Transgender prison nurse accuses state of discrimination

A transgender male who is a longtime Iowa Department of Corrections nurse has filed a complaint against the state and his insurance provider alleging he was discriminated against because of his gender identity.

Jesse Vroegh, 34, who was born a female but has identified as a male since he was 7, alleged the department turned down his request to use men’s bathrooms and locker rooms and denied him health coverage for transition-related care, according to a complaint filed Thursday with the Iowa Civil Rights Commission, the state agency that investigates discrimination claims.

Attorneys with the American Civil Liberties Union of Iowa, who are representing Vroegh in concert with the ACLU LGBT Project and cooperating attorney Melissa Hasso, are arguing the denials violate the nondiscrimination in employment section of the Iowa Civil Rights Act as well as Vroegh’s right to equal protection under the Iowa Constitution.

“Rather than setting a good example for other Iowa employers, the state has denied me the use of gendered spaces as well as the health insurance coverage I need simply because I am transgender,” Vroegh said in a statement. Vroegh said he has been a staff nurse at the Iowa Correctional Institution for Women in Mitchellville for seven years.

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Fred Scaletta, the corrections department spokesman, declined to comment on Vroegh’s specific case due to the litigation, but said in a statement that “the department strongly focuses to protect and treat with respect the public, staff and offenders.”

Insurer Wellmark Blue Cross and Blue Shield is also named in Vroegh’s civil rights complaint for "discriminating in the coverage plans it has provided to state of Iowa employees," said Rita Bettis, legal director of the ACLU of Iowa.

Teresa Roof, senior public relations consultant for Wellmark, said the specific procedures Vroegh requested "are not considered a covered benefit in the state of Iowa plan."

Gender identity, or the gender with which a person identifies, has been included in the Iowa Civil Rights Act since 2007, meaning transgender Iowans have legal protections against discrimination in education, employment, housing and public accommodations.

Once a civil rights complaint like Vroegh's is processed, the Iowa Civil Rights Commission can assist the parties in working toward a settlement or issue a "right-to-sue letter," which would allow him to bring a lawsuit in district court. After a 60-day waiting period, Vroegh and his attorneys have the option to file in district court regardless.

“We are not going to be talking about which of those courses we think are most strategic,” Bettis said.

Complaint: Issues called 'too controversial'

Joined by his wife, Jackie, who held her hand on the small of his back as he spoke, Vroegh said he informed his supervisors in 2014 that he was transgender and planned to begin his transition to living as a male full-time.

Vroegh started using what would be considered a male name in third grade and has presented in traditionally male clothing since 2000, he wrote in his complaint. Since mid-2015, Vroegh has used men's facilities in public places and asked people to use male pronouns when speaking to him or referencing him.

While meeting with his supervisors, Vroegh said he asked them to “establish policies related to issues affecting transgender employees.”

He also said he asked to use the restrooms and locker rooms matching his gender identity but was “forced to use a separate facility from everyone else.”

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The unisex facility in which he was required to dress and store his belongings didn’t have a shower, according to an ACLU news release, so in addition to “isolating him from all of his co-employees … Vroegh has no option for showering at work.”

In April, Vroegh said he was “informed that no policy for transgender employees … would be written, since transgender issues are ‘too controversial.’”

Vroegh's supervisors scheduled "a series of meetings where they made him feel like they were addressing this by developing policy," Bettis said. "Then, only recently, he was informed that they had decided not to proceed as they had indicated in developing a policy even though he had given them two years of notice."

Vroegh's union, the American Federation of State, County and Municipal Employees Iowa Council 61, issued a statement in support of his  "pursuit of a safe and inclusive working environment."

"We are disappointed in the Department of Corrections for their clear violation of Jesse’s civil rights on the basis of his gender identity," Iowa Council 61 President Danny Homan said in the statement.

"He is a man and that should be all that matters," he continued. "Why anything beyond that is the department’s business is beyond me.”

'Medically necessary' treatment underway

In March 2014, Vroegh said he was diagnosed with gender dysphoria, a diagnosis given to people who experience a profound sense of distress because their birth gender is different from the one with which they identify. A gender dysphoria diagnosis is necessary for many transgender people to get adequate health care, according to the American Psychiatric Association.

Vroegh said he has been taking prescribed hormone therapy since shortly after his diagnosis. In his complaint, Vroegh alleged that his physician has also "prescribed (chest) surgery as medically necessary" to treat his dysphoria, but Wellmark has "refused to cover (it) because I am transgender and because the treatment is for gender dysphoria."

"Cisgender men (or men who were born men and identify as such) can get coverage for gynecomastia, which is when men have excess tissue in their chest, and women, who are cisgender, can get coverage to have breast reduction surgery for back pain and other stresses that causes," Bettis said. "This is a procedure already covered for cisgender people. It is only being denied to Jesse because he is transgender."

Roof said that the state of Iowa's plan is "self-funded," which means "Wellmark administers the plan on behalf of the state of Iowa."

"In this case, Wellmark Blue Cross and Blue Shield applied the benefits per the plan," she said.

Donna Red Wing, executive director of One Iowa, Iowa's largest LGBT-focused advocacy group, applauded Vroegh.

"We've looked over the complaint, and it seems like Jesse has a really good case," Red Wing said. "He has done everything right. He's worked with his physician and service providers and employer when requesting accommodations."

"If this becomes a precedent-setting court case that opens up opportunities and accommodations to other transgender people, then I think that’s a great thing," she added.

When speaking at the ACLU's afternoon press conference, Vroegh stressed that he wasn't seeking special accommodations.

"AlI I want is for my employer to treat me like my co-workers, by allowing me to use the work restrooms and locker rooms that match my gender and by offering me insurance for the medical care I need," Vroegh said. "I don’t want different treatment. I just want the same treatment and facilities as every other employee."

Read the full complaint with the Iowa Civil Rights Commission here.