A legislative librarian who works for the State of Alaska continued her lawsuit against the State of Alaska this month, as she and her attorneys argued to a judge that her surgery to make her appear more female should be paid for by the state treasury.
Jennifer Fletcher says the surgery is medically necessary and sued the State of Alaska in 2018 to pay for the transition surgery.
The oral arguments were Feb. 19 in front of U.S. District Court Judge Russel Holland. Lambda Legal represented Fletcher, and the Department of Law’s labor and state affairs attorney, William Milks, represented the State of Alaska.
The case made by Fletcher is that surgery that makes a man’s body conform to that of a woman’s shape is medically necessary.
“AlaskaCare singles out transgender employees for unequal treatment by categorically depriving them of coverage for surgical treatment for gender dysphoria, which is the clinically significant distress that can result from the dissonance between one’s gender identity and sex assigned at birth. This exclusion contravenes a well-established medical consensus that such surgical treatment can be medically necessary and even life-saving,” the lawsuit says.
It goes on to argue that sex is assigned at birth based on the existence of certain genitalia, and that this practice is wrong-headed.
“An individual’s sex is generally assigned solely on the basis of external genitalia at the time of birth. Other sex-related characteristics such as chromosomes, hormone levels, internal reproductive organs, secondary sex characteristics, and gender identity, are typically not assessed or considered during the assignment of sex at birth.”
The argument leads to a conclusion that gender is mistakenly assigned at birth, since such assignment based on genitalia is unreliable.
The lawsuit says that gender dysphoria can lead to severe anxiety, depression, and suicidal ideation or suicide. If untreated, it gets worse over time, Fletcher’s lawsuit claims.
“The longer an individual goes without adequate treatment, the greater the risk of severe harms to the individual’s health,” the lawsuit says.
Fletcher, who started working for the State of Alaska in 2012, transitioned to living openly as a woman in 2014. She legally changed her name to Jennifer Rae Fletcher and has updated her legal documents, including her driver’s license and passport to indicate she is a woman. She went to Thailand to have vaginoplasty and mammoplasty surgeries. Vaginoplasty is generally a penile inversion done to to create a vagina, and mammoplasty involves breast implants.
In 2018, the AlaskaCare plan began covering transition-related hormone therapy, but still does not pay for transition-related surgical treatment.
In October, Judge Holland sided with Fletcher when the State asked for the case to be dismissed, and he scheduled the oral arguments for this month. Regardless of Holland’s decision, the case can be appealed by either party; it is in the federal court system.