Sharon Coolidge

scoolidge@enquirer.com

Cincinnati's public library Tuesday stood by its previous decision not to cover an employee's transgender transition surgery, citing costs.

Public Library of Cincinnati and Hamilton County Library employee Rachel Dovel, who legally changed her name from Nathan last year, brought the issue to light earlier this year after her insurance declined to cover gender confirmation surgery. The board initially declined to change their policy,

Tuesday's policy vote – which was unanimous – came after several people spoke, some emotionally about their own journey.

Dovel, 33, of Clifton Heights, had asked the board to give members of the transgender community hope.

The library will not add transgender medical needs to its insurance health plan.

"While we're sympathetic to the desire and even the need for transgender surgery, we're recommending no change for a number of reasons," board member Bill Moran said. "We are stewards of public money. It would not be fair to ask the public to pay, it's not just one rider. It’s a number of riders."

No costs were discussed publicly. The recommendation came from the board's human resources committee, which met privately June 2.

Dovel stayed for the rest of the meeting, visibly upset and crying. After the meeting, while board members were packing up to leave, board president Elizabeth LaMacchia told Dovel it was a "business decision." Dovel condemned the board, saying "I don't know how I go back into work tomorrow and continue to work for you guys when you're not supporting any of your employees... you should be ashamed of yourselves."

Outside the meeting, she added, "I hope someday they change their mind. If not I think history will look poorly on the decision they made today."

Her attorney, Josh Langdon, said, "No matter who the board believes should pay the costs – the library or (the insurance company) – it's unfortunate that the board chose not to send a more positive message in support of unity."

Dovel has worked at the library for 10 years. She is an electronic line assistant, a job in which she enters data on new materials into the system.

The library's board decision comes as transgender rights are at the forefront of LGBT rights. In December 2014, transgender teen Leelah Alcorn killed herself in Warren County, leaving behind a suicide note that said she wanted her death to mean something. It garnered worldwide attention, helping shed light on discrimination.

Cincinnati City Council member Chris Seelbach, who paved the way for the city to be the first city in Ohio to cover medically necessary transgender procedures for employees, spoke out during the meeting, asking the board to approve the insurance change "in the spirit of Cincinnati." After the vote he said the seven-member library board, which is appointed by judges and county commissioners, does not reflect the community. All but one of the members is white and older.

"Cincinnati has been a leader on inclusion efforts for the last decade – in particular, LGBT issues," Seelbach previously told The Enquirer.

Because the library has Anthem insurance – which in some cases covers the surgery – Dovel assumed she would be covered under the current insurance plan. But last year, on the day of the historic U.S. Supreme Court Obergefell v. Hodges decision that found it was a fundamental right for same-sex couples to marry, Dovel was told the library did not have the option to cover her gender confirmation surgery because of the exclusions in its contract with Anthem.

The following month, the library board, after a private discussion in executive session, voted not to change coverage for gender confirmation surgery, minutes from the meeting show.

Several Fortune 500 companies – including Procter & Gamble and U.S. Bank – offer transgender-inclusive benefits.

Nationally, large insurance companies like Anthem are being pressured under the Affordable Care Act’s non-discrimination clause. Ten states and the District of Columbia have explicitly banned transgender exclusions in most health plans. Ohio is not one of them.

Dovel's lawyer, Josh Langdon said Anthem has applied with the Ohio Department of Insurance to offer an optional policy rider to its fully-insured groups, like the library, to cover gender transition-related health care. It was approved, but Langdon said it's up to the library the option of providing coverage.

Dovel has filed an employment discrimination claim with the Equal Employment Opportunity Commission. The matter is pending.