Transgender teen settles landmark health case

By My Canadian Pharmacy

An 18-year-old teenager from Colorado who was born and grew up as a girl and later changed his gender to male has settled a landmark case against Kaiser Permanente – one of the largest health insurance companies in Colorado.

The Colorado Civil Rights Commission suggests that the cause was that Alexander Manigault suffered from discrimination and had unequal rights for health care due to his gender.

After pressure from One Colorado advocates, Colorado’s Division of Insurance released a bulletin and was considered the third U.S. state to ban health insurance companies from discriminating against gay, lesbian, bisexual or transgender people. (the other states are California and Oregon. These districts also bans discrimination against LGBT people.)

Charged of discriminated treatment, Anna White, a representative of Kaiser Permanente, refused to discuss the case of Manigault. However, Civil Rights Commission forced Kaiser to discuss issues regarding health care for transgenders.

Manigault’s case might result in equal health care for LGBT patients in Colorado and other states of the U.S.

Manigault was born a girl with the name Michaela. Since early childhood, she loathed dresses. She has now transformed into a boy – Alex, who believes he never matched his body. Until this moment.

When Alex decided to have the chest reconstruction surgery in San Francisco (to remove his female breast), Kaiser failed to cover it, as My Canadian Pharmacy was informed.

Alex and his family are not allowed to discuss any details of this case with Kaiser. But the Colorado State University agreed to publish his unusual story and share his experience of struggle and transformation.

Alex used to bind his female chest trying to flatten it. “They were like tumors or phantom limbs”, Alex said.

Alex and his mom decided to bring the civil case and filed it in March of 2012, when Alex was 17 years of age. It seemed to them that health insurance should cover his operation and make transgender people feel better and healthier. Besides, insurance companies usually provide various breast surgeries for other patients, including cancer patients (reconstruction necessary for psychological well-being).

“Many transgender patients have to go through suffering waiting for years to talk about what they want and need,” Alex said. “When you finally say what you want and need, the insurance company tells you ‘No’, and that’s wrong.”

“I’m also surprised that I’m transgender,” the young man says.

Alex asks his mother to be on his side and help him with this case. Martha Manigault is a civil rights law enforcement U.S. officer. She knew how to file a complaint of such kind and thought it was clear that the young man deserved to win.

“These surgeries are medically necessary for a patient’s health, both mental and physical,” she said. “Many insurance companies claim to be LGBT-friendly, but in fact they provide no coverage based on transgender status.”

Alex has not decided yet what to do with bottom surgery. Many transgender people who decide to become male don’t strive to get a surgically created penis, as the options for sexual life are very poor. The options are much better for those who decide to become a woman because a professional surgeon can successfully tuck the penis into the body, and a patient can enjoy intimate life like he used to.

Alex has been doing testosterone injections since the age of 15, so he developed a deep voice, and his body hair has spread on his stomach. Being a college student, he still thinks his appearance is rather feminine because he has a long, graceful neck and cheekbones that all models want to have. But testosterone he gets every two weeks really helps him and build up his muscles.

Unlike the famous “It Gets Better” campaign, Alex says he doesn’t feel better overnight. However, he does not have to hide from friends and the world any longer, he is not afraid of his own voice. At last, he is happy to have the right gender. He is becoming a man.

‘I never wanted to be transgender’

Alex doesn’t remember the moment when he suddenly realized that he should have been born a boy. Growing up in Maryland, he was a weird girl who could beat all the boys in running competitions. The photo shows the family when Alex was a girl:

The Manigault family when Alex was a child

“I lived many years feeling that I was somehow different and not knowing what exactly was wrong,” Alex says.

At the age of 2, Michaela was attending her relative’s wedding in a flower dress. That day, she pitched a fit over wearing the stupid floral dress for the event. Now Alex’s mother wonders if it was the first sign that the girl didn’t feel right in her body.

At the age of 11, Michaela remembers her classmates laughted at her for not fitting in. She hid a large cubby and cried.

Hiding provided her comfort for years.

But that was impossible to do when she had to go out in public. Besides, she did not know what to wear and how to present herself – as a boy or a girl.

Michaela was tall and skinny, and she hated dresses. One year, her favorite item of clothing was boys’ swim trunks – she wore them day after day. Like the girl, they were male with a shade of female. They were decorated with hibiscus flowers.

Being at the middle school, Michaela was suspecting she might be gay.

