I started work with a new employer right after transitioning to live as a female in 2002. My previous employer had made it clear that they were not going to accept my gender transition.
It was also the start of my one-year “real life experience” of living in my true gender. RLE, as it's called, is one step in the guidelines for gender transition set by medical professionals. It's intended to serve as a sort of trial one must pass before receiving the medical letter of approval required for sex reassignment surgery. With management at my new job fully aware of the “old” (male) me, I figured my transgender status might never be an issue.
I quickly filled out the Blue Cross application, excited about the prospect of having health insurance in my new name for the first time. Yet my excitement quickly faded a few days later when Blue Cross called me. "Ms. Herman, there is a person with the same last name in our database who has a male first name. Do you know this person?"
Argh. I had to tell them the truth—I had had Blue Cross coverage as my prior self. "Well, Ms. Herman, we can't code you as female in our system until you've had 'the surgery.'" I tried to explain the hardship that having an m on my HMO card would present. I would have to out myself to every doctor’s billing office, explaining that they would need to code me as male in their systems to be sure that their health claims for me were processed.
The representative went off to confer with her underwriting department and then called back. "Sorry, we must code you as male until surgery. And by the way, just a reminder, your surgery will not be covered by insurance." Insult to injury.
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