Systemic Denial After Surgery: A Survivor’s Report of Sabotage by UnitedHealthcare

📅 Surgery Date: August 13, 2024

🏥 Facility: Denver Health

💰 Cost of Procedure: $46,686.94

🧾 Covered by Insurance: 100%

🔐 Insurer: UnitedHealthcare / Rocky Mountain Health Plans

🩺 Post-Surgical Hormone Crash: A Manufactured Emergency What should have been a period of rest and healing became a medical and psychological crisis—not because of my surgery, but because of what happened afterward.

After my gender-affirming bottom surgery, I requested a prescription change from oral estradiol to estradiol valerate injections—a safer option due to my history of blood clots around 2016. This was a medically supported choice made during my once-yearly appointment with my long-term OB/GYN (who has treated me since 2008). My provider wrote a brand-new prescription for injectable estrogen specifically to reduce clot risk post-operatively.

But UnitedHealthcare said no.

They denied the medication. They claimed it was “non-formulary.” They told my doctor I didn’t need it.

Let me be absolutely clear: this wasn’t about dosage. Estradiol vials have a hard 28-day discard rule after being punctured—something coded directly into the pharmacy packaging (see ⬇️). This was about power and ideology, not medicine.

💊 Hormone Crash: Physical and Psychological Breakdown When United denied my prescription, I was forced to ration old pills—cutting my dose to make them last. The crash was brutal: 😵‍💫 Extreme dissociation, mental fog

😢 Emotional collapse and intensified depression

🥵 Hot flashes, fatigue, night sweats

😡 Rage, irritability, panic

🧠 Cognitive shutdown—loss of focus, memory, and control

This wasn’t a minor inconvenience. It was a full-body, full-mind, full-spirit collapse—engineered by an insurance company that had no medical justification to interfere.

And I wasn’t the only one.

🧑‍⚕️ OB/GYN Resistance: Fighting Back Against Discrimination My OB/GYN did everything right. She submitted multiple prior authorizations—at least three. All denied. At one point, we spent over an hour on a joint conference call with UnitedHealthcare, trying to plead with them to follow the law. She pushed. She explained the blood clot history. She explained the discard window. She fought.

United refused.

Eventually, out of desperation, she sent in a script for oral estradiol again. United approved the pills. Not because they were safer. (They aren’t.) But because they could feign “compliance” while still denying what I truly needed.

Finally, on December 12, 2024—three full weeks later—they approved my injectable script.

📦 What Stockpiling Looks Like After Betrayal

What you see above is seven unopened vials of estradiol valerate. That’s 35mL—because I don’t trust them. Because I don’t feel safe. Because if United takes this away again, the consequences wouldn’t just be clinical. They’d be existential.

I am stockpiling my survival. Because I know what it feels like to be cut off. And because I know they’ll try again.

❌ This Was Not a Glitch. It Was a Political Attack. UnitedHealthcare didn’t just violate ethics. They violated the law.

Under C.R.S. § 10-16-104.3(3)(b), Colorado law prohibits health insurance carriers from denying coverage for gender-affirming care when such care is:

“Prescribed or recommended by a licensed health care provider and medically necessary to treat a condition related to the individual’s gender identity.”

The Plaintiff’s injectable estradiol valerate prescription—issued by a long-term OB/GYN provider following gender-affirming surgery—met every requirement under this law. There was no lawful basis for denial.

The Colorado Division of Insurance (DOI) has also issued formal guidance clarifying that:

Formulary exclusions may not be used to deny transition-related care, including hormone therapies.

📍 Legal citation: “Per DOI Bulletin B‑4.126 (2022), insurers may not exclude gender‑affirming hormones from formulary, nor may they deny coverage based solely on route or dosage. United’s denial of injectable estradiol violated both this guidance and state law.”

Insurers must provide equivalent alternatives if a specific formulation (e.g., injectable versus oral) is denied.

Dosage differences alone cannot be a valid basis for denial when a 28-day expiration cycle, not daily usage, determines refill needs.

