State treasurer will comply with court order on health coverage for transgender people

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 “So, until it is no longer in force, I must comply with the court’s order.”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.

Treasurer Dale Folwell

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

Garner becomes latest NC town to adopt LGBTQ-inclusive non-discrimination ordinance

The Garner Town Council voted unanimously Tuesday night to adopt Wake County’s LGBTQ-inclusive non-discrimination ordinance, joining dozens of communities around the state in broadening protections from discrimination.

According to a resolution and inter-local agreement, Wake County will enforce the ordinance within the town The ordinance, which does not apply to religious organizations prohibits discrimination on the basis of “race, natural hair or hairstyles, ethnicity, creed, color, sex, pregnancy, marital or familial status, sexual orientation, gender identity or expression, national origin or ancestry, National Guard or veteran status, religious belief or non-belief, age, and disability.”

Garner is the seventh community within Wake County to adopt its own non-discrimination ordinance or sign on to the county’s. The others are: Apex, Cary, Knightdale, Morrisville, Raleigh and Wendell.

In April leaders from across the county gathered at Campbell University’s School of Law to celebrate the wave of new ordinances.Campbell’s law school has taken the lead in helping resolve complaints filed through the ordinance process.

As Policy Watch has reported, the new ordinances became possible when a state ban on new local protections — including nondiscrimination ordinances for employment and housing — was lifted. The ban was a legacy of the  brutal fight over HB 2 and HB 142, the controversial laws that excluded lesbian, gay, bisexual and transgender people from statewide nondiscrimination protections.

This year the LGBTQ people nationwide have seen been targeted by an unprecedented number of hostile bills in state legislatures. Though LGBTQ North Carolinians saw important legal victories last month, they have also been targeted by state legislation casting them as dangerous or mentally ill and been the focus of campaigns and protests fro local GOP officials. The ongoing political campaign was given a spot light late last month when masked right-wing protesters attempted to shut down drag queen story time events at libraries and private businesses.

Silence from UNC as public and private universities weigh in on Supreme Court abortion ruling

One week after the U.S. Supreme Court overturned Roe v. Wade with its landmark ruling in Dobbs v. Women’s Health Organization, public and private colleges and universities across the country have weighed in the elimination of a constitutional right to abortion.

From the University of North Carolina System and its flagship campus, UNC-Chapel Hill: total silence.

On Thursday Mimi Chapman, chair of the UNC-Chapel Hill faculty, released her own statement.

“When health and well-being are so threatened, what is our task as a community of scholars and practitioners?” Chapman wrote in the statement. “The real-world implications are so severe that we cannot hide behind worries about being “biased, uncivil, or too political.” We need to use our science, our moral, political and legal analyses, and our empathy to help our state make the best decisions for our citizens. As the University of the People, to do so is our job and our honor.”

“As I’m sure you know,  I do not and cannot speak for the University on these matters,” Chapman wrote. “So, I speak for myself and hope that provides you with a measure of courage and comfort in these difficult and uncertain days.”

Chapman is one of the founders of the Coalition for Carolina, which has been pushing back on what it says is the politicization of the campus and the UNC System by the Republican majority in the North Carolina General Assembly and their political appointees, who govern the university system.

In the absence of an official statement from UNC, UNC-Chapel Hill’s Gillings School of Global Public Health released its own statement on the ruling’s impacts on the day it was announced.

“I recognize that, as I make this statement, there are those in our community who support the Supreme Court ruling,” wrote Dean Barbara K. Rimer. “That is their right, and I respect the differences between people on the issues of abortion and reproductive rights. However, this is not and should not be an issue of politics. Abortion has never been the province of one party alone. And, when it comes to personal decisions, people have made choices that transcend party, religion, region and other factors. That is as it should be.”

“Self-determination over one’s body is a basic tenet of public health and enabling people to make choices about whether to end the medical condition of pregnancy is an integral part of that,” Rimer wrote. “Abortion is a part of the full complement of reproductive health services. The World Health Organization underscores this tenet by including comprehensive abortion care in its list of essential health care services. Bearing a child should be a personal, private, individual choice and should not be mandated by government. Ending a pregnancy certainly should not be criminalized.”

Other universities and colleges – in North Carolina and beyond – have not felt constrained in weigh in on the decision.

Duke University’s Duke Health released a statement last Friday, shortly after the high court’s ruling was officially released.

