This ended up playing out in milestone worries. I worried about each milestone I would hit during my transition. I’d hit one, then immediately worry about the next one.
I initially worried about my voice. My voice started dropping after three injections of testosterone. I worried that when it dropped enough, Lucky would be uncomfortable. Instead, he celebrated my deepening voice and laughed with me when my changing voice cracked. It still cracks three years on, but it happens less.
When it became clear he was fine with my voice, I worried about my face masculinizing. It took a while for that to happen, but when I started being reliably seen as male by strangers, Lucky was happy for me. In fact, he was ever the optimist, pointing out when folks might have seen me as male, when I was sure they didn’t.
I then worried about the muscle I was building. I built muscle faster and bulkier than most people with double X chromosomes before I even started on hormones. Testosterone just made it more prominent. In the first three months on testosterone, I gained ten pounds of muscle.
Lucky didn’t recoil, but professed some jealousy as to how I was just manifesting definition without any work. He also sympathized with me because building muscle that fast hurts like hell. I had to stop jogging for close to a year because the growing pains were terrible in my calves and thighs.
I worried the most about facial hair, though. Lucky had been a little worried initially about how he would feel about that. It’s also a powerfully masculine trait. There is no going back once you can grow a beard.
I shaved my baby fuzz ridiculously often, so he wouldn’t see it. I ended up shorting him out of an experience because I was so worried about it.
Lucky had been looking forward to helping me learn to shave my face for the first time. I had planned on waiting for him, but I was so worried that my shaving would freak him out, that I just couldn’t bring myself to let him see. Instead, I shaved before he got home from work, thinking he wouldn’t really care or notice.
I was wrong. It didn’t occur to me until that night when he said how sad he was not to be a part of it, that I had totally misjudged the situation. My husband wanted to be a part of my weird solo transition journey, and for him, teaching me to shave was a way he could help. I had panicked, and cut him out of one of the few ways he thought he could help me through.
He was good-natured about it, but I still felt bad for not letting him teach me to shave. I could see he was saddened by my choice to forge ahead without him.
As it would turn out, I didn’t have to worry about facial hair too much. I kept a 12 year-olds first facial fuzz for two and a half years. It wasn’t until I was closing in on three years on testosterone, that I started growing real bona fide beard hair.
It was after I made peace with the fact that I would probably never be too hairy, facially, that nature threw a beard at me. My family isn’t that hairy, nor do they sport beards, so I had assumed that was just me. Turns out, somewhere in my genetic history is a short hairy man, after all.
For his part, my husband never really cared. He now affectionately rubs my chin, and smiles at my beard. I know it’s for real, because he looks so happy for me. It makes me a bit ashamed for doubting him.
The last milestone I worried about was top surgery. I had large double D breasts. Binders had been only vaguely successfully at hiding them. I couldn’t shake the fear that once I had surgery, Lucky might not want to be with me.
All these fears were ridiculous. At each stage, my husband showed his love, and support for my transition, but I feared the worst.
It’s not that I didn’t trust him. I loved him with all my heart. It was because I know what happens to people like me. I wasn’t sure I could have my cake and eat it, too. There was a non-zero chance I would either be able to transition or have a marriage. Not both.
I’ve just never met anyone whose relationship survived one party’s transition. It’s not that it doesn’t happen, but it’s rare.
I think long standing relationships are hard to maintain for many people. Even the most normal, run of the mill people can break up. There’s that statistic that gets bandied about on the Internet that 85% of all relationships break up. Add additional stresses to that mix, and a serious set of social stigmas, and it’s not that shocking that partners of transgender people leave.
Even for my marriage, which is hitting 25 years, it was the additional pressure and social stigma that were the hardest factors about my transition. If Lucky and I had existed in a vacuum, my transition would have never been more than a bit of a curiosity. As it stands, we don’t live in a vacuum. We live in a world where people were very honest with him that he should leave me.
It’s because of all of these factors that I spent a great deal of my time worried that my husband was going to wake up one morning and decide he’d had enough.
Chapter Ten:
Fighting for Medical Coverage
It’s hard to fight, when the fight ain’t fair.
—Taylor Swift
From the Accidentally Gay Blog: Medical Frustration
Posted on March 15, 2015
The last few weeks have been a headache. Last August I left my state auditing job to come audit for the Department of Defense. The money is eventually going to be a lot better. I actually took a small pay cut to come here with the increased cost of benefits, but if I stay here two years, I will make 50% more than I made with the state.
I got here, and like I have talked about, there has been a mixed bag of reaction to being in a same sex marriage with a trans guy. Overall though I would say reaction has been good. However, the medical coverage is not so good.
Washington State passed a law that all state plans must cover transgender care—including surgeries. This got us really excited. After all, Group Health is the same plan I had at the state, and Group Health had just started covering surgeries. We were extremely excited that Wolsey’s top surgery would actually be covered.
