Chicago Transit Authority ( CTA ) will pay for the surgery needed by a male transgender employee after the city agency and its insurance provider initially refused, saying such procedures were only covered for patients with cancer.

Russia Brown has worked as a bus operator for CTA since 2016, the same year he began his transition process. He sought approval for insurance to cover a bilateral mastectomy.

"I assumed that the surgery would be covered since CTA is such a large [agency]," he said. "But about three or four months before my surgery date," I received an email from my surgeon's assistant, saying that the insurance rejected the surgery because they only cover bilateral mastectomies if you have cancer."

Brown spoke with a counselor with Howard Brown Health "to see what other options were out there," he recalled. "We discussed paying out of pocket or seeking my own insurance, but I didn't want to do either of those. Those are much, more more costly."

He was told, in fact, that the surgery would cost $30,000 were he to pay out-of pocket. That counselor later called Brown back with positive news, however.

"He said that he spoke with my situation with CTA, and he just so happened to be an attorney," Brown recalled. "He said to give CTA a call, that they might be able to help me. So I did, and they sent CTA a letter on my behalf. To my surprise, CTA agreed immediately. There was no pushback or anything. They just said, 'Okay, we're going to start covering this as of November 1, 2018."

The surgery was supposed to take place this past October, but, owing to the insurance complication, it has been delayed until March 2019.

"From the time that the letter was sent, CTA's response was very fast," Brown said. "They said that they pride themselves on being an organization that's diverse and providing their employees with the best care."

"Federal and state law requires insurance policies to pay for necessary medical coverage, including treatment for employees who are transgender, said Carolyn Wald, staff attorney at ACLU of Illinois," which assisted Brown. "We congratulate CTA for changing their policy and making the CTA a better work place for all of its employees."