FROM POLICY TO PRACTICE
The change in insurance coverage is in keeping with Harvard’s non-discrimination policy, which states that any form of discrimination based on race, religion, sex, political beliefs, and other categories contradicts the principles and policies of the University. This list was modified in July 2006 to include gender identity.
“Putting the insurance policy in line with Harvard’s goals of equity and inclusion goes along with the non-discrimination statement,” says Eva B. Rosenberg ’10, chair of Harvard Transgender Task Force. She says that the University is working to find places where policies or practices may be discriminatory and trying to change those behaviors.
“A lot of people don’t realize that using a bathroom or checking off gender on a form can be stressful to gender nonconforming people,” she says. “Some of the discrimination that goes on is just unconscious or routine rather than in the form of harassment or outright malice.”
While part of the changed insurance policy came from attempts to adhere to the university’s non-discrimination policy, the removal of the exclusion of coverage for the surgery has been years in the making. UHS agreed to cover sex hormones when the new policy was adopted in 2006, but the transgender community continued to fight for other necessary surgeries and cosmetic changes necessary in the process of sexual realignment.
ENSURING COVERAGE
Ultimately, a combination of pressure from within UHS, TTF, and other transgender individuals studying or working at the University contributed to the most recent change.
“TTF is very lucky that there is a core group of mental health professionals and administrators who understand where we’re coming from and act as our allies,” says Morgan L. Haven-Tietze ’10, a member of TTF. “TTF used to have to sift for understanding people in the administration, and now there are people who speak persuasively on our behalf.”
One such spokesperson has been Sara Kimmel, a psychologist at UHS. Kimmel consulted many members of Harvard’s transgender community and advocated against the discriminatory policy. She wrote in an e-mail that a team of medical experts examined the safety and efficacy of the related procedures while deliberating on the policy changes, and determined that top surgeries for gender confirming purposes are often medically necessary for transgender individuals hoping to pursue medical transitioning treatment options.
“For students and employees who have a medical need for the procedures that are now covered, it is an important increase in accessibility to surgeries that significantly improve one’s quality of life and often are necessary for ensuring safety,” she wrote.
Recognizing transgender as a medical need was another reason for removing the exclusion.Many transgender people experience discomfort and depression because of the incongruence between body and mind, a sentiment that is becoming more widely accepted as constituting a medical need and a right to treatment.
In June of 2008, the American Medical Association resolved as an association to “support public and private health insurance coverage for treatment of gender identity disorder as recommended by the patient’s physician.”
THE BATTLE ISN’T OVER
Students and employees are hopeful that the remaining exclusions will be removed in the near future.
“As further medical technology develops there’ll be further discussion about removing exemptions; I am hopeful they can be removed soon, and I don’t think we should feel content until they are,” says Rosenberg, who says the battle is not over yet.
“Say your insurance covers chemotherapy and you don’t have cancer but someone else does,” she posited. “That’s why it’s called insurance—it’s supposed to cover you for many conditions you never have and some you might have someday.”
Sensing, who is planning on having the surgery within the next few months, uses similar logic.
“I wouldn’t object if I were asked to pay a few cents extra for someone else’s need to have insurance cover something like prenatal care or a prostate exam, or some other procedure not applicable to me,” he says. “If it helps someone in my community have a healthier and saner life, the extra cost is a non-issue. It’s just the right thing to do.”
“There’s still a long list of things that aren’t covered, and it’s unclear to me why some things are covered and some aren’t.” he added. “If you’re going to cover two, why stop there?”
—Staff Writer Alice E.M. Underwood can be reached at aeunderw@fas.harvard.edu.