🔬 Evidence: 28‑Day Limit on Multi‑Dose Injectable Vials Medical and regulatory authorities uniformly affirm that the expiration—or beyond-use date (BUD)—for opened multi-dose injectable vials is 28 days, unless explicitly extended by the manufacturer. This standard governs safety and refill necessity, regardless of dose frequency or remaining volume.

1. United States Pharmacopeia (USP) Chapter <797> According to USP <797>, the primary authority for sterile compounding:

“Chapter 797 of United States Pharmacopeia recommends up to 28 days as the beyond‑use date for opened or ‘entered’ (i.e., needle‑punctured) multi‑dose vials of sterile pharmaceutical injection containing antimicrobial preservatives.” — American Regent Estradiol Valerate Prescribing Information, citing USP <797> standards.

2. FDA Guidance The U.S. Food and Drug Administration reinforces this rule in its official labeling guidelines:

“The beyond‑use date … for an opened or entered … multiple‑dose container is 28 days, unless otherwise specified by the manufacturer.” — FDA: Labeling Guidelines for Injectable Products (21 CFR § 201.57)

3. CDC Injection Safety Protocols The Centers for Disease Control and Prevention (CDC) injection safety guidelines mirror this requirement:

“Multi-dose vials must be dated and discarded within 28 days after first use, unless the manufacturer specifies otherwise.” — CDC Safe Injection Practices Coalition

Want PROOF? CLICK!

📌 Legal Relevance: UnitedHealthcare’s refusal to refill estradiol valerate based on remaining volume ignores these mandatory safety protocols. The refill necessity is governed by expiration timing, not dose consumption. Once punctured, the vial becomes unsafe for use after 28 days—even if hormone remains.

Any denial that fails to acknowledge this standard violates basic medical safety and undermines state and federal gender-affirming care mandates, including Colorado’s statutory protections under C.R.S. § 10-16-104.3(3)(b).

UnitedHealthcare violated each of these principles. They denied coverage for a medically necessary, legally protected treatment—despite a valid prescription, a supportive provider, and a medical rationale rooted in blood clot risk and post-operative care. They forced the Plaintiff to ration medication, suffer physical and emotional harm, and eventually seek an alternate formulation—one that carried greater health risks.

This was not clinical decision-making. This was

Deliberate Sabotage.

And it was illegal.

These denials weren’t just “miscommunications.” They were targeted and systematic.

How do I know?

Because other trans friends in Colorado—different doctors, different prescriptions—had the same thing happen:

❌Denials of testosterone

❌Denials of estrogen

❌Denials of post-op appointments

❌Hours of appeals that led nowhere

❌Psychologically destabilizing delays

And all of this started in the weeks after my surgery.

🏛️ Coordinated Timeline of Political Retaliation Let’s match the timeline:

August 13, 2024: My bottom surgery is performed.

October 16, 2024: Donald Trump declares: “On the first day we will revoke Joe Biden’s cruel policies on transgender treatments… we will stop taxpayer funding for transgender procedures and drugs.”

December 12, 2024: Then-CEO of UnitedHealth Group Andrew Witty states: “We will continue to guard against unnecessary care.”

Those words are not coincidental. They reflect a coordinated political and corporate agenda. To label gender-affirming care as “unnecessary.” To withhold it. To eliminate access by weaponizing bureaucracy.

This wasn’t healthcare.

It was a purge.

It was administrative erasure in action.

⚖️ Intentional, Retaliatory, and Illegal UnitedHealthcare’s actions were not a mistake. They were a calculated breach of trust, law, and bodily autonomy. They used insurance denial as a method of elimination—of denying care, breaking spirits, destabilizing recoveries, and pushing trans people out of the system entirely.

And it worked—for a while.

But now I’m speaking.

This is not an isolated grievance. This is part of a pattern. It is deliberate, documented, and legally indefensible.

United broke the law. They knew what they were doing. And they did it anyway.

✊ You Don’t Get to Erase Me Quietly.

If you’re reading this, then the defendants didn’t settle.

They chose silence.

They chose denial.

They chose the gamble.

But here I am. 📢 Still talking. Still posting. Still surviving. And now, the world gets to see what they did.

#AdministrativeErasure

#HormoneJustice

#SurvivorNotSilenced

#UnitedHealthcare

#RockyMountainHealthPlans

🩸 “You don’t get to erase me quietly.”

