The good news: Rem Wransky is scheduled for a surgery in October, which will hopefully relieve the pain she has been experiencing.
The bad news: She has traveled long and arduous journey to get to this point.
In August, Wransky filed suit in federal court in Cleveland arguing that her employer, the Cleveland Orchestra, and Business Administrators & Consultants Inc (BAC)—the orchestra’s third party healthcare administrator—unlawfully and intentionally discriminated against her when they refused to cover a surgery because she is trans woman.
The Cleveland Orchestra had denied Wransky’s request for coverage in July, citing a clause in its insurance policy that excluded “transsexual surgery or any treatment leading to or in connection with transsexual surgery.”
Although Wransky’s surgery had been determined to be “medically necessary” through her employer’s own verification process, it was excluded from coverage due to the fact that the new procedure was a remedy to a complication from a prior surgery that was part of her transition.
On September 21, all parties signed a settlement in which Musical Arts Association (MAA)—the parent organization of The Cleveland Orchestra—and BAC “voluntarily ceased enforcement of the exclusion.”
Meaning: Wransky’s surgery would now be covered.
André Gremillet, President & CEO of The Cleveland Orchestra, had sent a company-wide e-mail in August explaining they “don’t yet have a solution for the challenge [Wransky] is facing, but please know we are working to find one.”
As this was a self-insured medical plan for Cleveland Orchestra, the phrase “voluntarily ceased enforcement” in the settlement indicates to Wransky that her employer had the power to cover her surgery during this entire process.
This also means that Wransky did not have to push her surgery from July to October, which would have saved her months of extreme pain on top of the additional medical visits and bills.
The Buckeye Flame spoke with Wransky after the settlement to get her take on the entire process and where she heads next.
Gremillet also provided responses to various questions we posed to The Cleveland Orchestra, and we will insert those into the following interview where appropriate.
Describe how you ended up at this settlement.
It was a frustrating process. There was a lot of [attorney]Mark [Herron] and I offering them different terms for a settlement. For the first few weeks, we wouldn’t hear anything. No response. It wasn’t until around the end of that BAC’s attorney finally got involved.
I signed the settlement agreement on Wednesday, which was an important date. If I wouldn’t have signed, they would have had to publicly respond to the lawsuit. MAA and BAC had been given an extension to reply to the lawsuit and this week was the deadline. They had clear motivations to end this lawsuit before that deadline came.
I felt disappointment in everything they had removed. It was disheartening that they weren’t agreeable to the terms I would come up with.
What did you ask for that didn’t end up in the final agreement?
I requested a clause about no retaliation, and ones to report the settlement terms to the courts for accountability. Those were ignored and removed.
I also requested things from both MAA and BAC to demonstrate their commitment to preventing these kinds of mistakes from happening again. I had suggested partnering with a trans rights organization or becoming a continual donor or member of Equality Ohio. I would have appreciated an agreement on something simple like training for management and leadership at both organizations on LGBTQ+ topics, like cultural competency and how to treat employees who identify as LGBTQ+.
Throughout this process, I realized that—even within my own circle of friends—a lot of people don’t understand the barriers that have been put in place for queer healthcare and specifically for trans medicine. I felt strongly that both organizations needed to demonstrate that if you want to make a difference and avoid this for future employees, you have to train your people.
[Gremillet: As far as I know, there was not a request for more training related to LGBTQ+ issues as part of our discussions, so it was not deleted from the settlement. As part of our ongoing employee trainings, we do touch upon LGBTQ+ issues and we are constantly reviewing content to ensure our trainings are as current and effective as possible.]
I also requested they hold something like a charity concert with trans and gender nonconforming composers or featured artists and take those proceeds and give them to a trans-rights organizations. I knew I was asking for something unconventional but if they wanted to repair their relationship with LGBTQ+ residents and allies of Cleveland I thought that would have been a great way to start. They refused.
I was asking for compensation for [my]pain and suffering. They have effectively delayed this surgery for three months. My medical issues have not gone away. I’ve still been in pain. The settlement didn’t include a commitment to reimburse me for all of the additional medical expenses I have incurred during this exclusion period.
