Jennifer Simmons

by Jennifer Simmons

We had a wonderful over the top Christmas season full of family activities, baking cookies, spending time with friends that we dearly love, and taking stock of the blessings that life had to offer. My writing took a back seat for a while after I started antidepressants. They worked wonders for my anxiety, but they completely destroyed my ability to get my thoughts in writing. Writing was always cathartic for me. It gave me an outlet to release some of the ghosts that set up house in my head. Everything finally looked like I may be able to live in peace until I decided to pursue getting gender confirmation surgery.


With everything falling into place it just made sense that the timing was right to take the next huge step in my transition. My idea was to do a video journal and share all the steps of the process with you. I wanted to show the struggles of losing weight and the processes of getting the required letters. Taking you guys and gals with me was important to me and it was somewhat comforting being able to share the experience. So I started the process of contacting the clinic. Their welcome packet came with all the required materials and duties they needed. I ripped open the packet like a five-year-old opening Christmas presents. I was so excited we must have read through it six times that night. The first thing I had to do was get a letter from my general practitioner. She could see the excitement in my face as I showed he the list of requirements the letter needed. She was more than willing to write the letter and get it to the clinic. Next was the mental health letters from two therapists. My regular therapist sat with me and drafted the required letter. Boom! Another checked off box! I started getting the downstairs drapes removed. With laser taking multiple treatments I figured that by the time surgery came around that it would be taken care of. I had my first appointment with the urologist. He was informative and compassionate. He made Mandy and I feel comfortable with everything and answered every question we had for him. I was told that I needed to lose 40 lbs. to be approved for surgery. This was completely doable! We started a diet plan in our house and were off to a wonderful start.

Then the mail started coming in. It started with a claim for blood work from my general practitioner. Denied! A few days later another claim for my therapist. Denied! Then the others rolled in one after another. After the fifth claim came in I called my healthcare provider. They just told me the diagnosis code was wrong that I should have them resubmitted. I am not fluid in healthcare lingo so I thought it was a formality. I started calling the billing departments of the different clinics. They would either respond with “Okay we will send it through again” or “I will ask the doctor.” Then I started getting letters from them again saying that the claims were denied. I called the healthcare provider a few more times before I finally spoke with someone in the civil rights department. They informed me that my insurance does not cover gender identity or gender transition in any way. They were happy to include a letter that explained this followed with a memo attached saying how they do not discriminate “gender identity” was listed. It was a punch to the chest.

I emailed my benefits department to see if this was true. Their response was:

“I’m sorry that Highmark was not able to answer your questions regarding the availability for coverage for various types of services under our plans. I will address that with our Client Services Rep at Highmark.

Highmark is a third-party administrator for your company’s medical plan as it is a self-funded plan (not insurance). As such, the plan is only required to comply with federal mandates and it is exempt from all state insurance mandates. Our plan does not cover gender transition/reassignment services. Hopefully, this clarifies the issues that you are having with Highmark and why they have not paid various claims.”

I responded asking if there was a way to increase the coverage and if not when could this be addressed. Their response was swift:


Not at this time.

There has been no further information provided to me.

I can’t explain to anyone the devastation I feel. Mandy is upset but she is upset that it bothers me so much and she just wants me to be happy. She knows how unfair it is and why it upsets me but I still can’t explain how much this hurts me. Everyone says things like “It will be Okay. It will just take longer than expected” or “Maybe you should change jobs to get insurance that covers it”. I don’t need to explain to y’all that quitting a stable job that pays well while being transgender is not the best idea. It is more than just waiting. I allowed myself to get excited. I dropped that wall and allowed myself to be vulnerable and open. Now I feel violated on such an internal level that I do not know if I can approach this subject again and if I do, I don’t think I can allow myself to be excited about the process.


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