Arizona Provides Me Unequal Healthcare Because I’m Transgender

I’m a professor of family studies and human development at the University of Arizona, and I have dedicated my career to studying how discrimination impacts LGBTQ adolescents. I’m also transgender, and I know from experience that growing up is different — and still much more difficult — for LGBTQ youth. So it came as a disappointment when I learned that the state university where I work does not cover transition-related healthcare for its employees or their dependents.

On Wednesday, I filed a class-action lawsuit against the state of Arizona and the Arizona Board of Regents, which oversees the state’s universities, to rectify the damage done to transgender state employees, like me, and dependents. The fact that the state of Arizona’s health insurance coverage categorically excludes transition-related surgery is a violation of federal civil rights laws and the U.S. Constitution.

Arizona provides the same discriminatory health plan to nearly all state employees and their dependents. That means hundreds, if not thousands, of transgender state employees or transgender dependents of state employees cannot receive medically necessary care recommended by their doctors, such as a mastectomy or a hysterectomy. This is true even though that same care would be covered for cisgender people, individuals who identify with the sex they were assigned at birth.

I know of at least 20 families affiliated with the University of Arizona that are harmed by the state’s anti-trans health insurance policy. Without a doubt, there are many more across the state. I filed this lawsuit not only for me but also for all of the transgender and nonbinary youth and adults in Arizona whose lives would be made better by knowing that there is one less law that discriminatorily targets them.

Research shows that when adolescents are able to live authentically and begin gender-affirming treatment that is appropriate for them, they look just like their cisgender peers in terms of their mental health. The problem is, there are too many roadblocks to authenticity for transgender people. Hostile family members, discrimination in the community, and unfair government policies, like the one I’m fighting, are just a few of the factors that stop transgender people from being themselves.

A study I recently published in the journal Pediatrics confirmed that transgender teens have a much higher suicide risk than their cisgender peers. My co-authors and I discovered that half of transmasculine adolescents have attempted suicide at least once before they turn 20. The same is true for more than 40 percent of nonbinary adolescents and nearly 30 percent of transfeminine adolescents. For cisgender adolescents, the rates are much lower: under 20 percent, regardless of gender.

I was in my early 20s when I began my gender transition. In 2004, I had a double mastectomy that cost me $8,000 out of pocket. I was just out of college, and my father-in-law had to co-sign a loan so that I could afford the procedure. I am fortunate that my family supports me and that we were able to take on that debt, but many people are not that lucky. There are a lot of people across Arizona who cannot access the health care they need unless it is covered by insurance.

That’s the situation I’m in now. My wife, Danielle, and I have two young children and are taking care of an aging parent. It’s not financially feasible for us to pay out of pocket for the procedure my doctor recommends, a hysterectomy. So, until Arizona’s discriminatory health plan is improved, I will be forced to live with aspects of my body that do not align with my identity and cause me significant anxiety.

A recent court ruling in Wisconsin held that denying state employees health insurance for gender-affirming medical care violates the Constitution and federal law. I hope for a similar result in Arizona. It will improve not only my life but the lives of many other Arizonans.

Transition-related surgery can be life-saving. No one should be denied medically necessary care because of who they are. Denying this care is not only wrong, but it is also against the law. The state of Arizona has a constitutional and moral duty to change its healthcare coverage to include transition-related health care.

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Fred Upworthy

Troll on the loose here! It has really bad eyesight. It's also missing a heart and a brain.


Exactly. Trans people are human beings.


Gloria, of all things stated in this article and you are “confused” about who is in the photograph?? Ironically, if you understood the content of the article you wouldn’t be confused.


I’m confused by your comment. The article is written by Dr. Russ Toomey, there are two photos of him, and he specifically mentions his wife. Given these facts, and the obvious fact that his wife is clearly wearing a dress, why would you be confused?


The man on the left is the author. The women on the right is his wife.

Amy D.

Gloria, why does that matter? Great article! Good luck with this! I hope you win!


You shouldn't be confused. There is a photo of the author right next to his byline. Maybe you need to have your eyes checked?


Its covered the same as any other elective surgery. Its a personal choice surgery not a medical necessity. I respect your decision to do so, but do not feel your employer should have to pay just as i would not expect them to pay for a breast enlargement surgery.


No, it isn't a "personal choice surgery". It's mischaracterized that way because of the way sociologists and psychiatrists/psychologists have been relied upon to distract from the fact that many of us are born with endocrinologies that are more complex than the Lawson Wilkins Pediatric Endocrine Society wants to acknowledge. Think of the paper work - so many mis-assigned at birth, consigned by mis-assignment to live lives that are pure torture.

Hysterectomies and mastectomies are covered by the employer for cisgender people, though. Which makes the policy discriminatory, even if it WERE a personal choice- and, let me be clear, that viewpoint is woefully misinformed and does not take into account the medical science behind transitioning. At minimum, transitioning is an effective and proven medical treatment for depression and dysphoria, which both disproportionatley affect transgender individuals. A majority of modern health care professionals understand this, and will recommend that a patient transition as a medically necessary treatment for dysphoria- and, yet, this physician-recommended treatment goes uncovered. That's discrimination.


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