By the time “Joanne” entered kindergarten she felt trapped in the wrong body, and she didn’t know what to do about it.
She felt suicidal. And her despair and anxiety at such a tender age alarmed and bewildered her parents and the pediatric psychiatrist helping them navigate the crisis.
Ultimately, Joanne’s first step to reconcile the stressful mismatch called “gender dysphoria” between a boy’s orientation inside a girl’s body or vice versa began when Joanne renamed himself “Joe.”
We got to know this boy when he joined the church youth group my husband and I led for middle school students about 20 years ago. Then, Joe took hormone therapy to suppress secondary sex characteristics associated with girls and showed up in Converse Chuck Taylor high tops, a backwards baseball cap, jeans, and a faded t-shirt.
More importantly, his swagger and sense of humor told us he had become comfortable in his skin, though even well-adjusted transgendered people walk daily through minefields with tenuous social acceptance and limited appropriate healthcare access.
But on Tuesday, the LGTBQ+ community — one at greater risk for depression, anxiety, suicide, and substance abuse — got validation and support when Colordao Gov. Jared Polis announced the state as first in the nation to mandate “gender-affirming care” coverage in state-supervised health insurance plans funded jointly with the federal Centers for Medicare & Medicaid Services (CMS), effective Jan. 1, 2023.
These health insurance plans under the Affordable Care Act cover roughly 25 percent of Colorado residents. The new mandated coverage will cost each of those customers just 64 cents extra per month, Colorado Insurance Commissioner Mike Conway said.
Services include mental health support; jaw, cheek, and eye modification; face tightening; facial bone remodel for facial feminization; breast/chest reconstruction and reductions; and even hair removal through laser treatment, according to CMS.
The mandate, which also expands mental health wellness exams and more drug formularies for opioid pain management alternatives, does not affect large group employers or the self-insured — only state supervised health insurance plans for individuals and small groups (employers with fewer than 100 employees).
Since only 0.6 percent of the U.S. adult population identified as transgender in a Gallup poll conducted as recently as February 2021, I am reflecting on two points in the wake of the gender-affirming care news: 1) Almost everyone enjoys tremendous harmony between their gender orientation and their anatomy, which is humbling; 2) many of us may not know a single person wrestling with this issue, which is our loss.
Still, the mandate put Colorado in step with the gender-affirming care standard supported by the American Medical Association, the American Academy of Family Physicians, and the American Psychiatric Association.
Those endorsements explain in part why Children’s Hospital Colorado in Aurora now offers a comprehensive care center for young gender diverse people, and why our state’s largest healthcare provider offers adults a similar menu of multidisciplinary integrated gender-affirming care through the UCHealth Integrated Transgender Program at Anschutz Medical Campus, also in Aurora.
The tagline on the program’s website reads: “Transgender care — top-notch medicine with a big dose of kindness.”
Thankfully, kindness comes in so many doses from all sorts of people.
Yet, when we met Joe and his family in the early 2000s, journeys like theirs even then in Boulder County were so closeted that Oprah Winfrey invited them to share on her show how Joe survived suicidal thoughts at age 5 and got comfortable in his skin before adolescence.
That transformation came from kindness shown in many sectors of his life, including from us — his church family at the time.
Our small church in Boulder built a family restroom off the fellowship hall for this boy as a safe space away from the suspicion, stigma, and abuse that people who identify as transgender can face in public restrooms.
Remember how Target stores in spring 2016 weathered nationwide boycotts for officially welcoming transgender guests to use the restroom or fitting room that corresponded with their gender identity?
Instead of giving this sliver of the population the benefit of the doubt, a Mississippi-based religious non-profit organization circulated an online petition that targeted Target’s policy as a “danger to wives and daughters.”
Colorado’s new gender-affirming care mandate could stoke culture wars already sparking elsewhere.
In June, the Department of Justice ruled that by banning gender-affirming treatments and restricting transgender athletes Arkansas and West Virginia, respectively, those states violated the “equal protection” clause in the 14th Amendment — an amendment ratified in 1868 during the tumultuous Reconstruction era.
On the other hand, the state’s leadership around gender-affirming care coverage could inspire other states to do right by folks like Joe and others hoping to transition and get on with their lives.
“States can be incredibly interested in what other states do,” Chiquita Brooks-LaSure, the CMS administrator at the Polis press conference, said.
Pam Mellskog can be reached at p.mellskog@gmail.com or 303-746-0942. For more stories and photos, please visit https://www.timescall.com/tag/mommy-musings/.
