The Metro Employee Benefits Board of Nashville is once again considering a plan to expand employee health insurance to cover gender-affirming surgery for employees, but skeptics say it could be discriminatory for other employees or could get in conflict with the state’s new restrictive laws on such medical care.
The council, which is expected to vote on the issue next month, heard from transgender city employees and religious and medical experts affiliated with Vanderbilt University Medical Center. He also received a letter of support from Mayor John Cooper.
Cooper and the board’s supporters noted that many large companies already offer gender-affirming assistance to their employees. The Human Rights Campaign Foundations Corporate Equality Index found last year that 91 percent of the companies it evaluated offered “transgender-inclusive healthcare benefits.”
“We must demonstrate that we are not only a welcoming city to our visitors, but also to our residents and employees,” Cooper wrote. “Only then will Metro be able to attract and retain the diverse, creative and innovative talent it needs to succeed in the future and compete with our peer cities for top-notch talent. Include gender-affirming assistance at the Metro’s internal health coverage plans would allow Metro to catch up with Nashville’s major employers”.
The board voted 7-3 against that plan in December 2021 after five years of discussions on the issue. Members who voted against at the time said it would be discriminatory and likened it to paying for cosmetic surgery.
Jeremy Moseley, who voted for the idea in 2021 and said he’s still “generally supportive,” expressed skepticism this time around, noting that Tennessee has banned gender-affirming child care. The US Department of Justice is contesting that ban. Moseley suggested expanding benefits, even if only for adults, could lead to a challenge from state lawmakers.
“When we, as a council, typically try to step outside the bounds of public order in the state of Tennessee, usually a new law is created that says we can’t do something,” he said. “It’s a consequence that we have to be willing to acknowledge as a possibility.”
Board member Harold Finch expressed his doubts, saying that by helping a “subset” of employees, “we are, in essence, discriminating against other groups.”
Metro employees who have undergone gender-affirming treatment previously testified Tuesday that undergoing gender-affirming treatment significantly improved their mental health.
Brit Manor, an employee of the Davidson County Sheriff’s Office, said she started HRT in 2019 and eventually had a double mastectomy, sometimes referred to as “top surgery.” Manor said he needed to get a $10,000 loan to get the latter procedure done.
“It really broke my heart to find out that this was a procedure my employer specifically excluded,” she said. “I also felt confusion, disbelief and frustration because I thought Metro included gender identity. After my surgery, my health has improved dramatically. My mental and emotional well-being has been positively impacted. I am thriving socially and have more confidence than I’ve ever had.”
Alexandria Danner, an employee of the Nashville Public Library, said that prior to the transition, she suffered from severe anxiety and depression and struggled with drugs and alcohol.
“This feeling of hopelessness and incongruity with my body has caused me an amount of psychological distress and pain that’s hard to put into words,” Danner said. “For a long time, I didn’t think I knew I wasn’t going to make it at 25.” She added, 27-year-old Danner, who received gender-affirming treatment at 25, “I’m the happiest and healthiest I’ve ever been in my life.”
The American Medical Association, as well as all of America’s other major medical societies, have stated that they support gender-affirming treatments.
“This is life-saving medical care,” Dr. Christopher P. Terndrup of Vanderbilt Medical Center told the board. “We can provide stories, we can provide data. But I’d like to share with you that improvements in mental outcomes are incredibly important to this population.”
Frank Gluck is the health reporter for The Tennessean. He can be reached at fgluck@tennessean.com. Follow him on Twitter at@FrankGluck.
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