“Duke Health is committed to providing a full range of the highest quality family planning services, including abortion, in full compliance with current state laws,” the statement read. “This care is designed for the complex and highly sensitive health and emotional needs of people who are making childbearing decisions. Safe and reliable access to these services is a critical part of women’s health, and it is also a vital component of our educational mission to train physicians to deliver comprehensive care. We value the ability to deliver these critical services safely and compassionately, and we will assess changes if required by law.”

Johns Hopkins University, widely considered a peer institution to Duke and UNC in medicine and research, also released a statement the day of the ruling.

“As a major employer in Maryland with a presence in the National Capital Region and in Florida, and as a leading provider of clinical care, including health and well-being services to our students, we take seriously our obligation to the many populations we serve,” the statement read. “We have been monitoring closely the outcome of this decision and its implications for the provision of reproductive health care.”

“To the fullest extent allowed under the law, our institutions will continue to be guided by the evidence-based best practices established by medical and public health faculty experts and practitioners, which make clear that access to safe, legal abortion is critical for the health of individuals, families, and communities,” the statement read.

As private institutions, Duke and Johns Hopkins don’t face political constraints or fear of political reprisals from governing boards of political appointees. But public universities around the country have also spoken up on the decision.

The University of Connecticut released a statement this week saying it would continue to provide access to abortion as essential health care, as did the University of Michigan, the University of Oregon, California State University, the University of Wisconsin-Madison  and public universities across California. Several of those universities expressed concern as to how the decision would impact training and medical care at their university hospitals and medical schools.

In a message to his university community, University of Oregon President Michael H. Schill wrote that he was also concerned about the broader impacts of the ruling.

“This ruling is extremely distressing for many members of our community who see reproductive rights and protections as central to human rights,” Schill wrote. “It also may threaten other rights that many of us have come to rely upon. And, unfortunately, It is almost certain to fuel further division in our already polarized society.”

As Policy Watch reported this week, legal experts in North Carolina expect the ruling in Dobbs will be the beginning of an erosion of precedents involving legal access to contraception, the legality of same-sex sexual relationships and same-sex marriage.


Pew Research Center releases report from focus groups with transgender, non-binary Americans

This week the Pew Research Center released its findings from focus groups of transgender and non-binary Americans, in which they discuss their experiences, challenges and hopes for the future.

As Pew noted, their research comes at a time of increased visibility and acceptance of transgender people in American life as  evidenced by the U.S. State Department and Social Security Administration announcing earlier this year Americans  will be allowed to select “X” rather than “male” or “female” for  sex markers on passports and Social Security applications. At the same time, a number of states – including North Carolina – have moved to limit the rights of transgender people, what children may learn about them in school and may make teachers, counselors and administrators out LGBTQ students to their parents before they are ready.

One such bill, N.C. House Bill 755, is one procedural vote from heading to Gov. Roy Cooper’s desk. Though Cooper has signaled he will likely veto the bill, Republicans see it as a wedge issue in the coming elections.

From Pew’s announcement of its survey data:

A new Pew Research Center survey finds that 1.6% of U.S. adults are transgender or nonbinary – that is, their gender is different from the sex they were assigned at birth. This includes people who describe themselves as a man, a woman or nonbinary, or who use terms such as gender fluid or agender to describe their gender. While relatively few U.S. adults are transgender, a growing share say they know someone who is (44% today vs. 37% in 2017). One-in-five say they know someone who doesn’t identify as a man or woman.

In order to better understand the experiences of transgender and nonbinary adults at a time when gender identity is at the center of many national debates, Pew Research Center conducted a series of focus groups with trans men, trans women and nonbinary adults on issues ranging from their gender journey, to how they navigate issues of gender in their day-to-day life, to what they see as the most pressing policy issues facing people who are trans or nonbinary. This is part of a larger study that includes a survey of the general public on their attitudes about gender identity and issues related to people who are transgender or nonbinary. Those survey results will be released later this summer.

These focus groups were not designed to be representative of the entire population of trans and nonbinary U.S. adults, but the participants’ stories provide a glimpse into some of the experiences of people who are transgender and/or nonbinary. The groups included a total of 27 transgender and nonbinary adults from around the U.S. and ranging in age from late teens to mid-60s. Most currently live in an urban area, but about half said they grew up in a suburb. The groups included a mix of White, Black, Hispanic, Asian and multiracial American participants. See Methodology for more details.


The report delves into how those in the focus groups identify, when and how they realized they were transgender or non-binary and their experience navigating medical care, among other issues.

