Trans health town hall follow-up 2018

The University of Wisconsin GLBTQ People in the University Committee (hereinafter “Committee”) just wanted to provide you with some updates in light of the Trans Health Care Town Hall held on May 3, 2018. 

As a recap, we held this Town Hall in order to both provide more information to our community about health care system changes relevant to our community, focusing on transgender health care, but not excluding other LGBTQ health care and other administrative needs, and also provide a forum for you to voice your own experiences and concerns to us and to university administrators. This document provides an overview of next steps.

File: Trans-health-town-hall-followup-2018.docx

Dear UW LGBTQ community members,

Hi there!  We on the University of Wisconsin GLBTQ People in the University Committee (hereinafter “Committee”) just wanted to provide you with some updates in light of the Trans Health Care Town Hall held on May 3, 2018.  (As a recap, we held this Town Hall in order to both provide more information to our community about health care system changes relevant to our community, focusing on transgender health care, but not excluding other LGBTQ health care and other administrative needs, and also provide a forum for you to voice your own experiences and concerns to us and to university administrators.)

First, we want to thank you for either showing up or expressing interest in the effort.  Over thirty people attended this first-ever event, and many more expressed regrets that they were unable to attend but would be interested in future events.  We hope to continue such LGBTQ-relevant town halls in the future, either as “general” town halls or devoted to specific concerns, and your continued participation and interest provides significant support for this effort.  Thank you.  We hope that you will continue to participate in such events in the future, and also consider engaging in broader efforts on behalf of our community.

Next, we want to provide you with an update on a various matters, all based on what we heard from the Town Hall:

  • concrete steps for actions that we as a committee are doing on behalf of our community in the short run,
  • concrete steps for what we as a committee will do on behalf of our community in the medium run,
  • concrete steps for what we as a committee will do on behalf of our community in the long run, and
  • suggestions for what our community members can do as individuals (with our support!) to advocate for our needs.

We group these into both a shorter version (for those of you who are limited in time, which is probably most of you) and a longer version (for those of you who want more detail, which is also probably some of you.)

The shorter version

Here are actions we are planning on undertaking as a result of the Town Hall.

  • Addressing the UW recordkeeping system’s listing of people formerly registered as partners as “ex partners” now that the Wisconsin legislature passed a bill prohibiting benefit-plan coverage of domestic partners, as well as coverage gaps created by the bill.
  • Addressing disclosure concerns regarding Open Records requests and gender designations.
  • Addressing various inadequacies of our own webpage.
  • Addressing informational issues related to navigating our health care system.
  • Addressing UW Human Resources recordkeeping issues with respect to gender designations.
  • Addressing the lack of transgender healthcare for faculty and staff by advocating for “top up” or “grossing up” options for transgender health care coverage.
  • Seeking more clarification from the UW administrators about their own commitments as well as what actions they are taking.
  • Addressing transgender/nonbinary issues regarding bathroom facilities and policies.
  • Addressing transgender mental health care access and coverage.
  • Addressing issues related to healthcare provider treatment of transgender/nonbinary members of our community.
  • Welcoming volunteers to engage in any or all of these efforts.

The longer story

Short-run actions that the Committee is undertaking:

We heard a number of immediately (as in, hopefully, over the course of this summer) addressable concerns expressed during the Town Hall.  Here are the concerns we heard, and how we as a committee plan on advocating to address these concerns:

  • First, we learned that our Human Resources (HR) department has set the MyUW recordkeeping system such that after the September 2017 Wisconsin legislature budget bill prohibiting all Wisconsin municipalities, counties, and school districts from offering employee benefit plan coverage to domestic partners of employees as of January 1, 2018 (Wis. Stat. § 66.0510) such that partners formerly registered under the domestic partnership registry are now listed as “ex domestic partners,” regardless of actual relationship status. This is demeaning towards our relationships, and with your help, we will work with HR to change this aspect of the recordkeeping system.  We also welcome volunteers to work with us on such a domestic partnership task force to address additional concerns that have arisen due to the removal of the domestic partnership registry by the legislature.  (See below.)
  • Next, we learned that—when records requests for “all [particular gender] staff members” are made under the Wisconsin Open Records Law (Wisc. Stat. 19 Subchapter II)—for some departments, UW has at least in one instance disclosed the names of every single staff member and their gender records. This can create concerns especially for those whose gender records may not match their gender presentation, and can create opportunities for harassment.  We will address this by talking to HR and University Counsel to both present this concern, and also (1) ascertain whether the University Counsel’s office actually has procedures in place to deal with such disclosures, and (2) urge them to consider using the exception to the Wisconsin Open Records Law under Wisc. Stat. 19.35(1)(am)(2)(a) (providing an exemption to public records requests that “[e]ndanger[s] an individual’s life or safety.”) We will provide support for our argument that gender records can fall under this exemption.

