What Health Insurance Options are Availible for a Transsexual With a Same-Sex Partner?
Q: Dear Shannon,
What is the best way for a male-to-female transsexual with a same-sex spouse and child to apply for health insurance that's not sponsored by an employer? Are there any transgender-friendly insurers that you can recommend?
My California driver's license says female. I'm married (before transition) to a woman. I am currently unemployed and I am now shopping for health insurance for my partner, our young daughter and me. Yesterday, for more than two hours, I filled out an electronic application for Blue Cross, only to be refused at the end because my legally wedded spouse and I are of the same legal gender.
I don't mind filling out more forms, talking on the phone or meeting with insurance representatives. But I thought some expert advice could help avoid complications.
Do you have any advice on how to describe myself and family to health insurance companies? Should we continue to describe ourselves as married women or as a lesbian couple? How do I describe the results of a Pap smear when I have not had one? How can I best describe the diagnosis that led me to take estrogen and progesterone? Or should I not mention my medications and pay for them without insurance?
Thank you for any information.
Helen
A: Dear Helen,
These are very good questions! Unfortunately, they are difficult to answer because different insurance companies (and even different individuals working for the same company) often respond differently to transsexual applicants who married before transitioning, and who therefore have same-sex spouses. With that caveat, however, here are a few suggestions.
Generally speaking, it is preferable to go through the extra work of explaining your true legal situation than to present yourselves as an unmarried same-sex couple. This is because you ARE married, and you are entitled to all of the rights and benefits that flow to married couples. In addition, if the validity of your marriage is ever challenged (which hopefully will never happen), it will be important to show that you and your spouse have always held yourselves out as a married couple, so presenting yourselves as unmarried is not advisable. (When it comes to filling out electronic forms, however, you may want to consider leaving the gender box temporarily blank - if allowed, so that you can avoid being automatically rejected and at least have an opportunity to explain your situation to a personal representative.)
As far as answering specific medical questions, there are no hard and fast rules. With regard to Pap smears and hormone therapy specifically, there are many other women, such as those who have had complete hysterectomies, who do not undergo Pap smears, and many who require hormone therapy for a variety of reasons.
Unfortunately, I am not aware of any companies with a national reputation for being transgender friendly. At the local level, however, it is often possible to find friendly companies or representatives through word of mouth.
Finally, it may be helpful to get a letter from an attorney explaining that you are indeed legally married, or to ask the insurance company to speak with a legal expert who can explain that you are legally married. The good news is that while it may take some extra effort and time, many other people in your situation have been able to purchase appropriate coverage. If you are unable to do so or run into other problems along the way, please feel free to contact me or another attorney who specializes in transgender issues.
Sincerely,
Shannon Minter
Minter is the legal director at the National Center for Lesbian Rights.
Nov. 11, 2002