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Oregon Transgender Employee Sues State for Denying Health Coverage for Procedure

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Posted on 22 Jun 2011

A transgender public employee, Alec Esquivel, sued the state of Oregon on Tuesday because its health plan refused to pay for a hysterectomy as part of his transition to becoming a man.

The 41-year-old law clerk at the Oregon Court of Appeals who was born a woman sued the state and its public employee benefits board claiming discrimination based on gender identity.

"This is the first suit to apply (anti-discrimination) laws to health care," said Dru Levasseur, an attorney for the civil rights group Lambda Legal representing Esquivel.

"By not covering this procedure, the state is refusing to provide him with the same health care coverage as his co-workers," Levasseur said.

The suit, which was filed in Marion County Circuit court, argues that Oregon's anti-discrimination law prohibits an employer from denying insurance coverage on the basis of gender identity.

Esquivel is asking the courts to order the state to cover his operation and to award him $250,000 in damages for emotional distress.

A spokesman for the Oregon Department of Justice declined to comment.

According to the lawsuit, Esquivel began transitioning to a man in 2001 after he was diagnosed with gender identity disorder. In 2010 his doctor recommended he undergo a hysterectomy.

Esquivel was denied coverage for the hysterectomy by his state employee health insurance company based on the plan's categorical exclusion of transition-related health care, according to the lawsuit.

The suit says the procedure is medically necessary to reduce the serious health risks of ovarian and uterine cancer because Esquivel has female sex organs and is taking hormones as part of his gender change.

Earlier this month, Portland, Oregon's largest city, passed transgender-inclusive healthcare benefits for city employees. It joins San Francisco and Portland's Multnomah County as the third jurisdiction to specifically guarantee such coverage.


Bruce Wileman  Jun 22 2011 2:42PM Report Abuse
Contract of Adhesion. By signing on and paying premium (as a government employee one wonders how much, if any, he/she pays) the insured agrees to adhere to the terms of the policy. Fighting a 'categorical' Exclusion? Grow up! That this person found a lawyer is not as surprising as how out of control our legal system has become.
Hope  Jun 22 2011 10:00AM Report Abuse
I cannot believe that an attorney actually took this case. I am an insurance broker and am very well versed in healthcare policies. I can tell you that this person is being treated the same way that any other person on the plan is being treated. A woman can have a hysterectomy if she doesn't want her uterus anymore but why should the insurance carrier have to pay for that? This is an elective surgey just like a hair transplant or plastic surgery. These are NEVER covered unless medically necessary. And I can tell you right now that because the psychiatrist he is seeing things he should have his female parts removed so he feels more like a man does NOT make it medically necessary.
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