Houston Offers Inclusive Health Care to Trans City Employees Despite Failure of Nondiscrimination Law

Houston affirmed support for trans city employees even despite the repeal of its LGBTQ-inclusive nondiscrimination ordinance.

Texas’ largest city confirmed that it will be “offering comprehensive trans-inclusive health benefits to municipal employees,” according to the LGBTQ publication OutSmart magazine. Alan Bernstein, communications director for the city of Houston, claimed the move is intended to bring the local government in compliance with the Affordable Care Care (ACA), often referred to as Obamacare.

LGBTQ advocates say the decision is a major show of support for the city’s queer and trans community following the defeat of the Houston Equal Rights Ordinance (HERO) three years ago.

“As far as City employees go, no one’s health is being excluded,” Lou Weaver, transgender programs coordinator at Equality Texas, told OutSmart.

“This is a message that shows that the City of Houston is going to do everything that it can to take care of its trans employees,” he added. “Whether these employees are current or future, they now know that the city sees them.”

HERO extended the rights of equal access in all public accommodation based on 15 identity categories, including disability, military status, pregnancy, and gender identity. When HERO was voted down by a 61-to-39 margin in November 2015, it removed groundbreaking protections for people with disabilities, veterans, pregnant women, and transgender people enacted just 19 months earlier.

The ordinance was defeated after conservatives with the anti-LGBTQ campaign for Houston branded trans people as dangerous predators.

A 30-second TV spot released by the campaign warned that “registered sex offenders” or “any man, any time claiming to be a woman” could enter a public restroom and prey on women and children. In the commercial, an unseen boogeyman chases a little girl dressed in a Catholic school uniform into the bathroom and corners her.

The bigotry and vitriol unleashed by right-wingers three years ago is why Weaver believes the city’s trans-inclusive healthcare plan is a “huge win in Houston and in Texas.”

Currently, just two other cities in Texas Austin and Dallas offer healthcare to employees that recognizes each of their unique needs. These plans may include coverage for hormone therapy, gender confirmation surgery, or any care related to an individual’s transition.

These costs can be extremely expensive out of pocket. Transitioning costs an average of $20,000 over a two-year period a burdensome weight for a community that faces disproportionate levels of poverty.

But it remains to be seen if Houston’s trans-inclusive health care plan will become entangled in an ongoing debate about spousal benefits for LGBTQ city employees. In December, the Supreme Court declined to take up Pidgeon v. Turner, in which accountant Larry Hicks and religious leader Jack Pidgeon claim that taxpayers shouldn’t have to co-sign same-sex marriages.

That case has now been remanded to the lower courts, where it will be settled in the coming months. Any decision against LGBTQ couples could affect trans workers, depending on the scope of the ruling.

Studies have shown, though, that taxpayers have little to worry about when it comes to ensuring trans people have access to medical coverage. When San Francisco became the first municipality to offer inclusive care to transgender employees, the additional cost was so low that it disbanded the extremely minimal surcharge added to municipal health plans.

“[D]espite actuarial fears of over-utilization and a potentially expensive benefit, the Transgender Health Benefit Program has proven to be appropriately accessed and undeniably more affordable than other, often routinely covered, procedures,” noted its Human Rights Commission.

In the case of Houston, those costs are equally likely to be low considering how few transgender people will be affected.

The City of Houston has an estimated 23,000 employees. Although the number of individuals who are trans is not known, a 2016 survey from The Williams Institute found that Texas has the second-highest transgender population in the U.S., with around 125,350 adults in the state (or .66 percent) identifying as trans or gender nonconforming.

If the rate of trans people employed by city government is equal to the overall population, that comes out to around 150 people.

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