This is not a closing. This is a charge. In this final statement, Samara Dorn doesn’t just summarize a case—she detonates it. The courtroom was silent. The algorithms weren’t.

Listen now. Hear what they tried to bury. (Also features excerpts from THE AI HATERS REBUTTAL.)

☢️ Closing Statement – Dorn v. UnitedHealthcare

This is not a conclusion—it’s ignition. Samara Dorn delivers a final blow in the battle against healthcare profiling, metadata weaponization, and transgender erasure. This statement is part of the broader narrative, also featured in THE AI HATERS REBUTTAL.

🎧 Listen to the Opening Statement in Webamp Player

Below is the Actual words in the Complaint Opening Statement pages 2 -4 Closing Statement pages 146 - 148

OPENING STATEMENT “What is done cannot be undone, but one can prevent it happening again.” — Anne Frank.

“My silence will not protect me.” — Audre Lorde.

“On the first day, we will revoke Joe Biden’s cruel policies on transgender treatments. We will protect our children—and stop taxpayer funding for transgender procedures and drugs.” — Donald J. Trump, October 16, 2024.

“Gender ideology is a cult and it’s being used to harm children and mentally ill adults.” — Senator J.D. Vance, March 2024.

This is not a privacy case.

This is not a civil dispute.

This is a reckoning—against two giant corporations who chose the role of collaborators over caregivers.

The Defendants—UnitedHealthcare of Colorado, Inc., and its wholly owned subsidiary, Rocky Mountain Health Maintenance Organization, Inc., doing business as Rocky Mountain Health Plans—knowingly and unlawfully disclosed the Plaintiff’s protected health information to law enforcement without a warrant, subpoena, court order, HIPAA-authorized exception, or any other formal legal request of any kind.

What did they hand over? Her gender identity. Her surgical history. Her mental health diagnoses. Her medications. Audio recordings of her distressed but lawful calls. And most chilling of all—their own narrative framing her not merely as dangerous, but as a potential national security threat—first invoking the Department of Homeland Security. And when DHS declined to act, they took a second shot—turning to the Grand Junction Police Department as a last-resort mechanism to criminalize, profile, and potentially disappear the Plaintiff under color of law.

Why? Not because she committed a crime, but because her existence is inconvenient to a regime of denial, silence, and shame.

Because she dared to say three words—“Deny. Defend. Depose.”—a legal critique of healthcare denial, which Defendants twisted into a coded threat, drawing a false parallel to political violence. They exploited fear, fabricated meaning, and gave the police the script. They turned protected speech into surveillance. And they didn’t even wait for a judge!

This wasn’t a glitch. This was policy, in practice. This was HIPAA turned inside out—as a weapon.

The Defendants acted with full knowledge of what was happening in America. A presidential frontrunner calling for trans erasure. Federal allies demanding investigations into trans care. A climate of fear, hate, and political scapegoating. And when they had the choice to resist—they complied. They didn’t just obey. They helped. They handed her to the state because it was easier to disappear her than to defend her. The First Amendment doesn’t require politeness. It protects protest. The Fourth doesn’t ask whether you’re inconvenient. It prohibits warrantless search and seizure—especially by proxy. And the Fourteenth? It promises equal protection, not selective persecution based on gender, diagnosis, or defiance. The Defendants violated all of them—not with handcuffs, but with metadata. Not with a knock at the door, but with an email to the police. This wasn’t a mistake. It was a message. A message to every other trans person: Don’t raise your voice, or we’ll make you disappear, too.

Defendants didn’t just break the law. They became the law. Judge, jury, and courier—delivering personal truth into the hands of armed state power.

Surveillance becomes isolation.

Isolation becomes disappearance.

Disappearance becomes death.

Gulags began with clerks.

Gas chambers began with intake forms.

History shows us that genocide does not begin with violence

—it begins with systems. It begins with paperwork. And genocide always—always—begins with bureaucrats doing their job.

“How wonderful it is that nobody need wait a single moment before starting to improve the world.” — Anne Frank

This complaint is that moment.

This is not just legal. This is moral.

