The story of Donnie Collins, a transgender fraternity brother whose house raised $18,000 for him to receive top surgery to aid him in his transition, was exciting not only for him, but for those moved by the show of community from his fraternity.
Perhaps even more exciting was the revelation that Emerson College, where Collins attends school, has health care that covers the costs of transgender students’ transition. Collins will donate the money raised by his fraternity brothers to the Jim Collins Foundation, which helps cover the cost of sex reassignment surgeries for transgender people. Collins’ story, while heartwarming, brings up a number of questions about cost and coverage issues facing transgender people who want to transition.
What about sex reassignment surgery makes it so expensive for students like Collins? In short, everything. The procedure is not, as is sometimes thought, a single surgery, but instead a multiple year process that requires significant finances, including “expenses incurred in the year before surgery, during which hormone therapy and … counseling as the target sex are recommended; the cost of the surgery and follow-up care; and ongoing costs after the surgery, including hormone therapy for life and continued doctor visits.” This can be upwards of $40,000, and almost always costs around tens of thousands of dollars. As many transgender people face discrimination in their access to health care, or do not have the coverage to make this transition, they find living as their true selves to be cost prohibited.
There has been a move as of late for schools to meet the medical needs of transgender students. Emerson College claims that it is one of the first schools in the country to remove transgender exclusionary clauses from its health insurance policy, and it’s certainly unique in such provisions. Only 25 colleges, according to the records of the Human Rights Campaign, provide transgender students with health care that includes at least some transition services. Even fewer universities provide such services to the staff and faculty. However, more and more bodies, from city governments to public universities, are acknowledging the high cost of transgender health care and helping those they support accordingly. Even insurance companies recognize need for such treatment, as the New York Times reports: “several major insurers have taken the stance that the treatment, including surgery, can be considered medically necessary.”
Collins’ story also demonstrates that even when a school provides transgender inclusive insurance, it doesn’t mean that students will end up with access to them without serious red tape and bureaucratic barriers. As Collins says in his video, “It’s really cool, because it now means that we have this reconciled understanding of what the policy is, and that is evident in the writing of the policy now, even though it wasn’t before.” It seems that it was only Collins' media publicity that allowed the policy to be clarified.
The move for schools to pay for transgender students to have their needs met is an exciting one, and we can only hope that more colleges follow in Emerson’s footsteps.