They even refused to apologize to me. There was no, “Hey our bad.” It’s always been, “We’re helping you. We’re advocating for you.”
No, I called your bluff. I brought this to the public’s eye. If I had never brought this to a federal lawsuit, things never would have changed. My own moral compass says when you make a mistake, you say you’re sorry. That’s common human decency.
[Gremillet: We were apologetic from the very beginning and throughout the process.]
How do you feel post-settlement?
I feel dehumanized. Really, they agreed to the bare minimum. I’m thankful they covered my attorney’s fees so I’m not $6,000 in the hole. I’m grateful that I’m getting my surgery in October. But equal access to my healthcare should have happened since day one.
[Gremillet: As soon as we were aware of the exclusion, we immediately worked on finding a solution.]
Without an apology, without a commitment to training, I’m not convinced they have been held accountable or are moving towards creating a safe space.
When [my attorney]talked to me about it, he said it’s a victory. This feels like a hollow victory.
But he’s right that this is a big deal for the local and national LGBTQ+ community. This lawsuit proves we have a path towards healthcare equality, we have rights, and we do not have to accept being discriminated against. For me it has been a very painful journey, but maybe the next time someone else needs to walk down this path it will be a little easier for them.
Why a “hollow victory”?
I had to give up a lot just to have access to healthcare that I paid for. My dignity, my privacy, and my right to disclose my trans identity to people are all really precious, invaluable things.
I know that technically the orchestra didn’t force me to relinquish those, but I was up against a wall. I had to trade those in just to be treated somewhat like an equal. I would not want anyone else to have to do that. I’m a single woman going against an entire institution. The names of the people in the institution that have been making these decisions are off-the-record. All the people in Cleveland Orchestra’s HR. All the people in BAC. If you look up their names in google, none of these articles would come up.
But if you google my name, this is all that comes up. I have real concerns for my future, because all you have to do now is look up my name, and that effects future employment, relationships, everything. I’ve lost the ability to have control over conversations about my own life.
I have received hate mail. There was an attempted break-in in my home over Labor Day weekend. I can’t prove to you that it had anything to do with this, but my mind immediately goes there.
Where do you head now?
I feel like I have two paths, Ken. I can get my surgery. I can recover. I can change my name. I already did it once. I can try to recover some semblance of privacy or dignity. The name that I have now, I chose. It’s very meaningful to me and I don’t want to let it go, but I will if I have to.
Or I don’t hide anymore. I’ve been toying with the idea of starting a watchdog organization to have a system in place to provide resources for other trans people who are struggling with exclusions in their employer’s healthcare plan. I’ve learned that a lot of this could have been solved with education. That goes for me too. A few months ago, I didn’t know that the [Affordable Care Act] could protect trans people’s access to healthcare. People shouldn’t have to have a lawyer on retainer to access that information. I want to exterminate these exclusions everywhere.
It sounds like this experience has transformed you.
Prior to this, I was ok living a quiet life, skirting along the edges to avoid these issues, to not get involved. But now I feel like they poked the beast inside of me. I don’t know if I will be satisfied changing my name and going back to being quiet now. I feel like I need to make a difference. I couldn’t find resources in July. If it wasn’t for Equality Ohio putting me in touch with Mark, I wouldn’t have known what to do. There’s a real gap in education and resources where I can make a difference.
How was it reading about your settlement in an article?
I was at a trans right rally this weekend and I was saying hello to people. I introduced myself to a kind old lady. She paused and said, “You work for the Cleveland Orchestra. I read about you in the paper.” Somebody else in the crowd chimed in, “Yeah, we read about how the lawsuit was settled.”
I wasn’t consulted or given a chance to have my voice in that article. I was frustrated by the wording and the phrasing. Their statement made it seem like a harmless mistake. But I have had to let go that I’m never going to read, “We apologize how we treated Rem Wransky.”
This entire experience has been a trauma. It’s a trauma that will require time to feel safe again and to feel dignified again. 🔥