IN AN IDEAL WORLD, Alec Esquivel’s ovaries wouldn’t make headlines—the details of the transgender law clerk’s reproductive organs would be known only to Esquivel and his doctors.

But instead, Esquivel has decided to sacrifice his confidentiality—thrusting his most private parts into the limelight in what appears to be a groundbreaking fight for his right to health care.

Esquivel, an Oregon employee, filed a lawsuit against the state June 21, arguing that a blanket ban on sex-change operations by Oregon’s two public employee insurance plans directly violates the state’s anti-discrimination laws. Workers shouldn’t have to make their medical history a public spectacle just to get the state to follow its own damn laws, but good on Esquivel for being brave enough to come out and try to hit the state where it hurts the most: its budget.

If the state doesn’t agree to change its insurance plans so that every employee is covered equally, officials could be paying for a lot more than the cost of just one sex change: The lawsuit seeks $250,000 in damages.

Just this month, Portland City Council unanimously voted that city insurance must cover sex changes for employees. And now comes a perfect example of what will happen when employers aren’t so forward thinking: Workers will sue.

This is likely a first-of-its kind lawsuit. Although transgender prison inmates have successfully sued for coverage of gender-reassignment surgery, Lambda Legal, the LGBT advocacy group on Esquivel’s case, says it believes Esquivel is the first transgender state employee to step up and demand equal health care through the courts.

“I’m sharing a lot of stuff about myself that most people would rather not share,” says Esquivel. “But sometimes you have to do some education—and having a real face, a real person, makes it easier for people to see that discrimination is a real problem that affects real people.”

As the complaint filed in Marion County Court spells out, “Esquivel experienced increased anxiety, distress, and lack of sleep from the incongruity between his felt gender identity, which was now fully expressed outward as male, and his internal female reproductive organs.”

Esquivel has been living as a man since 2001, when he moved here to “escape from Nebraska” (as he puts it). He’s legally changed his name, his gender, and his birth certificate. For a decade, he has been diagnosed with gender identity disorder, with a sex change listed as the recommended treatment. But the state’s insurance providers—Providence and Kaiser—explicitly ban coverage for “all services related to sexual disorders or dysfunctions,” including sex changes and hormone therapy.

So since 2001, Esquivel has been paying for the treatment for his diagnosed, mainstream-doctor-recognized disorder, shelling out thousands of dollars for hormones and a breast removal operation. But when the insurance companies refused to cover his hysterectomy this year, Esquivel decided it was time to sue.

Not only does Esquivel not have the cash for the doctor-prescribed procedure (which can cost anywhere from $10,000 to 20,000), but he also wants to change a state insurance policy that clearly violates the state’s own anti-discrimination law.

ORS 659A was updated in 2007 to ban discrimination in the “terms, conditions, or privileges of employment” to someone because of their gender or sexual orientation.

There’s no excuse for Oregon insurance not covering doctor-prescribed treatments just because it deals with icky body parts. In a state where laws explicitly ban discriminating against employees based on their sexual orientation and gender, the only reason sex changes aren’t routinely covered is that insurance companies are three years behind the American Medical Association, which decided in 2008 that gender identity disorder is a disorder like any other and should definitely be covered by insurance.

Sexual Politics is an online column every week at blogtown.portlandmercury.com!

Sarah Shay Mirk reported on transportation, sex and gender issues, and politics at the Mercury from 2008-2013. They have gone on to make many things, including countless comics and several books.

13 replies on “Sexual Politics”

  4. This guy is a whiner. Just because you’re not born with the ideal body doesn’t mean other people should pay to transform you. That’s like me saying I have anxiety and can’t sleep at night because I am ugly, and now if my insurance doesn’t cover my plastic surgery I am going to sue the state costing shitloads of tax money and wasting a lot of people’s time. This guy should be thankful he was born with a healthy body. Maybe he should start doing yoga, search for some peace and stop wasting other people’s time and money with his ironically un-manly tears.

  5. Gender Identity Disorder is a mental disorder not a physical disorder and should be treated with counseling and psychological therapy to bring an individual to terms with who they are not who they think they should be.

    Mammals are not capable of being born the wrong gender nor are they able to naturally alter their gender.

    To encourage a person to mutilate themself because they have a mental disconnect from who they are is simplistic and primitive.

    To truly change the way people perceive gender a person has to be themself and show the world that what genitals they have does not decide what they can or cannot do socially.

