Would my insurance cover my post-orchiectomy HRT?

[Dena]

Hang on there--after all, I myself am certainly willing to wear a condom in order to protect myself from STDs as well as to have myself and all of my future sexual partners get and share regular STD tests.

A vasectomy and a condom and you still fear spreading your seed? You are really a safety first person. By the way, Aids sometimes takes a while to show up in the test so make sure your partner stay away from anybody for the several months it takes for an accurate test result.

[Futurist]

A vasectomy and a condom and you still fear spreading your seed?

Yes, of course. After all, the law of truly large numbers makes a vasectomy failure virtually inevitable for at least one person out of a large enough sample size; indeed, that one person can just as easily be me as it can be anyone else. Plus, condoms have like a 20% annual failure rate if one takes user error into account (as I myself certainly always do, considering that I can certainly screw up). Thus, it certainly wouldn't be surprising at all for a vasectomy and a condom to simultaneously fail.

You are really a safety first person.

Yes; of course! After all, unlike many cis-women, I myself certainly don't have the guaranteed option of abortion to fall back on in the event of an unplanned pregnancy. Also, I (would) never rely on any female-bodied person's word that she will get an abortion in the event of an unplanned pregnancy due to the fact that she can lie (after all, reproductive fraud can and sometimes does occur) or change her mind in regards to this later on. Also, the same certainly applies to adoption. In addition to this, though, please don't (falsely) accuse me of sexism; after all, if (purely hypothetically) I was a fertile cis-woman, then I would never rely on any man's word in regards to adoption and would thus always get an abortion in the event of an unplanned pregnancy. Thus, my own views and distrust in regards to this certainly isn't sex-specific.

By the way, Aids sometimes takes a while to show up in the test so make sure your partner stay away from anybody for the several months it takes for an accurate test result.

Exactly how many months, though? Also, isn't it extremely hard to get AIDS even from unprotected penis-in-vagina sex with an AIDS-positive person? Or am I completely misinformed in regards to this?

[iKate]

OK--I myself want to become a (literal) eunuch both for sterilization purposes and, if possible*, to help feminize both my body and my face. Thus, what I am wondering about is this--would my insurance cover my post-orchiectomy (post-castration) hormone replacement therapy (HRT)?

Any thoughts on this?

*I also strongly value my ability to get erections using my penis and to have penis-in-vagina sex, so yeah.

Without T your chances of "gettin' it up" far less penetrating are not guaranteed.

Also what state are you in? Some states would require them to cover you.

The insurance company may also not say "no" but they may require pre approval. My insurance will not cover more than 1mg without a doctor's explanation and pre approval. Prostate cancer and GID are two conditions I saw on the form.

That said, Walmart and target sell estradiol for $4/30 pills and $10/90 pills even without insurance. So there is that if you really need it. Prescription required of course.

[Futurist]

Without T your chances of "gettin' it up" far less penetrating are not guaranteed.

Can I find a good balance of both E and T, though?

Also what state are you in? Some states would require them to cover you.

California.

The insurance company may also not say "no" but they may require pre approval. My insurance will not cover more than 1mg without a doctor's explanation and pre approval. Prostate cancer and GID are two conditions I saw on the form.

Pre-approval from whom, exactly?

That said, Walmart and target sell estradiol for $4/30 pills and $10/90 pills even without insurance. So there is that if you really need it. Prescription required of course.

What about for testosterone replacement therapy, though?

[iKate]

California? Girl please. Your insurer pretty much has to accommodate you.

And yes your doc can tailor your meds to keep your function. No I'm not really sure they can do so effectively if you have an orchi. 

So why not simply have a vasectomy to prevent pregnancy and then take antiandrogen and estrogen? I don't know what your sexual goals are but if you want to have sex with women and avoid getting them pregnant while retaining the ability to have an election and feminize then this is the way to go, in my opinion.

But talk to your doctor as they will definitely know better. I dont have the fancy medical degree and stuff.

It's better if you produce your own T as testosterone is a controlled substance (anabolic steroid) and has stricter rules than estrogen. It may also be more expensive and then you'll be dealing with patches or shots as T is not available in pill form.

[iKate]

Pre approval from your insurance based on information supplied by the doctor. But it's California so that may not be necessary.

[Futurist]

California? Girl please. Your insurer pretty much has to accommodate you.

I'm not a girl, though. Rather, I am an aspiring eunuch/genderqueer person.

And yes your doc can tailor your meds to keep your function.

OK.

No I'm not really sure they can do so effectively if you have an orchi.

Why exactly is that, though?

So why not simply have a vasectomy to prevent pregnancy and then take antiandrogen and estrogen? I don't know what your sexual goals are but if you want to have sex with women and avoid getting them pregnant while retaining the ability to have an election and feminize then this is the way to go, in my opinion.

But talk to your doctor as they will definitely know better. I dont have the fancy medical degree and stuff.

The thing is, though, that vasectomies can and sometimes do fail.

It's better if you produce your own T as testosterone is a controlled substance (anabolic steroid) and has stricter rules than estrogen. It may also be more expensive and then you'll be dealing with patches or shots as T is not available in pill form.

While it might be better, the problem with keeping my testicles is that I will still be able to cause an unplanned pregnancy (considering that even vasectomies can and sometimes do fail). Indeed, as far as I know, a properly performed orchiectomy plus two successful semen analyses afterwards is the only way for me to completely eliminate the odds of an unplanned pregnancy.

