PHOENIX — A University of Arizona professor is suing the state for refusing to pay for surgery he said is medically necessary to fully become a male.
Attorneys for Russell B. Toomey said he was born with female sexual organs but suffers from gender dysphoria.
In legal papers filed in federal court, the attorneys say that can require “medical steps to affirm one’s gender identity and transition from living as one gender to another.” That can include everything from hormone therapy to sex-reassignment surgery.
“Being transgender is not a mental disorder,” wrote Kathleen Brody of the American Civil Liberties Union Foundation of Arizona, who is one of his attorneys. She said Toomey has been living consistently with his male identity since 2003 and is receiving testosterone for treatment of the dysphoria.
What’s bringing the case to court is that Toomey’s doctors have recommended he receive a hysterectomy as “medically necessary treatment” for the gender dysphoria.
Brody said the state’s self-funded health plan covers the same surgery when prescribed as medically necessary for other conditions.
But the plan “categorically denies all coverage for gender reassignment surgery regardless of whether the surgery qualifies as medically necessary,” the lawsuit states.
There is no opportunity for state employees like Toomey to demonstrate that the care they seek is medically necessary, nor an opportunity to appeal any rejection of coverage to an independent reviewer, Brody said.
Brody said all four health insurers that are providers under the health plan have adopted internal policies and standards to determine when surgery is medically necessary and therefore covered. But she said that doesn’t help Toomey because of the restrictions placed on those insurers by the state.
“Because the need to undergo gender transition is a defining aspect of transgender status, discrimination based on gender transition is discrimination against transgender individuals as a class,” Brody wrote. She said the categorical exclusion for gender reassignment surgery deprives Toomey and others of the equal opportunity to prove that the surgery is medically necessary under the same standards that apply to other medical conditions.
Toomey is doing more than asking for relief for himself. He wants a federal judge to void the exclusion in the state policy that governs health coverage for all state and university employees.
Neither the governor’s office nor the Arizona Board of Regents would comment on the lawsuit.
