Why is SRS "medically necessary," and not "cosmetic?"

[androgynouspainter26]

My understanding, and I try to break it down logically, the goal is to be accepted as a female by one's self and society. The goal is to be as close to a cis woman as possible.

Not all cis women have large breasts and some have faces that aren't 100% feminine (according to societal perception and natural instinct). A significant number of cis women have flat chests. However nearly all of them have vaginas. Almost none of them have penises. For a cis woman with a flat chest to get a BA or a "manly" face to get a facelift it is classified as cosmetic surgery.

This seems to be the rationale (as it seems to me anyway) behind the guidelines of covering GRS/SRS as medically necessary whereas FFS/BA/VFS/lipo etc is not.

Not quite-the goal is to be comfortable with your body, and I think that varies from person to person.  I'd argue that for some people, BA is TOTALLY necessary.  I can't even look down anymore without feeling incredibly triggered.  I don't want to *appear* female; I want to actually have a female body.  And there are some physical traits that are undeniable masculine about my body.  FFS too-if you have a male facial structure, and you can't look in the mirror without wanting to scream (once again, that's how I feel) then I suppose it is something that I need.  We can all only speak from personal experience of course; and a substantial part of my desire to have this is being able to find a place in our very unfriendly world.  But, it's also what I'd need to feel comfortable.  I don't think any one individual can decide what should be done, because each person here has a different set of needs.  Personally, ideally I'd have FFS (for safety as well as dysphoria), BA (just dysphoria), and SRS (safety and dysphoria again)-in that order of priority.  There are others who would put SRS first, and it's up to them.  I think we all are striving to be comfortable; insurance should cover whatever is necessary to achieve that psychological peace of mind that we are aiming for by transitioning in the first place.

[Serena]

For me, I'd think electrolysis and facial feminization surgery are more necessary, as they affect the outward appearance seen by the general public, while genitals are only seen by you and your partner. In my opinion, it is more necessary for my mental health to pass in a public setting, than in a private setting.

I agree with you, and if I do have srs, the order will be 1-laser 2- ffs 3- srs. It's not as important as the first two, but it's considered a medical necessity because people have dysphoria about their genitals (me comprised), and some people might even go as far as something like self-mutilation or injuring their genitals because of that, I mean I thought about it too when I was little, because I hated it so much.

Though, some people don't need to feel "whole", at all like some people suggest here, and they shouldn't be ashamed of that, we are all different, I know plenty of trans women who don't want srs, I think they should have the option of having another procedure be considered a medical necessity...

[ImagineKate]

Not quite-the goal is to be comfortable with your body, and I think that varies from person to person.  I'd argue that for some people, BA is TOTALLY necessary.  I can't even look down anymore without feeling incredibly triggered.  I don't want to *appear* female; I want to actually have a female body.  And there are some physical traits that are undeniable masculine about my body.  FFS too-if you have a male facial structure, and you can't look in the mirror without wanting to scream (once again, that's how I feel) then I suppose it is something that I need.  We can all only speak from personal experience of course; and a substantial part of my desire to have this is being able to find a place in our very unfriendly world.  But, it's also what I'd need to feel comfortable.  I don't think any one individual can decide what should be done, because each person here has a different set of needs.  Personally, ideally I'd have FFS (for safety as well as dysphoria), BA (just dysphoria), and SRS (safety and dysphoria again)-in that order of priority.  There are others who would put SRS first, and it's up to them.  I think we all are striving to be comfortable; insurance should cover whatever is necessary to achieve that psychological peace of mind that we are aiming for by transitioning in the first place.

What makes your "need" for a BA and FFS different from that of a cis woman? Nothing. Cis women have the same issues - they don't like how they look and they figure surgery could make them look better.

And yes I would like insurance to cover everything but see above, they would have to cover it for everyone, cis women included because the need is the exact same. You can be a woman without big breasts and an unattractive face. Cis or trans. This is not going to happen because plastic surgery to enhance your appearance is a luxury, not a necessity.

And the goal is to be comfortable with your body? Really? Sounds like every man and woman would have elective plastic surgery covered by insurance. Is that correct?

[androgynouspainter26]

What makes your "need" for a BA and FFS different from that of a cis woman? Nothing. Cis women have the same issues - they don't like how they look and they figure surgery could make them look better.

And yes I would like insurance to cover everything but see above, they would have to cover it for everyone, cis women included because the need is the exact same. You can be a woman without big breasts and an unattractive face. Cis or trans. This is not going to happen because plastic surgery to enhance your appearance is a luxury, not a necessity.

And the goal is to be comfortable with your body? Really? Sounds like every man and woman would have elective plastic surgery covered by insurance. Is that correct?

Well you're acting like the only goal in transitioning should be to culturally assimilate with the rest of the world in a female gender role, and that's not what I personally want.  I'm transitioning so that I can feel comfortable with who and what I am.

[ImagineKate]

Well you're acting like the only goal in transitioning should be to culturally assimilate with the rest of the world in a female gender role, and that's not what I personally want.  I'm transitioning so that I can feel comfortable with who and what I am.

