How much do you know about transgender rights? Do any government health care programs cover transition-related surgery or other transition-related medical treatment? If one spouse in a marriage undergoes sex reassignment surgery, is the couple still legally married? Does the law protect a transgender person’s right to use the restroom consistent with his or her gender identity?

Take the ACLU of Washington's quiz, then see below the jump for answers to these questions and more.

Do any government health care programs cover transition-related surgery or other transition-related medical treatment?

Although Medicare explicitly excludes coverage for sex reassignment surgery, transgender people have been successful in securing Medicaid coverage for the costs of transition-related care in Washington. This may be about to end, however: in 2010, Medicaid officials announced their plan to rewrite regulations to make it clear that the state will no longer cover sex reassignment surgery (although state-funded plans will continue to cover other services, such as hormone treatment and psychotherapy, for people diagnosed with Gender Identity Disorder).
The managed health care program for active duty and retired armed forces members (formerly known as the Civilian Health and Medical Program of the Uniformed Services) excludes all services related to Gender Identity Disorder, including therapy, prescription drugs (e.g., hormones), and surgery.

If one spouse in a marriage undergoes sex reassignment surgery, is the couple still legally married?

Yes. Generally speaking, the validity of a marriage is determined by the couple’s status at the time the marriage is performed. Therefore, as long as the couple was legally entitled to marry when they entered into the marriage—which, in Washington, still means that the couple was opposite-sex—they remain married until death, divorce, or annulment. (It would make sense that the same principle be applied to couples who enter into domestic partnerships.) It follows that, if the spouses were of different sexes at the time of their marriage, the marriage should remain valid even if one spouse later transitions to become the same sex as his or her spouse.
Even without a divorce or annulment, however, legal problems can arise from a spouse’s transition. For example, employers have been known to refuse health benefits to a spouse who is now of the same sex as the employee. Likewise, when one spouse dies, the surviving spouse may have problems collecting inheritance or tax benefits restricted to married couples. To date, there is very little law on these issues.

Does the law protect a transgender person’s right to use the restroom consistent with his or her gender identity?

It remains somewhat unclear. In 1993, the highest court in Washington upheld the right of an employer to prohibit a transgender employee from using the restroom consistent with her gender identity until after she had undergone sex reassignment surgery. A court might rule differently if such a case arose today. We now have a state law—the WLAD [Washington Law Against Discrimination]—that specifically protects against discrimination in employment and places of public accommodation based on one’s gender expression or identity. Moreover, the Washington State Human Rights Commission (HRC)—the organization responsible for enforcing the WLAD—publicly
supports the right of transgender persons to use the restroom consistent with their gender identity.
As a practical matter, many businesses, universities, and other public places are installing single-use, unisex (or “gender neutral”) restrooms, which alleviate many of the difficulties that transgender people experience when seeking safe restroom access.

Can a person change his or her name and gender on his or her passport?

Yes. To change his or her name, a person must provide a copy of a court-ordered name change. To change the gender marker on his or her passport, a person must show that he or she has undergone the clinical treatment determined by his or her health care provider(s) to be appropriate to facilitate gender transition; this can be accomplished by submitting a letter from the person’s treating physician stating that the person has had the appropriate treatment. No specific treatment is required, and the details of an individual’s treatment (e.g., details about surgery, hormone treatment) need not be included in the letter.

Do transgender prisoners have a right to get hormone therapy?

There is no definitive answer yet. Because Washington does not expressly prohibit the use of government funds to provide hormone therapy or sex reassignment surgery for prisoners, some transgender prisoners may be able to receive hormone treatment in prison. Further, the U.S. Ninth Circuit Court of Appeals has suggested that deliberately denying access to transgender-related health care for prisoners can amount to cruel and unusual punishment in violation of the Eighth Amendment and that a constitutional violation may exist where a prisoner’s course of hormone therapy is abruptly cut off.

Find more information about the rights of trans people in Washington, as well as how to file a formal complaint, here (PDF).