However, as Wolsey’s doctor pointed out, the federal government doesn’t cover any sort of care like that. I called Group Health and they confirmed it as well. The federal government has a specific rider that denies any sort of transgender coverage. That means not only do they not cover surgery, but they specifically went out of their way to deny it.
At this same point, Group Health mentioned my old plan with the state had just been cleared to cover any trans care 100%.
I have called HR for my sub-agency, then the DoD itself, and finally I have left messages with OPM, the federal Office of Personnel Management, who handle all the benefits for DoD employees. I haven’t heard back and I am a bit frustrated.
Don’t get me wrong, we didn’t expect any assistance when Wolsey first started this journey, but when we heard our state had changed the law, and that my old job covered it, we were hopeful. I am a little frustrated that the feds can ignore what is required in our state for coverage.
Maybe I will get this worked out, but I know that is probably just a pipe dream. I figure once we are out of debt in a couple of years, I may consider going back to a state position. I will get paid significantly less, but the state holds outlooks closer to my own. You never know, maybe other agencies feel differently.
Lucky’s Perspective Now:
Dealing with the medical system for us has always been like dueling with someone in a fight.
For most of our lives neither Wolsey nor I had medical coverage, not even when he was a nurse for a decade. It was common for his medical employers to officially work him less than 32 hours a week, because if you weren’t full time then you were not eligible for benefits. They would then turn around and make him work 40 plus hours a week on-call.
We suffered through this for a long time, and it is why when Wolsey got sick right as I graduated, he almost died from Graves’ Disease, and I had to support him for five years as he underwent treatment. This is also why when I got injured, and needed minor surgery, Wolsey had to buy lidocaine on the internet and perform it on me him
self, using some of his nursing skills.
We had to go to poor clinics, and have doctors that didn’t give a crap about us, look us over. Being poor in America will kill you, just because you are poor. When I graduated, it was the first time in over a decade we had medical coverage and could afford to go to a doctor that cared.
Honestly, I think I got a little spoiled by this. I worked for the state for years, and while the insurance wasn’t necessarily a platinum grade, it covered everything we needed. Even when Wolsey first transitioned we had hope that it would cover his transition at least in a decent manner. We knew there were hoops to jump through, but surely we could navigate it.
Wolsey’s transition started approximately the same time I started a new state job. It was 2012/2013 and it turned out that it still wasn’t covered. We struggled along for quite a while. Wolsey was worried about the debt it would incur, but I didn’t care. His health and well-being was all that mattered, so we did what a lot of people couldn’t do. We prayed to the gods of Visa and American Express, and they began to pay for his treatments.
During this time Wolsey encountered other issues. There were few clinics that would see him without forcing him to attend years of therapy and living as a man without hormones. I still, to this day, do not understand how any of the providers could believe that a 40 plus year-old man didn’t know what he wanted. Especially since he had been struggling with it most of his life.
This resulted in us finding one of the local LGBTQ clinics and they were great. The problem is we had no medical insurance for it and they were pricey. They could afford to be.
Don’t get me wrong, I don’t blame them. Their prices weren’t too far out of the realm of reasonable, but it was expensive enough. It was also incredibly frustrating because we did have medical coverage for everything else and it seemed ridiculous these few things were denied.
However, I can’t say we kept to the high road because we were pissed that the insurance wouldn’t cover him for hormones. We had found out from my regular doctor that he could write me a prescription for testosterone and I would only have to pay $20 for a 90-day supply. We paid so much more for Wolsey’s. We could have tried to get me a script for testosterone, but we didn’t believe that was right. We could afford Wolsey’s meds with our credit card and that was the decision we made.
What we did do though was submit every single bill and appeal every single rejection all the way up the ladder. We had free time and we knew our free time was worth less than the admin/physician’s salaries to deny it. It was petty, but we were angry as we felt it was unfair.
This process continued when I switched from my state job to my Department of Defense job. It was the same insurance company, the same plan and the same doctors.
In late fall of 2014, we started getting a different denial. No longer were they telling us it wasn’t covered. The letters said it was out of network.
I didn’t catch it at first, but Wolsey, with his nursing experience, noticed the difference in terminology and we both got excited. We called the insurance company and were disturbed by what they said.
One of the reps told Wolsey they may cover it, but he would have to stop taking hormones and go to therapy until he was signed off. This is one of the times when Wolsey was more forgiving of human nature then I was. He was sure it was probably a training issue, as that didn’t seem to be workable at all. I just thought the rep was a moron and chalked it up to human stupidity.
We called again and found out that Washington State was passing a law. All insurance companies had to cover surgeries for someone who was transgender for the same reasons they would do it for a cisgender person. This would include letting Wolsey get testosterone covered because he has low testosterone because they offer me the same thing already.