Medium-run actions that the Committee is undertaking:

We also heard a number of concerns that might take some time to address, but we think can be addressed in the medium run (as in, over the next few months into the fall). Here are the concerns we heard, and how we as a committee plan on working to address these concerns:

  • First, we heard that the UW webpage for this Committee fails to provide sufficient information about the activities of this Committee, as well as general resources for our community members. That is absolutely true, because the webpage has not been updated in a long time.  We will definitely address this by revising the web page to include more up-to-date information (such as the Health Care Explainer and copies of our annual reports), as well as links to university resources for UW LGBTQ community members.
  • Next, we heard that members desire particularized advice on how to navigate our UW health care system, including advice on trans-positive physicians, advice on how to present claims to insurers, etc. In light of these concerns, we will work with the UW–Madison: Gender and Sexuality Campus Center, the UW Center for Patient Partnerships, and the Wisconsin Transgender Health Coalition to provide both support and hosting services for such resources.  We welcome volunteers from our community to help with these efforts; indeed, we hope that many of you will volunteer with this effort, since we heard at the Town Hall that experiences can vary greatly from individual to individual, and health care provide to health care provider.
  • Finally, we are addressing the issue with HR records, where, when a UW faculty/staff/graduate student selects “other” as their gender designation, our actual gender defaults to “female” in the Wisconsin Employee Trust Funds (ETF)[1] Our approach is to both meet with HR to reformulate our internal system designation forms to make these consequences clear, as well as suggest appropriate language and gender selection options, and also to meet with ETF to ascertain the rationale behind their default designation, so that we as a committee and as a community can figure out better ways to address this.  Through these meetings, as well as our own internal meetings, we also plan to discuss whether to try to address this in a UW-system-wide manner, or in a UW-Madison-campus-specific manner.

Long-run actions that the Committee is undertaking:

We already recognized that UW could be doing far more to support transgender members of the UW community, and we plan on continue continuing to address this.  We also plan on continuing to address issues with respect to the changes to Wisconsin domestic partnership support. We will do so through two concrete avenues: (1) advocating before the UW HR, and (2) advocating before the Wisconsin ETF.  The following subsections outline our long-term plan for approaching UW HR and Wisconsin ETF in light of our expressed concerns.

Work with HR

We have been in ongoing discussions with UW HR to urge them to engage in concrete actions to address the many issues faced by our community.  These are the actions we will take during the following year.

  • First, we will continue to advocate for internal “grossing up” or “topping up” options for providing transgender health care for our community. For this, we will continue to regularly meet with HR and specifically the HR Design Benefits and Diversity Team.
  • Also, a number of folks at the Town Hall and the debriefing immediately afterwards stated that they would welcome some official commitment from UW HR not only expressing general support for our community, but also outlining specific and concrete steps they will pursue on behalf of equity and inclusivity. We will follow up on this, both to urge the development of such a plan on behalf of HR, but to also ask them to clarify steps that they are already undertaking.  On the latter point, we heard during the Town Hall that HR was developing a letter urging ETF to request that the Group Insurance Board, or GIB (the mostly governor-appointed board that sets ETF’s policies regarding insurance) revisit its December 2017 vote that led to the reinstatement of the transgender health insurance exclusions; among our other actions, we will ask for further clarification of these actions, and for a progress report on the status of these actions.
  • We also heard concerns regarding the lack of adequate mental health coverage for transgender community members within the UW system. We will continue to talk to HR to advocate for additional support for this much-needed resource. The push toward health care coverage will also address mental health care coverage, not just for trans policy holders but policy holders’ trans partners and dependents. The Wisconsin Transgender Health Coalition in Madison is also working on a provider directory, which will lead to a provider needs assessment and allow the Coalition to offer appropriate training to increase the number and capacity of trans-competent providers in the community.
  • Community members also expressed concerns regarding UW bathroom policy, specifically regarding concerns that transgender community members would be harassed for using the restrooms appropriate to their actual gender. We are continuing to advocate on behalf of our community through our work on the Phase II Gender Inclusive Restroom Facilities Task Force.
  • Finally, we plan on discussing with HR the gaps in health coverage left (as explained in our earlier 2017 Health Care Explainer) with respect to family health insurance for employees in domestic partnerships (versus married arrangements), and to suggest ways to address this gap internally. We welcome both ideas on how to address this gap, as well as volunteers who want to work with us in this effort.
Work with ETF

