Transgender woman denied mammogram wins battle with health insurance company



Beth Scott was shocked when her insurance company denied coverage for her routine mammogram.
She soon figured out why.
Aetna, Scott’s health insurance carrier, stated that the procedure fell under her policy’s exclusion for treatments “related to changing sex.”
Scott, a 44-year-old transgender woman from New Jersey, had developed breasts after undergoing hormone therapy.
Her physician had advised her to seek the breast cancer check.
After exhausting her appeals process, she enlisted the help of the Transgender Legal Defense & Education Fund for help in her reimbursement.
Scott, who eventually won the fight and received an apology from Aetna, is just the latest person to struggle against the institutional medical discrimination that transgender people face.
Due to exclusionary clauses in certain insurance plans, not only are people denied coverage for the medical procedured needed to undergo the gender change, they are denied ordinary care.
These clauses make it impossible to receive coverage for any procedure that could conceivably be linked to their transgender status.
“I’ve heard of transgendered people being denied coverage for blood tests,” said Noah Lewis, a lawyer for the TLDEF in New York. “I heard a story about a transgender woman who was denied coverage for a broken arm after the insurance company determines the injury occured while playing on a all-female baseball team.”
Transgender women and men are often denied routine gynecological care and medically necessary surgeries, including fibroid removal and hysterectomies, said Lewis.
Scott’s victory was a personal win, but could also help others in her situation.