Lambda Legal this morning filed a federal lawsuit against the State of Alaska on behalf of Jennifer Fletcher, a state legislative librarian who was forced to pay out-of-pocket for medically necessary surgical treatment because the state health insurance plan prohibits such coverage only for transgender state employees.

"Jennifer Fletcher was denied coverage for medically necessary treatment specifically because she is transgender. This is unlawful and stigmatizing discrimination that jeopardizes the health of hardworking state employees," said Lambda Legal Senior Attorney Peter Renn.

"The state employee health care program – AlaskaCare – covers medically necessary treatment for all state employees except transgender employees. That’s textbook discrimination by any standard."

“All that I am asking is that the State of Alaska stop discriminating against people like myself,” Fletcher said.

“My coworkers are able to receive coverage for their care, but coverage for transition-related care is denied. This sends a clear message that the State does not value me, and does not consider me equal to its other employees, by forcing me to pay out of pocket for my medically necessary care. How is this not discriminatory, when equivalent care is routinely provided to other state employees?”

Jennifer Fletcher is 36-year-old resident of Juneau, Alaska, who works as a legislative librarian for the State of Alaska. She has been working for Alaska since 2012 and was promoted to legislative librarian in 2014.

Assigned male sex at birth, she was diagnosed with gender dysphoria in 2014. In consultation with health care professionals, Fletcher started hormone therapy and transitioned to living openly as the woman that she is.

The AlaskaCare plan contains a blanket exclusion of transition-related surgical treatment, which has existed in the plan since at least 1979. Because of the exclusion, Fletcher had to pay out of her own pocket for surgical treatment in 2017.

Beginning in 2018, the AlaskaCare plan began covering transition-related hormone therapy, recognizing that such treatment is medically necessary, but continues to categorically prohibit coverage for transition-related surgical treatment, even though it can also be medically necessary.

In its lawsuit, Lambda Legal argues that the State of Alaska is violating the sex discrimination prohibition of Title VII of the Civil Rights Act.

In March, 2018, the U.S. Equal Employment Opportunity Commission (EEOC) determined that there was reasonable cause to believe that the State of Alaska had violated Title VII.

"Whether your insurance will cover medically necessary treatment should not depend on who you are," added Lambda Legal Counsel Tara Borelli.

“The State itself recognizes that transition-related care is medically necessary, which is why it covers hormone therapy. The only reason for this lingering blanket exclusion against surgical treatment is irrational discrimination.”

All mainstream medical associations including the American Medical Association and the American Psychological Association recognize that transition-related surgical treatment can be medically necessary for an individual. The AMA and other medical organizations have called for an end to discriminatory exclusions of medical care in public and private health insurance policies.