Mom sues after Minnesota teen denied coverage for gender reassignment

A northwestern Minnesota woman is suing her employer, Essentia Health, and her medical insurance provider, HealthPartners, alleging that her 17-year-old was denied coverage for medication and surgery to help him transition from a female to a male.

The suit filed in federal court in St. Paul by Brittany Tovar, who works as a family nurse practitioner for Essentia's hospital in Ada, said her teen was found in November 2014 to have gender dysphoria, meaning his gender identity was different from what was assigned at birth.

"I was really disappointed with my employer," Tovar said in a telephone interview Wednesday. "It's hard coming to work, and my employer considers my son a second-class citizen."

Part of her child's transition, Tovar said, included a name change three weeks ago: from Madison Olson to Reid Tovar Olson.

"It was quite a joyous day for the family to get that changed," Tovar said.

The suit alleges that Tovar's insurance plan for herself and her family "contains a categorical exclusion … for services and/or surgery for gender reassignment, regardless of medical necessity."

The teen was prescribed Lupron, which suppresses menstruation, and Androderm, a form of testosterone. The cost for Lupron was roughly $9,000, according to the suit.

"This was unaffordable for her, and as a result, her son was not able to obtain the medical benefit of Lupron," the suit read.

The mother paid for the Androderm herself, and Essentia later decided to cover that expense "as a one-time exception," the suit continued, but did not yield on the overall merits of the coverage denial.

In December, Tovar sought pre-authorization for her teen's gender-reassignment surgery but was denied, according to the suit.

Tovar has suffered from stress and migraines in connection with the dispute over her teen's medical needs, the suit alleges.

Olson has a mastectomy scheduled for this spring, his mother said, at a cost of up to $10,000.

"I get the bill," said Tovar, who is married with two other teenager sons. "But if your kid had cancer, you'd do anything. This is my duty, my job."

The claim against Essentia and HealthPartners alleges discrimination based on gender and is seeking unspecified compensatory and punitive damages. It also asks for Essentia to change its policies regarding coverage for sex-change services and surgery.

"It's not even about the money," Tovar said. "I'm trying to change [the coverage] and make access to health care for transgender [people] as it should be. To have a blanket exclusion for transgender is against the law. It's discriminatory."

The U.S. Equal Employment Opportunity Commission said Wednesday that it found that Tovar had "reasonable cause" to pursue the legal action, said EEOC spokeswoman Julie Schmid. In May, Tovar pursued the discrimination claim through the federal agency.

Jennifer McLaughlin, spokeswoman for Fargo-based Essentia, declined to address the suit's contentions, explaining, "We do not comment on pending litigation, and we have not been served with this lawsuit."

Officials with HealthPartners were not immediately available Wednesday to respond to the suit.