Morgan Haven-Tietze first sought gender-transition-related care in 2011 at Philadelphia’s Mazzoni Center, back when it was on Locust Street in the Gayborhood.
Today, the city’s decades-old center for LGBTQ health care has a sprawling space on Broad Street, and Haven-Tietze is more than just one of its thousands of transgender patients. He’s an employee and a member of the bargaining committee that this month won Mazzoni’s new 100-member union its first contract — one that includes what labor leaders are calling “breakthrough” protections for trans employees.
In what could be a first for health-care workers in Pennsylvania, the contract guarantees full- and part-time employees a minimum two weeks of paid leave for any gender-affirming surgery and ensures further paid time off as medically necessary. Prior to the contract, Mazzoni employees, a quarter of whom are trans or gender nonconforming, would have used sick days or vacation time.
“Trans workers have different life milestones and can’t often access [gender-affirming surgeries] until adulthood,” said Haven-Tietze, a 33-year-old care coordinator who lives in South Philadelphia. “We really wanted folks who reach those milestones to be celebrated in the workplace, too.”
The benefit will serve not only Mazzoni employees, but could be model language for future negotiations, said Matt Yarnell, president of Service Employees International Union Healthcare Pa., the state’s largest union of health-care workers. He said explicit paid time off for gender-affirming surgeries is to his knowledge the first of its kind in the state.
Yarnell also said the Mazzoni contract includes language that guarantees bereavement leave for workers’ “chosen families,” an important distinction for LGBTQ folks, some of whom are “shunned or thrown out of their [biological] families.”
“There were a lot of firsts at this center over the decades,” Yarnell said, noting that Mazzoni opened the state’s first HIV testing site in 1985, “and this is another.”
Plenty of companies offer some form of leave for transition-related care, either paid or unpaid. If gender-confirmation surgery is deemed medically necessary under an employer’s health-care plan, that employer would be required under the federal Family and Medical Leave Act to grant up to 12 weeks of unpaid — but still job-protected — leave.
The Human Rights Campaign, a national LGBTQ advocacy organization, rates hundreds of employers in its Corporate Equality Index, including whether companies offer trans-inclusive health care. Many large employers offer short-term leave for medical procedures and do not carve out transition-related surgeries, including locally based organizations like Comcast NBCUniversal, Aramark Corp., the Federal Reserve Bank of Philadelphia, Urban Outfitters, Vanguard Group, and Wawa.
What’s different in Mazzoni’s contract is the minimum two weeks paid leave and the explicit nature of the benefit. The center’s management team saw codifying support for employees to obtain gender-confirmation surgery as critical, said interim COO Alecia Manley.
The contract ratification punctuates a tumultuous couple of years at Mazzoni, which management says is finally regaining its footing after several controversies and leadership shake-ups. In spring 2017, the center’s longtime CEO resigned amid backlash over how she responded to allegations of sexual-misconduct against Mazzoni’s former medical director.
Then, an interim CEO fought staff members’ attempts to unionize (he was later accused of sexual harassment), and in early 2018, Mazzoni hired as CEO a straight woman from Florida, who six months later controversially fired the center’s diversity director. By the end of 2018, the CEO and COO resigned and the Mazzoni board promoted three employees to an interim, collaborative leadership team. The structure remains in place today.
Manley, a member of that leadership team, said including provisions specifically to support trans and gender nonconforming workers was essential to support staff in being their authentic selves.
“This is something that management was really excited to include in this contract,” they said. “It’s an opportunity for us to incorporate shared values into policies and procedures.”
That codification was significant for Haven-Tietze, who said the last couple of years have been challenging not just at Mazzoni, but for many trans folks who feel targeted in this political moment. The Trump administration earlier this year proposed rolling back Obama-era federal protections that ban discrimination against transgender patients.