Dealing with the medical community after gender change

[Stephe]

I recently got health insurance for the first time in 30 years and also had a bilateral orchi (before I got insurance) which allowed me in Georgia to change the sex marker on my ID to F around the same time. I filed my health insurance as F after talking to the insurance company, they said it needs to match my Gov ID, which makes sense. Also, I basically pass as a female without any problems now and I haven't been "clocked" in a long time.

Lately what has been happening is: when I go see a doctor about a non-trans related medical problem and tell the doctor in private I am MTF (I'm not going to hide this from a doctor who is treating me) they or someone in the office changes my records/paperwork from female to male and the next visit there is a big fat M all over everything, the nurse walks into the waiting room with my chart, calling for "Mr ____?" etc.

One doctor sent me to get a CT scan, sent the referral as my being male and I basically had to announce to everyone in their waiting room "Look, I am a MTF transsexual and that is why they, for some reason, have the wrong gender on the referral". Of course this leads to a lot of raised eyebrows and staring. Then I got in a discussion with the guy doing the scan, he kept saying "well what are you?". Finally the manager came back, I told him my ID and insurance says female, so they just dropped it.

Now I am finding out, some of the claims they filed, they used "male only" coding and the claims are getting kicked. I called the insurance company and asked them whats going on. They said they have no problems with paying for the doctor visits (or that I am trans) but they can't pay claims for a female coded as a male.

First of all, should any doctor be "outing me" to the whole office about something I told -him only- behind closed doors? And for Christs sake, they have a copy of my legal ID. Am I going to have to explain to everyone in the doctors office, in earshot of everyone in the waiting room, that I am really a female and to stop changing my charts to male? And now, I get to experience the joy of talking to their billing department, explaining my personal life just to get them to code the claims in a way that I don't have to pay out of pocket... And they possibly will refuse to do this, which means I have to file an appeal with the insurance company for every claim that is filed this way?

I plan to talk to this doctor on my next visit and question him discussing my gender issues outside of the examining room. And also why would they file claims using male only coding. Maybe he just hasn't thought this through or has never dealt with a TG patient before? He seems smart and kind so I can't imagine this is intentional but if it is, probably going to have to find another doctor.

 

[Dena]

I haven't had to deal with to deal with very many doctors but I think you need to take the male out of the conversations. You need to say you underwent gender reassignment and are a woman or you are a post surgical woman. Unfortunately doctors files are not very secure in the office. My first job I worked as a computer programmer setting up a medical billing service for a doctor. I didn't have an interest in the files, but had I needed information out of them, I could have pulled a file to get the required information.

Sadly if you can't resolve this, you may need to consider another doctor.

[Jenna Marie]

NO, they should not be doing this. More specifically, they may (depending on who's being told and how) be violating HIPAA, which is a *huge* deal in a medical practice. You are legally female, end of story.

I also don't even think you need to out yourself to the people who are being given the wrong gender marker; you go into the lab, etc. and say "My license and insurance both say female; must be a mix-up." They're more likely to fix it if you give them a story they understand, so claiming the doctor's office screwed something up will sound familiar. Plus, well, he DID.

I'm so sorry this is happening to you, and this is not acceptable or normal. (My doctor's office actually managed, somehow, to keep "name and gender she wants to be called to her face" and "name and gender to file with insurance" distinct and different for close to a year...)

[Stephe]

NO, they should not be doing this. More specifically, they may (depending on who's being told and how) be violating HIPAA, which is a *huge* deal in a medical practice. You are legally female, end of story.

That is how I feel. Like what I shared in private behind closed doors with the doctor was shared with his whole office and dozens of people. I feel like my trust in what was discussed between us was violated. He was the only person in that office that knew anything other than I was a female patient. He seems kind and very intelligent, I'm not sure why he felt this was OK to do?

[januarysunshine]

Im really sorry you're going through this...that sucks:(
I agree that you should have everything switched to female and leave it at that. Find a new doctor and don't transfer any records...just start fresh. If you get to change insurance carriers at some point too, this will all stop...Just remember one thing--you're female now, regardless of SRS--you live as a female and you're female now, so just go with it. I wouldn't even mention to anyone that you're transgendered unless it's absolutely necessary and even then only to people who are trans-friendly--most cities compile lists of doctors and whatnot who are trans-friendly.

I know it sucks right now but the further down the road, it'll disappear from your psyche and you'll be ok --you know? Right now it seems really horrid because you're living it, but down the road it'll be just a faded memory and you'll be so fully living your life, you won't even think about all this old stuff.
Sending light and love.

