VICTORY! Court Rules Alaska’s Denial of Health Care to Transgender Employee is Unlawful Discrimination

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March 6, 2020

A federal district court today ruled in favor of Lambda Legal client Jennifer Fletcher and ordered that the State of Alaska’s denial of health care coverage to a legislative librarian based on its blanket exclusion of medically necessary transition-related surgical treatment from AlaskaCare, the state employee health care plan, is unlawful sex discrimination that violates federal law.

“Transgender employees should never be forced to endure what Jennifer endured, to be denied potentially life-saving treatment simply because of who they are,” Lambda Legal Counsel Tara Borelli said.

“Jennifer was denied coverage for medically necessary treatment while her co-workers received full coverage for all their health care needs, all because of a discriminatory policy. The court rightly saw that as wrong and found that Alaska broke federal law, which prohibits sex-based discrimination in employment.”

“It was stigmatizing and traumatic to have my colleagues receive coverage for their medical needs while I was denied,” said Fletcher. “I am grateful that the court saw that treatment for what it was – unlawful discrimination – and I hope that this ruling means that no one else will have to go through being targeted for discrimination by their employer. We should all be able to count on our employers to treat us equally, especially for something as important as our health care.”

Jennifer Fletcher is 37-year-old resident of Juneau, Alaska, who works as a legislative librarian for the State of Alaska. She has worked for Alaska since 2012 and was promoted to legislative librarian in 2014. She is transgender, which means she was assigned male sex at birth, but her gender identity is female and she is a woman.

The AlaskaCare plan contains a blanket exclusion of transition-related surgical treatment, which has existed in the plan since at least 1979. Because the Carter-era exclusion remains in place, Fletcher had to pay out of her own pocket for surgical treatment in 2017, even after the State’s own consultant estimated in 2016 that the cost of coverage to the State was negligible. 

Beginning in 2018, the AlaskaCare plan began covering transition-related hormone therapy, recognizing that such treatment is medically necessary, but continues to categorically prohibit coverage for transition-related surgical treatment, even though it is also medically necessary.

Lambda Legal filed the lawsuit, Fletcher v. State of Alaska, in June, 2018, arguing that the State of Alaska is violating the sex discrimination prohibition of Title VII of the Civil Rights Act.

In March, 2018, the U.S. Equal Employment Opportunity Commission (EEOC) determined that there was reasonable cause to believe that the State of Alaska had violated Title VII.

All mainstream medical associations including the American Medical Association and the American Psychological Association recognize that transition-related surgical treatment can be medically necessary for an individual.

The AMA and other medical organizations have called for an end to discriminatory exclusions of medical care in public and private health insurance policies.