A proposal by Boston City Councilors Michelle Wu and Ayanna Pressley to assist transgender city employees is worthy of praise and replication across the Commonwealth. The ordinance, filed earlier this month with the encouragement of Mayor Marty Walsh, would ensure that transgender workers — whose gender identity diverges from their sex at birth — are given access through their health insurance to mental health services, hormone therapy, and gender reassignment surgery.
While it is unclear how many city workers would benefit from the measure, Wu says this isn’t a numbers issue, but one of “fairness, equity, and human rights.” She added, however, that “covering transition-related surgeries improves the health of transgender people, which may save money in the long run.” In the past, gender reassignment surgery has been seen as a costly elective procedure, more akin to cosmetic surgery than a medical necessity. But recent studies have shown that offering transition-related care improves health outcomes for the transgender population, resulting in lower rates of substance abuse; for those diagnosed with gender dysphoria — a serious medical condition that can lead to distress, debilitating depression, and increased risk of suicide — access to comprehensive health care can be lifesaving.
Boston should follow the example of cities like Portland, Ore., Seattle, and San Francisco, which became the first city in the United States to provide insurance coverage for transition-related care for its workers in 2001. In the ordinance, Wu and Pressley point to Portland as a particularly relevant example, where “a mere 0.08 percent increase in costs” was experienced “after removing exclusions on coverage of transition-related care for city employees.” Other Massachusetts cities and towns should pay close attention and follow this new and inclusive standard of health care.