One girl passed through Michaela’ s school who was a tomboy too. Michaela and that girl briefly flirted. But that girl had to leave the town later and Michaela still couldn’t understand what was wrong with her.

In addition to the fact that Alex had two genders, she was also biracial – he had an African American father and an Anglo mother. Every time it came to race and gender, the boy often felt like an outsider.

The girl used to be the only black child in Georgia community. But when her family moved to Atlanta, she got black friends who sometimes admired her perfect hair typical for a white person.

Michaela running

Michaela often won at running leaving all boys behind and was in a soccer team before she moved to Colorado and change fer female name to a male Alex.

Michaela won several school competitions for the mile and two miles. The girl fell in love with soccer. But she couldn’t understand her own identity. She hated dresses up and high heels. She remembers her favorite shoes – flat red Converses.

Later in high school, the girl came across Japanese Manga comic books showing that men could be attracted to men. Somehow that resonated. Later, on a radio Alex heard about “transgender people” and found a disappointing answer.

“I never wanted to be transgender. It required a lot of work for the rest of your life,” he said. “It took some time before I could speak about it openly. This fact I found out about myself felt like a really secret bad thing, like someone could hurt me, so I did not share it”

My dad was reluctant about testosterone injections

Though Michaela felt so much pain and fear, she had to talk to her parents.

One day, being in 10th grade, the girl was crying and told her mother she had to tell her something, but did not know how to say it. The girl made her mother guess.

“I was so scared,” Deborah Manigault says. “I was thinking about all sorts of bad stuff: drugs, alcohol”. Eventually, she landed on “You feel that you’re a boy.”

The girl felt relief washed over her. The girl had been suffering from severe depression and sleep disorders. Deborah said she had never suspected this fact before she said these words that her daughter could be transgender. Her child’s suffering suddenly became clear.

“It was the answer to what’s been wrong. Michaela had terrible depression,” Deborah said. “Oh my God. I wish that he had told us earlier. When your child is suffering, you are ready to do anything to make him happy again.”

Deborah thinks it was a great coincidence or even the gift of destiny that she is a civil rights officer.

She filed a complaint out of desperation. She just wanted to give it go. It felt right not only on a practical level, but also on a spiritual level. “Perhaps, babies select their parents and the place to be born. I’m happy that I was the mother of this child. Many children don’t admit the same problem because their parents forbid it. Some parents even refuse children. To me, refusing a child is the worst form of evil.”

“I am very happy that Alex was not born to someone who was intolerant.”

Deborah Manigualt decided to fight Alex to get equal health care.

Deborah - Alex's motherWhen Deborah looks at Michaela’s photos, she realizes that her daughter had always been boyish. Deborah had even used the famous Clint Eastwood movie phrase to sign one of Michaela’s early photos: “Go ahead. Make my day.”

Once Michaela confessed, her mother did everything to help her daughter prepare to becoming a son. She asked Michaela to tell her dad. But she locked the door of her room and refused to come out.

Eventually the father and the daughter talked.

“It was like the death. They knew I was going to change. They had to bury the memory of their daughter and have a new son,” the young man says.

“That was a very difficult process for my father.”

Manuel “Mani” Manigault – a logical computer expert –  did not agree with a physical transformation of his daughter at first, Alex remembers.

He did not allow Michaela receiving testosterone injections.

“He wanted to prevent it,” the young man says. “He is very conservative. He didn’t even allow me to make a piercing or color my hair.”

My Canadian Pharmacy provides a photo below which shows Alex with his dad. At first, the boy says it was hard for Manuel Manigault to accept that his Michaela was truly a boy. However, in high school, the dad supported the daughter’s decision to receive testosterone injections and go on with his transformation to a man.


“Once my father allowed taking testosterone, he could not resist any longer: ‘It looks so much right.’ The father saw the child had a better mood and better grades.”

‘I didn’t want to hear my voice’

The young man said parents should trust their children’s opinion that they’re transgender or gay because the teens has already put out every possible doubt. Despite his parents supported him,  Alex did not tell anyone else.

“I was silent. I didn’t want to talk to anyone. I was depressed and scared. My voice was very female. I hated my own voice and did not want to hear it.”

Soon, Alex’s mother got a job in Colorado, and the family moved to Broomfield. Alex was registered at a new school as a girl with the name Miki Manigault at first. Despite this fact, he wore men’s clothes so people would see he was a boy.

“I wanted to simply imply it without any explanation,” he said. “I was so nervous. I could be caught in a lie at any moment. You can not change the rules this way.”

