Thinking about health benefits

I sit here tonight considering the health benefits that may or may not be covered by my employers health plans, and, namely, the plan I selected when I first joined the company. While I am not in a position to name my company, I will say that my employer has scored a 100 on, it pains me to say it, HRC’s (ok I said it, I promise not to say it again in this post) equality index. The score card says that both hormones and office visits are covered. Well, I have already paid out of pocket for both hormones and office visits.

Armed with this new information, I now am beginning the process of getting some of my money back. The hormones are easy. The prescription drug coverage has a great tool that uses my information, including the fact that I biologically male, to estimate what I should have paid. I can now mail in a claims for to get the difference reimbursed. I got covered right away from my sprio, but my estradiol came from a mail order pharmacy that did not ask for my insurance information. I think some people are just used to our medications not being covered that they simply don’t ask. 

My next step is going to be tackling the topic of office visits. I do not know for sure if my particular plan covers office visits for transgender treatment. My doctor seems vary wary of submitting claims for transgender treatment, I think she was burned by an insurance company in the past. I don’t know it for sure, but I get that feeling. So, I would have to call my insurance company or my health benefits administrator and ask if it is covered and possibly even ask what codes need to be used by my doctor. I would much rather pay a $20 copay than a $90 out of pocket! I don’t know why I have some issues making this call. I guess it is because I have yet to discuss my trans status with anyone but my spouse and sister-in-law and other people in the transgender community. I guess I don’t want to risk hearing a silence after I ask,”So I wanted to see if office visits are covered for treatment related to being transgender.” While we hope that people will be professional and courteous, we never know for sure until we are in the situation. This would also be the first time that I indicated my status to someone that I did not know.

On a related front I began the process of reaching out to my companies GLBT employee group. I did it somewhat anonymously at this time, using my non-work e-mail address and my chosen name instead of my birth name. I have heard a figure that my company estimates there being about 300 employees who identify as trans. My hope is to get in touch with some of those employees, and learn from their transition experiences at the company. We are pretty well spread out, so there may be some social and geographical differences in their transition experiences, but have a strong policy around transition probably helped those who have transitioned at the company. For all the resources that seem to be out there, most seem to address people who are transitioning at companies with no formal policies. As we see more and more companies implementing policies protecting transitioning employees, I think we need to realize that even employees in companies with policies need some guidance and support. I admit that I an quite nervous about coming out to HR and starting the workplace transition process. I want to find the right time to start planning, but I am not sure how early is too early, or how long I should wait. There are other factors that play into it, such as growing out my hair in a profession that embraces professional appearance. I have a lot more to ponder on that. 

With all that is going on around ENDA, I do feel fortunate to be working for a company that supports its transgender employees. The more I look at my own companies policies, the more I think about those who do not have such protections. Ethan St. Pierre mentioned in his most recent podcast about a woman who was fired from a fast food restaurant the day after her manager realized that she was not protected under federal law. As long as we have people and companies like that, we need to continue fighting for protections. We also need to realize that even when we do have protection, there will still be people who will try and fire us because we are transgender. They will use the old excuses of work performance, misconduct, or other violations of company policy, but their reasons will be the same, it will be because we are transgender. Our fight will not end with the passage of legislation, we will simply need to change our focus from educating our legislators to educating employers and employees.

Thoughts on Independence Day

I sit here on July 4th, Independence Day, contemplating the significance of the day, and how my independence and my rights fit into the struggle of our countries founders to gain independence and broader rights. This year has been filled with many significant events. We continue to battle for an inclusive ENDA all the while the fight at state and local levels continues as well. I think we have probably seen that in many instances, gaining rights on the local level is often easier than gaining them on the Federal level. Colorado passed legislation protecting rights based on gender identity, despite some pretty offensive ads that were aired. I believe that it is these local victories that will pave the way for broader victories in the future. 

The LGBTQ community scored a major victory this year with the court ruling in California which extended the right to marry to all people, regardless of sex. We now have two states out of fifty that allow marriage equality. Two down, 48 to go. It may seem like a lot of work ahead, and it is, but I think one only needs to look at the increasing pace at which legislation is being passed to protect people on the basis of gender identity on the state and local levels. 

