Berkeley, CA employees may receive sex-change benefits
City looks into cost for insurance coverage for its 1,500 workers

BERKELEY After three marriages that quickly broke up as soon as she told her male and female spouses she felt trapped in the wrong body, Lynn Riordan decided she couldn't remain a man the rest of her life. So at age 39 she began taking hormones that would gradually begin her transformation from man to woman. Then, unemployed but with $11,000 scraped up from the equity on her home, she paid for a sex-change operation four years ago in Montreal. The procedures cost less there than in the U.S., she said.

"It seems to be a medical condition, not a choice, and many people have tried to be what they are not. I did, for 30 years, and couldn't do it anymore."

Today, the 49-year-old Riordan is an accounts clerk for Berkeley's finance department and, due to her persistence, the City Council is considering allowing sex-change operations to be covered as part of its employee health benefits.

City Councilmembers Darryl Moore and Kriss Worthington are asking the city managerand the city's personnel board to explore the financial feasibility of offering the benefit to the city's approximately 1,500 employees. They are to report back in six months.

Noting that the city's health care providers, Kaiser Permanente and Health Net of California, cover heart surgery and gallbladder surgery, Riordan couldn't understand why sex change surgery should be treated any differently.

"They have these exclusions specifically for transgender surgery being covered, and it's just not fair," Riordan said. "This is not about choice, it's a birth defect. It's just to alleviate suffering for some people, and, well, that's a noble thing."
Riordan said ignorance "is driving the fear to removing the exclusions to allow the surgery."

Brad Kieffer, a spokesman for Health Net, which insures 2.3 million customers in the state, said the company doesn't normally cover sex-change surgery under its group benefits, but will add it if a company or municipality asks for it.

Kaiser Permanente spokeswoman Alix Sabin said Kaiser offers sex-change operation benefits to all University of California employees and San Francisco city employees, but groups must ask for it to be included in their plan.

Why doesn't Kaiser offer the benefit without having to be asked?

"It's not because of Kaiser, it's because of society," Sabin said. "It's really controversial, that's really the answer. The society doesn't view it the same way as a birth defect. They view it as a psychiatric issue, and the psychiatrist and the patient make the decision whether it's medically necessary."

San Francisco started offering the benefit to its employees in 2001, said Marcus Arana, a discrimination investigator with the city's Human Rights Commission and one of the architects of that city's policy.

Arana said he faced resistance from people who feared it would end up costing the city too much money because those wanting the surgery would flock to San Francisco to get jobs or marry city employees just to get the benefits.

Insurance companies don't offer it unless specifically asked, and out of fear, he said.

"It's based on the fear that everyone will want sex changes," Arana said. "And it's based on the antiquated notion that these procedures are experimental or cosmetic, but the city of San Francisco has determined that it is a medically necessary treatment for transexualism."

Through 2005, the city collected $5.6 million from employees in increased premiums to cover the benefit, but paid just $183,000 on 11 claims for different surgeries, Arana said.

Worthington said many American corporations are already offering the benefit, so Berkeley should, too.

"I just think it's time for Berkeley to catch up with mainstream corporate America on this issue," Worthington said. "I think it's a medically desirable thing for Berkeley to include in health plans."

Moore said San Francisco's experience shows it won't cost Berkeley much money and it's the right thing to do.

"It applies to very few people, but we do have people who work for the city of Berkeley who should have this kind of surgery, and it's not cosmetic surgery," Moore said. "It's something we should offer to all our employees."

If Berkeley approves the plan, those who want the surgery will be able to avoid the financial and emotional hardship Riordan faced four years ago.

"There's so much suffering involved when you don't have the surgery," Riordan said. "Every single day you suffer it."