I have always had this deep, controlling desire that I was not born a man, but a dog in a mans body. I demand to be turned into a dog and that the government or the insurance companies have an absolute obligation to satisfy my needs, it is my right!
Devin Payne had gone years without health insurance—having little need and not much money to pay for it. Then Payne, who had a wife and four children, realized she could no longer live as a man. In her early 40s, she changed her name, began wearing long skirts and grew out her sandy blond hair. And she started taking female hormones, which caused her breasts to develop and the muscle mass on her 6-foot one-inch frame to shrink. The next step was gender reassignment surgery. For that, Payne, who is now 44, said she needed health coverage. “It is not a simple, easy, magical surgery,” said Payne, a photographer who lives in Palm Springs. “Trying to do this without insurance is a big risk. Things can go wrong … not having the money to pay for it would be awful.” Payne learned in the fall that she might qualify for subsidies through the state’s new insurance marketplace, Covered California, because her income fell under the limit of $46,000 a year. She eagerly signed up in March for a Blue Shield plan for about $230 a month, and began making preparations for the surgery that would change her life.