KPCC Radio is reporting on the case of Josef Robinson, a registered nurse at a Dignity Health Facility in Arizona who sued his employer after finding out that the hospital would not cover her transition-related treatment under the employee health insurance plan, a plan which excludes coverage for sex transformation surgery.
"I work for a hospital who treats all kinds of people – doesn't matter race, religion, whatever – yet they have an insurance policy that has an exclusion for transgender individuals," Robinson said. "It just doesn't add up for me."
It makes perfect sense to Dignity Health, however. This is a Catholic facility that follows the Ethical and Religious Directives for Catholic Health Care Services which was written by the U.S. Conference of Catholic Bishops and is in accordance with Church teaching. These directives forbid abortion, artificial insemination and assisted suicide.
Although the Directives do not directly forbid transition surgeries, the Bishops consider such procedures to be “detrimental to patients.”
"Such interventions are not properly viewed as health care because they do not cure or prevent disease or illness," the Bishops said in comments submitted to the federal government. "Rather they reject a person's nature at birth as male or female. Surgical alterations of the genitalia, in particular, mutilates the body by taking a perfectly healthy bodily system and rendering it dysfunctional."
Robinson opted to sue the hospital, alleging that its refusal to cover transition-related care qualifies as sex discrimination under Title VII of the Civil Rights Act of 1964 and the Affordable Care Act.
Title VII forbids discrimination on the basis of sex and the Affordable Care Act prohibits discrimination based on sex in health insurance and health care. In addition, a new regulation finalized by the Department of Health and Human Services declares any exclusions in health care coverage related to gender transition to be discriminatory.
However, the hospital claims that Title VII doesn’t address transgender people and says the Affordable Care Act’s rules regarding gender transition were not in place when Robinson first sought coverage for this treatments.
In the meantime, Robinson paid for her own double mastectomy.
"I lived my whole life not being in the right body," she said. "At that point I was 50 and I thought, 'That's long enough to be living the way I've been living.'"
She is now hoping to get coverage for one more major operation, a phalloplasty, which is the construction of a male penis, which could cost about $100,000, and is delaying this procedure with the hope that the courts will force the hospital to pay for it.
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