Trans woman wins disability coverage for facial feminization surgery |
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Seattle Gay News
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posted Friday, November 18, 2011 - Volume 39 Issue 46 Trans woman wins disability coverage for facial feminization surgeryby Mike Andrew - SGN Staff Writer The Transgender Legal Defense & Education Fund (TLDEF) announced on November 16 that it has settled a claim on behalf of a Transgender woman who had been denied short-term disability benefits for facial feminization surgery. Lina Kok, a 47 year-old North Carolina woman, had the surgery in November 2010 as part of her transition. 'My doctor and I both believed that this surgery was absolutely medically necessary for my well-being,' Kok said. 'Since adolescence, I struggled with seeing my face become more and more male. Now the outside matches, which makes me feel whole. For the first time in 47 years, I feel like the world sees me as the woman I am.' Kok submitted a short-term disability claim to Prudential, the company that administers her health insurance plan. Her policy provides pay continuation for employees who are temporarily disabled due to medical treatment. Kok's surgery had an anticipated three-week recovery period during which she would be unable to work, and she sought benefits to reimburse her for lost income consistent with the policy's terms. Prudential denied her claim, arguing that reconstructive facial feminization surgery was a cosmetic procedure that was not medically necessary. The company also rejected Kok's two subsequent appeals. After TLDEF intervened in the case, Prudential finally approved Kok's claim on September 30. In its settlement with Prudential, TLDEF pointed out that the World Professional Association for Transgender Health acknowledges facial plastic reconstruction and other sex reassignment procedures are 'medically necessary' to treat gender dysphoria, also known as gender identity disorder. 'Transgender-related health care is medically necessary care, and it should be treated that way in all respects,' said TLDEF staff attorney Noah Lewis. 'No one should be denied benefits based on the incorrect view that Transgender-related health care is optional or cosmetic. Transgender employees simply want the same benefits as any other employee.' The U.S. Tax Court upheld this standard in 2010 when it ruled that Trans-specific surgery is tax deductible. The legal principle that sex reassignment surgery (SRS) is medically necessary is based on precedents going back many years. The California Court of Appeals ruled in 1978 that the state's Medicaid program must cover SRS because it cannot be seen as a cosmetic procedure. The Minnesota Supreme Court in 1977 struck down state Medicaid's blanket exclusion for sex reassignment surgery, but state lawmakers subsequently passed a law in 2005 that barred SRS coverage. State Medicaid still covers therapy and hormones. The Eighth U.S. Circuit Court of Appeals struck down Iowa's blanket exclusion for sex reassignment surgery in 1980. State lawmakers subsequently passed another regulation that excludes SRS, but covers hormones. A New Jersey judge ruled in 1992 that the state's Medicaid program must cover the procedure. In 2006, Lambda Legal and the American Civil Liberties Union filed a federal lawsuit on behalf of three incarcerated Trans women who challenged Wisconsin's law that barred access to hormone therapy, sex reassignment surgery, and other Trans-specific procedures while in custody. In August, the Seventh U.S. Circuit Court of Appeals in Chicago upheld a lower court's ruling that the Wisconsin law was unconstitutional. |
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