[iKate]

I'm not a girl, though. Rather, I am an aspiring eunuch/genderqueer person.

Sorry about that. What's your preferred pronouns?

Why exactly is that, though?

Orchi is short for orchiectomy

The thing is, though, that vasectomies can and sometimes do fail.

While it might be better, the problem with keeping my testicles is that I will still be able to cause an unplanned pregnancy (considering that even vasectomies can and sometimes do fail). Indeed, as far as I know, a properly performed orchiectomy plus two successful semen analyses afterwards is the only way for me to completely eliminate the odds of an unplanned pregnancy.

Well if you decide to go that route there is a chance you may not be able to achieve an erection. Your doctor may then have to prescribe a small dose of testosterone because you aren't producing any. If your function is important to you you need to keep that in mind.

[Futurist]

Sorry about that. What's your preferred pronouns?

Male pronouns.

Orchi is short for orchiectomy

That doesn't address my question here, though.

Well if you decide to go that route there is a chance you may not be able to achieve an erection. Your doctor may then have to prescribe a small dose of testosterone because you aren't producing any. If your function is important to you you need to keep that in mind.

OK, and will do!

[Ms Grace]

Exactly how many months, though? Also, isn't it extremely hard to get AIDS even from unprotected penis-in-vagina sex with an AIDS-positive person? Or am I completely misinformed in regards to this?

It is absolutely possible - all you need is a sore or cut around the sex organs, sexual fluids and/or blood and you a running a fairly huge risk. It's more likely for the female partner to get it but the male partner can also be infected in those circumstances.

[Futurist]

It is absolutely possible - all you need is a sore or cut around the sex organs, sexual fluids and/or blood and you a running a fairly huge risk. It's more likely for the female partner to get it but the male partner can also be infected in those circumstances.

Thank you very much for this information! Also, though, do you please have any links to help educate me more in regards to this?

[Cindy]

Education about HIV and safe sex is widely available. I suggest you Google it.

[Futurist]

Education about HIV and safe sex is widely available. I suggest you Google it.

OK, and will do! After all, HIV and other STDs are certainly extremely nasty things and I have already forgot some of the information from my middle school sex education class 11 years ago.

[Futurist]

If nothing else either meeting the deductible or the cost of the policy would be greater that the cost of HRT.

Also, can you please clarify this part, Dena?

[Futurist]

A vasectomy is virtually 100% effective, it doesn't come "undone",  and would leave you with plenty of testosterone to maintain erections, vaginal sex, and prevent osteoporosis.

Frankly, the fact that vasectomy doctors are certainly unwilling to pay all of their patients' child support for 18+ years in the event of a vasectomy failure (and even in exchange for having their patients pay them several thousand dollars beforehand) is all that I need to know about the effectiveness of vasectomies. Indeed, since vasectomy doctors certainly don't have (full) confidence in their own surgeries, how the heck can I myself have (full) confidence in their surgeries?

[Dena]

If nothing else either meeting the deductible or the cost of the policy would be greater that the cost of HRT.

Also, can you please clarify this part, Dena?

I have Blue Cross and in my state the the cost of the insurance policy is $640 a month, up from about $400 as the result of the affordable health care act. My deductible on the policy is $3500. For a younger person, the cost of insurance might be about half that. It comes out to $11,000 a year I could pay out before the insurance company pays a dime. I have had blue cross for years in one form or another and so far they have never paid for any of my health related care. I never met the deductible or they had me on a HMO that didn't cover my doctor and they didn't have an Endo in the system I could trust.

$11,000 will pay for a lot of HRT

[Futurist]

Also, can you please clarify this part, Dena?

I have Blue Cross and in my state the the cost of the insurance policy is $640 a month, up from about $400 as the result of the affordable health care act. My deductible on the policy is $3500. For a younger person, the cost of insurance might be about half that. It comes out to $11,000 a year I could pay out before the insurance company pays a dime. I have had blue cross for years in one form or another and so far they have never paid for any of my health related care. I never met the deductible or they had me on a HMO that didn't cover my doctor and they didn't have an Endo in the system I could trust.

$11,000 will pay for a lot of HRT

Thank you very much for sharing this information, Dena!

Also, though, will my insurance cover my post-orchiectomy HRT if I will have/get a psychiatrist letter which states that my orchiectomy was medically/psychologically necessary for my own overall well-being?

Any thoughts on this?

[Dena]

The insurance company could question it as you will continue to have a male gender marker receiving female HRT. When dealing with the government or an insurance company, document everything because it might cost you if you don't. What you are asking for isn't common and procedures may not have been established to handle it. The more the medical community can show the need, the less hassle you will have with the insurance company.

[Futurist]

The insurance company could question it as you will continue to have a male gender marker receiving female HRT.

What about if I will take testosterone HRT, though? (While I might very well prefer estrogen, I certainly want to keep all of my options open in regards to this.)

Also, what about if I will provide proof to them that gender and gender expression certainly isn't always binary?

When dealing with the government or an insurance company, document everything because it might cost you if you don't. What you are asking for isn't common and procedures may not have been established to handle it. The more the medical community can show the need, the less hassle you will have with the insurance company.

OK.