We also plan to meet with ETF, either in conjunction with HR, or on our own, to advocate on behalf of our community.  Here are the steps we will take during the following year.

  • First, we will relay to ETF the continuing health care concerns of our community, especially transgender health concerns. We realize that simply expressing these concerns is insufficient for actual change, but we hope that continued pressure on this front will continue to emphasize our needs.
  • We will continue to directly request that the ETF urge the GIB revisit its December 2017 vote that led to the reinstatement of the transgender health insurance exclusions.
  • We also heard from the Town Hall that a number of our community members faced encounters with health care providers who are insensitive/ignorant of the medical needs of members of our community. This is unacceptable.  To address this, we will urge that the ETF—as the agency that directly works with insurance companies to develop coverage plans—expressly discuss with their insurance vendors about at least providing adequate support for awareness of LGBTQ coverage/treatment concerns, even if they are unsuccessful in requesting a “revote” by the GIB.
  • Finally, we plan on discussing with ETF the gaps in health coverage left (as explained in our earlier 2017 Health Care Explainer) with respect to family health insurance for employees in domestic partnerships (versus married arrangements), and to suggest ways that ETF can address this gap, in light of the statutory changes. We welcome both ideas on how to address this gap, as well as volunteers who want to work with us in this effort.

What each of us as UW LGBTQ community members can do:

Although this letter, so far, has focused on the actions that we as members of the UW GLBTQ People in the University Committee will be undertaking in the short-, medium-, and long-term future, we also recognize that this is a team effort, and that we are stronger when we all work together.  So we end this letter with a call to arms.

First, we have highlighted a number of areas that our Committee has identified as areas of needed support from our community.  We especially welcome additional support in these areas.

Next, we urge you to consider sharing your stories—to the extent that you feel comfortable, given our very understandably privacy concerns—to administrators within UW, as well as to folks within the UW system.  If you are interested in doing this, but feel inexperienced and uncertain about how to most effectively do so, we welcome working with you directly on these efforts; a number of us on the Committee currently come from advocacy backgrounds, and thus can share our own experiences.  Such stories are necessary to continue to highlight to HR to highlight the problems faced by our community, as well as to GIB should an actual re-vote request be granted.

We also want to let everyone know that our committee meetings are open meetings, and thus even non-committee members can attend and participate.  We absolutely welcome your participation, and if you want to know our schedule, please email us to be notified of future meetings.

Most importantly, we hope that this is just the beginning of a broader collaboration.  That is, we hope that the Town Hall is just the beginning of a broader, more organized effort from our community to advocate on behalf of the UW LGBTQ community.

Conclusion

We have made great strides as a community. This progress makes the obstacles and setbacks we face today that much more discouraging. But with vigilance, perseverance, and cooperation, we can move these modest goals to reality together. Thank you for being in community with us and for holding us accountable to this work—we couldn’t do it without you.

Please feel free to contact us to ask about what you can do to help, or to simply provide additional suggestions, critique, or support, either through committee members you already know, or through the co-chairs: Steph Tai (tai2@wisc.edu) and Kelly Krein (kelly.krein@wisc.edu). We look forward to hearing from you!

[1] ETF is the Wisconsin agency in designed by statute to “administer retirement, insurance and other benefit programs for state and local government employees and retirees of the Wisconsin Retirement System.”  Wisconsin Department of Employee Trust Funds, at http://etf.wi.gov/; see also Wisc. Stat. Chapter 40.