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The Tennessee Conservative [By Paula Gomes] –
Tonight, May 5th, 2025, the Wilson County Board of Education will take a vote to decide if gender reassignment surgeries will be included in the school district’s employee health plan.
Last year, the board voted to approve a health plan for its employees from insurance company Meritain Health with an exclusion against covering gender reassignment surgery. Now, with an upcoming renewal on the horizon, Meritain Health has requested that the exclusion be dropped.
In a social media post last night, Board Chair Jamie Farrough explained that she was unaware when setting the agenda for Monday’s meeting with Director of Schools Jeff Luttrell that the recommendation from Meritain had anything to do with gender surgery.
“I was told this recommendation had language from the plan regarding mental health,” wrote Farrough.
In a letter that Meritain wrote to the board, they stated that the gender surgery exclusion should be removed from the district’s health plan because “medically necessary gender affirming care is used for the treatment of gender dysphoria which is a mental health condition defined in the current version of the Diagnostic and Statistical Manual (DSM). Excluding coverage for this mental health condition creates Mental Health Parity risk, which has been a particular focal point for enforcement activity, as well as other discrimination concerns.”
The Mental Health Parity and Addiction Equity Act (MHPAEA), which published its final rules in 2024, is a federal law ensuring mental health and substance use disorder benefits must be covered equally like any other medical or surgical benefits in health insurance plans.
Originally passed in 2008, and building upon the Mental Health Parity Act of 1996 which prevented health plans for large groups from imposing stricter dollar limits on mental health benefits than medical benefits, MHPAEA does not mandate that health plans cover treatment for mental health or substance use disorders, but states that if they choose to cover them, that the coverage must be the same as other types of medical treatment.
Both financial requirements, such as copays and coinsurance, as well as treatment limitations – visit limits for example – for either substance use disorders or mental health must be similar to those applied to surgical and other medical benefits.
In Meritain’s letter, the insurance company pointed to recent updates to MHPAEA which seek to strengthen enforcement of the law as a reason for the school board to drop their exclusion.
Wilson County is self insured, but according to Farrough, a state plan exists that does not include the language covering gender reassignment surgery. If the board votes to keep the exclusion, they will get flagged. While the district could choose to insure their employees under the state plan, it could cost more than the plan they already have in place.
In an interview with the Tennessee Examiner, Zone 4 Board Member Joseph Padilla said, “To me, it’s simple. The science doesn’t support these services as helpful, and the people I represent don’t want to pay for them.”
One of the largest studies conducted on gender affirming medical care from 2020 that Padilla referred to concludes that surgeries to reassign gender, as well as hormone treatments, do not improve the mental health of those suffering from gender dysphoria over the long run.
“We keep hearing these treatments are essential,” said Padilla. “But if they’re not actually improving lives, then why should we use tax dollars to pay for them?”
The board’s meeting takes place at 6 PM at 415 Harding Drive in Lebanon.
About the Author: Paula Gomes is a Tennessee resident and reporter for The Tennessee Conservative. You can reach Paula at paula@tennesseeconservativenews.com.
