In an unprecedented move that challenges the current state of healthcare for transgender youth, a 15-year-old transgender boy and his family from King County, Washington have filed a federal class action lawsuit against a leading health insurer, Premera Blue Cross. The lawsuit alleges that the insurer repeatedly denied the teen, referred to as A.B., coverage for necessary gender-affirming surgery, highlighting a potential violation of sex and age discrimination laws.
A.B., who started identifying as male in May 2021 and began hormone therapy in February 2022, has been caught in an exhausting battle with Premera for months. The legal action taken by A.B.'s family follows a series of denied coverage claims for chest surgery, deemed medically necessary by A.B.’s providers. The insurer's refusal to cover this crucial surgery for a trans patient under 18 is at the heart of the current lawsuit.
Denise Diskin, one of the attorneys representing A.B. and his family and executive director of QLaw Foundation, criticized the insurer's stance. Diskin remarked, “Trans youth are being placed in this deeply contested, minority status and having their voice and agency taken away on a national scale." She pointed out the persisting myth that trans youth healthcare access is seen as overreaching by certain sections of society.
Contrarily, Premera insists it is committed to supporting access to gender-affirming care and highlights its age limitations are applied to various surgeries, not just gender-affirming procedures. However, A.B.'s attorneys counter this claim by arguing that the insurer does not impose similar age restrictions on comparable surgeries, like breast reductions, for cisgender youth.
Premera defended its position, stating that its medical policy for gender-affirming services is grounded in current, scientifically sound clinical evidence, implying that there isn't strong evidence to support surgical interventions in minors.
The lawsuit comes at a time when international guidelines on trans care have evolved. The World Professional Association for Transgender Health (WPATH) has relaxed minimum age restrictions on gender-affirming care for minors. WPATH argues that chest surgery could be performed earlier if the child's multidisciplinary medical team deems it clinically and developmentally appropriate.
A.B.'s attorneys argue that Premera’s policy is at odds with these widely accepted healthcare guidelines for trans individuals, and the insurance provider’s criteria for approval seem arbitrary. If successful, the lawsuit could pave the way for a broader transformation in the way health insurers handle gender-affirming care coverage for transgender youth, potentially leading to a more equitable and inclusive healthcare system. As Diskin pointedly puts it, "What that deprives trans youth, and by extension trans people, of is the dignity of using the health care and the health insurance that we pay for."
As the lawsuit awaits a response from Premera, it promises to shed a spotlight on the broader issue of healthcare rights and access for transgender youth. The outcome will be keenly watched by advocates of transgender rights and the wider healthcare community.
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