February 28, 2014 at 9:03 am EST | by Lou Chibbaro Jr.
D.C. requires insurers to cover gender reassignment
Vincent Gray, transgender, gay news, Washington Blade, gender reassignment

‘Treatment of individuals diagnosed with gender dysphoria is a covered benefit in all individual and group insurance plans in the District of Columbia, including Medicaid,’ said Mayor Vincent Gray. (Washington Blade photo by Michael Key)

D.C. Mayor Vincent Gray announced on Thursday that health insurance companies doing business in the District must provide full coverage for medically recognized treatments to help transgender people change their gender, including gender reassignment surgery.

At a news conference in a meeting room outside his office, Gray said the city’s Department of Insurance, Securities, and Banking issued a bulletin directing insurers to recognize a condition known as gender dysphoria, or gender identity disorder, as a medical condition to be covered by insurance plans.

Transgender advocates note that the American Medical Association and the American Psychiatric Association recognize gender dysphoria as a diagnosable condition through which physicians and other health care professional provide a wide range of approved medical treatments to assist people in transitioning from one gender to another.

“Today, the District takes a major step toward leveling the playing field for individuals diagnosed with gender dysphoria,” Gray said. “These residents should not have to pay exorbitant out-of-pocket expenses for medically necessary treatment when those without gender dysphoria do not,” he said.

“I’m clarifying today that treatment of individuals diagnosed with gender dysphoria is a covered benefit in all individual and group insurance plans in the District of Columbia, including Medicaid,” Gray said.

Gray’s remark drew a prolonged, standing ovation from LGBT activists, including transgender advocates, who gathered in the mayor’s ceremonial bill-signing room where Gray held his news conference.

“Those who know me know how proud I am that the District continues to be on the cutting edge and on the forefront when it relates to equality and fairness for its LGBTQ residents,” Gray said.

The bulletin, which the city sent to insurance companies on the day of Gray’s announcement, cites the D.C. Human Rights Act as among the legal grounds being used to require insurers to cover transgender related treatments. The Human Rights Act, among other categories, bans discrimination based on gender identity and expression as well as sexual orientation.

The bulletin cites the D.C. Unfair Insurance Trade Practices Act of 2001 as further grounds for not allowing insurers to exclude coverage of trans-related treatments from their insurance plans.

Among those speaking at the news conference was Mara Keisling, executive director of the D.C.-based National Center for Transgender Equality, which worked with the mayor’s office and insurance department officials to help draft the four-page bulletin.

Keisling said Gray’s action places D.C. among just five states that have adopted similar policies requiring insurers to cover treatments such as gender reassignment surgery and hormone therapy to assist an individual’s transition to another gender.

Those states are California, Oregon, Colorado, Vermont and Connecticut.

“This is really significant,” Keisling told the Blade after the news conference. “It means that transgender people in D.C. now can make their health care decisions with their doctor rather than with their insurance companies,” she said.

Mara Keisling, NCTE, National Center for Transgender Equality, gay news, Washington Blade

Mara Keisling, executive director of the National Center for Transgender Equality. (Washington Blade photo by Michael Key)

Asked what treatments are involved in a gender transition, Keisling said experts with the World Professional Association for Transgender Health Standards of Care (WPATH) have developed a wide range of treatments that may vary from person to person depending on individual needs.

“It’s a whole range of transition-related care — everything from diagnostic visits to experts in the field,” Keisling said. “It can mean hormone treatments. It can mean lab tests to make sure your hormones are working correctly and not causing any harm. There are various kinds of surgeries that transgender people may need. So it covers a whole range of things.”

D.C. transgender activist Andy Bowen, who recently joined the staff of the NCTE as a policy associate, called the D.C. initiative announced by Gray the most comprehensive among the states that have adopted similar policies.

“If you look at some of the other states they say they’re not going to cover some treatments,” Bowen said. “D.C. has not done that. It just said that if it’s one of the WPATH treatments we’re going to cover it. And that’s amazing to hear a government be that unequivocal about it.”

Philip Barlow, the city’s Associate Commissioner of Insurance, said after the news conference that requiring health insurance companies to cover the medical treatments for transgender people would likely result in a small increase in premiums over a period of time.

“It will just be incorporated into the general cost and utilization that insurers use in coming up with future rate increases,” he said. “But we don’t really anticipate it to have a significant impact on the rates.”

Michael Silverman, executive director of the New York-based Transgender Legal Defense and Education Fund, praised Gray for taking action that he said would “end health care discrimination against transgender residents of Washington, D.C.”

The bulletin issued by the city’s Department of Insurance that directs insurers to provide full coverage for medically approved treatments to transgender individuals in D.C. can be obtained here.

