Micah Rich, a staff accountant with the Georgia Department of Audit and Accounts, said he felt like his life was on hold when his employer denied him doctor-recommended medical care.
“From the time I was first denied surgery, I expected to have it in a month or two,” he said. “But it was two and a half years before I actually had the procedures I needed.”
“It’s agony,” he said. “It’s a painful experience, living in a body that doesn’t feel like your own, and basically it’s just a constant discomfort where you have a constant fear of not feeling safe because of the way you look.”
Rich identifies as transgender, and he is part of a group suing the state for denying coverage of transgender-related health care in the Georgia State Health Benefit Plan.
After a long struggle that included canceling several procedures because he couldn’t find the money, Rich is doing better, thanks in part to friends pitching in to pay his medical bills. He says he wants to make sure no one else has to go through what he did.
“I almost feel a sense of duty,” he said. “It’s like I’m very lucky. I am very lucky to have so many people in my life who care about me. And the idea that there are other people out there who might not have as much support or might not know as many people as I did, so it just happened that they’re never going to have access to care, I don’t want that to happen to anyone else. “
The lawsuit was filed Wednesday in federal court in Atlanta on Rich’s behalf; Benjamin Johnson, a Bibb County school media officer and an anonymous Department of Family and Children Services employee on behalf of her young adult child, who is enrolled in the state plan.
Court filings describe the three transgender men’s struggles with gender dysphoria, a feeling of distress caused by the mismatch of gender identity with their physical characteristics. To treat it, the World Professional Association for Transgender Health recommends a transition process that can include social, pharmacological, and surgical components.
The lawsuit details several hurdles the three men said they had to deal with when seeking testosterone treatment and chest reconstruction surgery.
State coverage plans exclude sex-reassignment surgeries and related services, even when they are recommended by a doctor as necessary care, the lawsuit alleges. And while treatments such as breast surgery and hormone replacement may be available to members who need them for other conditions, they are not available to members who seek them as part of transgender health care.
That amounts to discrimination against transgender employees, said David Brown, legal director of the Transgender Legal Defense and Education Fund and an attorney for the plaintiffs.
“Time and time again, the courts have ruled that denying people health care because they are transgender is not only morally wrong, but illegal,” he said. “In June of this year, TLDEF won a landmark victory in federal court on this very issue after we sued Houston County, Georgia, in federal court in Macon over the exact same exclusion in its own employee health plan.”
In that case, a federal judge ruled that a veteran Houston County sheriff’s deputy was wrongfully denied health insurance coverage for gender-affirming care.
The state also had to settle lawsuits that successfully challenged transgender health exemptions in its Medicaid plan and the University System of Georgia employee health plan, Brown added.
“We are confident of success in this case as well,” he said. “There is simply no place for discrimination in Georgia, and we urge the state to quickly settle this lawsuit and begin providing fair health coverage to all of its employees and their families.”
This summer, Gov. Brian Kemp signed a law barring transgender children from participating in school sports on the team that matches their gender identity. Other states are looking to pass laws banning gender-affirming child care, as Georgia Congresswoman Marjorie Taylor Greene is leading the push to do the same at the federal level.
A June report from the University of California, Los Angeles estimated that 48,700, or about 0.6 percent, of Georgians over the age of 18 identify as transgender. For Georgians between the ages of 13 and 17, this number is 1.18%. The state plan covers about 660,000 Georgians, including civil servants, pensioners and their dependents.
According to the lawsuit, in 2016 United Healthcare told the Georgia Department of Public Health that removing the transgender exclusion would result in additional costs of about ten cents per member per month.
But Brown said cost shouldn’t be an issue when it comes to the state taking care of its employees.
“The cost of this health care is no different than the cost of any other health care,” he said. “It’s not a matter of price. It’s just a matter of fairness because the state of Georgia has a health plan for its employees to ensure that they are healthy, come to work every day, take care of their families, have that most critical need taken care of. “
This story reached GPB through a reporting partnership with Georgia Recorder.