As lesbians, they may not fit the all-American ideal of family. But how's this for commitment: They have lived together for 10 years, jointly own their house and cars, pool their money and share parenting duties.
But when one of them, a nurse at Johns Hopkins, tried two years ago to add her partner's name to her health insurance policy, she learned the unsurprising fact that employee benefits were available to spouses but not to gay partners.
Then, the unthinkable happened. Her partner, who was temporarily out of work, came down with ovarian cancer, raising the twin specters of a potentially fatal illness and horrendous medical bills without any coverage.
Experiences like that have motivated a group of Johns Hopkins employees to ask officials at the university and health system to take the same bold step that the computer software giant Lotus Development Corp. of Cambridge, Mass., took in September: extend company benefits to the partners of gay employees.
For Hopkins officials, who have balked at the idea, it's a move that could open a Pandora's box of expensive benefits at a time when institutions like theirs are struggling against recessionary pressures to trim costs. For gay couples, it's a matter of civil rights.
"Look, we each adopted a child, and we co-parent them and raise them as sisters," said the nurse, who asked to remain anonymous to protect the children's privacy.
"Our wills make the other the guardian of our child in the event of death. We think our relationship should be validated in the way that a family relationship is."
At Hopkins, the movement gathered steam last spring when a core group of employees broached the idea of "domestic partnership" benefits with officials of the university and health system.
John Polenicek, a research associate with the school of public health, said the group was disappointed but not deterred when the administrators sent out letters rejecting the idea.
Besides branding it too expensive, administrators dismissed the notion that refusing benefits to gay families was discriminatory.
Family benefits, they pointed out, are also denied to heterosexual partners living out of wedlock.
Mr. Polenicek said he hopes to find a more receptive ear when he begins discussions soon with James Jones, the university's new vice president for human resources.
Support among faculty members is mounting, he said, and activists are organizing meetings aimed at gathering support among peers.
Earlier this month, about 60 people packed a lecture room to offer personal testimonials and plan strategies to convince officials of the university and health system, which together have about 15,000 employees.
When activists sit down with Mr. Jones, they may propose that Hopkins start modestly by extending "non-economic" benefits such as library and pool privileges first.
That way, Mr. Polenicek said, the administration could gauge how many homosexual couples would take advantage of benefits before taking the financial plunge with health insurance.
Despite widely quoted estimates that 10 percent of the U.S. population is gay, Mr. Polenicek said he would be surprised if more than 40 or 50 people enroll for benefits.
"My sense is that thousands and thousands of people aren't going to come forward," he said, adding that gays whose partners have company health benefits of their own won't need to apply.
But he recognizes an uphill fight when he sees one.
Peter McGinn, vice president of the corporation that runs Johns Hopkins Hospital and the Francis Scott Key Medical Center, said the health system has long maintained a policy protecting gay people from discrimination. But he draws the line at extending benefits to gay partners who are not employed at Hopkins.
"If laws recognizing gay and lesbian marriages [are enacted] in the state of Maryland, Hopkins may reconsider its policy," he said.
"I've got friends who are in the same situation," he added. "But I don't have a good answer for it in terms of change."
One major obstacle, he said, is cost. Officials worry that if they open benefits packages to gay couples, they'll find themselves entertaining similar requests from heterosexual couples who live together but have chosen not to marry.
It's an argument that doesn't wash with Mr. Polenicek, who argues that employers can legitimately make a special case in granting family benefits to gay partners: "Gays simply don't have the ability to make a decision as to whether they can marry or not."
Lotus generated instant headlines when it extended "domestic partnership" benefits to its 3,100 workers in the United States.
Almost three months after unveiling its new policy, 12 couples have enrolled for domestic partnership benefits, costing Lotus $2,500 in premiums for each additional recipient, according to a company spokesman.
Lotus isn't alone in granting family benefits to gays.
In recent years, about 10 private employers and nine municipalities, including Takoma Park, have decided to recognize gay partners in their benefits packages.
The past year has also seen Montefiore Hospital in the Bronx follow suit.
Despite Lotus' reputation for progressive personnel policies -- it provides day care, employs handicapped workers on assembly lines and operates an adoption referral service -- company officials had to convince themselves that liberalizing their
health insurance policies wouldn't cause the company undue economic hardship.
The issue was AIDS: fear that extending benefits to gay partners would mean a disproportionate number of expensive claims tied to the disease.
"We weighed AIDS into the picture," said Bryan Simmons, a Lotus spokesman.
"But the truth was that the average cost of AIDS is comparable or less than the average cost of cancer or major heart surgery."
Research by several major insurance carriers, supported the view that insuring "committed homosexual couples" would cost no more per capita than insuring married men and women, he said.
"So it came down to an issue of fairness," he said.
That's how the gay nurse and librarian see it.
After striking out with Hopkins, they encountered a different problem when they turned to the state for assistance. Because the librarian was temporarily unemployed, they figured that she might qualify for Medicaid. But the state turned her down, pointing to the joint bank accounts as evidence that she had assets beyond her own.
It was a classic Catch-22: Hopkins said their relationship wasn't traditional enough to qualify for family benefits. Maryland said their partnership was close enough to disqualify them for Medicaid.
To the couple's profound relief, the state reversed itself and granted benefits after considering their appeal for six months.
Meanwhile, surgery and chemotherapy were an apparent success. The librarian is now free of ovarian cancer and huge medical debts.
But the nurse, who recently left Hopkins to take a job elsewhere, felt strongly enough about the issue to return to the Hopkins medical campus three weeks ago to tell her story during the mass meeting of faculty supporters.
"What benefits Hopkins gives a heterosexual couple should have been available to me," she said.