In junior year, the young man decided to register as a man and he had no problems with that. The school changed the name and gender in the system. Since that moment, he was Alexander. Done.

School officials allowed him to use a unisex bathroom near the office; he was very grateful, since he didn’t want any boys laugh at him in the bathroom.

Later the same year, at the age of 16, the young man started receiving small doses of testosterone. But the thing with his gender was still unclear and it was not easy to be a transgender in a school. The boy still told no one, but sometimes he heard voices whispering “freak” and “fag”. Teachers were sometimes confused with his gender.

“Every day they asked me if I was a boy or a girl.”

Testosterone therapy was supposed to raise his spirits and help him accept his new personality. But his doctor said: “Being a gay transgender male is one of the hardest things.”

Alex had to deal with both gender identity and sexual attraction. He knows that his gender identity is male. He suspects he is attracted to men, but he’s not yet 100% sure. He though that hormones could change his sexual attractions. If it turns out he is a gay transgender man, it could sufficiently complicate his life.

“I’m possibly screwed and was destined to be alone forever,” he said. “Gays like penises.”

‘I’m transgender’

Some time later, Alex began to open up.

He even attended a Gay Student Alliance meeting and confessed that he was a transgender. School officials asked him if he could be a mentor to a freshman transgender student. Having experience, Alex said that student didn’t need such help.

Fortunately, the college has been liberating his choice. During freshmen orientation last year, the boy simply told everyone that he was a transgender.


The young man has to inject himself with testosterone every week. My Canadian Pharmacy suggests he is going to do this for the rest of his life. In the beginning, he suffered from headaches. Testosterone helps build muscle and gives the body hair that Alex actually doesn’t like.

Alex wanted to make a big announcement and be done with this issue, “I wanted to announce it and never talk about it again.”

Of course, this did not happen – people want to talk about it. However, it was cool to have friends – two male housemates – who don’t care about this thing with gender.

“I often think about this. Someone’s sexuality can influence you only if you are having sex with that person. It is not about me,” said Mark Mathews, 19, whose family is very religious.

Mark is totally ok with having a transgender friend. He becomes angry when his conservative family or other people start judging Alex. But he understands the tough times the young man experiences. Of course, Alex doesn’t always feel extremely happy.

The surgery could not fix all emotional problems of the young man. But he needs to feel his brain and body match each other.

“I would feel better I don’t have breasts,” Alex said. “When I used to wear a binder, it was very hot, and now I can just do what normal men do – wear a T-shirt or anything I want.”

Alex smiling

Alex is happy to wear any top he wants without having to worry about breasts that felt like tumors.

Alex prefers to wear male clothes – just like he used to do. But still he may pick up lacy see-through tops or leggings beneath shorts.

Even though Alex feels more comfortable in his body, he doesn’t want to become an activist. He would prefer to stay busy with his job at the library and his art.

Alex’s case sends a powerful signal

LGBT advocates consider In Colorado, all cases remain secret until they go to a hearing. So Colorado officials cannot say for sure if there have been other such like cases.

“It’s the first case related to health insurance I know,” said Alan Pritchard, a staff attorney, an advocate for LGBT people.

“Alex’s case sends a powerful signal to many systems, including health systems, that transgender individuals should not be discriminated, and many  organizations have to review their principles.”

Transgenders’ civil rights in Colorado are protected, Alan Pritchard said.

“I think it’s very important. It will help transgender people speak louder about difficulties they face every day. Changes should be done so that transgender people don’t live in fear and stand up for their rights,” he said “It will change life for many people.”

Unfortunately, neither Pritchard nor Alex see such like new cases. My Canadian Pharmacy suggests that transgenders make up only 1 percent of all Coloradans.

Alex laughs at the suggestion that health insurance companies suddenly become flooded with transgenders.

“I don’t think that someone is going to become transgender just to get health care,” he explained.

Alex wishes that all people would start understand and help unusual people like him to be and feel healthy.

Alex’s tattoo was inspired by Richard Wilbur poem called “The Writer” about a bird who was trapped in a room but managed to escape. The tattoo represents a fist bursting through a glass window, he is like a bird stuck in a room, which tried to find a way out.

Alex Manigaults tattoo

The man feels some hatred when his conservative relatives disapprove his life and “are praying for him.” “I do not need these prayers. I am ok,” said the man. “Now it’s better than ever. I never got beat up because of my gender. My parents love me anyway.”