State Treasurer Dale Folwell says he will comply with a federal court’s order to stop an exclusion against treatment for transgender people covered by the state health plan.
“I strongly respect the rule of law,” Folwell said in a statement Wednesday. “So, until it is no longer in force, I must comply with the court’s order.”
Earlier this month, a federal judge in Winston-Salem a federal judge ruled in favor of plaintiffs in a lawsuit challenging North Carolina’s exclusion of gender-affirming health care for transgender state employee under the state health plan.
Policy Watch reported extensively on the suit and related issues when the suit was filed in 2019.
“We obviously disagree with the judge’s order that is, in essence, assuming responsibility for determining plan benefits for sex transition operations. We’re also disappointed the court decided to stop the case from being heard by a jury of North Carolinians,” Folwell said. “However, I’ve always said that if the legislature or the courts tell me we have to provide for sex transition operations and treatments, I would.”
Folwell, a conservative Republican and former state lawmaker, is chairman of the board by virtue of his office. Gov. Cooper’s state budget director, Charlie Perusse, is also an ex officio member. The other members are all appointed by Folwell or the General Assembly, whose GOP majority continues to contend that transgender identity does not exist, but is the result of improperly treated mental illness.
That position is at odds with the view of the mainstream medical community, from the doctors who actually work with transgender patients to the American Medical Association and American Psychiatric Association. The APA recognizes gender dysphoria not as a mental illness but as “a conflict between a person’s physical or assigned gender and the gender with which he/she/they identify.”
More than 40 years of research into and treatment of transgender people experiencing dysphoria has led psychiatric and medical professionals to conclude the most effective course of treatment is gender transition — aligning one’s life socially and sometimes physically to better match their gender identity. Not all transgender people choose to medically transition, but for those for whom it is judged necessary, medical experts agree it can be life-saving.
That’s why Blue Cross/Blue Shield of North Carolina, which administers the State Employee Health Plan has, since 2011, recognized dysphoria as a serious medical issue and covered treatments related to transition, including hormone therapy and gender confirmation surgery. That’s in line with many private health plans, Medicare and the federal employee health plan.
The trustees of the state health plan voted to begin covering treatments for gender dysphoria at the end of 2016 in order to comply with federal anti-discrimination laws.
Folwell and the plan’s trustees allowed that coverage to expire at the first opportunity — not renewing it for the 2018 plan year and making no move to reinstate it since.
For years Folwell has characterized the treatment recommended by doctors for transgender patients as “elective, non-emergency procedures” and referred to the treatment as “sex change operations.” Read more