Our Exclusive Halloween Ogre Visits Again

The leaves are falling, blanketing the parks of Washington with their gold and red.  The breezes bring a chill now as the days shorten. . . .

Wait a second, didn't I write something much like that a year ago?  Let's see, there was To Peris(h) by Bicycle, Autumn Comes to 45-deg N, and what was it?  Oh yes, An Exclusive Halloween Ogre Just for Us!

Halloween is in the air once more.  It is again the time of witches, fairy princesses, hobos, Boo Radley, and the Hollywood fantasies of a childhood younger than mine.  It is the time when I am again reminded of the transgender exclusion, that special ogre that visits transgender women, men, and children of all ages in the form of exclusionary clauses in medical insurance policies.  In macabre fashion, these clauses deny coverage of medical procedures that are in any way connected with or, in the eyes of insurance providers, a consequence of gender transition.  

In many cases, the services being denied to transgender persons – such as estrogen or testosterone medications, hysterectomies, or mastectomies – are regularly being provided to others who are not transgender.  It is not uncommon for an insurance provider to deny coverage for claims for gender-specific care based on the person's gender marker on file with insurance.  For example, insurance may deny coverage to a transgender woman who develops prostate cancer.

The transgender exclusion brings consequences that may extend years beyond transition.  A provider may deny coverage for a heart condition if it decides that this condition was in any way transition-related.  My own provider, the Foreign Service Benefit Plan underwritten by Coventry, now routinely questions every claim whether it is directly related to my transition or not.

Last year I wrote of the growing list of progressive public and private employers who now offer medical policies without transgender exclusions  to their employees.  In the Washington, DC, area, American University is just the most recent addition to this list.  (See http://www.hrc.org/files/assets/resources/CorporateEqualityIndex_2013.pdf.)  Almost all employers that now provide transition-related coverage report that there has been little or no increase in premiums.  (See http://williamsinstitute.law.ucla.edu/wp-content/uploads/Herman-Cost-Benefit-of-Trans-Health-Benefits-Sept-2013.pdf )

"Has the U.S. Government (USG) joined this group of progressive employers over the past twelve months?"  I'm glad you asked.  

Alas, I regret to report that the transgender exclusion is still alive and healthily flexing his muscle in the FEHB plans offered to federal employees.  Sigh.  As equal employment opportunity and workforce diversity policies have progressed, health insurance has remained quaintly in the age of disco.

What I wrote a year ago still applies.  The answer has not changed, nor, I am given to understand, will it be any different in Federal Employee Health Benefit policies for 2014.

"Why has there been no change?" you ask.

"I don't know," your humble servant replies.

Unlike a year ago, however, I am now in a position to do something more than just wring my hands.  I am president of Gays and Lesbians in Foreign Affairs Agencies (GLIFAA).  We have written a white paper on the transgender exclusion in which we present all the arguments why this clause is discriminatory and must be removed.  We will be presenting this white paper to highly placed officials within the agencies whose LGBT employees are represented by GLIFAA.  We will be requesting that these agencies go on record with the Office of Personnel Management as favoring the exclusion's removal.  

Will this work?  We don't know, but we hope so.  

Meanwhile, as I wrote a year ago --

Beware as you make your rounds this Halloween night.  Amidst the witches, hobos, wizards, and zombies, our own exclusive hobgoblin lurks, waiting to pounce.  Someday he will transform into a beautiful fairy prince or princess, ready to grant all wishes.  Of this I am certain.  It hasn't happened quite yet, but like any fairy tale, this one too will have a happy ending.

For those of us covered by FEHB, may Halloween a year from now be ogre-free.

Rising from the Ashes

The sun is sinking low, the last rays filtering through the leaves and branches of the Norwegian pine that are my front yard in the lake region of Maine.  Three years have passed since I watched the sunset on the eve of my departure for Romania, worried about the future and not knowing quite yet that I had already set out on the path to gender transition.  Then, as now, the warm sun on an October day gave comfort and peace, a promise that somehow, however improbably, things would work out.  I took the promise with me, and the memory of that October sunset saw me through the weeks that were to come.

As I knew it would, life in Washington this year is proving to be both exhausting and exciting.  I broke away last Thursday evening and flew to Maine for a long weekend.  The reason was practical, to check on progress in the rebuild of my small camp.  The old camp, much like my old life, stood on a shaky, rotten foundation.  There was no way to fix it, my handyman said, other than to tear most of it down and start anew.  Where the camp once stood, there is a newly spread gravel footprint.  Between me and the Norwegian pine lies a black circle, the scene of a bonfire that consumed the old camp.  Building supplies are stacked to the side, ready to become the new camp that will rise on the ashes of the old.  The scene parallels my own life story of the past three years.  No longer can I turn around and walk inside to the familiar of the past.  Instead, I sit outside, exposed for all to see, the edifice of my new life a work still under construction.

I have slept nine hours each night since coming to Maine.  I am making up for a deep sleep deficit.  Six hours per night was the rule for the previous week.  The night before I left it was only five hours, and my coffee habit reached new heights to see me through the day.

Why such a deficit?  I have only one year in Washington before going overseas again, far away to Central Asia.  I have a real sense of a ticking clock.  Time is a precious commodity to be used as well as I can devise.  Even my personal life is being planned on a calendar weeks in advance.  My apartment has the temporary feel of a warehouse or dormitory, a place for sleeping and little else.

My official work keeps me busy, but this is only the base of my Washington life.  The volunteer job of serving as GLIFAA president is far more taxing and time consuming with meetings both official and unofficial filling the week.  (It is also one of the most personally rewarding jobs I have ever undertaken.)  Then there are my sisters, son, and friends with whom I want to spend as much time as possible.

Finally, there is dating.  Yes, without giving away details, I have begun dating as much as time will allow.  I have the very real sense that I must fit an entire decade of adolescence into a single year.  Dating for women at an overseas post is more difficult than in the US, and thus I must use this year more than just well.  Even the question of my sexual orientation is up in the air.  Borrowing a phrase from a friend, as of today I would say that I am asexual with romantic leanings.  I am much more attracted by personality than by physical chemistry.  I am, however, still only a 13-14 year-old adolescent girl.  By the time I'm on the Kazakh steppe a year from now, I want to have aged at least to my late teens or early twenties.

This weekend in Maine has been a beautiful autumn respite from the rush of Washington.  Much like the new edifice of my life, my new, better camp will rise from the ashes of the old.  Meanwhile, the last rays of sun shimmer through the branches of the Norwegian pine, bringing to a close an autumn day of peace in Maine.