Gender-affirming health benefits for Nashville employees would be affordable, new report says
A new report prepared by supporters of gender-affirming care takes aim at the Metro Nashville Employee Benefits Board for not expanding those benefits for county workers this summer. The yearly cost per employee would have been comparable to a couple of store-bought coffees, they argue.
The Tennessee Equality Project rebuked Metro's decision to reject expanded coverage. It cites comparably sized cities that offer such coverage, and it uses the city's own estimates to point out that employees would have paid less than $8 per year more for the added benefits.
"Large metro cities comparable to Nashville, such as Austin, TX, Louisville, KY and Atlanta, GA, as well as other TN cities, including Chattanooga and Knoxville, already provide coverage of gender-affirming surgeries for their city employees," the study states. "Metro Nashville still does not offer this level of care for its employees."
The report was released Thursday, the same day the U.S. Court of Appeals for the 6th Circuit approved enforcement of bans on gender-changing procedures for minors, such as surgeries, hormones and puberty blockers, in Tennessee and Kentucky.
For adult Davidson County employees, hormone-replacement therapy for gender-affirming care is already covered.
But the Metro Employee Benefits Board rejected insurance coverage for gender-affirming surgeries for adult employees this summer. The 5-3 vote against the measure came 18 months after a similar proposal failed.
It would cost Metro between $135,000 and $250,000 more per year, a Deloitte accounting study determined in 2021. The Tennessee Equality Project report points out that that breaks down to between $3.98 and $7.08 a year additional cost per employee.
A 2022 study by the health policy and analysis organization Kaiser Family Foundation similarly found that at least 23 states cover such surgeries through their Medicare programs.
Report comes with ethics complaint for board bias
Members of the benefits board who opposed expanding benefits cited their political and religious opposition to such treatments. Others also said such benefits weren't needed. Board chair Edna Jones said she opposed expanding health benefits because "my God does not make mistakes." She also likened gender-affirming care for children to child abuse, in comments during board meetings.
Jones did not respond to a request to comment for this story.
Related coverage: Ethics complaint filed against Nashville Board for opposing gender-affirming care benefits
This statement, in addition to comments by board member Harold Finch that the city doesn't need to recruit transgender employees, prompted a formal ethics complaint against the members. The city's Board of Ethical Conduct ultimately dismissed that complaint.
"This report helps create visibility and awareness of how less than a half-dozen people are using this Board as a bully pulpit and keeping us from being the arms-wide community we truly want to be," said Dahron Johnson, the Davidson County co-chair of the Tennessee Equality Project.
Board members also argued that it would be "discriminatory" to provide this level of care for gender procedures but not for weight-loss surgeries like gastric bypass.
Metro's existing health coverage defines hair removal and breast augmentation and genital reconstruction surgeries as cosmetic procedures.
"Comprehensive gender-affirming care involves having a full spectrum of treatment modalities and procedures available to support those individuals requiring this type of care," the report states. "CGAC is medically necessary for the well-being of transgender, non-binary, and gender-expansive persons. Having comprehensive gender-affirming care available will save lives for those who need the holistic options it provides."
Frank Gluck is the health care reporter for The Tennessean. He can be reached at fgluck@tennessean.com. Follow him on Twitter at @FrankGluck.
Want to read more stories like this? A subscription to one of our Tennessee publications gets you unlimited access to all the latest political news, plus newsletters, a personalized mobile experience, and the ability to tap into stories, photos and videos from throughout the USA TODAY Network's daily sites.
This article originally appeared on Nashville Tennessean: Gender-affirming care in Nashville would be inexpensive, report says
