Add Your Voice to End Trans Exclusions in Dane County Health Care Coverage

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Ending Trans Exclusions in Dane County Health Care Coverage

From: Dane County Trans Health Group
August 28th, 2015

Transgender* people face major barriers to proper health care in Dane County. Estimates suggest that 0.3% of the population is transgender, and many will seek some form of medical care for gender transition, such as hormone therapy or gender confirming surgery. This care is essential to our health and well-being, and insurance coverage for it has been proven not to increase overall costs or premiums. Yet nearly all of Dane County’s local insurance providers have “trans exclusion” policies, denying transgender patients otherwise standard medical care if the person is using it for gender transition. For example, a cisgender (non-transgender) woman can get hormone medication during menopause, but a transgender woman needing this medication for transition will be denied, specifically because she is transgender.

“Trans exclusion” policies are discriminatory by definition, even though gender identity is a protected class in Dane County and the City of Madison. Transgender people already face disproportionately higher rates of discrimination, assault, suicide attempts, HIV infection, and other health and safety issues. Being denied transition care only exacerbates this problem. Without it, we are even more vulnerable to discrimination, face a dangerous decline in our mental health, and may resort to unsafe substitutions for proper transition care. This discrimination has a serious negative impact on our life chances. We need health care justice now.

Dane County can help change this situation, and has a duty to take action. In addition to being a public health and safety issue, this is also a pressing matter of equity. In solving it, Dane County will join the first wave of states, federal programs, and local municipalities that are ruling in favor of trans-inclusive health care policies. Currently, local insurance providers do not even offer plans that include transition care. As a major employer, Dane County can directly change the market by asking insurance companies to create plans that do. Numerous studies show that this is highly cost-effective, with minimal charges to employers. The need for transition care within a given population is fairly low (though critical for those who need it) and so is the cost of transition care, relative to more common medical needs. Employers who cover transition care have had so small an increase in extra costs that their premiums didn’t change at all.

Our ultimate goal is universal health care for all people. Dane County can and should lead the way closer to this goal, by addressing one of the most obvious forms of health care discrimination: Trans-exclusion policies in health insurance plans.

We are asking that the County contract for an insurance plan that removes exclusions and covers “gender-confirming” surgery (also called “sexual reassignment” surgery), hormone therapy, and all other trans health needs.

*Transgender is an umbrella term for people who do not identify with the gender they were assigned at birth.


Gabe Javier, Director UW Madison LGBT Campus Center
Anders Zanichkowsky, community advocate
Z! Haukeness, community advocate
Nyle Biondi, LMFT
Alex Hanna, PhD candidate, UW Madison Sociology Department