University of Arizona professor suing state to pay for gender reassignment surgery

January 25, 2019

PHOENIX — A University of Arizona professor is suing the state for refusing to pay for surgery he said is medically necessary to fully become a male.

Attorneys for Russell B. Toomey said he was born with female sexual organs but suffers from “gender dysphoria,’’ saying he considers himself a man despite the outward physical appearance.

In legal papers filed in federal court, the attorneys say that can require “medical steps to affirm one’s gender identity and transition from living as one gender to another.’’ And that can include everything from hormone therapy to sex-reassignment surgery.

“Being transgender is not a mental disorder,’’ wrote Kathleen Brody of the American Civil Liberties Union Foundation of Arizona, who is one of his attorneys. She said Toomey has been living consistently with his made identity since 2003 and is receiving testosterone for treatment of the dysphoria.

What’s bringing the case to court is that Toomey’s doctors have recommended he receive a hysterectomy as “medically necessary treatment’’ for the gender dysphoria.

Brody said the state’s self-funded health plan covers the same surgery when prescribed as medically necessary for other conditions.

But she said the plan “categorically denies all coverage for gender reassignment surgery regardless of whether the surgery qualifies ass medically necessary,’’ the lawsuit states. And there is no opportunity for state employees like Toomey to demonstrated that the care they seek is medically necessary, nor an opportunity to appeal any rejection of coverage to an independent reviewer.

Brody said that all four health insurers who are providers under the health plan actually have adopted internal policies and standards to determine when surgery is medically necessary and therefore covered. But she said that doesn’t help Toomey because of the restrictions placed on those insurers by the state.

“Because the need to undergo gender transition is a defining aspect of transgender status, discrimination based on gender transition is discrimination against transgender individuals as a class,’’ Brody wrote. She said the categorical exclusion for gender reassignment surgery deprives Toomey and others of the equal opportunity to prove that the surgery is medically necessary under the same standards that apply to other medical conditions.

Toomey is doing more than asking for relief for himself. He wants a federal judge to void the exclusion in the state policy that governs health coverage for all state and university employees.

Neither the governor’s office nor the Board of Regents would comment on the lawsuit.