healthcare

When my partner was at another company, we had the same insurance for 7+ years. I found it amusing in February when the insurance company changed my gender marker from F to M on their own. Problem is, I only found this out because they kicked back a claim for gynecological services because, well, guys don't need that. But some guys do and I will get to my master plan a little later. At the time, I didn't bother clearing the matter up. The bill was small and I paid it out of pocket and thought "kewl, I'm already a guy according to the evil insurance company."

Well, over the past 6 weeks or so, some more gynecological issues have come up (everything's fine so no worries). Because of my family history of ovarian cancer, my doctor is extremely cautious about any new symptoms that pop up. So when I started spotting after no periods for over 4 years (thanks to an endo ablation), off I went to get an ultrasound. On the 19th, I received my explanation of benefits forms from the insurance company and saw that a number of claims had been denied because, once again, guys have no need for gynecological services. Considering this time I'd be on the hook for over $1200 if I didn't clear this up, I called the insurance company.

The first line out of my mouth was "you have me listed in your system as male which it turns out is now  correct and I don't want you to change it but I have an explanation for why these claims need to be paid." I then went into an explanation that I am a transgender male but as of now, I do still have female anatomy and when I had some gynecological issues come up, my doctor did the prudent thing and sent me out for some tests. Considering that this situation has nothing to do with my transition, the claims should not be denied under the "transsexual exclusion" clause of the policy (more on what I think about THIS later).

Luckily, I had a very helpful agent and it was decided that all I needed to do was have my doctor send in some chart notes for a medical review. I did ask if this should be our default action whenever I have something come up that would generally fall under the female healthcare category and got an affirmative.

I also asked for (and received) an address to write to in order to educate the company on the need for a cogent internal policy to help transsexuals get the healthcare they need without having to jump through hoops like I had to do. So now the work REALLY begins.

The AMA is starting to get its ducks in a row with a resolution passed in June of this year that states that it is time to remove the financial barriers of care for transsexual patients. The World Professional Association for Transgender Health recently came out with a statement clarifying the medical necessity of treatment, sex reassignment, and insurance coverage in the US. I also found a study of the cost-benefit analysis of providing transgender healthcare benefits. This paper provides case studies of Lucent, Avaya and the city of San Francisco regarding the cost of trans-inclusive coverage.

Gender Identity Disorder is a very real medical condition that has been treated successfully for decades. The surgeries involved are far from cosmetic. Denying coverage for medically indicated treatment out of ignorance or bias is simply cruel and inhumane. It is time to allow doctors and patients make the decisions regarding their healthcare without impediments by health insurers.