University to Include Transgender Benefits

By Shelby Evans

The Razorback Reporter

On an extremely windy and one of the first cold days of the semester, instead of going directly to the Pat Walker Health Center for his weekly appointment, freshman Rhyker Dye procrastinated at the Arkansas Union. He knew he couldn’t stay there long; his next class was in 45 minutes and if he didn’t start walking, he would be late for anthropology.

Dye made it to the center as quickly as possible to avoid the cold but realized that he had forgotten his student ID number again. The receptionist knew him after seeing him every week since the start of the semester. When his named was called he walked into the examination room and handed his testosterone to the same nurse who has been giving him the shot since he began college.

She filled a syringe. She apologized for how long the injection was taking – just as she did every week. After about 10 minutes, Dye headed to his next class.

Dye is a transgender man, and receives weekly injections of testosterone. He has to pay for the hormone himself, but his insurance covers the injection at Pat Walker.

Student insurance at the university has covered gender dysphoria benefits, including testosterone prescriptions since August 2016, said Pam Delaney, UA student insurance representative for Academic Health Plans.

Starting in January, the UofA will include gender dysphoria benefits in its insurance for faculty and staff members, under a requirement from the Affordable Care Act, which prohibits discrimination based on gender identity, transgender status or gender stereotypes in facilities receiving federal financial assistance, said Richard Ray, UA director of benefits for human resources. The estimated LGBTQ population in Arkansas is 78,339, according to The Movement Advancement Project’s Arkansas Equality Profile.

Gender dysphoria is the condition of feeling emotional and psychological identity as male or female to be opposite to one’s biological sex, according to the American Psychiatric Organization.
Transgender describes people whose gender identity differs from that on their birth certificate, according to GLAAD, formerly the Gay and Lesbian Alliance Against Defamation.
“The easy version of that is: gender dysphoria is the problem and transitioning is the result. Transgender is just a term to describe this transition,” Dye said.

Coverage will include psychotherapy for gender dysphoria, cross-sex hormone therapy administered by a medical provider or dispensed from a pharmacy, laboratory testing to monitor the safety of continuous cross sex-hormone therapy and surgery for the treatment of gender dysphoria, Ray said in an email.

Procedures considered cosmetic and not medically necessary will not be covered, Ray said.

Benefits will now be covered because of a requirement from the federal government, and it was not covered before because it was “not a normal benefit to cover,” Ray said. “We’re just covering what is mandated by law and required by us as of January 2017,” Ray said. “It hasn’t been covered before, but that is a normal thing. This has historically been an exclusion.”

Last year, there were no benefits for gender dysphoria under student insurance, but now it is covered, Delaney said.

Last year everything was excluded, but now it is “It’s treated like we would treat needing to get a gallbladder removed,” Delaney said.

The yearly price for the student insurance plan is $1,836, which is covered from the beginning of August to the end of July, according to the Pat Walker website.

The university pays for at least 72 percent of the medical coverage for faculty and staff, according to the UA Human Resources website.

Dye does not have insurance through the university and has to pay for treatments himself.

“I have Tricare insurance through my dad since he’s in the military,” Dye said. “It’s really, really good insurance, and it usually pays for everything except for like, testosterone.”

Dye has to buy the hormones himself, but only the hormone shot procedure is covered.
“If I purchase my testosterone and take it to like Pat Walker, they just do a point of service fee and don’t really have to label what type of shot they gave me,” Dye said. “I have a prescription for it, but they don’t pay for it.”
The cost of testosterone is not expensive, but having the cost out of pocket can add up, Dye said.

The cost of testosterone injections range from $40 a month to $200, depending on the dosage and frequency of the injections.
“I don’t pay a lot out of pocket, but if it was able to be covered it would be a bit of weight off my chest and a validating feeling,” Dye said. “They don’t give it to me because I’m female, but if my dad needed it, it would be covered.”

Testosterone injections are not covered for Dye because of his biological sex, which is female, Dye said.

The Pat Walker Health Center does provide physicals and lab testing for patients, but does not provide hormone replacement therapy, said Zac Brown, the assistant director of communications for the Pat Walker Health Center.

“We do work closely with patients to assist them with referrals in the community and of course offer support through the Counseling and Psychological Services Center,” Brown said.

CAPS does not have a specific counselor for gender therapy, but all of the mental health clinicians are able to meet with any student, Brown said.

“All of our CAPS mental health clinicians work with the UofA’s diverse student body, including transgender and genderqueer students,” Brown said. “Every clinician’s top priority is to ensure our clients receive the support they need to be successful not only in their academic careers, but their personal lives as well.”

CAPS also offers a weekly LGBTQ support group, where students can connect, build friendships and have a support outlet on campus, Brown said.

Dye’s insurance also does not cover gender therapy, and in order to see a counselor, he has to list his therapy to be for depression and anxiety.

“I go for anxiety and stuff like that, which is true because I do have that, but it’s not the reason why I go,” Dye said. “It just has to be used as a cover that way my insurance we be like ‘Oh yeah we’ll pay for that,’ because if we said it was for gender therapy, they’d be like, ‘Oh we don’t cover that type of therapy.’”

Dye’s therapist told him how to receive therapy that would be covered by his insurance.

“She said she was a gender therapist, but she tells her clients to put on their insurance for anxiety or general stress,” Dye said. “And it’s not a lie, you’re putting a lot of stress on your body, and you have self esteem issues and trying to cope with everything.”

While his insurance does not yet have benefits for gender dysphoria, having insurance at the university cover it is a step in the right direction, Dye said.

“It’s never been covered before,” Dye said. “It’s a progressive step to cover stuff like this because if you ever talk to a transgender person, it’s always about money.”