Should employers have to cover gender reassignment surgeries?

Some people think yes, they must do so or they are guilty of discrimination. Sandra Fluke and Karen Hu wrote a paper for The Georgetown Journal of Gender and the Law in 2011 that reviews employment, hiring and termination discrimination in the workplace against lesbians, gays, bisexuals, transgendered and queer (LGBTQ) employees. All fine and good. But then …

… the paper goes into Section III, where it discusses employment discrimination in provision of employment benefits. At some point, a line is drawn for everyone. I’d venture to guess Fluke and Hu may also run into something the government could mandate a person do or not do they find offensive and would not want to contribute to.

An example that may or may not cross the line for Fluke and Hu could be the government using tax dollars to send a kid to a Catholic high school or elementary school. For many liberals – a lot of them – this totally crosses the line when it comes to the “separation of church and state.” Even saying a prayer at graduation is a punishable offense, but that does not stop Fluke and Hu from demanding all employers – no matter their objections – pay for gender reassignment.

The argument, as I would think Fluke and Hu argue, is the “separation” works only one way.

Fluke and Hu refer to what they deem to be direct discrimination against LGBTQ persons because they are denied “insurance coverage for medical needs of transgender persons physically transitioning to the other gender.”

Transgender persons wishing to undergo the gender reassignment process frequently face heterosexist employer health insurance policies that label the surgery as cosmetic or medically unnecessary and therefore uncovered.

The paper goes on to argue there is a controversy within the medical community regarding the “treatment.” Supposedly the American Medical Association has “declared” the lack of coverage to be discrimination. One could argue the size of a woman’s breasts might be so traumatic to their psychological well-being employers should be mandated to provide breast enlargement surgery. I don’t even want to think of the other possibilities.

The paper is available online, but you have to pay $3.50 to buy it and it’s a secured PDF so I am not providing a direct link, rather a link to where you can buy it.

The argument of course will be insurance companies and employers should extricate themselves completely from the equation, and be willing to pay for this and anything else demanded by the doctor and patient no matter what. If not, you’ll be labeled as a racist bigot and your company will be targeted for destruction by the LGBTQ community.

Remember the California Proposition 8 maps? That map – still published today – provides specific “targets” on a map identifying individuals and the companies they work for who simply contributed the fund who wanted to changed the California state constitution to prohibit same-sex marriage. Boycotts, death threats and vandalism was the result.

More violence in the Castro District was documented by Michelle Malkin. And since then politicians on the right (exclusively) have been chastised for having a “target” in campaign ads … that never resulted in any violence at all.

The Face of Proposition 8 from Theremina on Vimeo.


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Steve McGough

Steve's a part-time conservative blogger. Steve grew up in Connecticut and has lived in Washington, D.C. and the Bahamas. He resides in Connecticut, where he’s comfortable six months of the year.


  1. kateinmaine on March 6, 2012 at 11:54 am

    cosmetic procedure–shouldn’t be covered.? out of pocket expense, period.

  2. crystal4 on March 6, 2012 at 1:26 pm

    A plastic surgeon once told me he does get some insurance companies to cover what he deems not cosmetic but necessary surgeries. (Don’t go off the wall..not all are necessary, I know.)? 1 example he cited was a young woman who had such large breasts she would not leave her house…it affected her mentally, she was depressed and? could not work because of it.
    Sometimes, he said, he gets an insurance to cover these “cosmetic” procedures, sometimes not.
    So the question is, if a surgery is needed to prevent say a suicide, would that transcend to being no longer “cosmetic” but necessary to save a life? He seemed to think so. He also told me in these cases where he felt it would be life-saving, he waived his fee when the person was only able to pay for the hospital.
    BTW, when I told him I thought he was a saint, he said ” No, Not really, I just charge the next couple of rich women more for the “lifts” they get”. (So, see, we all really end up paying for other people’s medical needs in some way or another, no getting around that.)

    • GdavidH on March 6, 2012 at 6:02 pm

      Crystal, that sounds like a slippery slope of subjective professional opinion.

      Does the Obamacare IPAB?have jurisdiction over this?? You know….The death panels that aren’t in it.?

    • Dimsdale on March 7, 2012 at 11:20 am

      If a doctor wants to give out freebies, by all means, let him/her do so.? If they want to practice income redistribution doing it, then are they part of the solution, or part of the problem?