Lou Chibbaro Jr. has reported on the LGBT civil rights movement and the LGBT community for more than 30 years, beginning as a freelance writer and later as a staff reporter and currently as Senior News Reporter for the Washington Blade. He has chronicled LGBT-related developments as they have touched on a wide range of social, religious, and governmental institutions, including the White House, Congress, the U.S. Supreme Court, the military, local and national law enforcement agencies and the Catholic Church. Chibbaro has reported on LGBT issues and LGBT participation in local and national elections since 1976. He has covered the AIDS epidemic since it first surfaced in the early 1980s. Follow Lou

  • **********
    “Those who know me know how proud I am that the District continues to be on the cutting edge and on the forefront when it relates to equality and fairness for its LGBTQ residents,” Gray said.
    Don’t you mean ‘cutting edge’ of an election, Mr. Gray? Stop your crass cynicism, please.

    Gray exquisitely TIMED this important reform to be announced just THIRTY DAYS before the Democratic primary election– and everybody knows it.

    DC is one out of five. So why didn’t ‘cutting edge’ Gray do this three years ago? Or last year? Even months ago? The truth is Vincent Gray intentionally waited to do this for his own self-serving political purposes.

    But Gray made DC’s Trans community wait, too.

    That is SO NOT leadership. That’s more akin to a patronizing daddy doling out bits of sugar candy to his LGBTQ children — expecting them to repeatedly and dutifully fawn over him in desperate appreciation.

    Why should any LGBTQ resident give a vote of confidence to Gray’s crass political cynicism and PR?

    DC’s LGBTQs can do a lot better than Vince Gray.

    • You are clearly not connected to nor listening to any member of DC’s trans community. This has been in the works for almost a year when an “advisory” was issued to insurance companies. Yesterday, Mayor Gray issued a “bulletin”, which is binding on insurance companies. I challenge you to find me a single member of the transgender community who was not moved to tears by what happened yesterday. The room was full of leaders of the trans community and they witnessed history take place.

      Mayor Gray has been a steadfast supporter of the trans community throughout his time in office and long before. From a high school friend that was transgender to serving transgender youth at Covenant House through his time in elected office, he has always been an ally to the entire LGBT community, including the T, which many often ignore. DC is the ONLY city or state to have run a public awareness campaign to promote acceptance of the transgender community, instituted by the Gray Administration. We are one of the only, if not the only, to have a comprehensive job training and placement program for the trans community, which was instituted at Mayor Gray’s order. And now we have the strongest non-discrimination policy in health care in the nation, which is happening at Mayor Gray’s order.

      This is something to be celebrated. I saw Mayor Gray at a fundraiser full of non-LGBT people last night. He beamed with pride at the historic nature of what he did yesterday. This is a life changer and life saver for so many of our trans brothers and sisters. Proper health care is directly tied to every one of the areas in which they have terrifyingly high rates of incidence: violence, discrimination, unemployment, homelessness, alcohol/drug addition, depression and suicide.

      Much work is left to be done, but this Mayor understand that and will continue to fight against discrimination in any form. I am incredibly proud of him and I am not alone.

    • Statement from NCTE:

      The National Center for Transgender Equality praised the move, announcing that the decision created “the most comprehensive [insurance] plans for transgender Americans in the United States.”

      Statement from Center for American Progress:

      Andrew Cray, a policy analyst at the Center for American Progress’s LGBT Research and Communications Project, said in a statement, “This policy will make D.C.’s healthcare programs and insurance coverage the most comprehensive in the country for the full scope of health care that transgender people need throughout their lives.”

      Further statement from Andy Bowen at NCTE:

      Bowen noted that the move will be used by advocates pushing for similar coverage elsewhere. “Critically important is that as more states follow the District’s lead, we’ll be better able to educate the medical community about respectfully and comprehensively meeting our healthcare needs. And that sets us up for more wins like this in other states,” she said.

    • Brian, your comments are self-serving as you intend on saying whatever you can to say something negative about the Mayor while demonstrating that you have no concept of what the Mayor has done for the Transgender community, and many other communities in DC,, not because it achieves anything other than the fact that it’s the right thing to do.

      • Alexa, fyi, I am not running for public office, nor have I ever. Nor have I been an activist for much of anything beyond trying to help end anti-LGBT police bias and anti-LGBT hate crimes in DC. I haven’t even selected a mayoral candidate to vote for yet.

        I *DID* vote for Gray, BTW, and supported him until it was clear Gray came to office with a criminally fraudulent ‘shadow campaign’ in 2010. And like tens of thousands of other DC voters, I simply don’t find Gray’s denials of knowledge of his criminal campaign any more credible than Chris Christie’s denials regarding his GW Bridge traffic jams.

