Oregon Taken to Court Over Treatment of Trans Worker

Lamda Legal filed a lawsuit Tuesday against the State of Oregon over a denial of health insurance coverage for a trans employee’s gender reassignment-related surgery that was deemed medically necessary in order to treat his Gender Identity Disorder (GID).

The man in question, Alec Esquivel,  is a law school graduate clerking for the Oregon Court of Appeals. Sex-assigned female at birth, Esquivel was officially diagnosed with GID in 2001, at which time he began the long process of altering his physical gender expression to match his male gender identity.

In 2010 Esquivel sought as part of that transition process insurance coverage for a hysterectomy, a procedure that with few exceptions is routinely covered under employee state health plans. However, on June 21, 2010, the coverage was denied Esquivel based on the plan’s exclusion of transition-related health care. This Lambda Legal will now argue in court is a violation of Oregon’s nondiscrimination guarantees.

From the Lambda Legal press release:

“Alec Esquivel was denied coverage for a medically necessary procedure specifically because he is transgender. This type of discrimination is unlawful and risks the health of hardworking, productive citizens of Oregon,” said Dru Levasseur, Transgender Rights Attorney at Lambda Legal. “By not covering this procedure, the state is refusing to provide him with the same health care coverage as his co-workers.”


“Whether your insurance will cover a medically necessary procedure should not depend on who you are,” said Jennifer Middleton, attorney for Middleton & Lee, PC. “The Oregon legislature outlawed this kind of discrimination in 2007 and the State has no place continuing to practice it.”

Gender Identity Disorder is a serious medical condition recognized by the American Medical Association, the American Psychological Association, the American Academy of Family Physicians, and the National Association of Social Workers. GID treatment varies by individual, but can involve a combination of hormone therapy, sex reassignment surgery and Real Life Experience (living for a period of time in accordance with your gender identity). The AMA and other the organizations above have called for an end to discriminatory exclusions of medical care in public and private health insurance policies for people with GID.

“My doctor has determined that this procedure is necessary for me,” said Alec Esquivel. “Other people who work here and who need this very same procedure get the coverage they need, why shouldn’t I?”

Read more about the case, Esquivel v. Oregon.

Lambda Legal filed the suit against the state of Oregon and the Public Employees’ Benefit Board on the grounds that Oregon’s nondiscrimination law prohibits an employer from denying insurance coverage on grounds of gender identity.

Senate Bill 2, the Oregon Equality Act, passed in May of 2007 and brought into force January 2008, added sexual orientation to the state’s nondiscrimination statute as it applies to employment and housing.

Sexual orientation is defined by the statute as “an individual’s actual or perceived heterosexuality, homosexuality, bisexuality or gender identity, regardless of whether the individual’s gender identity, appearance, expression or behavior differs from that traditionally associated with the individual’s sex at birth.”

Related Reading:

New York Assembly Passes Trans Protections

VHA Issues New Directive on Trans and Intersex Veteran Health Care

Portland Adopts Trans-Inclusive Health Care Benefits


Photo used under the Creative Commons Attribution License, with thanks to brainchildvn.


Lika S.
Lika P6 years ago

I feel as if birthmarks of certain types and these gender reassignment of gender ought to be covered, but, I'm wondering what the law suit has to do with anything? Please excuse my ADD. Can someone please send to my inbox in plain English?

K s Goh
KS Goh6 years ago

Thanks for the article.

David J.
David J6 years ago

They should also be forced to pay for the addadicktome.

Faye S.
Faye S6 years ago

A friend of mine has a huge wine birthmark on his face which has had a psychological effect on him all his life. His doctor wanted it operated on to make it less prominent which would have made my friend very happy. Insurance company said 'nay-nay' and said the surgery was considered 'elective'...and not a life saving necessity.
The same could be said for Eric's situation. Just because a condition is recognized by the AMA (an organization which only 20% or less of USA's doctors are members), it doesn't mean the insurance company is going to agree to a surgery or treatment...unfortunately.

Mickey J.
Mickey Jones6 years ago

You go, Eric, may you get the treatment and surgeries that you need to make your life whole and complete!!

Beth M.
Beth M6 years ago

Since Gender Identity Disorder is recognized by the AMA, the hysterectomy should be covered. Tubal ligation is usually covered by insurance and that is an elective procedure. This should be covered, too, since this is an actual medical condition.