Rachel's Surgery Fund

Hi there! I’m Rachel. I’m a wife, a mother, and an artist living in Central Vermont. I have a chronic illness that keeps me from working - I’m officially disabled. Oh yeah - and I’m transgender.


I was assigned male at birth, and lived in the role for 36 years before I finally accepted that my gender identity didn’t match my body. That was four years ago, and the transition process has deeply challenged me personally and has been a strain for my family, but we are moving, slowly but steadily, toward a new kind of wholeness and honesty the likes of which we’ve never known - certainly that’s been my experience, but there remain a lot of challenges to overcome.

More than four years ago, I began the process of dealing with my crippling gender dysphoria, which came along with a deep clinical depression, anxiety, and self loathing. Gender dysphoria is the clinical name for the distress that transgender people feel about the incongruence between their bodies and their gender identities. It’s a recognized and well-studied condition, with some pretty common treatment methods, including therapy, hormone treatment, and surgeries - all aimed at bringing the physical more in line with the innate identity of the patient. This is HUGELY important, because more than 40% of transgender people have attempted suicide, largely due to dysphoria. I’ve been very close to that place, myself.


There’s a lot of science here, and decades of research and experience - we’re getting better at treating trans folk. One of the recognized treatments for transgender women is Facial Feminization surgery, or FFS. FFS is a suite of surgical reconstructive procedures that correct facial features that formed under the influence of testosterone. These are called “secondary sex characteristics," and they’re a big deal. People recognize gender in these features very quickly, and mine are pretty prominent.

Over a year ago, I began working with my insurer, Blue Cross Blue Shield of Vermont to get FFS, as recommended by seven different providers. The procedure was deemed medically necessary by my doctors and mental health providers. Every major medical and mental health professional association recognizes FFS as a valid and necessary treatment for some transgender women with gender dysphoria. Despite this, Blue Cross Blue Shield denied my request on the grounds that they view the procedure as cosmetic rather than reconstructive. This view is FAR out of step with medical consensus, and I believe that my insurance company has deliberately prolonged, complicated, and obscured the process over the course of an entire calendar year in order to deny me my benefits and discriminate against me based on my gender identity. I’ve just lost my final appeal in the VERY biased and one-sided appeal process, overseen by doctors employed by my insurer.

That’s a lot of background - probably more than you need, but if I’m going to ask for your help, I want you to see that I haven’t gotten to this point lightly. I’ve enlisted lawyers (pro bono), experts, and over a dozen medical and mental health professionals. I’ve jumped through every hoop I’ve been asked to, and spent hundreds of hours in legal and scientific arguments. I’ve put a year of my life into the process, and I’ve suffered with this dysphoria the whole damn time.

I had faith that if I just kept going, truth would prevail. There are a number of states that require FFS coverage for trans women. Even federal healthcare programs like medicare cover this procedure when it’s indicated. I’m not ready to give up, but the legal fight moving forward could take YEARS, and I’m just so tired of hurting. When people see me in public, they see a man. My face has so many masculine features, they can’t help it. Even staunch allies frequently misgender me, regardless of my presentation. It wears away at me a little every day, breaking down my confidence, exacerbating my depression, and giving me severe anxiety attacks. I don’t hate my face - but it makes it very difficult for me to live anything resembling a normal life. I need this procedure, and I need it soon. Will you help me?


The recommended work will cost $40,000 to complete. That’s just not something I’ll ever be able to swing on my own. Every contribution of any amount gets me closer to that goal, and even if I’m not able to raise enough for all of the procedures I need, maybe I can get the most important work done? I’ve reached the end of my rope, here. Blue Cross Blue Shield would cover a boob job. They’d build me a vagina. These services are covered. Who sees my crotch at the grocery store? Do I present my boobs to new people when we meet? No. The single most important procedure I could have, though, has been denied coverage. It’s not right, it’s not based on the science, and I firmly believe that it’s illegal.


No matter what, I intend to continue the legal fight - very few trans women could have taken the process this far. Many trans people face huge barriers to access to healthcare, education, and other services. That I have a roof over my head and a supportive family obligates me to hold the torch for other trans women in Vermont, and to continue to fight for clarity and coverage of medically necessary care for as long as there is breath in my body. I can sue for damages even after surgery, and I will. I’m going to fight for clarity around regulation and transgender coverage for just as long as I can, and getting the FFS that I need will make me all the stronger.


I’ll gladly share the science, the process, and the HUNDREDS of pages of legal and medical information that I have with anyone who asks. Please help me to get this potentially life-saving procedure as soon as I can. Please help me find the strength to continue to fight for transgender care in Vermont. Please share this campaign with absolutely everyone you can. I’m very accessible, and incredibly grateful for anything you can do.


-Rachel