Transcend Legal Logo

Transcend Legal delivers again!

Tayo Michiko

Like any aspiring actor, Tayo Michiko has a day job to pay the rent and provide health insurance. But when Tayo is not auditioning, he’s not waiting tables—he’s delivering mail for the United States Postal Service.

USPS career employees are covered under the Federal Employee Health Benefits program. That plan banned trans exclusions in 2016. Problem is, Tayo is among the 20% of the USPS workforce who are non-career employees. They’re covered under a self-funded plan administered by USPS.

Tayo was excited to finally get top surgery. But when his surgeon applied for preauthorization, the plan denied coverage, citing an exclusion for “sex transformation operations.”

That’s when Tayo sought help from Jordan Aiken at Bet Tzedek Legal Services in Los Angeles. Jordan told us about the case, and we decided to join forces.

We sent a letter—yes, via USPS Certified Mail—to USPS’s General Counsel, and we patiently kept following up.

We sent word of the Tovar v. Essentia Health decision finding that Section 1557 of the Affordable Care Act prohibits transgender discrimination. We sent news of the $780,000 jury verdict in the case over a trans exclusion in the Wisconsin state employee plan.

Our message was clear: covering trans-related treatment is the right thing to do, but it’s also the law, and it’ll cost you to disobey the law.

Our tenacity paid off.

Seven weeks later, USPS let us know that they would be removing the exclusion, effective January 1, 2019. Now Tayo and the 130,000 other people covered under the plan will have equal coverage for health needs that happen to be trans-related.

When we Told Tayo the news, he said he was on cloud nine. It’s hard to deliver mail all day while wearing a chest binder. He’s also been held back from doing things he loves such as hiking, dancing, and performing in martial arts, where he was asked to train with women and stopped training because of that.

Now Tayo is on the road to surgery, and after that, hopefully soon to a theater near you!


Victory with Teamsters' health plan!

Blake McNeill and wife

Blake McNeill has been driving for UPS for 31 years, but it’s only for the last four years that he has been out as Blake. He was initially drawn to the job at UPS because of the union and the fact that employees were treated equally regardless of gender.

So he was disappointed that the otherwise excellent health plan he had through the Teamsters union contained an exclusion for “gender reassignment surgery.” Three years ago, Blake paid out of pocket for his top surgery, but paying for phalloplasty was another matter.

In addition to the discomfort that Blake experienced from gender dysphoria, there were practical considerations as well. Because truck driving is a male-dominated field, many of the rest stops and facilities Blake uses in the course of his work have only one stall, which is usually occupied. He also enjoys camping and riding motorcycles with his nephew, but is uncomfortable using the campsite showers and bathrooms as the stalls often do not have doors—forcing him to shower while everyone else is asleep.

Blake’s wife found our website when doing research about insurance coverage. Our first step was to help Blake apply for preauthorization.

We submitted the request and, just as we expected, it was denied. It said, “This decision is not based on the medical necessity of clinical appropriateness of these service(s).”

We wrote to the Teamsters’ northern New England health fund, Allegiant Care, and explained why having the exclusion was unlawful. In its response, Allegiant Care said they didn’t think they were doing anything wrong.

Nevertheless, they agreed to remove the exclusion.

This is great news not only for Blake, but also the other 10,000 members and their families—a total of 25,000 individuals covered under the plan! We also hope that it encourages other unions to remove exclusions in their health plans.


Folsom Street East donates $10,000!

Folsom Street East donates $10,000!

Folsom Street East chose Transcend Legal as one of the beneficiaries of its 2018 annual street festival, which celebrates pride in fetish, kink, and LGBTQ communities through the creation of safe spaces for public expression of these sexual identities.

Folsom Street East​ recently presented Transcend Legal with a check for $10,000! We are grateful for the opportunity to serve more people due to the generosity of Folsom Street volunteers and attendees.


Fighting for fairness in North Carolina

Transgender advocates outside the North Carolina State Health Plan Board of Trustees meeting

When Transcend Legal was founded two years ago, one of the very first people to contact us was a North Carolina state employee who sought our help after learning that the State Health Plan would not cover surgery for her 18-year-old son.

We organized testimony for the December 2016 board meeting, and in order to comply with the Affordable Care Act’s nondiscrimination provisions, the trustees voted to remove the exclusion—but only for the 2017 plan year.

Along with Equality North Carolina, we again arranged more testimony in 2017, but the Board did not take up the issue, and the exclusion was put back into effect for the 2018 plan year.

This meant that many people who had appointments scheduled for early 2018 were suddenly cut off from receiving coverage for hormones or surgery. Over the past two years, we have heard from over 20 people who’ve been affected by this exclusion, and there are many more who are too afraid to pursue legal action.

Last month Noah Lewis traveled to Raleigh, North Carolina to testify alongside affected members at a Board of Trustees meeting for the North Carolina State Health Plan for Teachers and State Employees. The members delivered powerful testimony about their need for health care for themselves or their transgender dependents, but the Board did not publicly vote on the issue.

Following the meeting, one Board member came out in support of removing the exclusion.

We had previously written to the Board, but it declined to remove the exclusion.

So along with the North Carolina law firm of Patterson Harkavy LLP, which specializes in civil rights and workers’ rights, we’ve now filed charges of discrimination with the federal Equal Employment Opportunity Commission (EEOC) on behalf of three employees.

The State Treasurer, who is in charge of the plan, stated that he would remove the exclusion only if the legislature or a court forced him to.

The Board meets again on December 10 and has one last opportunity to do the right thing for the 720,000 plan members for the 2019 plan year. If not, Transcend Legal will have to take the Treasurer upon his offer.


Support us on #GivingTuesday

Giving Tuesday

Today is #GivingTuesday, a global day of giving. Following Thanksgiving, Black Friday and Cyber Monday, #GivingTuesday kicks off the charitable season, when many focus on their holiday and end-of-year giving.

While the Trump-Pence administration continues to try to rollback protections for transgender people, Transcend Legal keeps working on the ground to ensure that transgender people have health care equality today.

Give now!


Upcoming Events

  • National Trans Bar Association Nationwide Launch Celebration Dec. 6, 7 p.m. - 10 p.m.
  • Transgender Legal Services and Medical-Legal Partnerships Webinar, Dec. 10, 1 p.m. Noah Lewis presents in conjunction with the National LGBT Health Education Center.
  • Transgender Health Symposium, Medical College of Wisconsin, March 18. Noah Lewis will give the keynote address, Protecting the Rights of Transgender Patients.