Publicly Financed Sex Change

Chicago taxpayers who aren’t in favor of sex change operations will be paying for them anyway: The city this week buckled to allegations of discrimination and became the largest U.S. metropolitan area to cover sex-change operations for employees and their dependents.

Mayor Rahm Emanuel announced that the city would remove an exclusion on gender-reassignment services for all non-union employees and is negotiating with union members to offer the same benefit.

The new policy, if approved by the Chicago Benefits Committee on Aug. 11, will go into effect Oct. 1.

Male-to-female and female-to-male surgical procedures will become standard under the Chicago’s health insurance plan. The city is working out final criteria that employees or their dependents must meet in order to receive coverage.

“Chicago is known for being a city that is welcoming to all and inclusive of every resident, and this new policy is in line with our efforts to support the rights and well-being of transgender individuals,” Mayor Emanuel said in a statement. “With this change, Chicago will ensure that transgender city employees are able to receive the medical care that they need.”

The policy change drew a rebuke from the Family Research Council.

“We would certainly oppose that as a matter of policy,” the Washington-based group’s senior fellow for policy studies, Peter Sprigg, told LifeZette. “A person’s biological sex is immutable … We think that this concept is misguided from the start.”

Sprigg said gender-reassignment surgery is an elective, cosmetic procedure, not a medical necessity.

“It should not be covered by insurance any more than a facelift,” he said.

Emanuel acted in Chicago weeks after the American Civil Liberties Union of Illinois sent the city a letter on behalf of a transgender employee, complaining that the city’s policy was discriminatory.

Emanuel acted in Chicago weeks after the American Civil Liberties Union of Illinois sent the city a letter on behalf of a transgender employee, complaining that the city’s policy was discriminatory.

John Knight, director of the organization’s LGBT and AIDS Project, said Chicago acted quickly.

“We told them what they were doing was illegal,” he said, citing an Illinois statute. “We’re lucky to live in a state that offers these protections.”

Insurance coverage for sex-change operations is becoming increasingly common in both the private and public sectors. According to the Human Rights Campaign’s Corporate Equality Index, 418 of the Fortune 1,000 companies offer transgender-inclusive health care coverage.

A 2013 report by the University of California at Los Angeles’ Williams Institute found that 12 cities and counties offered transgender health services. But Jody A. Herman, a Williams Institute scholar who prepared the report, told LifeZette that the number has grown since then.

She also wrote in an email that Illinois and nine other states prohibit private insurance plans regulated by the states from excluding “transition-related health care.” A handful of states also pay for those services in their Medicaid programs for low-income residents. Those exclusions have been removed from Medicare, and beginning in 2016, they won’t apply to the health insurance plans that cover federal workers.

It is unclear how much the change in Chicago will cost. Mayoral spokeswoman Shannon Breymaier said in a email to LifeZette that the city’s health care costs are budgeted as a whole and not broken down by service.

Each individual will have a lifetime cap on gender-reassignment services of $100,000, and city officials do not expect the the change to affect premiums.

Each individual will have a lifetime cap on gender-reassignment services of $100,000, and city officials do not expect the the change to affect premiums.

Knight, the ACLU lawyer, said his organization used data from California’s Medicaid program — which covers the services —to estimate that a couple dozen Chicago employees might be affected.

“Economically, it’s a no-brainer,” he said.

Sex-change operations are quite pricey. The surgery itself can cost $40,000 to $50,000, and patients also require pre-surgery counseling and ongoing hormone therapy. Facial reconstruction to make features more masculine or feminine can cost thousands of dollars more.

Sprigg, of the Family Research Council, said the overall cost likely will be low since a minuscule number of people want such procedures.

“Nonetheless, I think citizens have good reason to resent this,” he said.

Knight said every Illinois county and city should be offering sex-change operations to employees. But he said that probably is not the case.

“There’s a lot of work to do to persuade and convince people to do the right thing,” he said.

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