The report also uses pull-quotes from participants in the focus groups to highlight their experiences in their own voices.

Read the full Pew Research Center focus group report here.

Read more about methodology here.

Senators advance controversial ‘Parents’ Bill of Rights’ disregarding concerns of educators, LGBTQ advocates (w/video)

Members of the Senate Health Care Committee sought to limit debate over the Parents’ Bill of Right Thursday by restricting comments to only the portion of the bill that deals with parental consent for treatment.

But even with that narrow focus, more than half a dozen speakers told lawmakers House Bill 755 would be harmful to LGBTQ students, who may not be out to their parents or peers.

Gretchen Phillips

The current version of the bill prohibits curriculum that teaches about sexual orientation and gender identity in grades K-3. The measure also spells out parents’ legal rights to consent or withhold consent from participation in reproductive health and safety education programs.

If a child asked that a different name or pronoun be used, the school would be required to first notify the parents of the request.

Gretchen Phillips, a former teacher and Wake County parent, said she has real concerns about the health care implications of the bill.

“This is going to make it so teachers feel pressure not meet their students where their needs are, but to go by their parents’ comfort level, even when their parents’ comfort level is directly against the best interest of the mental health care of their children,” Phillips testified.

Iliana Santillan

Iliana Santillan, executive director of El Pueblo, said as a queer activist and former teacher she was troubled by the message the bill sends to young people like her own teenage daughter.

“When she was in third grader her peers would ask her why she didn’t have a Dad, why her Mom was with another woman. I am proud of who I am today,” Santillan said.

Santillan said rather than fast track this measure, lawmakers should turn their attention to the Leandro school funding plan.

“Get more nurses, get more counselors in the school system. What you are doing now is wrong and it’s going to damage families like mine. It’s going to further exacerbate the anxiety of my child.”

Olivia Neal said the bill was laden with discrimination against North Carolina’s LGBTQ community.

Olivia Neal

“I was a queer student in North Carolina public schools,” Neal said. “If this bill were made law in my youth, I would have lost many of the outlets that I had to explore and understand my identity without the interference of the government or the school system.

“Even as someone with parents who supported my queerness, I would have felt unsafe seeking help in my school, even mental health care, if I was constantly worried about being outed by my counselors before I was ready.”

Neal said students should be focused on learning in school, not worried about the backlash and abuse they might be subjected to when they return home.

“In some cases, school may be the only place where LGBTQ students can access supportive mental health care, but this bill would force them to run the risk of outing. The reality is for LGBTQ students, parents do not always have their best interest at heart.”

Forty-five percent of LGBTQ youth seriously considered attempting suicide in the last year, according to a recent survey by the Trevor Project.

“This bill is not about securing rights for parents, it’s about trying to eradicate LGBTQ identity from public life,” Neal added.

Taylor Cortes, a former educator, said the bill was unfair for LGBTQ youth and their families.

Ari Becker

“Unfortunately there are many households where children are not safe coming out. Forcibly making children come out in environments that are hostile will absolutely put their lives at risk,” Cortes warned.

“Children are not their parents’ property. They are their own people. And if they are in an environment that is not safe to their authentic selves, they need to be protected.”

Ari Becker told lawmakers before she was a graduate student at NC State, she was a homeless LGBTQ youth.

“A student who discloses they want to use a different name or pronoun to their teacher or health care provider may have good reason not to want this reported to their parents,” Becker testified. “Forcibly outing children will put them in physical danger.”

Becker said the bill as written would allow for broad censorship, leaving some educators unable to teach about historical figures if they were part of the LGBTQ community.

Sen. Ralph Hise

“Would this result in people life me being ousted from the classroom?” Becker asked.

Senator Ralph Hise (R-Mitchell) dismissed the concerns.

“Take a school nurse, how many hours do you think they have actually spent with a child?” Hise asked his colleagues.

“When it comes to health and those sorts of things, parents have been there since the children were born. They know the mental health issues they’ve gone through; they know the physical health issues and having a school professional on limited knowledge be able to make those decisions and not inform the parents should be criminal as a matter of fact.”

As for concerns a child might face physical abuse at home from being outed, Hise said teachers with proof have a duty to report that abuse to the department of social services.

HB 755 advanced on a voice vote Thursday and moves to the Senate Rules Committee next week.

Bonus content: Watch a sampling of some of the educators and LGBTQ advocates speaking out against HB 755.