UofA Class Action Says Transgenders Get Unequal Health Care Coverage

Top Class Actions’s website and social media posts use affiliate links. If you make a purchase using such links, we may receive a commission, but it will not result in any additional charges to you. Please review our Affiliate Link Disclosure for more information.

A University of Arizona professor lodged a class action lawsuit against his employer, as well as the state of Arizona, over claims of failing to cover the medical costs of physician recommended gender reassignment surgery.

Lead plaintiff Russell Toomey, Ph.D., alleges in the UofA class action lawsuit that his doctor prescribed the surgery because of his medical condition – gender dysphoria.

However, the University of Arizona reportedly refused to cover the cost of a surgery included as a part of his gender reassignment, a hysterectomy.

“The State of Arizona provides healthcare coverage to State employees through a self-funded health plan controlled by the Arizona Department of Administration,” explains the UofA class action lawsuit.

“The Plan generally provides coverage for medically necessary care, but singles out transgender employees for unequal treatment by categorically denying all coverage for ‘[g]ender reassignment surgery’ regardless of whether the surgery qualifies as medically necessary treatment.”

According to the University of Arizona class action lawsuit, Dr. Toomey has been identifying as a man and has been living consistently as a male since 2003.

The plaintiff says he started taking testosterone supplements in 2003, and had a prescribed mastectomy the following year.

The UofA class action lawsuit claims that Dr. Toomey was diagnosed with gender dysphoria and has since been recommended a hysterectomy, or removal of the uterus – a widely accepted course of treatment for gender dysphoria.

“The Plan provides coverage for the same hysterectomies when prescribed as medically necessary treatment for other medical conditions. But, the Plan categorically excludes coverage for hysterectomies when they are medically necessary for purposes of ‘gender reassignment,’” notes the University of Arizona class action lawsuit.

Dr. Toomey says the University of Arizona’s health plan for employees excludes gender reassignment procedures. While plan beneficiaries can appeal the denial of coverage for other medical procedures, he and others seeking gender reassignment are not allowed to participate in the appeals process.

“Transgender individuals enrolled in the Plan have no opportunity to demonstrate that their transition-related care is medically necessary, and they have no opportunity to appeal any adverse determination to an independent reviewer,” alleges the UofA transgender class action lawsuit

According to the University of Arizona class action lawsuit, state employees in Arizona are not provided coverage for any type of transgender surgery under any of the insurance plans offered by the state.

However, the insurance companies themselves provide opt-in additions to the policies that would provide a standard for determining the necessity of gender reassignment surgeries.

“In the past, some public and private insurance companies excluded coverage for treatment of gender dysphoria (or ‘transition-related care’), including surgical treatments, based on the erroneous assumption that such treatments were cosmetic or experimental,” contends the UofA class action lawsuit.

“Today, however, every major medical organization to address the issue has recognized that such exclusions have no basis in medical science and that transition-related care is effective, safe and medically necessary for treatment of gender dysphoria.”

Such a denial of medically prescribed care is a violation of the Civil Rights Act and Equal Protection Clause under the Fourteenth Amendment of the Constitution, claims the University of Arizona class action lawsuit.

Dr. Toomey wrote on ACLU’s Speak Freely blog that he knows of others who are harmed by the institution’s policies regarding gender reassignment procedures.

“Arizona provides the same discriminatory health plan to nearly all state employees and their dependents. That means hundreds, if not thousands, of transgender state employees or transgender dependents of state employees cannot receive medically necessary care,” stated Dr. Toomey in the post.

The University of Arizona class action lawsuit seeks to represent transgender individuals enrolled in the state of Arizona healthcare coverage.

The UofA class action lawsuit is seeking declaratory relief, as well as a court order requiring the University of Arizona and the state of Arizona to remove categorical exclusions of coverage for “gender reassignment surgery.”

The plaintiff is represented by Kathleen E. Brody, Molly Brizgys, Joshua A. Block, and Leslie Cooper of the American Civil Liberties Union Foundation and James Burr Shields, Heather A. Macre, and Natalie B. Virden of Aiken Schenk Hawkins & Ricciardi PC.

The University of Arizona Gender Reassignment Coverage Class Action Lawsuit is Toomey v. State of Arizona, et al., Case No. 4:19-cv-00035-LCK, in the U.S. District Court for the District of Arizona.

UPDATE: On March 6, 2020, a transgender University of Arizona professor filed a motion for Class certification for his class action lawsuit claiming that the state healthcare plan in which he is enrolled denied treatment for his gender transition and for the transitions of others on the same plan.