Jay Cabell doesn't get health insurance from the exterminator company that hired him. It's not because it isn't offered. It's because Jay, who was born female and now lives as a man, is afraid to fill out the forms that require him to choose a gender.
Cabell wears men's clothing, has a man's haircut and grew a goatee. Like other transgender Delawareans, he's afraid of what consequences he might face if his employer found out he wasn't always identified as a man.