        As to LGBT rights and benefits in DC, there is nothing that Gray has done on behalf of LGBTs that likely would not have also been done by Wells, Evans, Bowser or Catania. Moreover, there really is a ‘soft bigotry of low expectations’– especially when LGBT activists demand so little competent and honest performance from their public officials.

        I was just shocked to read that some trans activists will be appeased/ satisfied with merely a statement (i.e., more excuses) from a police leadership that has repeatedly demonstrated its own anti-LGBT biases since 2007.

        After the first or second bold police harassment of LGBTQs, don’t you get it? It is intentional police harassment– and it is CRIMINAL. That encouragement of police bias has been signaled to MPD’s rank and file in a variety of subtle actions and comments by MPD’s police leadership.

        Many of us have witnessed it before, BTW. Indeed that’s why, in large part, Lanier’s predecessor was brought in from Chicago to clean up MPD’s biased policing.

        Smell the coffee, please.

  • The Mayor was accused of making this announcement as a political maneuver just prior to the upcoming election. Why? So he could gain all 800 votes from the District’s transgender community. The provision will probably alienate quadruple that number of conservative voters who oppose the action. Vincent Gray already had the transgender vote, almost without exception. he believes in equality and human rights. He has been to the memorials of our slain. He has been to our TDORs. He has promoted changes in all District agencies based on inclusion and employment opportunities. He has been extremely accessible to our community and to EVERY citizen within the District. he has done more for the promotion of equal rights for the LGBT community than any other mayor in the Nation – and that is BEFORE this latest announcement. Remember, he scored a 10+ on the GLAA survey. Brian, your cynicism is an insult. And it just doesn’t make any sense. Try thinking about it, and give the man credit where it is due.

  • **********
    Remember, he scored a 10+ on the GLAA survey. Brian, your cynicism is an insult.
    Jeri, let’s park the mock outrage and ad hominem attacks, and stick to the issues, please.

    Many of us believe GLAA was in error in rating an embarrassing, ethically-challenged mayor– who now leads a police department with homophobic, secretive and unethical practices– a “perfect 10.” But that’s OK. GLAA is a very human organization. It always has lots of irons in its volunteer-based, advocacy fire. GLAA can not be expected to be “perfect” with every rating.

    Jeri, I do appreciate that you’re an outstanding soundbite herald for our dubious mayor. Still, why don’t we tackle this ONE ISSUE that might really matter NOW to LGBT peoples’ lives and safety.

    Please get your pal, Mr. Gray, to provide detailed answers to the following…

    — How many anti-LGBT hate crimes cases that have occurred during Gray’s term are still OPEN?

    — How many anti-LGBT hate crimes cases have been CLOSED/ CLEARED with an arrest?

    — How come Gray’s secret police does not provide an ONLINE LOOKUP– for that individual case information– so that victims, their friends and neighbors can take their own precautions to avoid being assaulted by the many hate crimes perpetrators MPD has failed to apprehend?

    — Indeed, why do LGBT victims of prior hate crimes have to continue to fear for their safety in Gray’s DC?

    — And why is it NYPD can catch their anti-LGBT hate crimes perps so quickly, but Gray’s MPD can not?

    Answers to the above questions might actually help *ALL* LGBTs in staying SAFE from the hate crimes Gray’s secretive police– through their biased policies and practices– now encourage.

    Be “insulted” if you must, Jeri. But those are reasonable, non-cynical questions to which any LGBT citizen or business can expect answers from their mayor.

    • Brian, the argument I presented dealt as a specific response to your statement, point by point. Although I did find your cynicism repugnant, there were no “ad hominem” attacks. I merely asked you to re-think your argument. On the other side of the fence, you respond by attacking GLAA, claiming that the organization was “in error” for the high rating provided to “an embarrassing ethically-challenged mayor” and continue by adding spurious allegations concerning “a police department with homophobic, secretive, and unethical practices.” Shame.
      GLAA specifically provides the points and the reasoning supporting each rating. The organization is comprised of individuals who have been defending the rights of the LGBT community for decades. The results of the GLAA survey deserve credibility, and the members deserve your respect for a lot more than just being “human”.

      I find your reference to me as “a sound bite herald for our dubious mayor” as a veiled personal attack, insinuating that my opinion should be reduced to the promotion of my “pal”, Mayor Vincent Gray. For the record, he is not a personal friend, and I owe him no specific allegiance.

      As a member of the transgender community, a deeply oppressed minority, I am delighted that the Mayor of the District of Columbia has taken the time to acquaint himself with me and so many, many others in response to our efforts to obtain relief from discrimination. Vincent Gray’s concern is real, and he has provided considerably more than lip service. He responds to ALL of our concerns. We are citizens, and he accords us that respect. Without question, he has EARNED respect and loyalty in return.