    Cutting up a person’s body and pumping them full of hormones they do not naturally produce is not a way to cure a mental issue.

    That is why lobotomies have fallen out of favor.

    This is not about discrimination, this is about misunderstanding both on the part of the individual with the disorder, the doctor who prescribed giving up and just pretending that gender is something that can be assigned, and the people who think that there is discrimination in not providing “services related to sexual disorders or dysfunctions”. Because it is not a physical disorder. It is a mental one.

    If this becomes “ground breaking legislation” then the world will never understand science. It will just succumb to emotion on every argument and things will get further out of hand and away from a reasonable society.

    Let this person have counseling. Find a better way to come to terms with being a person.

    Mutilation is not an answer. Nor is any other kind of physical harm.

  7. Why the fuck can’t this guy save up his own fucking money
    to pay for his own surgery?! I absolutely disagree
    With the punk ass pdx city council voting
    That city insurance has to pay for this shit.
    Btw: I am not straight, white or male republican.

  8. this guy has no base for complaint sex change is a voluntary body augmentation. If he is covered them boob jobs and piercings should be covered.

  9. Why get sucked into the right or wrong debate about gender identity disorder (GID) and associated rights? There are so many unsubstantiated claims that obscure, simply, and outright distort the reality of the situation.

    Regardless of what folks think about the disorder, does anyone find the stand-alone claims “mainstream-doctor-recognized disorder” and “doctor-prescribed treatments” persuasive? The only thing that backs up these claims is that the AMA recommended insurers cover the disorder in 2007. The AMA isn’t a dispassionate scientific research organization. It credentials doctors and lobbies for their interests. Ask the AMA if they would recommend coverage under a universal healthcare scheme with negotiated rates. My guess is nay.

    Also, apparently the denial of coverage constitutes a clear violation of Oregon’s state constitution, in section ORS 659A. Look up that section online. It’s not a brief paragraph, it is a dense clause with multiple stipulations that span many pages. Without precedent or a favorable cultural climate, I’d put good money on the defense if they go all out. Either way, the inner workings of the legal system should be the focus, not a lay person’s unqualified interpretation of Oregon law without support or context.

    But what about those prudish insurance companies that balk at GID coverage because it deals with “icky parts’? They seem work well enough with entire disciplines of medicine (Proctologist, urologist, gynecologist, etc.) that deal with “icky parts”. Doesn’t seem like an excuse they’d put forth, although they probably will deftly channel GID bigotry and confusion to avoid unacceptable liabilities they don’t want to cover. Anybody who thinks that’s because of the “Ickiness” of GID is flattering themselves. Insurers attempt limit all forms of mental health coverage because it’s unpredictably expensive, period.

    Finally, what about the brave, quixotic lawsuit? If it succeeded would it be a big victory for the transgendered community at large. Maybe. Or it might encourage other state legislative bodies tighten state constitutional language to protect against future lawsuits, legal fees and higher premiums. In the process they could reverse other codified gains for the LGBQT community.

    In an ideal world this article would do more than skim the surface. In the real world, this article should have been a empathetic narrative that softly disarms readers instead of a condescending, poorly warranted lecture that puts undecideds on the defensive.

    Boo Mercury. You can do better. Not for the petulant critics. For the children … or something sentimental.

  10. The debate IS about what the rights / coverage of transgender people.
    Exactly which part of ORS 659a do you see as a clear violation of the State Constitution?
    Be specific, as I couldn’t find it.
    In my mind, the ‘inner workings’ of the legal system should serve to administer fairness of our system, not be the focus itself.
    http://www.guardian.co.uk/society/2004/jul…

  11. Alec gets my respect for taking this issue and running with it. Just because there is a social stigma around something do we deny treatment? In that case, we would deny treatment for alcohol or drug addiction, or vasectomies or anything having to do with “dirty parts.” I applaud Alec for what he is doing.

    Anyone who has met him would never think of him as anything other than a man.

  12. Equal rights for all human beings. Gender identity is not a mental disorder! It is a fact of human existence and also occurs in other species. We live in the 21st Century not the past where lots of bigots exist. If you haven’t talked with a transsexual person how would you know that you are mistaken in your views for saying that this condition is a mental illness. I know what mental illness is and gender identity is not a mental illness. Borderline Personality Disorder is a serious mental illness as is Bi-Polar Disorder. Get your facts right.

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