IN 1975, Minneapolis passed the first even legislation that protected the transgender community. This was unheard of at the time. During that decade, two other municipalities took similar action, Los Angeles, CA and Urbana, IL. I never heard of Urbana, IL, yet they were way ahead of the rest of the country in their crafting of legislation in the 1970’s. We saw things slow down for a while, with only two similar laws being enacted in the 1980’s, and the 90’s got off to a slow start with only 5 such laws being enacted during the fist half of the decade. 

On July 4th, 1996, In Houston, TX, not exactly the most LGBT friendly state(I do live in Texas by the way and have found acceptance when I live), the International Bill of Gender Rights was adopted at the 6th and final conference of the International Conference on Transgender Law and Employment Policy(ICTLEP). In the years that followed, we saw and dramatic increase in the number of states and municipalities passing gender identity protections. The following two years saw the passage of more legislation than the previous two decades. Since the year 2000 ,we have seen over approximately 80 such laws or ordinances being passed. Talk about acceleration.

As we have gained rights, congress has finally taken notice. ENDA was initially set to go before congress with protections for gender identity, we all know what happened there, thanks in no small part to our friends at HRC. The ensuing uproar over the issue has had a ripple affect. People throughout the LGBTQ community have stood up and said that they are not going to leave us behind. Lesbian, Gay, and Bi allies are showing their support through actions such as boycotting HRC events, and organization that was founded to support the rights of the LGB community, and probably had a significant impact on the rights that they now enjoy. But, the outrage has been so strong, that they are willing to turn their back on this organization, and stand next to us as we fight to be included in employment non-discrimination legislation.

We have had the first ever hearing on transgender issues and employment discrimination before a house subcommittee. I think most of us thought that day would be years or decades away after the ENDA events. But, our voices have been heard. We are gaining recognition. We may be a small community, but we are a vocal community, we are a community with allies and support, and we are a community that will not rest until we have equal rights. We are not asking for special rights. We are only asking for the rights that every cisgender American has, the rights to job, housing, education, health care, insurance, and the right to the American dream. 

Below I have included the text of the text of the International Bill of Gender Rights. I think that the rights enumerated in the IBGR will one day be ours. It may not be today, or tomorrow, but if we continue to educate and enlighten, and we continue to fight, we can attain the rights the we should not have had to give up when we chose transition over death. No other Americans have to give up rights when they choose life over death, why should we?

 

The International Bill of Gender Rights.

(As adopted June 17, 1995 Houston, Texas, USA)

“The International Bill of Gender Rights (IBGR) strives to express human and civil rights from a gender perspective. However, the ten rights enunciated below are not to be viewed as special rights applicable to a particular interest group. Nor are these rights limited in application to persons for whom gender identity and gender role issues are of paramount concern. All ten sections of the IBGR are universal rights which can be claimed and exercised by every human being.” 

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The Right to Define Gender Identity

All human beings carry within themselves an ever-unfolding idea of who they are and what they are capable of achieving. The individuals sense of self is not determined by chromosomal sex, genitalia, assigned birth sex, or initial gender role. Thus, the individuals identity and capabilities cannot be circumscribed by what society deems to be masculine or feminine behavior. It is fundamental that individuals have the right to define, and to redefine as their lives unfold, their own gender identities, without regard to chromosomal sex, genitalia, assigned birth sex, or initial gender role.

Therefore, all human beings have the right to define their own gender identity regardless of chromosomal sex, genitalia, assigned birth sex, or initial gender role; and further, no individual shall be denied Human or Civil Rights by virtue of a self-defined gender identity which is not in accord with chromosomal sex, genitalia, assigned birth sex, or initial gender role.

The Right To Free Expression Of Gender Identity

Given the right to define ones own gender identity, all human beings have the corresponding right to free expression of their self-defined gender identity.

Therefore, all human beings have the right to free expression of their self-defined gender identity; and further, no individual shall be denied Human or Civil Rights by virtue of the expression of a self-defined gender identity.

The Right To Secure And Retain Employment And To Receive Just Compensation

Given the economic structure of modem society, all human beings have 8 right to train for and to pursue an occupation or profession as a means of providing shelter, sustenance, and the necessities and bounty of life, for themselves and for those dependent upon them, to secure and retain employment, and to receive just compensation for their labor regardless of gender identity, chromosomal sex, genitalia, assigned birth sex, or initial gender role.

