Chicago Transit Authority to Cover Gender-Affirming Surgeries for Trans Employees

America’s second-busiest mass transit system will now start covering gender-affirming surgeries for its employees.

The Chicago Transit Authority (CTA) is rolling out a new policy that allows transgender employees to apply for medically necessary surgery through the agency’s insurance program, Cigna Health. While the plan has long covered hormone therapy and other forms of care affecting trans workers, surgeries were excluded from coverage.

Russia Brown, a bus driver for the CTA, assumed his employer would cover top surgery after he began medically transitioning in July 2016. The thought that Brown would be refused “never really crossed [his] mind,” he told INTO over the phone.

But that same month, the 28-year-old received an email back from the CTA saying his benefit plan only covered bilateral mastectomies in the event of cancer.

Brown claimed he was “very upset” at the news.

“I was very angry because I had already chosen a surgeon and I waited four months for the consultation,” he recalled. I had the consultation and I had been waiting maybe a month or two already for the surgery that was supposed to be in October.”

“They had to cancel it,” Brown added. “I really didn’t know where to go from there.”

A counselor at Chicago’s Howard Brown Health Center referred him to the American Civil Liberties Union of Illinois, who sent a letter to the CTA in September demanding the department cover confirmation surgeries for its trans staff members.

According to ACLU of Illinois Deputy Director of Communications Max Bever, the City of Chicago had “already figured this out.”

“[The City of Chicago] started covering it back in 2015,” Bever told INTO in a phone conversation. “So it was more of just a surprise that the city sister agencies hadn’t had a clear policy yet.”

What surprised Brown was that the CTA didn’t fight the request. The department changed its policy so he could receive the care he needs.

Brown was able to reschedule his top surgery for March 2019.

“I couldn’t hold my excitement together,” he said of learning the news. “I remember going to get on the bus to finish my route and I was skipping through the train terminal because I was just so excited.”

Carolyn Wald, a staff attorney for the ACLU of Illinois, added that there’s a big reason the CTA complied with the petition so quickly: It’s the law.

“Federal and state law requires insurance policies to pay for necessary medical coverage, including treatment for employees who are transgender,” Wald claimed in a press release shared with INTO via email.

Across the country, the ACLU has been lobbying to ensure city and state insurance plans are fully inclusive of the needs of trans people.

In Wisconsin, the civil rights advocacy group sued on behalf of two transgender women who were denied health care coverage as state employees. Alina Boyden works in cancer research at the University of Wisconsin Hospital and Clinics, while graduate student Alina Boyden is employed as a teaching assistant at the university.

Two months ago a jury awarded the plaintiffs $780,000 in damages. The state is currently appealing the decision.

But rather than oppose trans inclusions in their health coverage, the ACLU of Illinois credited the CTA with doing the right thing by meeting its legal obligations to its transgender staffers.

“We congratulate CTA for changing their policy and making the CTA a better workplace for all of its employees,” Wald said.

More than 11,000 individuals work for the CTA, although it is unknown how many transgender people will be affected by the policy. If the department’s staff corresponds with the percentage of trans people in the U.S. overall, around 66 workers now will be eligible for gender-affirming surgery.

More than 1.4 million Americans identify as transgender.

But in addition to covering its trans workers, Brown argued the CTA’s decision recognizes the special importance of bus drivers, train conductors, and other transit employees to the city of Chicago.

In his years of servicing America’s third-largest metropolitan area, Brown claimed he’s witnessed the special bonds between bus drivers and the public. When he’s assigned to a route long enough to get to know people’s schedules, he sometimes waits for customers he knows are running late to work or to get their children to school.

“People that have enough seniority, they pick the same routes every season when we get a chance to pick,” he explained. “They know the regulars and they build these very intimate relationships with them. They talk about their lives and give them advice.”

“I’ve actually seen a bus driver pay someone else’s fare,” Brown added.

As a transgender man who was terrified of coming out after seeing the 1999 film Boys Don’t Cry, Brown said the CTA’s decision was important in recognizing his struggles to be affirmed and respected for who he is. But as a driver, he was happy to see the department giving back to the employees who keep the city running every day.

“It doesn’t seem like it for a lot of people, but it’s a very important job,” Brown said. “The city does not move without the CTA.”