San Fran. Poised to Pay for Sex Changes

S A N  F R A N C I S C O, April 22, 2001 -- San Francisco is prepared to make historyby becoming the only city to pay for employees’ sex changes — amove some say is long overdue in ending discriminatory practicesagainst transsexuals.

“It really is a civil rights issue,” said Marcus Arana, atransgender San Francisco Human Rights Commission discriminationinvestigator. “We have an insurance issued that will pay for ahysterectomy in Mary but not in Marcus, and will pay for hormonetherapy in Mary but not in Marcus.”

After a five-year fight in the city’s Health Service System, thegender-switching benefits earned approval last week from a citycommittee and will go before the full Board of Supervisors onMonday.

San Francisco apparently would be the only governmental body inthe nation to make sex-change benefits available. The state ofMinnesota offered such benefits, but the program was phased out in1998. The issue was discussed in Oregon, but a commission decidedagainst it in 1999.

Public Support, E-Mailed Opposition

Several supporters have publicly endorsed the measure, and noone has spoken against it. Opposition has come only in e-mails andphone calls from people living outside San Francisco, mainly Texas,said Board Supervisor Mark Leno, founder of the Transgender CivilRights Implementation Task Force.

The term transgender covers a broad range of categoriesincluding cross-dressers, transvestites, transsexuals and peopleborn with characteristics of both sexes.

“We have transgender people living and working among us,” Lenosaid. “They deserve the same dignity and respect as every othercitizen. One way is to make sure the city provides equal benefitsfor equal work.”

On average, male-to-female surgery costs about $37,000, whilefemale-to-male surgery runs about $77,000.

The coverage extends to hormone treatment and medical matterssuch as mastectomies or breast cancer. It will not cover cosmeticprocedures and can only be used after a doctor deems treatmentmedically necessary. Employees first must go through an extensivemedical review process that takes up to six months.

Payouts Capped

Even if the benefits are approved, they will not be equal, Aranasaid. Transsexuals would have to be employed a year by the citybefore they’re eligible for the coverage, which also has a lifetime$50,000 cap and a 15 percent or 50 percent deductible, depending onwhether the physician is in the city’s health network.

“We hope to eliminate that down to 10 percent,” said TheresaSparks, a transgender member of the city’s Human Rights Commission.

Sparks underwent surgery to become a woman last year in Thailandbecause she couldn’t afford it in the United States. She’s paidabout $30,000 since she began making her transition in 1997, butwill still be able to enjoy the city’s benefits, which would kickin July 1.

Sparks said she hopes San Francisco’s adoption of transgenderbenefits sends a message to other municipalities that all employeesneed to be treated equally. She also hopes insurance companies willbegin extending similar benefits to private employers.

“It’s a symbolic benefit. The city is recognizing this is amedical condition and there are medical procedures that can correctit,” Sparks said. “How can the city enforce nondiscriminationordinances if they, themselves, are discriminating?”

About 14 of the city’s 37,000 workers are transgender. Allemployees’ health costs would increase about $1.70 a month underproposed changes which also include coverage for hearing aids andacupuncture.