April 7, 2014

Victory! Transgender Man’s Surviving Spouse Wins Pension Benefits

We are thrilled to announce a major victory for the widow of a transgender man. Following TLDEF’s intervention, a major American car manufacturer reversed an initial decision to deny the woman her husband’s pension benefits based on its determination that their nearly-30-year marriage was void because he was transgender. We are sharing more details below, but changing the names of those involved, because the surviving spouse wishes to remain anonymous. It’s a long story, but a good one.

Michael was employed by a major car manufacturer in the Midwest for 40 years. After he was diagnosed with terminal cancer in 2012, Michael and his wife Nancy contacted his company’s benefits administrator. Michael and Nancy wanted to ensure that everything was in order so that Nancy, as Michael’s widow, would receive his pension benefits after he died. The benefits included lifelong income and health insurance.

From the very beginning of the process, Michael and Nancy were told that Nancy would not receive benefits. The benefits administrator challenged the validity of Michael and Nancy’s marriage because Michael was transgender, stating that their marriage was void as a same-sex union. When he died in 2012, just after contacting TLDEF, he and Nancy were still being told that Nancy would not receive spousal benefits. It was Michael’s dying wish that Nancy do everything she could to get the benefits that would protect her and their family.

Michael had reason to be concerned. Upon his death, Nancy lost his income. His family lost its grasp on the middle class life that they had. Their company health insurance was cancelled. They adjusted to a new life of survival on food stamps and Medicaid benefits.

About Michael & Nancy

Michael and Nancy first met in 1965. They grew up in the same Midwestern town and were close friends throughout high school. They lost touch for a period after school, during which time Nancy married another man and subsequently divorced. Michael and Nancy reconnected after thirteen years apart and rekindled their friendship.

It soon blossomed into a romantic relationship. To Nancy it had always been clear that Michael was male, even though he had been labeled female at birth. That is not to say that Michael’s journey was an easy one. Michael and Nancy together faced many challenges relating to Michael’s gender transition. But they made the decision to marry. And by the time of their marriage, Michael had completed steps to socially, legally and medically transition to living an authentic life as a man.

The Road to Victory

Nothing came easily after Michael died. Because his birth certificate listed his sex as female, the funeral home insisted upon recording Michael as female on his death certificate. We worked with Nancy to ensure that Michael was laid to rest and officially documented as male, providing him with dignity in death, and sparing Nancy at least a bit of heartache.

After Michael died, we repeatedly contacted his company’s benefits administrator in an effort to facilitate Nancy’s receipt of Michael’s pension. In November 2013, we were informed that Michael was not “conclusively” male at the time of his marriage to Nancy, rendering their marriage invalid for pension purposes. Nancy was ineligible to receive Michael’s spousal benefits.

We filed an appeal with the benefits administrator and then contacted the company’s General Counsel in February to convince the company to do the right thing. In our letter, we reminded the company that while Michael had spent his personal life in love with Nancy, he had spent his professional life in service to the company. He was male throughout his life, and had made his gender transition known to the company decades ago, despite the great personal and professional risk he faced. He was married to Nancy for decades and the company had always treated them like any other married couple. Michael expected that his service to the company would be rewarded – not with special treatment – but with equal treatment and the same benefits that any other 40-year veteran of the company’s workforce would expect to receive.

We pointed out that the company had consistently recognized Nancy as Michael’s wife while he was alive and that it could not suddenly treat her differently now that he had died. We informed the company that Michael was considered male by state and federal authorities and that the company’s refusal to recognize Michael as male flew in the face of all of the evidence.

Late last week, Nancy received great news. The company has agreed that she is Michael’s surviving spouse. She will begin receiving his pension benefits next month, along with the back payments she is due since Michael’s death.

