Tom Tobin

staff writer

Laine Delaney of Rochester was young when he awoke to who she was.

She liked to play with the girls, not the boys. It's where she felt comfortable.

It's where she felt true to herself.

Yet the world she inhabited — the world we inhabit, the world fired Rochester shock jocks Kimberly and Beck inhabit — told Delaney that, because she was born male, she couldn't, she shouldn't, be the person she felt herself to be.

She was a child who, like most children, believed in honesty. But she was told, indirectly, that she couldn't be honest with herself, that, if she couldn't be a boy, the world wanted lies over the truth.

"It was very confusing," Delaney said. "I remember being in school and being told I couldn't wear an off-the-shoulder shirt. Boys didn't do that, I was told."

Delaney made a life for herself, anyway. She became a transwoman — a male-to-female transgender female. She has worked in the white-collar world. She heads Trans* Alliance of Greater Rochester, a support group for transsexuals. She is a writer. She has faced down the prejudice and hate.

That's not the same as saying it has gone away.

Last month, Kimberly Ray and Barry Beck, former hosts of "The Breakfast Buzz" radio show on 98.9-FM in Rochester, were suspended and then fired for disparaging comments they made — 12 minutes of them — regarding the city of Rochester's announced intention to include transgender treatment, including "gender reassignment" surgery, as part of its employee health plan.

The firing resulted in a storm of reaction. Some applauded the quick dismissals. Some said the pair's free speech rights had been violated.

Medical acceptance

The controversy brought to the fore something Kimberly and Beck may not have anticipated — a serious discussion in the Rochester area about an issue that, despite the shock-jock chatter, is gaining acceptance in the medical and insurance communities.

Cultural and social acceptance is something else again.

Gender dysphoria — those distressed by their gender identity — is no longer considered pathological, local doctors and advocates said. Conversion therapy once geared to get people like Delaney to accept the gender she was born with has given way to greater understanding.

Gender "transition" — primarily hormone treatments, but up to and including reassignment surgery — has long been considered an appropriate medical course.

Insurers like Excellus BlueCross BlueShield, the Rochester region's largest health carrier, cover treatments as established, not experimental — if the employer client wants it.

"We've done this for years," Excellus spokesman Jim Redmond said, though he and others stressed that such a process involves psychological as well as medical interventions that may take years to complete.

"Gender reassignment procedures are covered under some of the MVP Health Care plans," MVP spokesperson Jacqueline Marciniak said. "However, benefits vary depending on plan type and coverage is governed by medical criteria that must be met prior to to procedure approval."

In short, there are few barriers to coverage other than the complexity of the process and the time it takes to complete it.

LGBT issues

Despite the comments of Kimberly and Beck, and some of the invective found on the Internet after their firing, Rochester is known as a progressive place when it comes to LGBT (lesbian, gay, bisexual and transsexual) issues.

Dr. William Valenti, staff physician at Rochester's Trillium Health, formerly AIDS care, which now specializes in a range of LGBT issues, said there are many myths about transgender individuals, most particularly that anyone who is transgender is also homosexual.

"For transgender people, mind and body do not match, Sexual orientation and gender transition are not the same," Valenti said. "One does not mean the other."

He said the psychological aspect of the treatment helps people adjust to the realities of the kind that Delaney discovered about himself at an early age.

"Public awareness is much higher now than it was, primarily because of the Internet and social media," Valenti said. "But gender is binary in many people's minds. You're one or the other. That's the way people look at gender identity.

"Culturally, socially, ethnically, religiously, we're led to these attitudes. In a way, we're programmed."

Valenti said it helps to understand that medical care and services for transgender people can vary according to individual needs.

For some, hormone replacement surgery is enough. For others, reassignment surgery is the route to mental and physical health for the patient.

Delaney said social biases are bigger than Kimberly and Beck, and that she doesn't blame them for what happened. "I wish them the best," she said.

Despite the many positive changes for those in the LGBT community, the stigma remains — and it can ruin lives. "Poverty is rampant because employers often won't hire us," Delaney said. "The suicide rate among the population is high."

"There is huge prejudice against transgender people," Pamela Barres, a transwoman, said. She and Jason Ballard, who is a transman, said private employers who resist these prejudices and who offer transgender benefits are making a good investment.

"The end result is that you're getting a more productive person," Ballard said. "You no longer have all these gender worries and other societal things on your back."

Private insurance

The number of private businesses offering all-inclusive transgender coverage, including surgery, has increased enormously in recent years, though the starting point was low.

According to the Human Rights Campaign, 17 percent of the Fortune 1000 — the largest 1,000 companies in America — offered these benefits in 2012. In 2004, only one company in that group did so. The numbers are even better among the Fortune 100. In 2012, 56 percent offered the benefits. In 2004, only one did.

Such coverage among Rochester's business is a hit-or-miss proposition. For example, Time Warner Cable's health plans for employees include gender reassignment surgery, while Paychex Inc.'s plan ordinarily does not.

"Transgender reassignment surgery has been provided for the last several years and Xerox employees have utilized the services available," Xerox Corp. spokesperson Bill McKee said.

Because of state Senate resistance, New York's Medicaid program for the poor and disabled, which is famous for the breadth and cost of its menu of services, does not include transgender-related medical services.

Gov. Andrew Cuomo has not made the issue a priority.

Nonetheless, state and local government are moving with some dispatch to ensure transgender health benefits are covered, Allison Steinberg, communications director of the Empire State Pride Agenda, a LGBT support group, said.

"Rochester has really stepped up," she said. "It is only the third city in the country to offer this kind of coverage."

For their part, Kimberly and Beck issued a written apology on the day their firing was announced. They haven't been heard in public since.

"I think it was sincere," Delaney said of the apology. "I'd like to think so, anyway."

TTOBIN@DemocratandChronicle.com

Twitter.com/tobin3