Some but not all corporations expanding options for transgender employees
JAMES RUSSELL | Contributing Writer
Starbucks, the Seattle-based coffee chain, last month announced expanded health insurance coverage for transgender employees.
The plan has included gender reassignment surgery since 2012. But it now also covers breast reduction or augmentation surgery, facial feminization, hair transplants and other surgeries previously deemed cosmetic but that many transgender people and allies see as crucial to transitioning.
“The approach was driven not just by the company’s desire to provide truly inclusive coverage, but also by powerful conversations with transgender partners about how those benefits would allow them to truly be who they are,” said Ron Crawford, vice president of benefits at Starbucks.
The corporation began working on the expanded coverage plan last year. They reached out last year to the World Professional Association for Transgender Health, a nonprofit devoted to transgender health.
According to a press release, Starbucks was the first corporation in the world to ask the organization to assist with a comprehensive benefits package.
“Starbucks was not afraid to ask all the right questions and demand that people get the best possible care,” said Jamison Green, immediate past president of WPATH, who lives in Washington state. “We produced a list of the most crucial benefits and those that are deemed problematic to insurance companies, such as facial feminization and electrolysis.”
According to the 2015 National Transgender Discrimination Survey, one in four respondents reported having had some form of transition-related surgery, with transgender men more likely to have had any kind of surgery than transgender women.
But the number of transgender men and women who want various surgeries, such as feminization and electrolysis, is higher than those who have had the surgery. Among transgender women, hair removal or electrolysis was both the most commonly reported and the most commonly desired procedure; 48 percent have had hair removal or electrolysis, and 14 percent had received voice therapy. Another 47 percent want electrolysis and 48 percent want voice therapy.
Some 41 percent of respondents attempted suicide at some point. Familial rejection, misunderstanding and discrimination all attributed to the high rate. But so did lack of access to care.
In Texas, transgender adults face numerous barriers. At work, only 43 percent of the respondents had employer-based health insurance, while 19 percent postponed necessary medical care when they were sick or injured due to discrimination.
“It’s a huge lifting of a burden when you are a trans person and you need to have certain treatments in order to actually stay alive, to realize that you are not going to face horrendous obstacles,” said Green. “It’s like an asthmatic being able to breath.”
According to the 2018 Human Rights Campaign Foundation’s Corporate Equality Index, 79 percent of responding businesses offered at least one plan option including short-term leave, counseling by a mental health professional, hormone therapy, medical visits to monitor hormone therapy and surgical procedures.
But many employers still exclude procedures they consider cosmetic. Or, if they do cover it, insurance may still deny the procedures, said Vartan Mardirossian, a Florida plastic surgeon who has worked with transgender clients since 2007.
“Large companies may cover the procedures, but that does not ensure the insurance company covers it,” he said. “There are still so many instances where someone could be denied.”
An employer may cover the procedure, he said, “But the real question is, how well?”
A recent court ruling in Switzerland, however, may make insurers reconsider their denial. Just last week, the court ruled Lynn Bertholet’s insurance must pay for her facial feminization surgery, according to Swiss news station RTS, Groupe Mutuel refused to cover the cost of the facial surgery, arguing that it “must be considered an aesthetic improvement.”
The insurer has no plans to appeal the ruling.
