DiversityInc - February 2010

BOOK EXCERPT

TRANSGENDER EXPLAINED

or municipalities that have transgender nondiscrimination protections in place. Finally, women’s groups and those focused on eliminating sexual assault reject the idea that transgender people present any heightened risk to the safety of women and children. They decry the specious characterization of transgender people as predators as diverting attention from the real issues of concern around women’s and children’s safety.

Regardless of how you present, you may face discrimination just because administrators or employees know you are transgender. GLAD has successfully challenged a situation in which a transgender middle-school student was disciplined for wearing gender-appro-priate clothing, and another in which a loan applicant was told to go home and come back dressed in clothing that matched the gender on her ID.

Discrimination pops up in all kinds of places, including your tax return. Since you must have the authorization of mental health professionals to have sex-reassignment surgery, and because you must pay the full cost of the surgery given that it is generally not covered by insurance, Rhiannon O’Donnabhain deducted the costs of her sex-reassignment surgery on her 2001 return, believing they surely qualify as medically necessary. Upon audit, the IRS denied her deduction, deeming it cosmetic. GLAD went to trial in U.S. Tax Court in 2007 on her behalf and won the case. Sex reassignment surgeries now qualify as deductible medical expenses, decided in O’Donnabhain v. Commissioner of Internal Revenue. I

Scoring 100 percent each year on the Human Rights Campaign Corporate Equality Index (CEI) is rapidly becoming essential for major employers. In 2006, HRC raised the bar to require transgender parity in at least one of five wellness benefits, and the results were exciting. Of the 446 companies in the survey, 303 offered at least one of the specified benefits for their transgender employees, and a staggering 67 offered all five. More impressively, 28 percent of the employers provided health benefits for trans-related surgical procedures.

The percentage of employers whose Equal Employment Opportunity policy includes gender identity or expression has grown impressively from 5 percent in 2002 to 66 percent in 2009. Yet HRC looked more carefully in 2009 at the responses concerning transgender benefits and found, sadly, that only 12 percent of employers surveyed actually provide benefits for transgender surgical procedures. Because the CEI requires employers to offer only one of its five specified transgender health benefits in order to satisfy the criteria—and because the American Psychiatric Association’s manual “Diagnostic and Statistical Manual of Mental Disorders” diagnoses unfairly favor reparative therapy over transition—employers overwhelmingly choose to offer only mental health benefi ts.

HRC has responded in a big way. It has announced that the 2012 CEI will require that at least one insurance option available to all employees is a contract where:

; Transgender exclusions are removed or substantially modified to ensure coverage for transgender-specific treatment either directly in the contract or in clinical guidelines referenced by the contract

; The WPATH Standards of Care are used to determine what treat-
ment will be considered medically necessary and not cosmetic
HRC says that some companies are surprised to find that their health-
insurance coverage excludes gender-identity-related treatments. The
language is often in the master policy because it is the standard offering
from the insurance company. Once employers learn this, HRC says
it is often only a matter of demanding that their insurers remove the
exclusion.

ABOUT THE AUTHOR After almost half a century living as a male, Joanne Herman transitioned in 2002 to live as a female in order to resolve a gender incongruity she had felt for as long as she remembers. She has since been an active spokeswoman for transgender awareness and understanding. Joanne is one of the first openly transgender alumnae of Dartmouth College, and a graduate of the last all-male class. Dartmouth’s president awarded her a Class of 1975 diploma in her new name in 2006. In 1975, when her name was Jeff, Joanne married Barbara Wermeyer. After Joanne underwent sex-reassignment surgery in 2003, Barbara helped Joanne get established in her new life, while Joanne helped Barbara battle a rare form of cancer known as carcinoid. She was widowed from Barbara in 2006 after 30 years of marriage. Joanne is currently financial controller at New England Foundation for the Arts and lives in Boston with her fiancée.