Berkeley Considers Some Trans-Specific Health Care Benefits; Outrage Ensues

Berkeley, California has recently been considering beginning to provide some benefits to its trans employees for sex reassignment/affirmation surgery. It’s unclear precisely which procedures would be covered under such a plan, since all news reports merely use the outdated and offensive term “sex change” to describe what is being considered.[1. While there is some disagreement about what the proper term ought to be, with “sex reassignment surgery” itself being highly imperfect and considered very cissexist by many, it’s at least my understanding that “sex change” is rarely accepted in trans communities as anything other than outrageously transphobic.] A vote on the very modest proposal has just been delayed:

The Berkeley City Council has postponed a vote on a proposal to use taxpayer money to pay for sex-change operations for city employees.

Council members on Tuesday decided to delay a final decision on the issue until Feb. 15.

The proposal calls for the city to maintain an annual $20,000 fund for gender-reassignment surgery, which can cost up to $50,000. The money would be distributed on a first-come, first-served basis.

Berkeley health insurance providers Kaiser Permanente and Health Net don’t pay for the procedure under the city’s current health plans.

To be eligible for the fund, employees would have to have lived as the opposite sex for at least one year and undergone hormone therapy. They also would have to have worked for the city at least a year.

The San Francisco Gate notes that several of the city’s 1,500 employees have apparently inquired about such benefits.

So basically, even if this proposal were passed, trans people would have to race each other to claim the woefully incomplete benefits, the inadequacy of which any cis person who is supposed to be receiving health care through their job would rightly throw a temper tantrum over. Trans folks, on the other hand, not only have to fight tooth and nail for these minimal benefits and defend themselves against national furor and smear campaigns that seek to define their health care needs as frivolous, deviant, and unnecessary, but also stand neatly in line so that one person a year might succeed at obtaining them.

Particularly as a cis woman with mountains of privilege in this debate, I’m not arguing that that the benefits would not be very real for those very few who might be lucky enough to access them. My point is simply that more is deserved. And as a general rule, if we were talking about cis folks, more would be expected. But because it’s trans rights up for debate, those same cis people are looking at the proposal as “special rights.”

One also has to wonder precisely how many cis employees must first satisfy their employer’s medical, not occupational, requirements in order to access specific kinds of care. Surely, health insurance carriers have restrictions on what they will and will not cover, and when they will and will not cover it. But one’s employer rarely designs those restrictions themselves, and rarely leaves it up to themselves to decide which medical criteria must be met. The idea that trans employees seeking such benefits must “have lived as the opposite sex for at least one year and undergone hormone therapy” is all kinds of absurd and cissexist. (For a start, how can one’s real gender be “opposite,” and how can a gender be “opposite” when there are more than two genders?) As though trans folks don’t suffer enough cis gate-keeping regarding whether or not they’re “really” trans. As though they are likely to find any cis gate-keepers who would provide such surgery to them without these restrictions being met already.

The possibility of these crumbs being thrown trans people’s way has nevertheless ignited outrage, even in Berkeley, with its reputation of being as liberal as anywhere in the U.S. gets. We’ve got biased fear-mongering headlines like “Berkeley taxpayers may pay for sex-change surgery,” Fox News surprising no one with its sensational coverage, and others filing a story about basic health care access for trans folks under “strange news.”

The general spin is an old one: SRS is “weird,” it’s unnecessary, it’s wasteful, and it’s going to result in countless cases of fraud and abuse. There’s a reason, after all, why transition-related benefits are left out of most insurance, and why the right to these benefits was not guaranteed in the latest U.S. health reform. It’s not about actual cost. It’s about what the public believes is “deserved” and “legitimate,” and who they’ll tolerate being left out in the cold. Sadly, a vast majority of the population is cis, and couldn’t care less about trans health, the very real health reasons why many trans people need medical transition care, or what happens when that need is not met.

So we’re seeing Berkeley delay its vote pending “further research.” Because clearly, research is required to determine whether or not trans people should be afforded rights slightly more equal to their cis peers.

I’m so sick of debating whether all people deserve access to health care, or just the ones who meet some arbitrary standard of social approval. Until we view health care as a fundamental human right, there’s always going to be someone who is undeserving of it — whether it be because they’re poor, or sex workers, or disabled, or trans, or in need of care related to their reproductive organ that offends somebody’s sensibilities. Until health care is a fundamental human right, there will always be someone whose life is not worth as much as “our” tax dollars.

At the same time, it’s important to remember that even framing health care as a fundamental human right still wouldn’t fully solve the problem. “Human rights” rarely end up applying to those who society still sees as less than human, and even “universal health care” rarely works out well for trans people. So health care as right or not, until trans folks are properly understood to be just as human and deserving as cis folks, the equation of “our” (super special cis-only) tax dollars being worth more than trans lives is unlikely to change.

0 thoughts on “Berkeley Considers Some Trans-Specific Health Care Benefits; Outrage Ensues

  1. tabitharose

    Thank you so much for writing about this, Cara, and so well too. This is such a monumentally frustrating issue for me as an ally, and I can’t even begin to imagine what it feels like for those without the cis privilege I have who, as you said, have to fight to the bone just to get some tiny bit of basic recognition as a worthy human being. I live in the Bay Area and seeing this fauxgressive bullshit around here is so angering.

  2. suspectclass

    It’s too bad they can’t or won’t get a plan that covers gender confirmation surgeries; there certainly are such plans in the Bay Area (I’m on one, for instance).


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