Insurers struggle to justify the sex discrimination of legally mandated “transgender care” while surgical providers continue to decline
October 30, 2014
Less than 50 physicians worldwide are willing to provide transgender surgical “sex reassignment” or “sex change” procedures, and as the few existing practitioners retire, no one is replacing them. Modern cosmetic and reconstructive surgeons at large are opting not to do these procedures, even when they are state mandated and funded.
Now, insurers are struggling to fulfill state mandates covering transgender surgical procedures for men that are excluded for women based on sex discrimination. Transgender state medical mandates pushed by lobbyists insist that procedures such as breast implants and “face lifts” are medically necessary for men who wish to look more like women, while denying coverage for those same procedures to actual women. Transgender advocates have successfully lobbied for such government provided “care” on the grounds that without such procedures men may become depressed or abuse alcohol or other substances, and that such men have a state-protected right to avoid being mocked or socially ostracized for their appearance. Males must declare a “transgender identity” to receive coverage.
From the Boston Herald:
Four months after the state Division of Insurance put health plans on notice that denying medically necessary treatment to transgender people is prohibited sex discrimination, insurers are still grappling with what constitutes medical necessity, and patients are struggling to find doctors who’ll treat them.
“We were concerned people were having to go all over the country for this surgery,” Dr. Joel Rubenstein of Harvard Pilgrim Health Care said yesterday at a Division of Insurance informational session. “We’re hopeful somebody would step up to put together the surgical piece so it could all be in one place.”
On the other hand, he said, Harvard Pilgrim does not want to approve procedures such as facial feminization for transgender people if those procedures would be considered merely cosmetic for other people.
But Ruben Hopwood of Fenway Health said facial feminization is not about wanting a “cuter nose.” A transgender person’s appearance is more likely to be the difference between getting a job or not getting one, and walking down the street unafraid or being attacked, Hopwood said.
Getting the proper treatment also can save money that might otherwise be spent on treatment for alcohol or substance abuse or depression, said Pam Klein, a nurse at Boston Health Care for the Homeless.
[bolding by me-GM]