January 22, 2013
From the post: “I’m concerned about how medical necessity is applied to current conceptions of gender identity. If gender identity and/or gender dysphoria (GI/GD) medically necessitates physical changes to the body, then certain “gender identities” are medically consistent with particular kinds of bodies. In other words, there is a “right” and a “wrong” way to embody gender. Depending on one’s “gender identity,” certain sex-specific body parts can be diagnosed as erroneous and, therefore, in need of medical treatment or correction. Contrast this with the radical idea that gender non-conformity is a sociologically foreseeable departure from, and/or individually calculated resistance to, rigid gendered conditioning.”
Insurance coverage of medical treatments for “sex changes” is very controversial. Medicaid coverage of gender identity related conditions is practically a legal field of study unto itself.[i] Like the various definitions of “gender identity,” the rules that control driver’s license and birth certificate amendments, and whether violence against someone is considered a hate crime; health insurance is governed differently in every state.
In Oregon, the Insurance Division of the Department of Consumer and Business Services (division) recently issued a comprehensive bulletin (INS 2012-01)[ii] about health insurance coverage of medical treatments for gender identity/gender dysphoria (GI/GD) (see discussion of meaning below, Principle #4). I will use the framework of this guidance to highlight some of the legal and practical inconsistencies that concern me about the socially constructed…
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