    • yeah on March 8, 2012 at 7:46 am

      Hey crystal did you ever take a statistics class?? How is a <1% outlier reason to provide something for everyone?

  3. RoBrDona on March 6, 2012 at 2:38 pm

    I have a problem of what constitutes “affected mentally”. Who then rules on what is a desperate life-saving situation? I respect your altruistic doctor Crystal, and there is no question that some of these surgeries are needed on that basis, but it has to be very few. The vast majority must be considered cosmetic as the decision to change gender is NOT medically imperative, it is a lifestyle decision. ?

  4. Sad4CT on March 6, 2012 at 3:28 pm

    I’m affected mentally because I am not independently wealthy…? Sometimes I lie awake at night wondering if I will be able to pay all of my bills and still take the family on vacation to Hawaii…? I think someone should be mandated to put a couple of million dollars into my bank account.

    • GdavidH on March 6, 2012 at 5:57 pm

      Vote for O and start a green energy company.

      Hope this helps.?

    • Jeff S on March 7, 2012 at 7:57 am

      Don’t forget to be a campaign donation bundler and you’re in.

    • Dimsdale on March 9, 2012 at 8:29 am

      Or maybe “out” might be more apropos!? 😉

  5. Truthseeker on March 6, 2012 at 7:45 pm

    Why is the media even paying attention to Sandra Fluke?? As an American, she is entitled to her beliefs, but who cares?? She is a nobody like the rest of us.? When will the extreme talking heads?on both sides start ignoring these people rather than making them “media stars?”

    • JBS on March 7, 2012 at 9:17 am

      When Mr. and Mrs. Use Ful Idiot stop watching those programs. The Nealson ratings will go to Zero and advertisers will abandon ship. It’s happening slowly. Fox has to do a better job of just reporting the news, not shaping or making it.

  6. Shared Sacrifice on March 6, 2012 at 9:18 pm

    Why are the liberal and nature loving crowd always first to line up for surgical intervention when they feel that nature has done them wrong?? I once laid on a stretcher for nearly five minutes while a surgeon and two residents tried to figure out how to turn on the damned exam light!? The surgeon was amused with her two interns when patient turned the light on for them.? I should have offered a prayer to God that he might step in and help my doctors after I was anesthetized!? The surgery was necessary, they saved my life, but would I trust the same folks to cut and forever alter my little democrat?? Hell No!!!

    • JBS on March 7, 2012 at 9:18 am

      How many interns does it take to turn on a light bulb?

  7. ricbee on March 6, 2012 at 10:33 pm

    Who cares,every employer is going to stop offering health care anyway. Which will solve the high cost of care when we have to pay for it personally.

  8. Tim-in-Alabama on March 7, 2012 at 9:00 am

    This type of surgery needs to be performed in elementary school by the insurance plan of the patient’s parents. No one should have to wait until he/she goes to work to have plastic surgery to treat crazy.

  9. JBS on March 7, 2012 at 9:22 am

    So there is help and salvation (at the edge of a knife) for the terminally ugly and obese. Plastic surgeons (why does that sound odd?) will be in fat city (pun intended) with all of the work they will have. The new American Billionaires, plastic surgeons.

    • Lynn on March 7, 2012 at 12:04 pm

      All you have to do is walk around Sag Harbor and you will see Plastic surgery gone way beyond it’s purpose. I can’t believe they like what the Dr. Frankensteins have done to them. The plastic surgeons are laughing all the way to the bank. I hope none of these babes are complaining they can’t pay for birth control when they pay so much for plastic surgery and tatoos. YES I said BABES

  10. Lynn on March 7, 2012 at 12:07 pm

    Now as to the actual post here.? Should employers have to cover gender reassignment surgeries? NO

    • phil on March 7, 2012 at 5:24 pm

      Wait!? Today I want to be a girl.? Tommorrow, I want to be a boy.? Next day?? Who knows?? Barry has enough loot in his stash to cover it.? Like the Hokey Pokey.? “First you cut it off, then you sew it back.? That’s the Hokey Pokey, that’s what its all about!”
      Sorry. Rough day, I’m punchy.

  11. JBS on March 7, 2012 at 2:07 pm

    And, NO, employers AND insurance companies shouldn’t have to pay for someone’s whim. “I’m so depressed, I am tired of being who God made me, so . . . ” YUCK, SICK, Sick, sick.
    What if the changee doesn’t like who the changer makes them into?
    I’m stopping there, this is getting too weird . . .?


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