While Wilson County Schools voted to exclude gender reassignment coverage, Williamson County has quietly funded it since 2017. With health plan renewal looming, the WCS board remains silent. Taxpayers deserve answers.
By TruthWire News
While Wilson County Schools made headlines this month for voting to uphold a policy that excludes coverage for gender reassignment surgery in its employee healthcare plan, it turns out Williamson County Schools (WCS) has taken the opposite approach—and done so quietly.
According to internal email correspondence obtained by TruthWire News, WCS has offered coverage for gender reassignment surgery as part of its employee healthcare plan since January 1, 2017. The coverage aligns with Cigna’s standard policy and has never been accompanied by an explicit exclusion clause. That means, for the last eight years, taxpayer-funded health plans for WCS employees have included what many consider a controversial and deeply divisive medical procedure.
The revelation came in response to a citizen inquiry sent to WCS board member Dr. Claire Reeves. The question asked whether the Williamson County plan included the same exclusions that Wilson County Schools had just voted to maintain. Because of her recent addition to the board, Dr. Reeves forwarded the inquiry to Assistant Superintendent of Human Resources, Dr. Vickie Hall, who confirmed in an email that the plan does in fact cover gender reassignment surgeries. Hall noted that the WCS health plan includes the procedure and that the plan document “does not have language specifically indicating the coverage criteria.”
In stark contrast, Wilson County’s school board voted unanimously on May 5, 2025, to keep an existing exclusion in place for such procedures. Board members there expressed concerns about rising healthcare costs and pending legal uncertainty. Notably, Wilson County Schools is also self-insured and must renew its plan annually—meaning the board had the discretion to decide whether to keep or remove the exclusion. They chose to keep it.
Meritain Health, the third-party administrator for Wilson County’s plan, had requested the removal of the exclusion citing compliance concerns with federal law. Specifically, they referenced the Mental Health Parity and Addiction Equity Act (MHPAEA), which requires that mental health conditions—including gender dysphoria—be treated equitably with other medical and surgical benefits. The concern, Meritain argued, is that excluding sex reassignment surgery for a mental health condition such as gender dysphoria could trigger legal scrutiny.
The MHPAEA, combined with Section 1557 of the Affordable Care Act (ACA), has increasingly been used to pressure school districts, private employers, and insurers into covering gender-affirming care. The Biden administration further clarified in its 2024 rulemaking that denying coverage for such procedures could constitute discrimination under federal law.
As noted in Meritain’s statement to Wilson County, “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.”
But Wilson County’s board stood firm, with one community member urging the board not to let the fear of lawsuits dictate moral or fiscal responsibility. Board members echoed that concern, noting that while litigation may come, standing for what they believe is right—even in the face of legal risk—is part of their responsibility to taxpayers.
With all of this information regarding the inclusion of this treatment in Williamson County for this specific disorder being brought to light , whether the WCS Board can or should follow in the footsteps of Wilson County, is unclear.
With the district’s health plan coming due for renewal and renegotiation, the need for a clear public stance is more important than ever, as this issue will continue to resurface until the rules that created the problem at it's core are dealt with at the federal level.
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