There are a lot of cis girls who feel unattractive. Should their surgery be covered?

[androgynouspainter26]

There are a lot of cis girls who feel unattractive. Should their surgery be covered?

It's not about feeling unattractive though.  It's about correcting male traits.  Just as a penis is a trait that should not be on my body, my brow bossing is the same.  Facial features are as biologically sexed as our genitallia are, and for some people (like me) having a male face can really trigger a lot of dysphoria. 

[ImagineKate]

It's not about feeling unattractive though.  It's about correcting male traits.  Just as a penis is a trait that should not be on my body, my brow bossing is the same.  Facial features are as biologically sexed as our genitallia are, and for some people (like me) having a male face can really trigger a lot of dysphoria.

But can you give me an objective standard as to what is a male face and what is a female face? Or male size boobs and female size boobs?

[androgynouspainter26]

Yes, actually, there are scientific traits that determine what gender a face is recognized as.  There are specific dimensions that are considered male, and specific dimensions that are considered female.  Besides, if someone had a big ugly growth on their neck that wasn't cancerous but still quite intrusive, insurance would cover it.  It's not about feeling pretty, it's about seeing a person of the appropriate sex staring back at you.  This is something I feel dysphoric about, and I believe I should have the right to change it because it causes me significant distress on a daily basis.

[ImagineKate]

Yes, actually, there are scientific traits that determine what gender a face is recognized as.  There are specific dimensions that are considered male, and specific dimensions that are considered female.  Besides, if someone had a big ugly growth on their neck that wasn't cancerous but still quite intrusive, insurance would cover it.  It's not about feeling pretty, it's about seeing a person of the appropriate sex staring back at you.  This is something I feel dysphoric about, and I believe I should have the right to change it because it causes me significant distress on a daily basis.

But you say you "need" FFS yet people here tell you you pass. How is that an objective standard? That seems pretty inconsistent.

[androgynouspainter26]

But you say you "need" FFS yet people here tell you you pass. How is that an objective standard? That seems pretty inconsistent.

Well, to be fair you could put Jay Leno in a blond wig and half the gals here would tell him he passed...

I feel dysphoric about my face.  Not self concious-dysphoric.  If the goal of transitioning is to alleviate dysphoria, then I think it constitutes a totally legitimate part of my transition.

[ImagineKate]

Well, to be fair you could put Jay Leno in a blond wig and half the gals here would tell him he passed...

I feel dysphoric about my face.  Not self concious-dysphoric.  If the goal of transitioning is to alleviate dysphoria, then I think it constitutes a totally legitimate part of my transition.

But why isn't it covered for cis women?

[Dee Marshall]

...I feel dysphoric about my face.  Not self concious-dysphoric.  If the goal of transitioning is to alleviate dysphoria, then I think it constitutes a totally legitimate part of my transition.

Then I would have to agree with you.

[androgynouspainter26]

But why isn't it covered for cis women?

Because cis women do not experience gender dysphoria.

[kelly_aus]

There are a lot of cis girls who feel unattractive. Should their surgery be covered?

In some cases, under the Australian system, a BA can be covered, at least partly, but only when it causes significant psychological distress.. It's rare, but it does happen. Breast reductions are also covered here, mostly for other health reasons.

[ImagineKate]

Because cis women do not experience gender dysphoria.

I would say that isn't true.

Dysphoria is basically dissatisfaction.

And there was one cis woman who came on here asking for advice for plastic surgery because she felt that people didn't view her as a woman.

[ImagineKate]

In some cases, under the Australian system, a BA can be covered, at least partly, but only when it causes significant psychological distress.. It's rare, but it does happen. Breast reductions are also covered here, mostly for other health reasons.

Agreed, but as you said it is rare, not the norm. As far as I know in the USA it is covered only to reconstruct it after mastectomy or similar but not for other reasons.

[androgynouspainter26]

I would say that isn't true.

Dysphoria is basically dissatisfaction.

And there was one cis woman who came on here asking for advice for plastic surgery because she felt that people didn't view her as a woman.

No.  It's not just dissatisfaction.  If dissatisfaction is the only reason you're doing this, perhaps you should re-examine your transition goals, and ask yourself why you're doing this, because dyphoria is a whole lot more than petty dissatisfaction.   

[ImagineKate]

No.  It's not just dissatisfaction.  If dissatisfaction is the only reason you're doing this, perhaps you should re-examine your transition goals, and ask yourself why you're doing this, because dyphoria is a whole lot more than petty dissatisfaction.

I was referring to the dictionary definition.

No comment about the cis woman who came here seeking advice on ffs?

[androgynouspainter26]

I was referring to the dictionary definition.

No comment about the cis woman who came here seeking advice on ffs?

The cis woman did not have gender dysphoria.  She did not require treatment for gender dysphoria.  Why are you so against the idea of me being able to access the surgeries I'd need to feel comfortable? 

[androgynouspainter26]

If we will provide someone with free reconstruction post mastectomy, how come we can't get our chests reconstructed?  I lost mine to biology, not surgery, but it's the same thing.  Should be the same thing.