Medical Insurance and WPATH RLE "Gatekeeper" Requirements

[Allyda]

What bothers me is having to rely on the opinion/judgement of someone who has, at best, a textbook or second-hand notion of what I'm going through and how I may be feeling about it.

Agreed, I second this. I'm reading about this from the link Cindy provided (above) so I can be prepared. Even though planned SRS is 2 years off I'm not one to wait for the last minute on things.

[Allyda]

After reading through the clinical requirements for SRS, while still "gatekeeping" in my books it doesn't sound like I'll have too much of a problem obtaning my SRS when the time comes provided I contunue on my current path of transformation. My insurance may even pay for some or all of the SRS, however Facial Femminization (which I don't think I'll need), and a Trachea shave (which I may or may not need) and the Voice femminization (which I may or may not need) are another matter because they are mostly considered aisthetic. So I'mnot going to worry about any of it because I know that finally I'm doing what is best for me and my well being in order to live as me, who I really am.

[Jessika Lin]

My insurance may even pay for some or all of the SRS, however Facial Femminization (which I don't think I'll need), and a Trachea shave (which I may or may not need) and the Voice femminization (which I may or may not need) are another matter because they are mostly considered aisthetic. So I'mnot going to worry about any of it because I know that finally I'm doing what is best for me and my well being in order to live as me, who I really am.

I'm pretty sure that the SoC considers FFS, Trachea shaving and voice therapy to be medically necessary, mind you that probably doesn't mean much to the average insurance company.

[Allyda]

I'm pretty sure that the SoC considers FFS, Trachea shaving and voice therapy to be medically necessary, mind you that probably doesn't mean much to the average insurance company.

You could be correct. I may have misunderstood. I plan to read through it again a few more times. I am glad though that SRS is considered medically necessary. I just started hrt though so I have a little time to get all my ducks in order to comply with what I believe to be Gatekeeping as far as the RLE goes. However 12 months isn't so bad especially since I've been doing it for the last 5 years.

[Cindy]

Agreed, I second this. I'm reading about this from the link Cindy provided (above) so I can be prepared. Even though planned SRS is 2 years off I'm not one to wait for the last minute on things.

To be honest I think the SOCv7 is pretty good. OK getting people to follow them is a task, but as a 'guide for all' they are reasonable. I think they need a mention of flexibility for individuals and a definition of informed consent that is workable rather than the vague statements at present.

Remember also the TS is regarded as a pathology in the USA by the MSM or is it the MDS? whatever that is not used outside of the USA.

[Allyda]

To be honest I think the SOCv7 is pretty good. OK getting people to follow them is a task, but as a 'guide for all' they are reasonable. I think they need a mention of flexibility for individuals and a definition of informed consent that is workable rather than the vague statements at present.

Remember also the TS is regarded as a pathology in the USA by the MSM or is it the MDS? whatever that is not used outside of the USA.

That it is considered pathology and not a psychiatric disorder is a good thing, I think. The only problem I see is finding trans friendly Doctors in rural areas such as where I live. However I don't mind driving a few hours for surgery when it's time.

[DrBobbi]

It's the DSM (Diagnostic Statistical Manual-V)