By Dr. Russell B. Toomey, Associate Professor, The University of Arizona
January 24, 2019
I’m a professor of family studies and human development at the University of Arizona, and I have dedicated my career to studying how discrimination impacts LGBTQ adolescents. I’m also transgender, and I know from experience that growing up is different — and still much more difficult — for LGBTQ youth. So it came as a disappointment when I learned that the state university where I work does not cover transition-related healthcare for its employees or their dependents.
On Wednesday, I filed a class-action lawsuit against the state of Arizona and the Arizona Board of Regents, which oversees the state’s universities, to rectify the damage done to transgender state employees, like me, and dependents. The fact that the state of Arizona’s health insurance coverage categorically excludes transition-related surgery is a violation of federal civil rights laws and the U.S. Constitution.
Arizona provides the same discriminatory health plan to nearly all state employees and their dependents. That means hundreds, if not thousands, of transgender state employees or transgender dependents of state employees cannot receive medically necessary care recommended by their doctors, such as a mastectomy or a hysterectomy. This is true even though that same care would be covered for cisgender people, individuals who identify with the sex they were assigned at birth.
I know of at least 20 families affiliated with the University of Arizona that are harmed by the state’s anti-trans health insurance policy. Without a doubt, there are many more across the state. I filed this lawsuit not only for me but also for all of the transgender and nonbinary youth and adults in Arizona whose lives would be made better by knowing that there is one less law that discriminatorily targets them.
Research shows that when adolescents are able to live authentically and begin gender-affirming treatment that is appropriate for them, they look just like their cisgender peers in terms of their mental health. The problem is, there are too many roadblocks to authenticity for transgender people. Hostile family members, discrimination in the community, and unfair government policies, like the one I’m fighting, are just a few of the factors that stop transgender people from being themselves.
A study I recently published in the journal Pediatrics confirmed that transgender teens have a much higher suicide risk than their cisgender peers. My co-authors and I discovered that half of transmasculine adolescents have attempted suicide at least once before they turn 20. The same is true for more than 40 percent of nonbinary adolescents and nearly 30 percent of transfeminine adolescents. For cisgender adolescents, the rates are much lower: under 20 percent, regardless of gender.
I was in my early 20s when I began my gender transition. In 2004, I had a double mastectomy that cost me $8,000 out of pocket. I was just out of college, and my father-in-law had to co-sign a loan so that I could afford the procedure. I am fortunate that my family supports me and that we were able to take on that debt, but many people are not that lucky. There are a lot of people across Arizona who cannot access the health care they need unless it is covered by insurance.
That’s the situation I’m in now. My wife, Danielle, and I have two young children and are taking care of an aging parent. It’s not financially feasible for us to pay out of pocket for the procedure my doctor recommends, a hysterectomy. So, until Arizona’s discriminatory health plan is improved, I will be forced to live with aspects of my body that do not align with my identity and cause me significant anxiety.
A recent court ruling in Wisconsin held that denying state employees health insurance for gender-affirming medical care violates the Constitution and federal law. I hope for a similar result in Arizona. It will improve not only my life but the lives of many other Arizonans.
Transition-related surgery can be life-saving. No one should be denied medically necessary care because of who they are. Denying this care is not only wrong, but it is also against the law. The state of Arizona has a constitutional and moral duty to change its healthcare coverage to include transition-related health care.