Would my insurance cover my post-orchiectomy HRT?

[Futurist]

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.

[Dena]

Most likely two things have to happen. Your policy has to indicate it provide coverage and the procedure has to be medically necessary. I suspect you will have difficulty getting insurance to pay for it.

[Futurist]

Most likely two things have to happen. Your policy has to indicate it provide coverage and the procedure has to be medically necessary.

OK.

I suspect you will have difficulty getting insurance to pay for it.

Why exactly do you say that, though?

[Futurist]

Indeed, wouldn't my post-castration hormone replacement therapy be prescribed by a doctor and be considered to be medically necessary?

[Dena]

It took a while to get policies to cover gender reassignment and some still don't. I suspect so few want the type of surgery you are asking for that the policy and doctors will only declare it medically necessary for something like cancer. Just because you want the surgery may not be enough to get coverage.

[Futurist]

It took a while to get policies to cover gender reassignment and some still don't. I suspect so few want the type of surgery you are asking for that the policy and doctors will only declare it medically necessary for something like cancer. Just because you want the surgery may not be enough to get coverage.

I wasn't talking about getting coverage for the actual surgery, though. Rather, I was talking about getting coverage for the post-orchiectomy hormone replacement therapy.

[Dena]

Again it would be determined by how the policy was written and the reason for hormone replacement. If it was a recognized medical condition, it should be covered. If it's not a recognized medical condition, it may not be covered. Something we were told 35 years ago in our group, read the policy. Each policy is written differently and without the exact policy in hand, it's hard to say for sure.

[Futurist]

Again it would be determined by how the policy was written and the reason for hormone replacement. If it was a recognized medical condition, it should be covered. If it's not a recognized medical condition, it may not be covered. Something we were told 35 years ago in our group, read the policy. Each policy is written differently and without the exact policy in hand, it's hard to say for sure.

Wouldn't things such as osteoporosis be considered to be recognized medical conditions, though?

[Dena]

Should the policy consider it self mutilation, it might not be cover much as suicide is often excluded from life insurance policies. You have to have the doctor certify the reason for treatment and the doctor will put down the primary cause. To do anything less would be fraud and would risk their ability to practice.

To treat osteoporosis they would put you back on male hormones unless you had therapist certify you were transgender. Again, read the policy and don't ask me for insurance payment advice because each policy is different. Read it very carefully because I suspect you would have to pay most or all the cost out of pocket. If nothing else either meeting the deductible or the cost of the policy would be greater that the cost of HRT.

[Ms Grace]

How about just asking your insurance company? Most of them have such labyrinthine policies anything we say here would be sheer conjecture anyway.

[Futurist]

Should the policy consider it self mutilation, it might not be cover much as suicide is often excluded from life insurance policies.

Why exactly would surgical castration be considered to be "self-mutilation" if a qualified doctor is the one who performed this surgery, though?

Also, it appears that at least some suicide exclusions in regards to insurance are illegal:

http://www.fiercehealthpayer.com/story/suicide-related-benefit-exclusions-may-be-illegal/2014-02-18

You have to have the doctor certify the reason for treatment and the doctor will put down the primary cause. To do anything less would be fraud and would risk their ability to practice.

OK. Also, though, what about if I will tell a doctor that I got surgically castrated for sterilization purposes (because all non-drastic forms of birth control, including vasectomies, can and sometimes do fail) and, if possible, to help feminize both my body and my face?

To treat osteoporosis they would put you back on male hormones unless you had therapist certify you were transgender. Again, read the policy and don't ask me for insurance payment advice because each policy is different. Read it very carefully because I suspect you would have to pay most or all the cost out of pocket. If nothing else either meeting the deductible or the cost of the policy would be greater that the cost of HRT.

OK.

[Futurist]

How about just asking your insurance company? Most of them have such labyrinthine policies anything we say here would be sheer conjecture anyway.

OK, and will do! However, I think that I first need to ask my parents about this since I think that I and my parents still share the same insurance right now.

