Tuesday, September 27, 2016

Insurance

We are now getting insurance coverage for healthcare related to our transition and that is starting to make hospitals take notice.
With Insurers on Board, More Hospitals Offer Transgender Surgery
Doctors say demand is high from transgender people seeking medical procedures
Wallstreet Journal
By Sumathi Reddy
September 26, 2016

Surgery is becoming more available for transgender people as a growing number of academic centers and hospitals offer the procedure and insurance companies provide coverage.

Stacey Parsons, a 45-year-old from Kent, Ohio, had genital surgery in August at Cleveland Clinic, which last year launched a transgender-surgery-and-medicine program. For years the procedure was unattainable for Ms. Parsons because it costs upward of $20,000 and was rarely covered by insurance.

Other medical centers also have begun offering transgender surgeries, including Boston Medical Center, Oregon Health & Science University in Portland and Mount Sinai Hospital in New York City. Baltimore’s Johns Hopkins Hospital, which had one of the first such centers in the 1960s, is in the process of re-establishing a transgender program and will begin accepting patients by early next year. Previously, patients wanting transgender surgeries had to seek them out through private-practice plastic surgeons or in countries such as Thailand.

Demand is high, say doctors. Boston Medical Center, which opened its Center for Transgender Medicine and Surgery this year, began performing vaginoplasty, which creates a vagina, earlier in September. It currently has 200 people on a waiting list for the procedure, says Joshua Safer, the transgender center’s director.
Cha-Ching $$$$! That is the sound that the hospital administrators are hearing… there’s gold in them thar surgeries.

Here in Connecticut I know of a couple of hospitals that are thinking of starting a gender clinic and there is one hospital that has started to offer Gender Confirming Surgery, but they are off to a rocky start because not everyone is on board and that the administration is timid with the idea.

But not everyone is hearing it.
Anthem Sued by Transgender Librarian Over Surgery Coverage
Bloomberg BNA
By Patrick Dorrian
September 27, 2016

Sept. 26 — A transgender public library worker in Cincinnati is asking a federal court to order her employer and its health insurer to cover the cost of her upcoming sex transformation surgery ( Dovel v. Pub. Library of Cincinnati and Hamilton Cty. , S.D. Ohio, No. 1:16-cv-00955, complaint filed 9/26/16 ).

Rachel Dovel alleges that the Public Library of Cincinnati and Hamilton County’s policy with Community Insurance Co., doing business as Anthem Blue Cross and Blue Shield, unlawfully excludes coverage for the sex transformation surgery required to treat her gender dysphoria—an intense and persistent discomfort with the characteristics of one’s birth sex. Dovel says the library’s board of trustees has continually refused her calls to change the policy, forcing her to advance the costs of her scheduled November 2016 surgery and incur high-interest debt and depleted savings.

The lawsuit is notable because it’s similar to one filed in June by the American Civil Liberties Union against Dignity Health. The Equal Employment Opportunity Commission enforces federal job rights laws and has ruled administratively and otherwise publicly taken the position that discrimination based on gender identity is discrimination based on sex under Title VII of the 1964 Civil Rights Act. The EEOC in August filed an amicus brief supporting the plaintiff in the case against Dignity.
This case is based on cases like the one where the U.S. Departments of Education and Justice have ruled that Title IX covers gender based discrimination. Both cases have their bases in the Supreme Court on the Price Waterhouse decision and other court cases that found that we are indeed covered because sexual stereotyping.

Will it go to the Supreme Court? Or will they see the handwriting on the wall and cover the medically necessary healthcare.

One thing you have to realize that even with insurance not every trans person can afford to pay the co-pay. In many cases we still have to come up with several thousand dollars which they can’t afford, the same is true for their hormones and they end up buying them off the street or from the internet.

Some trans people may have a medical condition that precludes surgery like a heart condition, diabetes, or another condition that makes surgery risky.

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