Victory! Maryland to Provide Nondiscriminatory Health Coverage for Transgender Employees

FreeState Legal is proud to announce that the State of Maryland has changed its employee health benefits policy to remove language that denied coverage to transgender state employees for...
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FreeState Legal is proud to announce that the State of Maryland has changed its employee health benefits policy to remove language that denied coverage to transgender state employees for transition-related health care.  The State made the change as part of settlement of a legal claim filed by FreeState Legal on behalf of our client, Sailor Holobaugh.

Mr. Holobaugh is an employee of the University of Maryland – Baltimore, and is a transgender man.  He was denied coverage under the state employees’ health benefits program for a medically necessary bilateral mastectomy, on the basis of a provision that excluded coverage for any “procedure or treatment designed to alter an individual’s physical characteristics to those of the opposite sex.”  In November 2013, FreeState Legal filed an equal employment opportunity claim against the State on Mr. Holobaugh’s behalf, on the basis that the State’s denial of coverage to Mr. Holobaugh violated Governor O’Malley’s 2007 executive order prohibiting discrimination on the basis of gender identity in state employment.  In January 2014, we filed an additional complaint of discrimination with the Maryland Commission on Civil Rights.

In a comprehensive settlement of both claims, the State of Maryland has removed the discriminatory exclusion from all health plans in the state employee health benefits program.  In place of the exclusion, the State has instituted a new, comprehensive “gender dysphoria benefit.”  The State also reimbursed Mr. Holobaugh for his out-of-pocket costs for his surgery.

The new gender dysphoria benefit provides coverage for medically necessary transition-related care, including hormone replacement therapy and certain surgical treatments.  The standard for medical necessity under the benefit closely tracks the internationally recognized “Standards of Care” issued by the World Professional Association for Transgender Health.  The gender dysphoria benefit is included in all health plans under the state employee health benefits program and is effective immediately.

With this change, Maryland becomes the third state in the nation to provide nondiscriminatory health coverage to transgender state employees, following Oregon in January 2013 and California in January 2014.  FreeState Legal will continue to fight to remove such exclusions from all health plans in Maryland, including in the Medical Assistance (Medicaid) program, in insurance regulated by the Maryland Insurance Administration, and in self-funded employee health benefit plans offered by large employers.

Learn more:

  • Read the full press release.
  • Read FreeState Legal’s Complaint of Discrimination filed on behalf of Sailor Holobaugh.
  • Read the Settlement Agreement, which includes the terms of the new gender dysphoria benefit for participants in the state employee health benefit program.
  • Are you a Maryland state employee with questions about what this settlement means for you?  Do you have other insurance coverage and want to know what can be done about similar exclusions in your health benefits plan?  Contact FreeState Legal.






Since we hired our first full-time staff member in 2011, FreeState has served hundreds of clients in legal matters ranging from name and gender change cases to taking on the State of Maryland for its failure to provide transition-related healthcare to transgender people, and from employment discrimination cases to bitter custody disputes over legal parentage for children of same-sex couples.

We have so much more work to do.

We have to turn away hundreds of low-income LGBTQ heartbreaking stories of discrimination every year just because we don’t have enough attorneys to provide legal help to all that need it. Help us hire a new attorney!



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