Therefore, individuals shall not be denied the right to train for and to pursue an occupation or profession, nor be denied the right to secure and retain employment, nor be denied just compensation for their labor, by virtue of their chromosomal sex, genitalia, assigned birth sex, or initial gender role, or on the basis of a self-defined gender identity or the expression thereof.

The Right Of Access To Gendered Space And Participation In Gendered Activity

Given the right to define one’s own gender identity and the corresponding right to free expression of a self-defined gender identity, no individual should be denied access to a space or denied participation in an activity by virtue of a self-defined gender identity which i5 not in accord with chromosomal sex, genitalia, assigned birth sex, or initial gender role.

Therefore, no individual shall be denied access to a space or denied participation in an activity by virtue of a self-defined gender identity which is not in accord with chromosomal sex, genitalia, assigned birth sex, or initial gender role.

The Right To Control And Change One’s Own Body

All human beings have the right to control their bodies, which includes the right to change their bodies cosmetically, chemically, or surgically, so as to express a self-defined gender identity.

Therefore, individuals shall not be denied the right to change their bodies as a means of expressing a self-defined gender identity; and further, individuals shall not be denied Human or Civil Rights on the basis that they have changed their bodies cosmetically, chemically, or surgically, or desire to do so as a means of expressing a self-defined gender identity.

The Right To Competent Medical And Professional Care

Given the individual’s right to define one’s own gender identity, and the right to change one’s own body as a means of expressing a self-defined gender identity, no individual should be denied access to competent medical or other professional care on the basis of the individual’s chromosomal sex, genitalia, assigned birth sex, or initial gender role.

Therefore, individuals shall not be denied the right to competent medical or other professional care when changing their bodies cosmetically, chemically, or surgically, on the basis of chromosomal sex, genitalia, assigned birth sex, or initial gender role.

The Right To Freedom From Psychiatric Diagnosis Or Treatment

Given the right to define one’s own gender identity, individuals should not be subject to psychiatric diagnosis or treatment solely on the basis of their gender identity or role.

Therefore, individuals shall not be subject to psychiatric diagnosis or treatment as mentally disordered or diseased solely on the basis of a self-defined gender identity or the expression thereof.

The Right To Sexual Expression

Given the right to a self-defined gender identity, every consenting adult has a corresponding right to free sexual expression.

Therefore, no individual’s Human or Civil Rights shall be denied on the basis of sexual orientation; and further, no individual shall be denied Human or Civil Rights for expression of a self-defined gender identity through sexual acts between consenting adults.

The Right To Form Committed, Loving Relationships And Enter Into Marital Contracts

Given that all human beings have the right to free expression of self-defined gender identities, and the right to sexual expression as a form of gender expression, a/l human beings have a corresponding right to form committed, loving relationships with one another, and to enter into marital contracts, regardless of their own or their partner’s chromosomal sex, genitalia, assigned birth sex, or initial gender role.

Therefore, individuals shall not be denied the right to form committed, loving relationships with one another or to enter into marital contracts by virtue of their own or their partner’s chromosomal sex, genitalia, assigned birth sex, or initial gender role, or on the basis of their expression of a self-defined gender identity.

The Right To Conceive, Bear, Or Adopt Children; The Right To Nurture And Have Custody Of Children And To Exercise Parental Capacity

Given the right to form a committed, loving relationship with another, and to enter into marital contracts, together with the right to express a self-defined gender identity and the right to sexual expression, individuals have a corresponding right to conceive and bear children, to adopt children, to nurture children, to have custody of children, and to exercise parental capacity with respect to children, natural or adopted, without regard to chromosomal sex, genitalia, assigned birth sex, or initial gender role, or by virtue of a self-defined gender identity or the expression thereof.

Therefore, individuals shall not be denied the right to conceive, bear, or adopt children, nor to nurture and have custody of children, nor to exercise parental capacity with respect to children, natural or adopted, on the basis of their own, their partner’s, or their children’s chromosomal sex, genitalia, assigned birth sex, initial gender role, or by virtue of a self-defined gender identity or the expression thereof.

