A transgender man has filed suit against Independence Blue Cross, claiming he was unfairly denied coverage for body-contouring procedures and had to pay for them himself.
On Nov. 5, “John Doe” filed a 15-page federal lawsuit in Philadelphia, alleging that Independence Blue Cross violated multiple laws by denying him gender-affirming care to treat his gender dysphoria.
The lawsuit claims the procedures requested by Doe are medically necessary, but Independence Blue Cross views them as cosmetic in nature.
According to the lawsuit, Doe purchased a “top-tier” health-insurance policy from Independence Blue Cross and fully expected coverage for procedures to alleviate his gender dysphoria.
“[Doe] paid premiums for health insurance coverage that [Doe] believed would constitute a ‘top-tier’ plan of health insurance,” the lawsuit states.
The masculinizing body contouring procedures requested by Doe include a body lift; tummy tuck; the removal of a flap of skin and fat called a “pannus” that hangs over the abdomen; a thigh lift; and liposuction.
Doe’s surgeon discussed with Doe that he had an “A-frame,” female body shape, thus necessitating the masculinizing body-contouring procedures, according to the lawsuit.
“[Doe’s] surgeon for the masculinizing body contouring procedures at issue had extensive experience in providing gender affirming care and treatment, and this was part of the reason [Doe] selected that particular surgeon,” the lawsuit states.
Doe’s therapist provided a letter of support which established the medical necessity of masculinizing body contouring procedures for Doe. The letter was subsequently submitted to Independence Blue Cross, according to the lawsuit.
“On or about December 7, 2022, [Independence Blue Cross] denied [Doe’s] preauthorization request seeking coverage for masculinizing body contouring procedures even though the procedures constituted a form of gender affirming care and treatment for [Doe],” the lawsuit states.
The lawsuit maintains that Independence Blue Cross applies its health-care policies in a biased manner against the trans community.
“[Independence Blue Cross] discriminated against [Doe] and other people who are transgender based on sex, gender identity, gender stereotyping, and disability (gender dysphoria), by refusing to extend insurance coverage to [Doe’s] and other people who are transgender suffering from gender dysphoria for masculinizing body contouring procedures as part of the health insurance plan offered to [Doe] by [Independence Blue Cross],” the lawsuit states.
Doe’s lawsuit also blasts Independence Blue Cross for creating unnecessary barriers to health care.
“[Independence Blue Cross], in practice, created a barrier for [Doe] and other people who are transgender to access medical services to treat their gender dysphoria,” the lawsuit states.
The lawsuit goes on to assert that Independence Blue Cross intentionally created the alleged health-care barriers.
“[Independence Blue Cross] intentionally created an obstacle for [Doe] and other people who are transgender to access medical services to treat their gender dysphoria,” the lawsuit continues.
Doe expended large amounts of money to pay for his gender-affirming care, according to the lawsuit.
“[Doe] expended large sums of money to pay for gender affirming procedures and related treatments not covered by [Independence Blue Cross] including approximately $27,471.00 to cover the aforementioned masculinizing body contouring procedures and related treatments,” the lawsuit adds.
Nevertheless, Independence Blue Cross still refuses to reimburse Doe, according to the lawsuit.
Doe seeks damages from Independence Blue Cross to not exceed $150,000.
The civil counts cited in the lawsuit against Independence Blue Cross include sex discrimination; disability discrimination; insurance bad faith; and breach of contract.
The case has been assigned to U.S. District Judge Kai N. Scott. A jury trial has been requested.
Attorneys for Doe had no comment for this story.
Grant Gegwich, a spokesperson for Independence Blue Cross, issued this statement: “We cannot comment on pending litigation. Our core mission is to enhance the health and well-being of the people and communities we serve. While we can’t comment on this case, what we would emphasize is that we serve all people, regardless of sexual orientation or gender identity. Equitable care and protections against discrimination based on sexual orientation or gender identification are written into our medical policies and required by law. Our policies for gender affirming care also take into consideration the standards published by the World Professional Association for Transgender Health (WPATH).”