My Son's Medical Care Wasn't Covered by Insurance Because He's Trans

This was not an optional surgery; it was a necessity for Pax. I believed—and still believe —that his life depended on it.
Photos courtesy the author.

Following the Supreme Court's decision in Masterpiece Cakeshop v. Colorado Civil Rights Commission, we are taking an in-depth look at how religious freedom is increasingly being distorted and exploited to justify discrimination against LGBT people, women, and others. This six-part series examines the resulting consequences through the firsthand accounts of those who have experienced it. You can read more from the series here.


For me, like for most mothers, being a mom means doing whatever it takes to ensure my children are happy, healthy, safe, and given every opportunity to be themselves and prosper.

Two years ago, my son Pax was denied coverage for medical treatment by our insurance. At the time, I was employed at PeaceHealth St. Joseph Hospital, and Pax was denied coverage under my employee benefit plan because he is transgender.

When Pax was 12, we could tell something was wrong. His grades plummeted, he avoided going outside as much as possible, and he no longer wanted to participate in any extracurricular activities. He was sleeping more. We met with his teachers, and got him into counseling. Still, his depression and anxiety worsened, so he started medication. He showed slight improvement at first, but not what was expected, then began to worsen no matter what we tried. Not knowing what to do was like hiking up an icy mountain with smooth-bottomed, worn-out sneakers. But we were sure trying.

That’s when he told us that he is transgender.

Watch: Gavin Grimm: The Student at the Heart of the Trans Civil Rights Movement

He initially struggled with this truth and he suffered through transphobia himself, he explained. He waited to tell us until he was absolutely sure. At first, this was confusing and worrisome to hear, but at the end of the day, ensuring our child’s happiness and well-being eclipsed everything. We told him that we loved him, supported him, and would do everything we could to help him. We started interventions that were reversible, like shopping for all boy’s clothes, respecting his name change, and using he/him pronouns. He said binding his chest helped the overwhelming torment he felt.


Despite receiving the best possible research-based treatment for depression and anxiety, he started having trouble getting out of bed and began missing lots of school. As parents, we felt like we were freefalling, but our own angst was nothing compared to Pax’s anguish. He dreaded every day. This we now know was the result of untreated gender dysphoria—the medical term for the distress caused when one’s gender identity is at odds with one’s sex assigned at birth.

At the time, his doctors expressed great concern that wearing a chest binder over 8 hours a day would restrict his breathing and cause permanent damage. Pax tried to be compliant, but he simply couldn’t. He stopped getting out of bed altogether and wasn’t able to sleep at night. He was wearing his binder 24 hours a day. After consulting with his doctors, getting second opinions, and talking to many other transgender individuals and families, we started researching chest reconstructive surgery. We finally had some footing.

This was not an optional surgery; it was a necessity for Pax. I believed—and still believe—that his life depended on it. His doctor considered it a medically necessary intervention. The American Medical Association, the American Psychological Association, the American Academy of Pediatrics and WPATH (World Professional Association for Transgender Health) have also all recognized that this surgery is often medically necessary for transgender individuals, including adolescents.


However, PeaceHealth—where I was employed and insured through—would not cover this crucial care for Pax, citing a policy of excluding all “transgender services.” The hospital happens to be a Catholic healthcare facility, and they claim that, as a religious organization, they are exempt from state and federal anti-discrimination laws. In other words, their religious beliefs allow them to discriminate against my son.

We learned that the attempted suicide rate for transgender people is nearly nine times that of the US population. As parents, that’s all we needed to hear.

It was crushing. Up until then, I had felt that PeaceHealth St. Joseph’s was a pretty inclusive place, “respecting individual dignity and worth” “every time, every touch.” Through 20 years of working there, I deeply held these core values as my own, in my work and everyday life. PeaceHealth’s refusal, though, now made it hard for me to simply walk through their doors every day, knowing its mission and values didn’t apply to Pax.

This surgery could help my Pax live his life to the fullest, relieve his depression and anxiety, and it could make him less susceptible to suicide. It wasn’t a special surgery; it was something that hospitals all over the country—including PeaceHealth—perform every day, for a variety of patients. If my son weren’t transgender, the surgery would have been covered at 90 percent. PeaceHealth’s policy excluding coverage for all gender transition services is founded in discrimination, not in medical judgment or in Pax’s medical needs.


As Pax’s suffering became more acute, we found out from his doctors that delaying preventative and necessary medical care would only increase his depression, while putting him at much greater risk for illness and suicide. We learned that the attempted suicide rate for transgender people is nearly nine times that of the US population. As parents, that’s all we needed to hear. We could not lose our child or stand to see him suffer anymore.

The author and Pax as a baby.

My husband and I ultimately took out a second mortgage on our home to pay for the procedure. We also had to use some of the money we saved for Pax’s college education to pay more than $11,000 out-of-pocket.

It’s a price I would pay a thousand times again if it means that Pax has a shot at living a happy, fulfilling life. We’re lucky we had this option. Not everyone does.

But it’s a price that no parent should have to pay, and no individual should have to bare.

We are now suing PeaceHealth for their discriminatory policies that target and single out transgender individuals.

Since we started this journey, we have learned how healthcare organizations throughout the country routinely claim a right to discriminate against employees and patients for a variety of reasons, including based on gender identity, sexual orientation, sex, and even race. This is simply wrong.

Despite recent progress, the current presidential administration is trying to empower more organizations to refuse healthcare to transgender people and others who desperately need it, even creating a new office to shield healthcare providers from incurring penalties for refusing to provide medical care, so long as they claim their refusal is due to their religious beliefs. This is wrong and discriminatory.

Religion should never be used to deny people critical medical care or to justify discriminating against them. A patient’s healthcare decisions should be made by a patient and their doctor. And when medical procedures are prescribed as necessary, it should not matter whether the patient is transgender or not. Patients should be able to receive the treatment they need.

By the way, we started getting our healthy child back the day after surgery. Pax is now a happy, healthy eighteen-year-old, who just graduated high school and will enter the Cleveland Institute of Art next year. He volunteers speaking to groups about gender and discrimination. I’m a much better person from knowing him, and deeply proud to be his mom.