Community

Community is a word that is thrown around amongst people going through transition. As we begin meeting other transgender people, we begin to hear about the transgender community, and even the lgbt community. For many of us, a sense of community has eluded us for much of our lives. We may have been born into a community based on ethnic, religious, professional, or economic ties, but for many of us we may not have found a true sense of belonging in these communities. While we may have felt the same ties that drew our parents or friends into these communities, we were still left with a feeling that we were different. Some of us may have known that our difference was in our gender identity and our physical self, while others just knew that we were different. This difference, and usually the fear to express that difference often keeps us from fully sharing ourselves with these communities. 

     When we joint the transgender community, we are suddenly welcomed into a community the encourages us to be open, embraces what we once hid from, and encourages us to become the man or woman that we have always known ourselves to be. Suddenly we find a community in which we feel that we can finally be free to be ourselves and be comfortable because we do not have to hid anything from the other members of this community. In essence, we are finally free to fully participate with and in a community. For some transgender people, this marks a period in their lives when they begin to thrive socially. A once socially awkward person can find in a community of acceptance, they are finally able to free themselves of the hang-ups and fears that previously paralyzed them in social settings. Being honest with themselves, and being able to be honest with other brings about a change that can only be brought forth by a supportive and understanding community. It is this support and understanding that makes the transgender community such a wonderful community to be a part of. 

    The concept of community came to me while I was watching and interview with Betty Crow and Helen Boyd(author of “She’s not the Man I Married“). This was and interview with Gordene MacKenzie posted on Gender Vision. In that interview, they discuss how the old model of transitioning included the requirement by many therapists that, if married, a transsexual divorce prior to surgery. Many also advocated the idea of moving away from friends and family and starting a new life. In the process, families and communities were split up. In a recent episode of Talking Tranny, Susan Moses describes a friend who cut all ties to the trans community once she had undergone GRS. At the time that such actions were suggested and even mandated in order to obtain surgery, building a cohesive transgender community must have been quite difficult. Those women who had been through the entire transition process disappeared soon after surgery, leaving those just beginning their transition without the benefits of the knowledge and shared experiences of a strong and lasting community. While the reasons for advocating such moves post transition may be many, I think that Julia Serano presents some sound thoughts and opinions in her book “Whipping Girl.”

     Fortunately, for us, today the transgender community is growing not only in numbers but also in its strength and recognition. The importance of the transgender community I think is underscored by not only the recent opinion put forward by the AMA, but also by the recent hearings held by in Congress. As out community grows and comes into its own, we are left with the hefty responsibility of defining the community and how it interacts with society in general. I think part of this process includes reconsidering that attitudes of old that left us severing ties with our past in order to build a new future. Often times, such ties include cisgender people who are supportive of our decision. As we move forward in our battle for equal rights and equal opportunity, having cisgender allies becomes extremely important, not only for our fight but also for our community. If our community is made up only of people who identify as transgender, then I think that we are doing ourselves a disservice. I think it is important that we be an open community that welcomes and makes space for not only those who identify as transgender, but also those who who are friends, family, coworkers, and acquaintances of transgender people. People who accept us for who we are, and see that we are just as deserving of rights as cisgendered people. Such inclusiveness brings an added dimension to our community, and enlists added support for our cause. It also creates an even more diverse community. I think Betty Crow put it quite well when she said,”Communities are healthy when they are diverse.” This is a concept that is seen in nature, and is equally as relevant and important in human communities. One only need to look at the success of organizations such as PFLAG. PFLAG was founded to bring together members of the gay and lesbian community with members of the straight community. It exists as a support network for families coping with coming out issues, and in the process has created an added dimension to the LGBT community by integrating allies of the community into an organization that furthers the causes faced by the LGBT community. Such diversity serves to strengthen the community and ensure that it is not just the members of the community fighting for their right, but that there are members of “other” communities fighting for LGBT rights as well. The more voices standing up for right, the more likely it is that we will be heard, and that we will see progress. 

    What the concept of community comes down to for me is the idea that we have created our own community. We have forged a transgender community out of a society that once completely rejected us and had not place for us in their communities. Today, as we continue to build and strengthen our community it is time to show the world that rejected us that we do have room for them in our community. We welcome supporters from the cisgender communities. All we ask is that they stand with us, side by side, as we fight for the rights that they take for granted everyday, that they demand that we be afforded the same rights given freely to others, and that we not be judged by our gender presentation, but by our character and our unique abilities.