NCTE, Kaiser Permanente Host First “Community Clinician Roundtable”

This month, the National Center for Transgender Equality (NCTE) and Kaiser Permanente co-sponsored a first-ever convening of over 30 Washington, DC area physicians, therapists, lawyers and advocates to share information with each other about providing comprehensive care for transgender people. Topics included recent changes in healthcare insurance coverage, Medicare and Medicaid rules, and specific ways providers can better treat transgender clients and patients.

Lisa Mottet, Deputy Director of NCTE, offered an overview of changes in laws and policies governing insurance, Medicare, and Medicaid. Mottet’s training included provider’s obligation to sign up to take insurance, Medicare and Medicaid.

Photo: Ted Eytan

Empire State Becomes Ninth to Ban Transgender Health Exclusions

New York State today became the ninth state, in addition to the District of Columbia, to apply its existing laws to prohibit discriminatory transgender exclusions in many health insurance plans. New York joins California, Colorado, Connecticut, Illinois, Massachusetts, Oregon, Vermont, Washington State, and DC, as well as the federal Medicare program in taking action over the last two years to eliminate these arbitrary exclusions.

Today’s letter from the New York State Department of Financial Services, addressed to all insurers in the state, declares that, “An issuer of a policy that includes coverage for mental health conditions may not exclude coverage for the diagnosis and treatment of gender dysphoria.” Notably, New York relied on state and federal mental health parity laws to arrive at this conclusion, and becomes the second state (with Massachusetts) to reach this conclusion without an explicit gender identity nondiscrimination law applicable to insurance. Other states have interpreted nondiscrimination laws based on sex or gender identity, or general prohibitions on arbitrary or unfair insurance practices, ban trans exclusions.

NCTE Announces Law Fellowship and Award in Honor of Andrew Cray

By Mara Keisling, Executive Director, NCTE

Andy Cray came to work at the National Center for Transgender Equality (NCTE) as a law fellow right out of law school. Coming from one of the handful of best law schools in the country, he really could have gone anywhere, but he wanted to work for the transgender community and he wanted to do it at NCTE. An even smaller organization at the time than we are now, we were unable to pay Andy; so he even brought his own funding from his law school. Less than a year later he found a permanent, full-time position doing trans health advocacy at the Center for American Progress (CAP). We continued to work with him, for which I will always be amazed, but less than two years later, after accomplishing a body of work that any activist would be proud of, Andy passed away this August from cancer, leaving behind an improbably large group of devastated but amazed family, friends and admirers—people who really were touched deeply by Andy.

In honor of that body of work, NCTE is so proud to announce our new Andrew Cray Law Fellowships. The NCTE Board of Directors has also initiated an annual recognition called the Andrew Cray Trans Health Advocacy Award, which we will give each year at our anniversary event to an activist who significantly advances trans health.

Andrew Cray was such a significant part of the rapidly advancing transgender health movement. He was a key player in the recent success in eliminating insurance exclusions for transition-related care through state insurance commission rulings. His work to get transgender and other LGBT people enrolled in Affordable Care Act plans caused President Obama to name Andy as a Champion of Change.

We know how lucky we are to have known and worked with such a beautiful and brilliant star, and we know too we are lucky for our exposure to everyone of the law fellows who has and will pitch in over the years. So, having future law fellows be called Andrew Cray Law Fellows just felt like a match about which Andy would have been pleased and honored and a bit embarrassed.

New Federal Plans Take Modest Step On Trans Health

The National Center for Transgender Equality expresses our disappointment that virtually every Federal Employee Health Benefits (FEHB) plan has failed to update their coverage to stop excluding medically necessary healthcare for transgender federal employees. Disregarding OPM’s June 2013 invitation to insurance companies to drop discriminatory trans health exclusions, the majority of FEHB plans that were announced have retained these outdated and wrong trans health exclusions.

NCTE calls on the Office of Personnel Management (OPM) to take stronger proactive steps to end discrimination against their transgender employees and cover trans health care needs. We urge federal employees who have been denied necessary care due to an exclusion to immediately file an EEO complaint with OPM.

In June 2013, the Office of Personnel Management (OPM) provided notice to insurance companies who have Federal Employee Health Benefits (FEHB) plans that OPM will no longer require insurance carriers to have blanket exclusions on trans-related care.  Advocates, including NCTE, celebrated this change, which gave insurance companies the opportunity to modernize their health benefits ahead of open season that begins this month.

