San Francisco has long led the nation when it comes to providing health insurance benefits for transgender residents. It is doubling down on that reputation.

Health Service System Director Catherine Dodd is proposing to expand the health insurance benefits available to transgender employees of the city, school district, City College of San Francisco and Superior Court.

Some elective procedures like rhinoplasty or forehead reconstruction not now covered would be if considered “medically necessary.” A doctor could determine them medically necessary if the surgeries are crucial to the patient’s mental health, Dodd said.

The proposal would also allow children as young as 12 to receive hormonal therapy.

Dodd presented the proposal Thursday to the Health Service Board, which selects the medical and dental plans for employees and retirees, and sets the amount members pay for each plan. The board will vote on the plan at its meeting next month, Dodd said. If it supports the proposal, it would take effect in 2018.

“We are doing this at a time that when the first thing that happened when Trump got elected president is that the court upheld the ruling that transgender services are not part of the Affordable Care Act,” Dodd said.

In December, a federal judge in Texas barred enforcement of an Obama administration policy that would have guaranteed transgender-related health care services.

“It’s kind of a statement that we are making sure our employees have this,” Dodd said.

In 2001, San Francisco became the first city in the country to pay for gender reassignment surgeries for city employees. In 2012, it made history again, when it extended that benefit to uninsured transgender residents.

— Emily Green

Former San Francisco Supervisor David Campos is returning to government — in Santa Clara County. Campos will become deputy county executive.

In a statement, Santa Clara County Executive Jeffrey V. Smith praised Campos’ “proven track record for requiring transparency and accountability for government agencies.”

Smith added that Campos “possesses the right combination of management expertise, knowledge of policy implementation and a clear understanding of how to meet the needs of a diverse community.”

Campos said he was excited about the post.

“Like San Francisco, Santa Clara is not afraid to lead on critical issues facing the region and the county. I’m excited to work for such a diverse and forward-thinking county as Santa Clara,” he said in a text message.

Campos has had a long career in San Francisco government and politics. He served two terms on the Board of Supervisors, from 2008 through 2016, representing the Mission District and Bernal Heights. He was a leader of the board’s progressive bloc and a frequent adversary of Mayor Ed Lee.

He made a name for himself going after Airbnb and pushing for more affordable housing. Last year, he championed an unsuccessful ballot measure that would have created an office of public advocate in San Francisco — a position he was rumored to want.

From 2004 to 2007, Campos was general counsel for the San Francisco Unified School District. He began his career in government as a deputy city attorney in San Francisco, from 1999 to 2004.

— Emily Green

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