Nancy is thrilled with the outcome, and we are, too. Too often, transgender people find that the families they have created are challenged as “void” and “invalid.” Hard-working people who have played by the rules and simply want to be treated fairly find that their plans and dreams are upended. Stories like Michael and Nancy’s spotlight the importance of relationship recognition for transgender families. We will continue to speak out and take action in cases like this as we move towards a society that treats transgender people equally in all aspects of life.

In addition to TLDEF, the legal team representing Michael and Nancy included Sarah O’Connell and Michael Flynn of Norton Rose Fulbright LLP. We are grateful for their assistance.


The Sacramento Bee, December 17, 2013


Ordinarily, the sight of a hypodermic needle might leave Shane Tilstra
flat on his back, floored by wooziness from his fear of needles.

But on a recent night at the Gender Health Center, Tilstra, 25, was able to sit upright in a straight-backed chair as he persuaded a physician’s
assistant to use the tiniest needle possible to draw his blood.

The ability to be a partner in his care at the center, where staff is “like
family,” helps Tilstra continue on a journey toward his chosen gender. For more than a year now, the Arden-Arcade, Calif., artist has been physically transitioning from being a woman to being a man.

“To find a place like this was very surreal. I just kept coming here and
questioning them, ‘Are you serious?’” said Tilstra, who gets his
testosterone prescriptions from the center’s hormone clinic. “It’s really
awesome how they organize the services. They are the community everybody deserves.”

Such is the reputation among clients of the Gender Health Center, a clinic on 29th Street flanking the tangle of freeway overpasses near
downtown Sacramento, Calif. Here, people transitioning from one gender to another can access care at minimal cost as they obtain prescriptions for the hormones that are crucial for altering gender.

In the three years since the center opened, there has been a marked shift in public awareness of transgender issues.

This year has seen a number of headlines featuring transgender people, as well as changes in state and federal legislation outlawing discrimination against transgender individuals on sports teams, on public school campuses and in the workplace.

Chelsea Manning (nee Bradley Manning) was at the apex of a high-profile espionage case. Jennifer Pritzker, heir to a family fortune, became the first known transgender woman on the Forbes 400 list of billionaires. And in the pop culture arena, Chaz Bono stepped up to coach his mom, Cher, in her gig as judge for ABC’s “Dancing with the Stars.”

Institutions are adapting, too. Companies and colleges announced they would start offering health care coverage that includes gender-change medical services. The California Assembly awarded Theresa Sparks, 53, a San Francisco transgender human rights activist, its “Woman of the Year” award. And Democratic Gov. Jerry Brown signed a bill allowing transgender students access to school bathrooms and other facilities of their choice.

The head of Sacramento's Gender Health Center, Ben Hudson, sees value in those headlines. “What really changes the tide is multiple exposures,” Hudson said. “Over time, these exposures start to change what people think.”

Amid these changes, the Gender Health Center has grown in capacity, size and reputation. The center has been expanded and remodeled to serve more people and ensure privacy of medical records. The support staff includes a clinical director and two program coordinators.

At the heart of the operation is a married couple who saw the need for a
safe, welcoming place where transitioning patients who often are not
comfortable in traditional doctors’ offices could access counseling
support, legal services and health care services.

Hudson, 35, is the executive director. A transgender man with a bushy red beard and curlicue mustache, Hudson has been an advocate, community organizer and peer counselor for more than 15 years. He likes to say he was “born into activism,” the son of a feminist lesbian mother and gay father.

His wife, Rachael, 46, is also transgender. They met in Sacramento several years ago through a peer counseling group they attended to discuss their new identities. Over time, the two became close and married. Like the majority of transgender people, neither chose radical surgery but achieved their gender identities mainly through hormone therapy, which changes physical characteristics such as voice, facial hair, body shape and facial structure.

“The way men and women speak, just the way they say their words are
different. Their tones are different,” said Hudson. “Then there are the
mannerisms. The way you act and present yourself in men and women are totally different.”

Hudson likes to share a “happy story” about his wife, who works as the
center’s operations manager. Before coming out, she was employed at a
nearly all-male sign shop.