[Lady Smith]

I would be so furious if that happened to me.  From the sound of it I would say that it may be that some self-righteous person working in the office has made the change.  This is so very wrong and here in New Zealand would be grounds for a formal complaint through the Health Dept advocacy service.
I used to work as a social worker for the adult mental health service and if I'd pulled a trick like that on a patient/client I would have been sacked and rightly so.

[SorchaC]

There is no way a doctor should be outing you. The record also shouldn't be getting changed. If it were me I would make a formal complaint to whoever the governing body for the doctor is demanding that the person who changed the record is fired and a formal apology from the doctor and practice concerned.

You've done what the law says you need to so your gender can be legally changed so from that point on you are legally a female and no doctors office worker has a right to amend your records. Also the doctor broke your trust in sharing this with them and they too should be at least reprimanded

Hope you can sort this and go back to living anonymously

Hugs

Sorcha 

[Stephe]

In this case, it was medically necessary to tell the doctor I am MTF as the problem was lingering pain in my groin area related to or at least seemed to be related to my cut spermactic cords. Turns out I have a small hernia in the same area.

This was a new doctor, the only records transfer were from his office to the lab doing the CT scan. My new insurance/ID etc all match, showing me as female. The insurance people had no clue I was transgendered. So the doctor shared my status or it was in his written report and someone in the office took it upon themselves to "correct" the gender on my file and report it to the insurance company etc. I can see online at their "portal" on my first visit the report shows female, on my second visit it shows male. So far the insurance company agrees that my gender on their policy needs to match my legal ID and seem OK that I am trans. Then again for all I know they could decide to kick future claims because of my status now. As much headway as obamacare made, they left "transgender care exclusions" as being legal and most affordable policies have them.

And I understand about using "trans-friendly" doctors/offices but when you need a specialist, sometimes you just have to go to a "regular doctor" and hope they won't be judgmental or do something like this.

I don't believe it was the doctor doing this maliciously. I really don't plan to file an official complaint either but I do plan to mail him a written letter explaining the situation so -maybe- they will set a policy on transgendered care for future patients.

[Eva Marie]

What they did was wrong and like someone said they may have violated privacy laws.

I would have a frank chat with the doctor in private and in a calm voice explain that you are legally a female and that someone in his office is coding things as male which tells you that he violated your privacy and that's not acceptable. Tell him that his leaking your information has now caused a mess with your insurance company and that you expect his full and complete cooperation to fix it.

And then tell him that if it happens again you are going to file complaints on him with whatever governing or legal body he is under.

That gives him a fair warning and gives him a chance to make the changes that his office apparently needs, and if he doesn't make the changes he gets the stick instead of the carrot.

[CrysC]

I think you should just change doctors. 
We are talking about the people that take care of our medical health and we should be able to trust them.  Regardless of what you say to him I would never trust that guy and definitely would never want him having anything to do with my body. 

[Tessa James]

NO, they should not be doing this. More specifically, they may (depending on who's being told and how) be violating HIPAA, which is a *huge* deal in a medical practice. You are legally female, end of story.

I also don't even think you need to out yourself to the people who are being given the wrong gender marker; you go into the lab, etc. and say "My license and insurance both say female; must be a mix-up." They're more likely to fix it if you give them a story they understand, so claiming the doctor's office screwed something up will sound familiar. Plus, well, he DID.

I'm so sorry this is happening to you, and this is not acceptable or normal. (My doctor's office actually managed, somehow, to keep "name and gender she wants to be called to her face" and "name and gender to file with insurance" distinct and different for close to a year...)

I was a provider for 33 years and now serve as a transgender patient representative.  Jenna has it exactly right and you would have a very good HIPAA violation claim if you wanted to pursue it.  So sorry you dealt with such ignorance in a place that should be safe and caring.  I also agree with you about being truthful regarding our medical history, it is important for many reasons.  They should at least assist you in resolving the problems they created.

[iKate]

Well I go to a LGBT clinic for all my care so I have no problems there. They ask preferred name and call me by it. However I haven't changed anything from M to F yet even though my driver license is female. I am going to change passport and naturalization cert when I change my name.

My insurance may be a bit tricky as it's under my wife's name and I have to ask her to change it. She may be reluctant to do so since it officially tells her job to recognize her as being in a same sex marriage, something she is opposed to.

For now though, I am fine, because they cover all my care regardless. Only the estrogen they don't but that is $10 at walmart.