Some gender-affirming care for Nashville government’s transgender employees isn’t covered by the current health insurance plan. If it were, it could be protection from future discrimination complaints and would make the employer more equitable. 

That’s according to a new Metro Human Relations Commission report presented to the city’s benefits board Tuesday.

As a volunteer, Liz Movius helped set up story time and model active listening for kids and parents at the Bellevue library. This is when they realized that they wanted to become a librarian.

“I think that libraries are a really important community resource,” Movius says, “and I like connecting people with resources.”

Movius got their master’s degree in hopes of landing a job with Nashville Public Library. But after getting the job and learning more about their gender identity, Movius knew they couldn’t work for Metro forever.

“Because if I go to a therapist and they put gender dysphoria on my chart, that’s not covered,” they say. “But if my coworker goes to a therapist and doesn’t have gender dysphoria on their chart, that is covered.”

Last winter, Movius decided to leave their job since it didn’t offer fully transgender-inclusive benefits.

The data is limited, so it’s hard to know how many employees, dependents or retirees might seek gender-affirming surgery in a year. In a 2017 diversity and inclusion survey, 24 employees self-identified as transgender. 

The Metro Human Relations Commission report shows care is typically inexpensive since a small percentage of people use it. In 2001, San Francisco expanded its benefits and set up a surcharge for each employee every month. Five years later, it spent only $386,417 of the $5.6 million collected.

The report notes that people that are able to transition are happier — and that one of the workplace issues and equality recommendations by the Mayor’s Council on the Status of Women in 2010 included full medical benefits for transgender employees by fiscal year 2022.

“If you say you don’t discriminate, prove it,” Movius says.

The recommendation comes months after the state legislature created bills segregating transgender youth and people in sports and bathrooms.

After a meeting this week, the benefits board will pick the topic back up in November.

In an email to WPLN News, MHRC points out that, “currently, hormone replacement therapies, including androgen blockers and GnRh hormones, as well as related laboratory tests and monitoring are covered. Mental health care to support the transition process is also covered. What is not covered is … gender affirming surgery,” which is one reason why, the commission says, it’s recommending full inclusive coverage.

Clarification: This story originally reported Metro’s transgender employees aren’t covered by the current health insurance. Additional details about what care is currently offered has been added for clarity.