive. Most physicians no longer consider them experimental, there have been medical studies demonstrating medical necessity, and the cost per insured is low. This is not to say that health benefits should in every case be changed to cover any and all treatments for transgender employees, but rather that health benefits should be reviewed to determine whether the organization considers its current coverage appropriate.

Bottom line: Communication between the CDO and the benefits department may be useful, especially when there is a policy change to include "gender identity" in the EEO statement.