HB2 is the NC legislation entitled, "Public Facilities Privacy and Security Act," which mandates that multiple occupancy bathroom or changing facilities be based on biological sex according to birth certificate (http://www.ncleg.net/Sessions/2015E2/Bills/House/PDF/H2v1.pdf). The legislation is facing serious attacks and boycotts by businesses.
For my purposes, there is another avenue that should be used and that is health insurance coverage of transgender surgeries. Obamacare does NOT require that insurance plans cover the surgery associated with transgender change though it prohibits denial of insurance to transgenders based on the idea of transgender being a pre-existing condition.
What's surprising to me is ignoring the very obvious opportunity for pushing for mandatory coverage of such surgeries by Obamacare and all health insurance based on reasoning put forth by Obamacare itself, specifically in the context of the individual mandate forcing everyone to purchase health insurance where in arguing to expand premium assistance (King v. Burwell) the government argued that you can't mandate something without assisting in paying for it.
This same rationale should apply to HB2. If a person's body parts are going to be used by government to force them to use a certain facility by government, then government must ensure that access to correcting that mismatch is also accessible, specifically all treatment up to and including surgery, and paying for it.
Obamacare truthfully has not assisted the transgender community in addressing these costs nor has it furthered the notion of inclusiveness. By characterizing transgender as a pre-existing condition, Obamacare actually stigmatizes transgender based on labeling transgender as a "gender identity disorder," http://obamacarefacts.com/questions/is-there-transgender-health-coverage/. While the new DSM-5 will replace "gender identity disorder" with the less offensive "gender dysphoria," the terminology is in the DSM-5 which itself is "Diagnostic and Statistical Manual of Mental Disorders." (emphasis added)
Naturally, some will argue that transgender has to be categorized as a "problem" in order to avoid having it characterized as an "elective" surgery that is unlikely to be covered, but Obamacare covers other elective surgeries specifically based on choice without defining a problem--such as female sterilization.
A second issue is that the surgery is expensive and as we all know, Obamacare has reinforced the cheap fix and stunningly neglected consumer protections with affordable access to more expensive medical needs of individuals with policies that have taken us in the wrong direction such as the Obama Administration's creation of end-of-life counseling that pays providers to address the cost of things like cancer treatments with the "odds" that they will work. Unfortunately, this "odds" game is also present in the consideration of transgender surgery where individuals such as Dr. Paul McHugh argue that the surgery doesn't "fix" the "problem."
This might be an opportunity for the transgender community to take a stand on behalf of all those with differences in terms of access to medical care, services and drugs by removing financial barriers--including men who want to undergo sterilization (which is not covered under Obamacare for "free" while such services are available to females for "free," including noncoverage under Obamacare of domestic violence counseling for men which is "free" only for women).
BUT, ultimately, if a government such as that in NC makes it ILLEGAL to use a bathroom based on gender identity when that identity differs from body parts, then it should also provide a mandate that individual efforts to "correct" the mismatch NOT face monetary barriers that prevent legal compliance, therefore requiring insurance policies to cover such surgeries.
