City Probe Leads YMCA to Cover Gender-Affirming Care Nationwide

Kyle Rapiñan, a city Commission on Human Rights attorney who worked on the YMCA case.
Point Foundation

It all started with an anonymous tip three years ago.

That’s all the New York City Commission on Human Rights (NYCCHR) needed to start snooping around the YMCA of Greater New York, which, according to an unnamed previous employee, offered its workers healthcare plans that did not cover certain medically-necessary transgender and gender-affirming services.

So the team at NYCCHR rolled up their sleeves and investigated the family-friendly non-profit, known for fostering youth-focused athletic activities, to determine whether there was a violation of gender identity and expression and disability employment rights under the city’s jurisdiction.

The YMCA, originally founded as the Young Men’s Christian Association, was created in the mid-1800s and had ties to “muscular Christianity” — a concept promoting nationalism, Christianity, and physical strength in the upbringing of young men. The group first emerged in England and spread in its earliest years to mostly white populations in nations including United States and Apartheid South Africa.

Fast forward to 2020. The YMCA has established a longstanding reputation as a community-focused hub where families can go to the gym, swim, or take classes — but it hasn’t always been fun and games for transgender and non-binary employees there seeking gender-affirming care.

NYCCHR’s key attorney on the case, Kyle Rapiñan, told Gay City News that the commission found that the YMCA’s healthcare policy did not cover certain gender-affirming services for trans, non-binary, and intersex folks and those omissions created potential disparate impacts on those empolyees at odds with city human rights law.

In a refreshingly rare twist, however, the YMCA changed gears rather quickly: Upon the filing of a complaint, the organization reached out to the NYCCHR to seek a resolution and immediately expanded its healthcare plan to cover more procedures.

“In this case, the YMCA was quite receptive to us,” Sapna Raj, the deputy commissioner of the NYCCHR’s Law Enforcement Bureau, told Gay City News. “The YMCA wanted to be seen as a good employer.”

The city embarked on a thorough review of the YMCA’s healthcare plans. Rapiñan underscored the complicated nature of healthcare policy, noting that some employers offer hundreds of plans to employees while others, like the YMCA, only offer as few as three plans.

The organization submitted their healthcare policies and plan information to the NYCCHR, which then sent lawyers digging through the details “with a fine-tooth comb,” Rapiñan said, to ensure that the healthcare needs of trans and non-binary individuals were sufficiently covered in policies.

The city sought out ways to help bolster the healthcare plans by recommending the removal of ambiguous policy areas so employees would have access to specific kinds of care, such as facial feminization surgery.

In the end, the organization opted to settle with the NYCCHR in a way that had a far-reaching impact: Although this particular case pertained to the YMCA of Greater New York, the YMCA took the improvements a step further by changing its plans to cover all medically-necessary procedures and gender-affirming care for employees nationwide.

“We see this as an employer taking a big step to treat employees equitably and fairly,” Rapiñan said.

The YMCA of Greater New York said nobody was available to speak with Gay City News in a phone interview, but a spokesperson sent a written statement from the organization acknowledging the changes and praising NYCCHR for the collaboration.

“The YMCA of Greater New York values all of our employees who work each day to make the YMCA one of the longest-standing community institutions in the city and across America,” the statement said. “To ensure we fully support all of our staff, including transgender and gender non-conforming employees, we are proud to announce that our health care plans now offer comprehensive coverage for gender-affirming treatments, and that these plans are accessible to all YMCA employees nationwide. We thank the New York City Commission on Human Rights for working with us to change over our plan. Transgender and non-conforming people are integral members of our staff, and the YMCA will work to ensure we are a workplace where all feel they belong.”

Rapiñan said the years-long case was in the works long before the recent Supreme Court decision clarifying that Title VII of the 1964 Civil Rights Act bans employment discrimination on the basis of sexual orientation and gender identity. But now, with those rights enshrined across the country — even in Republican strongholds where GOP leaders have sought to undercut gender-affirming care at every turn — Rapiñan emphasized the far-reaching impact that the ruling will have on workers.

“[The ruling] has huge implications for healthcare across the country and now employers should be on notice to cover transgender and non-conforming people,” they said.

Even absent the high court ruling, the YMCA case serves as a key example of the ways in which large organizations can use their own power to bring influential change nationwide — even where laws do not require it — in very much the same way that many nationwide retailers during the coronavirus crisis are requiring everyone to wear masks in their stores, even in areas that do not have statewide mask requirements.

When reflecting on the YMCA case, Rapiñan offered some important advice to workers: Review your employer’s healthcare policies, and if transgender, non-binary, or intersex individuals are not covered, that issue should be reported to the NYCCHR. Individuals are welcome to file an anonymous report since many folks fear retaliation from their employer.

As for the employers, Rapiñan said, it’s quite simple: “Do the right thing.”

“Remove discriminatory plans from the marketplace and treat trans people fairly,” they added.

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