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Blue Cross of Kansas changes policy on sex reassignment surgery

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KANSAS CITY, Mo. — Blue Cross and Blue Shield of Kansas has changed a policy that denied sex reassignment surgery to people who did not legally change their names, the company confirmed Thursday.

The change came after the American Civil Liberties Union of Kansas and the Transgender Legal Defense and Education Fund raised the issue on behalf of Charley Osman, a transgender man, who was rejected after he sought pre-authorization in June for two surgeries.

"I'm pretty sure I'm not the first person to go through this, but I want to be sure I'm the last," Osman said in a news release issued by ACLU Kansas. "This is an incredibly expensive surgery, and for a long time I was afraid I wouldn't be able to have it. I'm very glad Blue Cross Blue Shield changed their policies so that no one else has to go through what I did."

Several medical providers agreed Osman's surgery was medically necessary, ACLU of Kansas said. The organizations sent a letter to Blue Cross Blue Shield on Osman's behalf in August saying the name change requirement was outdated, inconsistent with medical standards, discriminatory and illegal.

With the policy change, Osman will undergo the surgeries by the end of the year, according to the statement.

Blue Cross and Blue Shield of Kansas said it makes decisions based on feedback and insights from its members.

"Policies are important to ensure we keep costs down and insurance affordable," the company said in a statement. "However, we are constantly reviewing and updating these policies to meet the evolving needs of our members, and this is a good example of that process working."

Ezra Cukor, senior staff attorney with the Transgender Legal Defense and Education Fund, said many transgender people may not want to change their names. Legal name changes can also be expensive and time consuming and have no relation to medical necessity, he said.

"We're glad that BCBS of Kansas stepped up to change this antiquated policy requirement," said Sharon Brett, legal director for the ACLU of Kansas. "This is an important first step toward ensuring that Blue Cross/Blue Shield of Kansas provides care that is inclusive, non-discriminatory, and rooted in clinical standards."

Thomas Witt, executive director for Equality Kansas, the state's leading LGBTQ advocacy group, praised the change.

"Transgender Kansans have struggled for years overcoming disparities in access to health care and insurance," Witt said in a statement. "Today's news signals another step forward for LGBTQ Kansans on our long road to full equality."

The insurance company's new policy lists 18 procedures often associated with gender reassignment that it said are considered cosmetic and will not be covered. Those include such things as breast or calf implants, hair removal, voice modification or chin reshaping.

Brett said the two advocacy groups will continue to work with Blue Cross and Blue Shield Kansas for policy changes to ensure other subscribers are not denied "medically necessary care."