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A 15-minute call to Transcend Legal...

A 15-minute call to Transcend Legal could save you $10,000

A $25-billion company, GEICO is the second-largest auto insurer in the United States. It employs 38,000 people.

One of those employees is Andy, a claims adjuster who loves working with numbers and said that he’d always wanted to work in insurance. (There really is a lid for every pot.)

Andy enjoyed his job, but there was a problem. He urgently needed top surgery. He had been binding his chest since 2011, but had to stop because it caused back pain and made doing his job difficult as he could not bend to inspect cars while wearing a binder.

So he wore layers instead, including hoodies and vests, which was very hot and uncomfortable in the summer.

It all got to be too much to take. Andy contributed nearly $200/month to be covered under GEICO’s self-funded health plan. But his plan explicitly excluded “sex transformation operations,” so the insurance company denied pre-authorization for his top surgery.

That’s when he called Transcend Legal.

GEICO doesn’t appear on the Human Rights Campaign’s Corporate Equality Index because it’s a Berkshire Hathaway company and Warren Buffett doesn’t believe in taking the time to fill out surveys.

So we were unsure what kind of reception we would get when we wrote to the company urging a change in policy.

But just 10 days after we sent our letter, GEICO’s attorney called to let us know they would be removing the exclusion—effective in time for Andy to keep his surgery date.

Andy had his surgery and is enjoying the relief of finally having a male chest. And now other trans employees of GEICO can enjoy the same benefits.

And it started thanks to a short call to Transcend Legal!


Lush donates $10,000!

Lush launched a Trans Rights are Human Rights campaign

Lush launched a Trans Rights are Human Rights campaign earlier this year to increase awareness of trans issues and acceptance. The campaign included company-wide personnel training, an extensive in-store marketing effort including trans-supportive signage, and a pamphlet on how to be a trans ally.

Lush sold a special trans bath-melt with 100% of the proceeds going to trans-specific advocacy groups.

Many thanks also to the National Center for Transgender Equality for recommending us as one of the recipients.

We’re going to use the money to further develop our Trans Insurance Roadmap with more self-help resources, including templates that people can use to file appeals on their own. Stay tuned for the launch!

You too can support our life-changing work!


What’s social transition got to do with it?


We were intrigued when we were contacted by a trans woman (we’ll call her Karen) who was denied coverage for vaginoplasty simply because she was not out at work.

Karen’s insurance company required that she have 12 months of living full-time openly as a woman, including at work. Karen had been in therapy and on hormones for 19 years. She was female in her social life, but had never come out in her public-facing job; she simply wore androgynous clothes on the job.

Her therapist, Kit Rachlin, recently published an article, Medical Transition without Social Transition: Expanding Options for Privately Gendered Bodies, about trans women like Karen. Dr. Rachlin points out that society has come to be accepting of people who socially transition but don’t undergo the full range of medical treatments available to them. The same is not true for people who seek surgery to alleviate their gender dysphoria but may need only partial or no social transition.

At age 71, Karen was unsure if she wanted to disrupt her work life, but she was sure that surgery would help to alleviate her lifelong distress. Karen went ahead with the surgery, risking being on the hook for a huge bill. The surgeon did a first appeal to no avail.

That’s when Karen asked Transcend Legal for help, and we stepped in to make a second appeal.

In our letter to the insurance company, we pointed out that Karen’s providers had no reservations about her having surgery. There was no doubt about her diagnosis of gender dysphoria or that surgery would help resolve it. What’s more, we said, if the insurance company were to deny any other surgery on the basis that the member wasn’t feminine enough, it would be clear sex discrimination. The insurer would not require a female cancer survivor to dress or behave in a certain way before she could get breast reconstruction, nor would it require her to get reconstruction in order to maintain a typical female appearance. It is only in the case of transgender surgeries that the insurer imposes rigid sex stereotypes on members.

The insurance company administering the plan still insisted that coverage was improper, but the employer disagreed and approved coverage.

We will continue opening the door for people to access surgery regardless of what they choose to tell others about their gender.


Nonbinary victory—hormones not required!


In another example of insurance companies being overly invasive about what constitutes appropriate treatment for gender dysphoria, the Blue Cross Federal Employee Health Plan requires individuals to have “12 months of continuous hormone therapy appropriate to the member’s gender identity.”

August Gant, who is a is a forestry student at Texas A&M University, identifies as androgyne rather than male. They needed top surgery but did not require testosterone therapy. August’s providers agreed that surgery alone was the best treatment for them. But Blue Cross denied coverage because August had not been on hormone therapy.

In our appeal, we explained that under the WPATH Standards of Care, testosterone was not a prerequisite for male chest reassignment surgery for either trans men or nonbinary people. And even under Blue Cross’ own requirement, August met the criterion because hormone therapy appropriate to August’s gender identity was no hormone therapy.

Blue Cross agreed and reversed its denial so that August can proceed with surgery.

But Blue Cross’ federal policy still has this unfair requirement, along with other requirements that don’t match up with the Standards of Care, such as having to be 18 to undergo any surgery. The federal Blue Cross plan covers 5.6 million federal employees, retirees, and their families. And without the help of an attorney, countless numbers of people are unable to access care under the plan.

That’s why Transcend Legal is going to continue advocating with Blue Cross to get the plan language changed so that anyone can get coverage without the help of an attorney.


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