New WHO Report: Decriminalize Sex Work, Drug Use to Prevent Spread of HIV

A World Health Organization (WHO) report issued this month details guidelines to address policies on and treatment of HIV among vulnerable populations including transgender people. Notably, the report urges governments to decriminalize behaviors to more comprehensively and competently address the spread of HIV:

“Countries should work toward decriminalization of behaviours such as drug use/injecting, sex work, same-sex activity and nonconforming gender identities, and toward elimination of the unjust application of civil law and regulations against people who use/inject drugs, sex workers, men who have sex with men and transgender people​.

Improving policies that aid in HIV prevention and improve treatment requires, as the report notes, a combination of efforts. These efforts include making access to contraception, testing, and health facilities available to vulnerable populations; ending violence and stigma against vulnerable populations like transgender people and sex workers; and eliminating laws and policies that criminalize behaviors, which instill fear in these populations and deters individuals from seeking care.

NCTE Commends Introduction of Health Equity and Accountability Act

The National Center for Transgender Equality commends the Congressional Tri-Caucus, comprised of the Congressional Asian Pacific American Caucus (CAPAC), the Congressional Black Caucus (CBC), and the Congressional Hispanic Caucus (CHC) for reintroducing the Health Equity and Accountability Act (HEAA) of 2014 on Capitol Hill today. The bill’s lead sponsor is Congresswoman Lucille Roybal-Allard (CA-40), along with Congresswomen Barbara Lee (CA-13), and Donna Christiansen (VI).

The Act was first introduced in 2003 and has provided a principled, comprehensive, and strategic plan to eliminate health disparities and improve the health of communities of color. This 2014 version of the bill expands upon the original by providing more federal resources, policies, and infrastructure to eliminate health disparities, with a special emphasis on racial and ethnic minorities as well as subpopulations that face additional barriers due to gender identity and sexual orientation, immigration status, age, disability, sex, and proficiency in English.

Win: Maryland Drops Insurance Exclusions for State Employees

The National Center for Transgender Equality (NCTE) celebrates a Maryland resolution ending transgender health care exclusions for state employees. The case, brought forward by FreeState Legal, settles a complaint on behalf of Sailor Holobaugh, a transgender state employee who was denied medically necessary care. FreeState filed an Equal Employment Opportunity complaint as well as a complaint with the Maryland Commission on Civil Rights, alleging the denial of health care coverage for a transition-related procedure was discrimination on the basis of gender identity.

Today’s settlement includes reimbursement for the employee’s surgery, but also requires removal of transition-related care exclusions from all state employee health plans. The settlement also creates a new comprehensive Gender Dysphoria Benefit in state employee health plans. The benefit covers all medically necessary transition-related treatment, including hormone replacement therapy and various surgical procedures.

“We applaud Maryland and the administration of Governor O’Malley for becoming the fourth state to ensure coverage of transition-related care for state employees, joining Massachusetts, Oregon and California, along with the District of Columbia,” said National Center for Transgender Equality Executive Director Mara Keisling.  The decision follows enactment of the Fairness for all Marylanders Act earlier this year, explicitly banning discrimination on the basis of gender identity and gender expression in employment, housing, credit, and public accommodations.

Justice Dept. Calls for End of HIV Criminalization Laws

The National Center for Transgender Equality (NCTE) welcomes Monday’s announcement from the U.S. Department of Justice (DOJ) that calls upon states to eliminate or reform their antiquated HIV criminalization laws, which criminalize conduct by HIV-positive individuals that would be legal if they were not HIV-positive or did not know their status. The DOJ’s guidelines, “Best Practices Guide to Reform HIV-Specific Criminal Laws to Align with Scientifically-Supported Factors,” explain how these laws are contrary to the science of HIV today and how these laws harm individuals and public health by reinforcing HIV stigma.

Over the decades, states have enacted or used existing criminal laws and policies, in the name of public health and safety, to effectively criminalize and silence persons living with HIV/AIDS. For example, state laws have been used to prosecute persons living with HIV when they failed to inform consensual sexual partners of their status—regardless of the actual risks involved or the precautions taken. In other examples, individuals have faced serious criminal charges based on actions like spitting that have no real risk of transmitting the virus.