S.F. expected to approve sex-change benefits

The Associated Press
Saturday February 17, 2001

SAN FRANCISCO — The city that symbolizes liberalism and sexual openness is about to extend its health insurance to cover sex-change operations for municipal employees. 

The Board of Supervisors and Mayor Willie Brown are expected to sign the measure within the next couple of weeks. It will extend up to $50,000 in benefits to city workers who want to switch their gender. 

San Francisco apparently would be the only governmental body in the nation to make sex-change benefits available. The state of Minnesota offered such benefits, but the program was phased out in 1998. The issue was discussed in Oregon, but a commission decided against it in 1999. 

The benefits would be available starting July 1, but employees would have to work for the city for at least one year before they would be eligible. In addition, the coverage would be capped at $50,000. The city’s Health Service System board approved the benefit earlier this month.  

The benefit would cover male-to-female surgery, which costs about $37,000, as well as female-to-male surgery, which runs about $77,000.  

It also would cover hormones and other procedures. 

In order to have any procedures performed, employees first must go through an extensive medical review process that takes up to six months, said Nathan Purkiss, legislative aide to Supervisor Mark Leno, a leading supporter of the measure and founder of the Transgender Civil Rights Implementation Task Force. 


“You can’t just choose to do this,” Purkiss said. 

City employee Cecilia Chung said the surgery is necessary for her. 

Chung flew to Bangkok in 1998 and paid $6,000 to become a woman. It was much cheaper than having the procedure performed in the United States, but there also was an increased risk. 

“Unfortunately, I had medical complications since then,” said Chung, 35, who works for the Department of Public Health. “I’ve been trying to get the problem corrected, but it’s not covered from my regular health insurance.” 

Chung said she will be first in line to take advantage of the new insurance. She’s also thrilled to be part of a community that’s finally accepted openly. 

But transgender advocates said the measure’s symbolism is more valuable than the benefits. 

“I think it’s really politically important to do that,” said Susan Stryker, executive director of the Gay, Lesbian, Bisexual, Transgender Historical Society of Northern California. “Transgender rights are often considered as a joke: ‘What are those wacky San Franciscans going to do next?”’ 

Stryker, who had male-to-female surgery 10 years ago, said San Francisco’s transgender community numbers about 15,000. 

“Now, over the last five years the movement has grown and we have made more allies,” Stryker said. “We’re not looked down at as freaks.” 

The term transgender covers a broad range of categories including cross-dressers, transvestites, transsexuals and those born with characteristics of both sexes. 

People wanting sex-change surgery would have to pay 15 percent out of pocket if they use a doctor in the city’s health network. If an out-of-network doctor is used, that goes up to 50 percent. 

Ammiano said the city has at least a dozen transgender employees. All 37,000 city employees’ health costs would increase about $1.70 a month under proposed plan changes that would include the sex-change benefit as well as items such as hearing aids and acupuncture. 

Claire Skiffington, chairwoman of the task force’s health committee, has had all of her sex-change procedures completed — and has been fighting for 4 1/2 years to give others coverage for such surgery. 

“They thought California was going to dip into the ocean because everyone on the East Coast is going to move out here to get transgender benefits,” she said. “I do not foresee any increase of additional transgender hires.”