“Basically, she began working there as a male and then transitioned while she was on the job. I think it was really impactful for her co-workers to know this person (the male) who was really quiet, shy, wasn’t interacting with others and never participated in the social part of work.

“When she came out and transitioned, she blossomed as a person and became a co-worker that people wanted to be around. They just couldn’t deny that change in her level of happiness and joy.”

Both say they are committed to expanding the center’s services with a team that meets one-on-one with clients. Recently the small enterprise, with an annual budget of less than $150,000, managed to double its paid staff to four.

“How do you create a community for transgenders that’s healthy? I think you start with mental health,” Hudson said. “We are a mental health-based organization because we believe that when your emotional health is intact, you have a better ability to function. …

“We just meet the basic needs of transfolks _ meaning name and gender
change, access to medications, other health care and legal services _ and once those basic needs are met, then transfolks can go out and be whatever it is that they have to offer to the world.”

Sacramento’s Gender Health Center has a larger footprint than its size might suggest. Three years after it opened, the center has become known as one of the leading support facilities for transgender people in Northern California. Covered California, the state’s health insurance exchange, tapped the nonprofit organization as an official education and outreach coordinator. Trained marriage and family therapists provides counseling services on a volunteer basis.

Ilona Turner, legal director of the Transgender Law Center in San
Francisco, said, “Almost all the people we hear from in
the Sacramento region are getting some kind of help from the Gender Health Center. Ben and Rachael have done a great job providing critical services, like mental health services, which are often very hard to access for transgender people. It’s truly inspiring to see what they’ve been able to create.”

The center has about 200 regular clients accessing its mental health
services and another 200 enrolled in its hormone clinic. University of
California-Davis Medical Center has embraced the hormone clinic as an
official student-run community clinic, meaning family practice residents
cycle through.

According to the center’s analysis, people come from across Central and
Northern California to access services, from the rural north state to the
Gold Country and as far south as Merced. The Transgender Law Center
estimates about 0.5 percent of the overall population is transgender.

Twenty-year-old Alex Beskeen of Elk Grove, Calif., said he found the clinic after coming out a year ago.

“I’d never heard of any other place that offers all this stuff in one
package,” Beskeen said. “The people here are very smart. The fact that they are always there to talk to is unusual.”

During a recent hormone clinic _ they are held from 6 to 10 p.m. twice a
month _ Hudson welcomed Tilstra and pulled him aside.

He said he hadn’t seen Tilstra in a while, and recommended that he check out counseling. Tilstra agreed, acknowledging he’d been cocooning in his apartment. Hudson followed up with contact information before Tilstra finished his appointment.

Appointments consist of consultations at different stations, with clients
getting routine blood draws, blood pressure checks and an assessment of their progress on the hormone therapy.

For Tilstra, testosterone has been effective: His voice is deeper, his arms bulkier, and his body cushioned with 30 extra pounds, bringing him to all of 140. He’d already undergone what’s called “top surgery,” or a full mastectomy.

Before finding the Gender Health Center, Tilstra said, he had exhausted his insurance allowance and spent $7,000 out of pocket using services at the University of California-Davis Medical Center.

At the gender center, Tilstra donates $5 or $10 per visit and pays about $65 for each testosterone prescription, generally every six weeks. The center is able to keep prices low because of its low overhead.

He said his transition is going “great,” though he acknowledges long-term costs may add up, given that transgender people need
near-lifelong hormone therapy.

U.C.-Davis group physician Dr. Katherine Gardner is among the volunteers who straddle both worlds. She works as a family practitioner for U.C.-Davis in Rancho Cordova and also runs the center’s bimonthly hormone clinics. The draw, she said, is helping people become whole.

“It’s really great seeing people become happy,” she said. “I feel really
privileged to be a part of it. … It’s a matter of embracing people and
being interested in what it means to be a human, to be a person.”


(c)2013 The Sacramento Bee (Sacramento, Calif.)