Aetna Life Insurance Co. is being sued in a proposed class action by three transgender women who claim the insurer violates federal healthcare laws by excluding coverage for gender-affirming facial reconstruction surgery. The lawsuit, filed in Connecticut federal court, alleges that Aetna's refusal to cover the surgery under its workplace health plans causes emotional and financial harm to transgender individuals.

Aetna Gender Lawsuit : Allegations in the Lawsuit

Plaintiffs Binah Gordon, Kay Mayers, and S.N. argue that Aetna's policy of categorizing facial reconstruction surgery as "cosmetic" for transgender individuals violates the anti-discrimination provision of the Affordable Care Act (ACA), known as Section 1557. They claim that the procedure is medically necessary to alleviate their gender dysphoria, which arises from the mismatch between their facial features and their female identities.

The plaintiffs allege that Aetna covers other gender-affirming surgeries but denies this specific procedure, treating transgender plan holders "differently — and worse — than their cisgender counterparts." They are seeking an injunction to prevent Aetna from excluding coverage for facial reconstruction surgery and compensatory damages for the out-of-pocket costs they and others have incurred.

Aetna Gender Lawsuit : Plaintiffs’ Experiences

The plaintiffs are covered by Aetna-administered health plans through their employers. Gordon, 42, from Nebraska, is covered under the Federal Employee Health Benefits program, while Mayers, 52, from Alaska, and S.N., 48, from Pennsylvania, are also covered by employer-sponsored plans. The complaint highlights the emotional distress and discrimination the plaintiffs face due to the incongruence between their gender identity and their facial characteristics.

Aetna's Response and Legal Representation

Aetna has not commented directly on the lawsuit but stated that it is committed to supporting the healthcare needs of the LGBTQ+ community. The plaintiffs are represented by a legal team including Joseph Wardenski of Wardenski PC and attorneys from the Transgender Legal Defense & Education Fund and Cohen Milstein Sellers & Toll PLLC.