State denies plan discriminates against transgender members


The health insurance plan that covers state employees does not discriminate against transgender people even though it excludes drugs and services for gender transformation, the state of South Dakota argues in a court filing.

The exclusion in the state health plan for gender transformation services applies even if those services are deemed medically necessary, the state says.

Those arguments are included in the state’s answer to a lawsuit filed by a state employee who says the health plan discriminates against transgender people by excluding those services. Terri Bruce, a transgender man, filed suit in federal court, arguing that the state’s exclusions violate the U.S. Constitution and the 1964 Civil Rights Act.

The history of the U.S. Courthouse in Sioux Falls, South Dakota Wochit

The state health plan is available to thousands of state employees as well as their spouses and dependents. Bruce has been a full-time state employee since 2010.

Bruce, who is represented by the American Civil Liberties Union and Rapid City lawyer James Leach, argues the plan discriminates because it allows some medical services to members who aren’t transgender while denying those same services to transgender members. In June 2016, Bruce was scheduled to receive a mastectomy as treatment for gender dysphoria, but the state plan denied coverage.

“I was denied coverage simply for being who I am – that’s discrimination, and it’s painful,” Bruce said in a statement when he filed suit last month. “All I am asking for is to be treated like anyone else on my insurance plan. Transgender people face discrimination in so many aspects of their lives, including health care. I want to stand up and make sure that no one else is denied coverage for medically necessary treatments just because of who they are.”

In its answer, the state admits that medically necessary chest reconstruction surgery is a service covered under the plan, but subject to “the limitation, exclusions, and other provisions of the plan,” which includes services related to gender transformations.

The state also argues that “whether there is a legitimate medical justification for the exclusion is the subject of an existing dispute in the medical field.”

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