      The questions you seek answered would be better addressed to the OGLBTA than directly from the Mayor. Certainly, if you truly want answers from the Gray administration, you would not address them to me in a newspaper blog. You would do well to phrase the questions without including unsubstantiated and biased statements like “staying SAFE from the hate crimes Gray’s secretive police – through their biased policies and practices – now encourage.” However, as a former citizen of NYC let me assure you that I feel more secure and safe within the borders of the District (and I specifically include all six wards) than I ever did in the City. I personally only know of two hate crimes against the members of the transgender community during the Mayor’s term. Both cases are closed. One perpetrator is convicted and sentenced; the other is in the process of being tried. I have developed working relationships – and I might even call them friendships – with several officers serving in the MPD, and in the DOC. So have many of my friends. Things are so much better in DC than anywhere else that I have ever lived, but it isn’t perfect. Bigotry and prejudice still exist in these agencies as well as the general public. Discrimination cannot be eliminated solely by legislation. Ending discrimination is an ongoing effort. Mayor Gray has championed, prioritized, and spearheaded reforms, but he has not been personally responsible for all of the progress the District has enjoyed. Advocates, allies, Council members, and innumerable agencies have participated and share in whatever credit may be allotted. Perhaps that credit should be shared with you, as well. We don’t need to knock each other down. We need to support each other’s efforts and move forward. We still have work to do. Let’s get to work.

      • Well, Jeri, I’d say we’re both hard at work on our respective tasks, as we see them. We just have fundamental differences regarding this mayor and his increasingly biased and secretive MPD.

        However, Gray *IS* the incumbent candidate voters must pass judgment upon– not Gray’s MPD, nor Gray’s OGLBTA. Vince Gray is THE candidate who has and owes DC voters those answers.

        Let’s do hope together, though, that we see no more police harassment episodes as reported by Ruby Corado happened last Friday. Maybe the mayor will surprise me and ask for Lanier’s resignation.

        Whatever, thank YOU, Jeri! Thanks for the time and the consideration of your frank responses– and thanks for the many ways YOU further our city’s LGBTQ causes! See you in the funny papers.

  • Brian, Let it go or move to NYC Gray is winning re-election!

  • Any effort to paint Vince Gray anything other than fully supportive of the LGBT community is not genuine. And despite the headline that the Blade gave the report given to Cathy Lanier, members of that committee feel like her response to them was a home run. There is no greater ally that I know if in elected office than Vince Gray.

  • John Adams wisely noted, “facts are stubborn things,” Lane.

    Even if Gray dares to answer the questions I put to Jeri (above), Vince Gray still can’t run away from his mixed record on life/death and LGBTQ public safety/ policing issues.

    Of course, Vince Gray can’t run away from his criminal shadow campaign of 2010. But neither can he run away from his homophobic and transphobic police chief.

    “Fully supportive,” you say. Really?

    Hasn’t the Gray 2014 campaign hired former NOM-supported, Marriage Equality foe Bob King to work in his campaign, after Bowser’s campaign wisely let him go? …

    Gray also can’t run away from the ongoing anti-LGBT police bias at local police stations like MPD’s Fifth District and its exclusionary, anti-LGBT MPD-5D-Citizens Advisory Council.

    Nor can Gray run away from the fact that his police chief just weeks ago used a MPD awards ceremony to reward anti-LGBT/ anti-Marriage Equality politicians in the chief’s home ward (Ward 5)? TWO of those Lanier crony awardees, btw, are running to unseat Ward 5’s Councilmember Kenyan McDuffie (who really *IS* fully supportive of Ward 5’s LGBTs).

    That’s highly unethical and biased interference by any police chief! Lanier ought to be FIRED for that unethical political interference alone. When citizens call MPD for help, will it matter which campaign sign they have in their front yard? Is DC subtly morphing into Gray’s Police State?

    Gray also can’t run away from his police chief’s repeated public verbal harassments of DC transgender activists– and just this week, the police chief’s very public, gratuitous, homophobic insult of attendees of DC’s Leather Week.

    No wonder why MPD’s rank and file officers feel encouraged by their MPD bosses to discriminate against LGBTs in general– and to harass transgender citizens like Ruby Corado and her friends– as reportedly happened Friday night.

    “And despite the headline that the Blade gave the report given to Cathy Lanier, members of that committee feel like her response to them was a home run.” –Lane
    And is it any wonder that Cathy Lanier’s cronies on her exclusionary Hate Crimes Task Force think Lanier’s response to it (including, presumably, her gratuitous, homophobic remarks against DC Leather Week) was a “home run.”

    Sorry, Lane. DCTC’s Jason Terry already blew the cover off of Gray’s police chief’s “independent” task force…

    LGBT voters can see for themselves, in numerous instances, how “genuine” Vince Gray is to their interests. We can do better.

  • This is why I love DC.

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