Montana Human Rights Bureau says Yellowstone County discriminated against transgender woman by denying her 'gender-affirming health care'

The Montana Human Rights Bureau sided with a transgender woman who claims her employer discriminated against her by denying "gender-affirming" care.

Yellowstone County unlawfully denied Eleanor Andersen Maloney "gender-affirming health care," the MHRB said, according to the Helena Independent Record.

In a complaint filed by the American Civil Liberties Union in September, Eleanor Andersen Maloney alleged that she received a letter of denial for transition-related health care services from the Yellowstone County's health care plan.

"I find that the County discriminated against Maloney based on sex when it denied her healthcare coverage under its healthcare plan that excludes 'services or supplies related to sexual reassignment,'" Barry Ivanoff, an investigator for the Montana Human Rights Bureau, wrote in his findings last week.

Maloney worked as a county prosecutor on child abuse and neglect cases from February 2017 to June 2018.

What are the details?

Initially, Maloney sought counseling after being diagnosed with gender dysphoria. She met with various therapists from December 2017 to May 2018.

The county's health plan had covered therapy sessions until April 2018 when she began exploring her medical options for transition.

"After the County denied Ms. Maloney multiple requests for pre-approval of coverage for medically necessary gender-affirming healthcare services, she filed formal grievances with Yellowstone County Human Resources, and ultimately filed a complaint with the Montana Human Rights Bureau," the ACLU wrote in a release.

The insurance company also requested a return of payments for her therapy sessions citing the same exclusion from coverage.

The county's insurance plan stated that mental health treatment must be for "recognized mental illness; and the treatment must be reasonably expected to improve or restore the level of functioning that has been affected by the mental illness," the complaint said.

In May, Maloney began the appeals process for her denial. She met with Yellowstone County Commissioners and requested removal of the transgender health care exclusion. She also filed multiple grievances with the county.

"If an insurance product carves out medical procedures, relying only on a person's status as transgender as the determinative criterion, this is a distinction based on sex and it violates the Montana Human Rights Act's insurance provision," Ivanoff wrote in his report.

In June, she resigned from her position based on the county's denial to approve her transition-related services, including laser hair removal, hormone replacement therapy, facial feminization surgery, gender confirmation surgery, among others, according to the complaint.

The transgender woman has since moved to western Montana where she works for a nonprofit organization. She provides legal services for battered women and children.
"I was denied medically necessary coverage because of an outdated and 
discriminatory insurance practice," Maloney said in a statement released by the ACLU. "It hurts to be treated differently just because of who you are."

What did the county say?

Yellowstone County "maintains there is no federal or state law designating transgender as a protected class, therefore, Maloney has no viable claim of discrimination," according to the documents.

What did the ACLU say?

Attorney Elizabeth Ehret said in a statement that the ACLU of Montana was pleased with the investigations' findings.

"It's very simple: discrimination on the basis of gender identity is illegal," Ehret said. "Yet, the only reason Eleanor was denied coverage for her health care was because of her gender identity. We are pleased with the findings of the Montana Human Rights Bureau and hope this leads to a change in Yellowstone County's policy."

What else?

The county has 30 days to respond to the Montana Human Rights Bureau's complaint.
A formal hearing will be scheduled if the parties are unable to resolve the complaint.
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