This is a declaration—that trans people will not be flagged.

Will not be profiled. Will not be erased.

That our medical records will not be twisted into indictments. That when the next history is written, it will remember not just what was done—but who refused to be silent.

The Plaintiff survived. She speaks. And she is not alone.

---

XIII. Closing Statement

There is no justice in waiting 35 days to turn a transgender patient’s plea for medication into a criminal profile.

 There is no emergency in dredging up call recordings and mischaracterizing political frustration as violence.

 There is no “good faith” in crafting a narrative to police that begins, not with fear—but with justification.

Defendants will claim they acted to protect safety. But their own employee admitted otherwise. When first contacted by police, the UnitedHealthcare representative hesitated—stating plainly, “I’m not supposed to do this…” before turning over private audio files, internal metadata, gender identity, surgical history, medication, and psychiatric information. That is not legal confidence. That is admission of a breach—a confession made in real time, before she hit send.

And she did hit send—thirty-five days after the fact. Not on Day One.

Not on Day Two.

Not even on Day Ten.

There was no 911 call. No escalation to crisis services. No clinician referral.

Just silence—until it became strategic.

After the calls had stopped. After the medication had been filled. After the perceived “threat” had evaporated—if it had ever existed at all—they made their move.

Not out of fear.

Out of control.

They had already alerted the Department of Homeland Security—who took no action. DHS did not issue a warning. Did not call back. Did not escalate. Because there was no threat.

But Defendants weren’t satisfied with that outcome.

 So they tried again. They made a second attempt to erase me—this time by reaching out to the Grand Junction Police Department, re-framing the same audio with an even more sensationalized narrative, hoping this time someone would act.

Let’s be clear: the Defendants sat on this for 35 days!!! 35 DAYS!!!, YES, you heard that right.

Their bureaucrats passed it back and forth behind closed doors. They debated liability. They knew HIPAA prevented this. They knew there was no threat.

And still—they chose to do it!

They weighed liability versus erasure.

They weighed silencing me versus this lawsuit never being filed.

And they bet their money on that!

They packaged five recorded calls. They printed my name, date of birth, phone number, surgical history, medication, and gender identity. They flagged quotes stripped of context. They linked me to national violence. And they delivered that packet to law enforcement under the guise of public safety—while quoting me as saying, “I kinda mean what I say.” And Defendants now hinge their entire justification on that moment—on a vague, distressed expression, said under duress, in the middle of a desperate plea for hormone medication.

They treat that one sentence as if it nullifies my right to privacy, care, and personhood. But that quote wasn’t a threat. It wasn’t a plan. It wasn’t a warning.

It was a cry for help. A reaction to being denied care—again. And the fact that they needed 35 days, legal review, and law enforcement embellishment to weaponize it proves that even they knew it wasn’t enough.

This was not a protective act.

It was a bureaucratic hit job. Let’s call it what it really was. It punished protected speech. It criminalized transgender identity.

It stigmatized psychiatric disability.

It created a police record.

And it sent a message: that vulnerable people who resist insurance abuse can be reclassified—not as patients, but as threats.

And beneath that message, a deeper one: That I would disappear.

That the stress and stigma of police contact would destabilize me.

That this document would never exist, and no complaint would ever be filed.

That I would be erased quietly, and they would never be forced to answer for what they did.

That is not care. That is not oversight. That is RETALITION! I do not bring this lawsuit lightly. I bring it because my existence—already marginalized by gender, disability, and trauma—was targeted and reframed as dangerous for the crime of asserting my rights. I bring it because if insurers can do this to me, they can do it to anyone whose life is inconvenient to defend.

This Court is not merely a forum for contracts and compliance. It is a bulwark against institutional abuse dressed up as diligence. A firewall against bureaucratic dehumanization cloaked in corporate policy.

What was disclosed—my hormones, my trauma, my identity—was mine alone to share. Defendants had no legal right to weaponize that data against me. And they most certainly had no moral right to do so under color of safety, 35 DAYS after the moment had passed.

Five phone calls. Thirty-five days of silence. One irrevocable breach.

The law must mean more than procedural permission to harm. It must mean protection for those who have already been harmed too many times before.