"Gatekeeping" Semantics - Flame Free

[MrTesto]

Unfortunately, this doesn't mean that we can get insurance at affordable rates on individual plans....

That's very true. If the national model follows the way it is in Massachusetts, however, there may be some better news. The plans for formerly-uninsured, and low income residents tend to have decent actual coverage for blood work and hormones, even while there are often explicit exclusions. I was not a big fan of being forced to buy insurance, but it seems to be working out better than I had thought it would.

It's commonly that way with employer-sponsored plans, too (exclusions, and yet coverage), even when it's clear that a person is transitioning. I don't understand why it happens that way, and because it's an exclusion, it's hard to advocate on a mass scale without shining a spotlight where people are actually getting needed services.

[MacKenzie]

As for causing other folks headaches, my sincere apologies if this somewhat complex issue not being watered down into lowest common denominator platitudes and politically correct TG talking points has been problematic reading.

-Miki

It's not really that complex, gatekeeping has it's pro's and con's. You guys are just making a mountain out of a mole hill. 

[Stephe]

It is my understanding that one of the real benefits of the upcoming health care reform in the US (a.k.a. 'obamacare') for trans people is that we can no longer be refused care under pre-existing condition exclusions.

Things are going to be changing drastically over the next few years, I think. The new WPATH SOC include and encourage informed consent for hormone access. The US govt has said that gender markers on passports can be changed without a specific requirement for medical transition, either hormones or surgery. More US states are changing driver's licenses to be updated based on primary care dr (or other providers) attestation of lived gender consistency. The next DSM has some significant changes removing binary identity requirements for trans people. More insurance companies are covering trans care, including SRS. And the ICD-10, the international healthcare coding structure, is itself being revised. Not all of these documents and policies agree, by any means. But the stranglehold that the DSM has had is loosening, and a new generation of medical and mental health providers is coming on the scene.

I just hope this health care reform doesn't get crushed before it ever takes effect... The insurance companies are still pushing to get it repealed as it would force them to be fair.

On your other points, I have read the newest version of the DSM and like the direction it is headed. I really make an effort to make things easier for future generations of trans people and feel I have made a dent in this, at least where I live. I think if this gay marriage thing can be federal law, a lot of these gender marker holdouts will give in being its a moot point as far as blocked "gays claiming to change sex so they can marry" mindset.

It's not really that complex, gatekeeping has it's pro's and con's. You guys are just making a mountain out of a mole hill. 

I can assume then you've never been beaten about the head by it..

[Cadence Jean]

I'd rather have a guide than a gatekeeper.  I feel like gate keeping is unethical to a certain extent: the medical professional has the ability to ease the mental and emotional suffering of an individual, but won't until certain arbitrary criteria are met.  If I had a malignant tumor, I would sign a paper and have it removed.  If my testes are secreting a hormone that has effects which cause me mental and emotional distress, I should be able to sign a paper and have them removed(after appropriate education is given to the individual).  I'm an advocate of informed consent, but completely understand why some medical professionals wouldn't put themselves out there in such a fashion and favor what is commonly referred to as "gatekeeping."