That's why it's reserved for cisgender people.

Jamison Green is president of the World Professional Association for Transgender Health (WPATH), formerly the Harry Benjamin Gender Dysphoria Association (HBIGDA). He has a new book out now, Making the Case for Transgender Health and Rights.

Jamison spoke Monday at the Capitol Hill Library to a capacity crowd.

Jamison first became involved in the health care issue when he was selected to be on the LGBT/HIV advisory committee in San Francisco. They were discussing whether to include the LGBTQ and transgender communities as part of their focus. After meeting for two years, they had a hearing in May of 1994 on why transgender people need access to healthcare. Green, who has a PhD in law, was chosen to write the official report.

It took six years to get the city — six years of monthly meetings — to agree to have one of their health insurance plans that they offer to city employees have exclusions removed.

The change was met with broad resistance from employers and insurance providers who feared the costs that would be incurred because of how transgendered individuals were viewed.

The only consideration was the demand for what was termed sex-change operations.

--Green

The actuaries were so scared that this was going to break the bank, and this is the argument that we are still hearing today; it’s going to break the bank to have transgender people included in health coverage. They didn’t think we get the flu or that we could break a leg or we might need a colonoscopy. They didn’t think about any of those things because we’re not human.

They think that there’s not enough people being bothered by this, ‘why should we be bothered by this?’ This is the damaging part of our social construction of both sex and gender. We trans-people are marginalized and treated as a minority that has no rights and that is not entitled to health. If we had access to healthcare, we would automatically be human beings. And if you don’t have access to health, then you are not a human being.

--Green

Health insurance exclusions have become a hot topic for nearly every American navigating insurance policies and changing laws, but nowhere more difficult than for transgendered people, Green said. Coding procedures and medical guidelines outline many services and procedures exclusively for men and women, Green said, causing serious limitations that even extended to breast reconstruction for women who had battled breast cancer in certain cases.

My argument always was if you include trans-people across the board, it will not cost a penny.

There will be no increase, because trans-people are already covered under your plan if they have a job; they just can’t access the plan. If they are medically indigentt and just have Medicaid services, they are still covered under those services.

--Green

Employers are the consumers of insurance policies, so employers are the customers and the customer is always right. We now have two-thirds of Fortune 500 companies that offer trans-inclusive health coverage.

There has been a lot of progress, but we must press on.

--Green