He could get a mastectomy/breast reduction since they offered it to cisgender women who needed it for other medical reasons. This meant that insurance had to accept gender dysphoria as a diagnosis.
We were elated at this discovery. When 2015 came around, Wolsey immediately contacted our insurance company and worked with a transgender specialist to see a therapist that believes in “informed consent.”
There are two ways most therapists handle transgender patients. The first is requiring years of therapy before hormones or surgery so the therapist can be sure the patient is transgender. This is rather quite insulting and a holdover when they believed being transgender was a mental illness.
The second option was informed consent, where the patient would see a therapist once, and if the therapist believed the transgender patient actually had gender dysphoria, they could then have the patient sign some forms indicating they understand that hormone and surgical treatment could be permanent. However, once this form is signed, they wouldn’t have to jump through any more hoops.
We had finished all of this when we discovered that even though I was still with the same insurance company, they wouldn’t cover us for transgender care because I work for the federal government. Evidently the federal government had a rider on their insurance specifically denying transgender health care. If I had stayed with the state, this would have been covered at the start of 2015, and evidently they had given approval on the request before then.
I called the Office of the Insurance Commissioner and they walked me through the law. They at first believed I should be covered too, but we both found out that the federal government was one of two insurance riders that denied it. Somehow there was an Idaho insurance company that didn’t have to do it, either.
This was in violation of Washington State law. Sadly, the OIC representative explained they couldn’t do anything and that I would need to approach the human resources of my agency.
Thus, began my quest for answers. It started with a call to my human resources people. This was right after President Obama had signed an executive order for treatment of transgender employees. I thought I might get somewhere, but it was just the start of a lot of frustration. They showed no pity, no mercy and no give in my request for transgender coverage. They denied it. I had it with them and decided to move things up the road.
My next stop was to file an Equal Employment Opportunity Complaint (EEO) and to push it up the chain. I talked with our EEO officer and submitted it with the applicable Washington State laws and the notice about Obama’s executive order. The officer commented she had never seen such an organized start to a complaint. I guess it is good that I am an auditor for a living.
Three weeks later I got a response with boilerplate language saying, “At this time, FEHB plans are not subject to the transgender ruling issued by the Officer of the Insurance Commissioner (OIC).” In addition, the notice claimed this was due to the insurance company, not the federal government.
This yanked my chain and I couldn’t let it drop. I called the insurance company first, to make sure that it wasn’t their decision. They confirmed what I thought, that they had no input on the rider, that this was coming from the federal government. I then went back to the OIC, verified with them that this was in fact considered discrimination and that it was dictated by my employer and that they couldn’t do anything about the federal government.
Wolsey and I talked about this for a while. He was worried that I was still in my probationary period and he didn’t want to make my life harder. He talked about putting off surgery because we could keep using the credit card for the hormones.
I had considered it, but even if we could swing it, and he was willing to give up the rest of the transition, I realized there are others who are transgender in the portion of the federal government I worked. They may not have the resources or support that both Wolsey and I have and I couldn’t let it go. The social justice warrior in me was in full rage.
It was at this time that we read about a patient on Medicare that had sued for surgical services and that two different active duty members had sued the Army and won. This gave us both hope that it could be done. After all, we hadn’t finished raising the problem t
o HR’s superiors.
I called EEO and told them I wanted to push the complaint up the ladder. It took time for the EEO complaint to make its way up. At one point the complaint had gone to the highest point of contact in the Department of Defense. It then went to the Office of Personnel Management, the agency in charge of all HR/Benefits for the entirety of the federal government. It turns out I was the first federal civilian DoD employee to push for transgender rights for my spouse.
I knew there had to be more transgender people working for the federal government, so I couldn’t let up. I had found out that for some reason I was not allowed to talk directly to that HR/Benefit contact. Instead I had to go through my HR and then they would send answers back the same direction.
This continued for weeks until September of 2015. Then I got a call with good news. The Federal government was going to remove the anti-transgender rider at the end of the year. I was asked if I would let this complaint rest until then. I talked with Wolsey about what we should do. It is true, I could have pushed hard anyway, but we decided all of our contacts in the DoD had been more than fair (even if we disagreed with them) and we could wait.
While we waited, we contacted our insurance and told them to prepare for the rider to be lifted. Our transgender care specialist got all the paperwork set up so she could just sign the day it was lifted. Appointments were tentatively made with the surgeon.
Christmas was stressful, but happy and we were given the best gift. At the beginning of the New Year, Wolsey received the approval from our insurance company for transgender care, including top surgery. It felt like we had finally won the duel.
Wolsey’s Perspective Now:
I started my medical transition right before medical insurance would cover basic hormone therapy or surgery for transgender people. I knew this was most likely going to be an out of pocket expense for the rest of my life. I had no idea eventually the world would change and it would be covered in the future. It was worth it to me, even thinking I’d always have to come up with the cash, to transition.
Acidentally Gay Page 11
