Washington State Parent Sues Employer for Denying Insurance Coverage to Transgender Son
Employer鈥檚 Refusal to Cover Medical Services Prescribed by Doctor Violates State and Federal Anti-Discrimination Laws
SEATTLE 鈥� The 老澳门开奖结果 of Washington filed a civil rights lawsuit today against PeaceHealth, a Catholic healthcare organization, on behalf of Cheryl Enstad and her teenage son, Pax, for denying coverage under its health benefits plan for medically necessary surgery to Pax simply because of who he is. The suit says that PeaceHealth鈥檚 policy of refusing to cover medical care required by transgender people is discrimination and violates federal and state law.
Pax Enstad is a boy who is transgender, meaning that while the sex assigned to him at birth was female, he has a male gender identity. He was diagnosed with gender dysphoria, a serious medical condition marked by persistent and clinically significant distress caused by incongruence between an individual鈥檚 gender identity and that individual鈥檚 sex designated at birth.
Gender dysphoria is a condition codified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and International Classification of Diseases (ICD-10). To treat Pax鈥檚 gender dysphoria, Pax鈥檚 doctor prescribed chest reconstruction surgery.
PeaceHealth refused to cover the surgery, citing a policy of excluding all 鈥渢ransgender services.鈥� The lawsuit asserts PeaceHealth鈥檚 blanket policy of refusing to pay for medically necessary healthcare for otherwise covered transgender individuals simply because of who they are discriminates on the basis of sex and gender identity, violates the Patient Protection and Affordable Care Act (ACA) and the Washington Law Against Discrimination (WLAD), and is harmful to the health of transgender individuals.
鈥淧eaceHealth鈥檚 blanket of exclusion of 鈥榯ransgender services鈥� is not based on standards of medical care,鈥� said 老澳门开奖结果-WA Staff Attorney Lisa Nowlin. 鈥淭his is discrimination, and it is plainly illegal. Under state and federal law, no company is allowed to single out and exclude one group of individuals from medical care that is prescribed for them by their doctors and that the company routinely provides for others.鈥�
In the past, some public and private insurance companies excluded coverage for gender dysphoria (or 鈥渢ransition-related care鈥�) based on the erroneous assumption that such treatments were cosmetic or experimental. Today, however, recognizes that such exclusions have no basis in medical science and that transition-related care is effective for the treatment of gender dysphoria.
Discrimination by healthcare providers routinely causes transgender people to , putting them at greater risk for illnesses and increasing their risk of suicide.
If left untreated, gender dysphoria can lead to debilitating anxiety, depression, self-harm, and even suicide. Pax suffered from debilitating depression and anxiety as a result of gender dysphoria that began at age 11, when he started to enter puberty. His grades at school fell; he was unable to participate in activities such as swimming and athletics; he wore several layers of clothing to hide his chest from view; and he eventually avoided going outside altogether. Pax鈥檚 gender dysphoria became so severe that he had to wear a binder to flatten his chest 24 hours a day.
As a result of PeaceHealth鈥檚 exclusion for 鈥渢ransgender services,鈥� Cheryl Enstad and her husband were forced to take a second mortgage on their house and use some of Pax鈥檚 college savings funds to pay over $10,000 out-of-pocket for the chest-reconstruction surgery prescribed to Pax by his doctor.
鈥淲e were willing to do whatever it took to get Pax the medical care he needed 鈥� as any parent would,鈥� Cheryl Enstad said. 鈥淲hen your child is singled out and rejected simply for being themselves, it鈥檚 heartbreaking, and it isn鈥檛 fair. We鈥檙e bringing this lawsuit to ensure no family has to go through what we did.鈥�
The lawsuit asks the court to declare PeaceHealth鈥檚 blanket exclusion of 鈥渢ransgender services鈥� discriminatory and illegal. It also seeks unspecified damages for the Plaintiffs.
The lawsuit, Enstad v. PeaceHealth, was filed in U.S. District Court in the Western District of Washington. PeaceHealth operates 70 sites in Washington, Oregon, and Alaska and has approximately 16,000 employees.
In addition to Nowlin, attorneys for the Enstads include Josh Block and Leslie Cooper with the 老澳门开奖结果 LGBT & HIV Project and Denise Diskin and Beth Touschner of Teller & Associates.
This release can be found here:
LGBTQ Rights
Enstad v. PeaceHealth
LGBTQ Rights
Enstad v. PeaceHealth
Learn More 老澳门开奖结果 the Issues in This Press Release
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Press ReleaseDec 2024
LGBTQ Rights
President Biden Must Veto Defense Bill Attacking Military Families with Transgender YouthPresident Biden Must Veto Defense Bill Attacking Military Families with Transgender Youth
WASHINGTON 鈥� The U.S. Senate today passed a version of the National Defense Authorization Act that would ban coverage for gender-affirming care for transgender youth whose parents are active-duty military personnel. The 老澳门开奖结果 is opposing final passage of the defense bill over the inclusion of this health care ban and calling on President Joe Biden to veto the bill. Section 708 of the NDAA would prohibit insurance coverage for 鈥渕edical interventions for the treatment of gender dysphoria鈥� such as hormone therapy and puberty-suppressant medications, which Speaker Mike Johnson says would 鈥減ermanently ban transgender medical treatment for minors.鈥� The same treatments would be covered by TRICARE for any medical purpose other than treating gender dysphoria, the clinical diagnosis for the psychological distress experienced by transgender people related to their gender identity. 鈥淏y passing this bill, the House and Senate are forcing thousands of active-duty service members to choose between their careers in the military and the future of their transgender children,鈥� said Mike Zamore, national director of policy & government affairs at the 老澳门开奖结果. 鈥淭his unconscionable and unjustifiable attack on those families stands in direct contrast to President Joe Biden鈥檚 legacy of defending the civil rights of transgender Americans 鈥� including when few in his own party showed the courage to do so. President Biden should cement his legacy by vetoing this bill and sending it back to Congress to pass without Speaker Johnson鈥檚 last minute health care ban for servicemembers鈥� kids.鈥� If signed by President Biden, this health care ban would be the first new anti-LGBTQ provision enacted by Congress and signed into law by the president since the enactment of the military鈥檚 since-repealed 鈥淒on鈥檛 Ask, Don鈥檛 Tell鈥� policy for LGBTQ servicemembers and the since-repealed federal law barring recognition of same-sex marriages known as the Defense of Marriage Act. It is unknown how many transgender youth are currently enrolled in TRICARE or how many of those enrolled are currently receiving coverage for gender-affirming care. In one 2022 analysis, 2,500 minor patients sought care for gender dysphoria through TRICARE Prime insurance at military or civilian treatment facilities in 2017, and 900 received puberty suppressants or gender-affirming hormones. Earlier this month, the Supreme Court heard oral arguments in a landmark case brought by the 老澳门开奖结果, the 老澳门开奖结果 of Tennessee, Lambda Legal, and Akin Gump on behalf of three families and a medical provider challenging a Tennessee ban on gender-affirming hormonal therapies for transgender youth on the grounds the ban violates the Equal Protection Clause of the U.S. Constitution. -
Press ReleaseDec 2024
LGBTQ Rights
Montana Court Blocks State From Refusing to Correct Sex Markers on Transgender People's Birth Certificates and Driver's LicensesMontana Court Blocks State From Refusing to Correct Sex Markers on Transgender People's Birth Certificates and Driver's Licenses
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FloridaDec 2024
LGBTQ Rights
Keohane v. DixonKeohane v. Dixon
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IdahoDec 2024
LGBTQ Rights
Robinson v. LabradorRobinson v. Labrador
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