The Montana Human Rights Bureau last week released a finding in support of a transgender woman who experienced unlawful discrimination during her time as an employee for Yellowstone County.

Eleanor Andersen Maloney, a transgender woman, was denied all gender-affirming healthcare under Yellowstone County’s Group Health Benefit Plan. According to the complaint -- filed by the ACLU of Montana in September of 2018 -- Eleanor belongs to a protected class on the basis of her sex, but the County discriminated against her because she is a transgender woman. Under both state and federal law, discrimination against people for being transgender is a type of sex discrimination.

The Montana Human Rights Bureau found that“[i]f an insurance product carves out medical procedures, relying only on a person’s status as transgender as the determinative criterion, this is a distinction based on sex and it violates the Montana Human Rights Act’s insurance provision.” According to the investigative report, “the County is denying medical procedures related to changing from one sex to another sex.  If Montana has a statute that says an insurance product cannot discriminate on the basis of ‘sex’ and an insurance product denies coverage for procedures involved in changing from one sex to another sex, it seems like a leap of logic to argue this is not ‘sex’ discrimination.”

After the County denied Ms. Maloney multiple requests for pre-approval of coverage for medically necessary gender-affirming healthcare services, she filed formal grievances with Yellowstone County Human Resources, and ultimately filed a complaint with the Montana Human Rights Bureau.  The County had denied all of her requests, and even denied payments for Ms. Maloney's therapeutic counseling - a service that was covered until the County found out that the sessions were for treatment of gender dysphoria.

“It’s very simple: discrimination on the basis of gender identity is illegal,” said Elizabeth Ehret, ACLU of Montana Attorney. “Yet, the only reason Eleanor was denied coverage for her healthcare was because of her gender identity. We are pleased with the findings of the Montana Human Rights Bureau and hope this leads to a change in Yellowstone County’s policy.”

The complaint sites that the discrimination against Ms. Maloney was unlawful under the Montana Human Rights Act, the Montana Constitution, the Federal Constitution, Title VII of the Civil Rights Act, and the Affordable Care Act.

“I was denied medically necessary coverage because of an outdated and discriminatory insurance practice,” said Eleanor. “It hurts to be treated differently just because of who you are.”

Ms. Maloney resigned from her position as Senior Deputy County Attorney where she prosecuted child abuse and neglect cases on June 18, 2018, identifying the gender-affirming healthcare exclusion as the sole reason for her resignation. She had been employed with the County since Feb. 13, 2017. She has since found a different job that has an insurance plan that does not discriminate. 

“Gender-affirming health care is vital, often life-saving care. Here, the County interfered with Ms. Maloney's treatment for no reason other than gender bias,” said Gabriel Arkles, Senior Staff Attorney with the ACLU LGBT & HIV Project.

Yellowstone County has 30 days to conciliate with Ms. Maloney, or the complaint will move forward to the Hearings Bureau for a formal hearing.  
The Federal Government has not contracted with insurers that exclude care for transgender employees since Jan. 1, 2016 because those exclusions are unlawful. Twenty states, in addition the District of Columbia, have also issued guidance confirming that such exclusions are discriminatory and unlawful.Montana’s Medicaid policy explicitly covers gender-affirming health care for transgender people