Thread by @ireneista

Just so people know, if you're a trans person working any sort of professional job and you're interested in advocating to your company about healthcare, we're happy to chat privately about what to ask for and how.

We were heavily involved in efforts around that during our time at Google, and there's a lot of transferable knowledge that applies to any company.

Belatedly, we realized that because we DO have that highly detailed knowledge on this topic, we should directly talk about Discord's thing.

We have not spoken to people who have inside knowledge of Discord's health benefits; we are going on the basis of already-public information.

(If you are one of those people, and you're based in the US, health benefits are squarely in the middle of the definition of "working conditions", and you have some very strong rights protecting your ability to talk about them.)

So the benefit as we understand it is that Discord offers a reimbursement of up to $10,000 USD for medical expenses which are paid out of pocket.

There is a lot of important subtlety to that. For example, we have no information as to who decides what counts as a medical expense. If it's the same insurance company that denied payment, that wouldn't be great.

Overall, we think that reimbursements like that are an important measure *as one piece of an overall package*. When the system fails people - as it often does - it's good to have something that at least makes you whole, even if you had to put out the money originally.

That $10k reimbursement should not be misconstrued as a surgery benefit. There's a wide variety in gender-related surgeries, and in the surgeons who perform them, but generally the cost will be somewhere between $5k and $40k.

That's actually quite small. It is SUBSTANTIALLY less than a typical pregnancy. The only reason that insurance companies are reluctant to cover gender-related surgeries is that they can get away with not doing so, for now.

Again without knowing any of the details, it's hard to speculate, but one gender-related expense that the $10k reimbursement might be helpful for is hair removal. Hair removal, depending on its scope, can have costs around that amount.

Hair removal is sometimes done as a preparation for surgery, and sometimes for its own sake. Insurance companies often have blanket policies against covering it, because they call it "cosmetic".

It should be clear to everyone that when hair removal is done to address gender dysphoria, that it is a medically necessary procedure, even if it might be cosmetic in other situations. Plus sometimes (not always) it's necessary prep for medically necessary surgeries.

So that's the kind of scenario which is likely to be the motivating example behind the reimbursement policy. It does not sound like a comprehensive plan, by any stretch, bu by itself it's not a bad policy, it just doesn't go far enough.