Teri Wright was excited to finally have transgender-inclusive health benefits—until, suddenly, she didn’t have them anymore.
Wright, a transgender woman living in northwest Arkansas, had finally learned last year that her wife’s employer, the six-campus University of Arkansas system, would begin offering health-insurance coverage for the treatment of gender dysphoria at the start of 2017. The couple started making plans for Wright’s reassignment surgery right away.
But then, on Jan. 24, they received an email from HR—first published on the blog ManicSquirrel and later obtained by The Daily Beast—notifying them that “the university will suspend gender dysphoria coverage” pending the outcome of a Dec. 31 preliminary injunction against an Affordable Care Act regulation that prohibits discrimination in health care on the basis of transgender status.
“It was devastating,” Wright told The Daily Beast. “It really was.”
The email noted that “services received on or before March 6th, 2017” would still be covered. But that’s probably not enough time for Wright to get her surgery.
“It really sucks for them to say they’re gonna cover it and then pull the rug out from underneath my feet like this after I’ve already made plans to move forward,” she said.
In response to a request for comment on the suspension of the benefits, University of Arkansas System Communications Director Nate Hinkel sent The Daily Beast the text of the email that was sent to employees last week. He did not immediately respond to follow-up questions but made it clear that “this decision was not made on a campus level, but here at the UA system office.”
The preliminary injunction—issued by a federal judge in Texas on the last day of 2016—does not prohibit the University of Arkansas System from continuing to offer transgender-inclusive health benefits of its own accord. As the UA System email to employees stated, the preliminary injunction “prohibits [the U.S. Department of] Health and Human Services from enforcing regulations addressing gender identity and the coverage of treatment for gender dysphoria.” In other words, the injunction simply gives the UA System more legal leeway to justify suspending the coverage.
Justine Turnage, vice president for the Fayetteville, Arkansas-based organization Transgender Equality Network, thinks it’s telling that the UA System would back out of offering the coverage so quickly after the preliminary injunction was issued against the ACA regulation.
“Colleges and college towns tend to be more progressive in nature,” she told The Daily Beast. “So seeing our university show very plainly that they aren’t interested in providing the necessary coverage for their transgender employees for its own sake but only when they’re forced to by law, really speaks volumes to how much further the transgender movement still has to go.”
Even with the preliminary injunction, some advocates believe that the UA System could still face legal action. Kenneth Upton, senior counsel for the LGBT advocacy group Lambda Legal, told the Arkansas Democrat-Gazette that the injunction might block HHS from taking action against the UA System but “what it didn’t do was keep a private individual from suing their employer directly.”
Upton also argued that the Affordable Care Act still bars the denial of transition-related health services—and that the ACA hasn’t been eliminated just yet. President Trump has signed an executive order calling for the law to be repealed but eliminating it still requires congressional action.
The UA System’s email to employees—and sent to The Daily Beast as a comment—said that the “frequent changes and uncertainty of the ACA regulations” were “challenging,” and specified that “further clarification of the ACA coverage guidelines” could affect the decision to suspend gender dysphoria coverage.
“This was either the university prepping for the ACA to be completely repealed or they just simply did not want to cover transgender individuals and found this window of opportunity to do so,” Kacee Sparks, a transgender UA System staff member, told The Daily Beast.
The suspension of the trans-inclusive benefits has put Sparks, who was only recently hired into a full-time position with the university system, in a difficult spot. Without transgender-inclusive insurance benefits, she was “nowhere near able to afford any sort of surgery or hormone replacement therapy.” So as soon as she got the full-time job, she started making plans to start hormones at the Fayetteville campus health center. Then the email came.
“It’s just a lot worse having waited so long for this and then finally getting right there, within arm’s reach—and then it just cuts off,” she told The Daily Beast. “It’s really heartbreaking.”
For Wright, the suspension of the benefits is another bump in a years-long effort to obtain surgical coverage. She told The Daily Beast that she has been sending emails to the UA System since 2013, urging them to comply with the ACA. Even now, she hopes that the UA System will reconsider the suspension of the transgender benefits.
“I would like to see them start covering it and be in compliance with the Affordable Care Act and not give in to something that they didn’t have to,” she told The Daily Beast.
Turnage has pledged that, moving forward, the Transgender Equality Network will “serve as a rallying point for people who want to tackle this problem.”
But while that advocacy gets underway, Wright and Sparks have both had their transition plans upended overnight. Wright told The Daily Beast that she would try to get her surgery processed by the insurance carrier before March 6th but she was “doubtful” she would succeed.
And for Sparks, the wait for hormones just grew even longer.
“There are a few people on campus like [Wright] who were on a plan who may have had treatment for a long period of time,” she told The Daily Beast. “Then there are people like me who had just recently got on the plan—and were about to utilize it for the first time ever—and then just this abrupt cutoff.”