[Cindy Stephens]

Have you seen a Dr. regarding this?  If you are still on your parents insurance program, then you are probably under 26.  You may find it difficult to even find a Dr. to perform it at your age.  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.   If you then wanted feminization, you could use reversible drugs to lower your testosterone levels.  An orchi seems like overkill for the results you are looking for, and not very effective for at least half of your requirements.  Like having vaginal sex.  Is there another reason you seem to be so insistent on an orchi?  I say this with the highest respect, get to a sex therapist and make sure that there are not some other issues going on.  These things are permanent, and what seems like eternity to a young male may seem like utter foolishness to that same male at 30 or 40.  I suspect that any reputable dr. is going to ask you that same question and point out the same inconsistencies in your reasoning.   

[Dena]

Why exactly would surgical castration be considered to be "self-mutilation" if a qualified doctor is the one who performed this surgery, though?

Also, it appears that at least some suicide exclusions in regards to insurance are illegal:

http://www.fiercehealthpayer.com/story/suicide-related-benefit-exclusions-may-be-illegal/2014-02-18

OK. Also, though, what about if I will tell a doctor that I got surgically castrated for sterilization purposes (because all non-drastic forms of birth control, including vasectomies, can and sometimes do fail) and, if possible, to help feminize both my body and my face?

Insurance policies are create by first deciding what they will cover. Next they figure out often they will have to payout then determine how much to charge from that. The policy is iron clad so they don't pay for anything they don't want to and any attempt to get around the contract is considered fraud and you can end up in legal trouble if you try to work around the rules.

Suicide often isn't covered because somebody could buy a policy and then the next day, kill themselves to provide for their family. Most of the time that clause expires after a few years but not always.

What you are asking to do is considered very out of the ordinary and if you want insurance to cover it, You first need to see a qualified therapist who can diagnose you for medically approved treatment. Most doctors will not perform surgery without what they consider a valid reason. A clear cut medical reason or a diagnosis from a therapist are valid reasons. That is why so many threads here involve therapy, because the surgeon and Endos need to be sure will will not regret treatment at a latter date. It's also why you should consider therapy as well.

A doctor who would preform surgery like this without a valid diagnoses would make me very nervous because they would only be doing it for the money and would not be considering the welfare of the patient.

[Futurist]

Have you seen a Dr. regarding this?

Not yet, but I have made plans today to see a therapist about this on December 9. Hopefully this is going to work out and yield some productive results.

If you are still on your parents insurance program, then you are probably under 26.

Yes, I am currently 23 years old.

You may find it difficult to even find a Dr. to perform it at your age.

Actually, I already appear to have found a couple of doctors who would be willing to perform an orchiectomy on me (as in, surgically castrate me) if I will get one or two therapist letters and undergo some other requirements beforehand.

A vasectomy is virtually 100% effective,

Actually, No, it isn't. Rather, a vasectomy is only 99.95% to 99.98% effective. Thus, the law of truly large numbers indicates that there are extremely high odds that there will be at least one vasectomy failure out of every 10,000 vasectomies. Indeed, that one vasectomy failure can just as easily be mine as it can be anyone else's.

it doesn't come "undone",

False; after all, re-canalization can and sometimes does occur.

Indeed, the only thing that might make me rethink my desire for surgical castration would be if a doctor is willing to remove my entire vas deferens and sign a legal contract where he or she promises to pay all of my child support (regardless of how many unplanned pregnancies I will cause--after all, I myself am certainly a fan of polyamory) for 18+ years in the event that my entire vas deferens will grow back and an unplanned pregnancy will occur. Anything short than that would be absolutely intolerable to me and would only make me even more determined to get surgically castrated (as in, get an orchiectomy). Seriously--after all, we have a strict liability theory of sperm in regards to child support here in the United States of America. Heck, vasectomy failure certainly isn't a valid excuse in court to avoid paying child support.

Of course, if you do find a doctor who is willing to agree to all of these demands of mine, then please make sure to let me know about this doctor.

and would leave you with plenty of testosterone to maintain erections, vaginal sex, and prevent osteoporosis.

Do you know of any way other than an orchiectomy (surgical castration) which is guaranteed to permanently stop all of the sperm production in my body, though? If not, then I am afraid that keeping my testicles is certainly not an acceptable option for me.

If you then wanted feminization, you could use reversible drugs to lower your testosterone levels.

Yes, I could, but this certainly wouldn't deal with the sterilization issue.

An orchi seems like overkill for the results you are looking for, and not very effective for at least half of your requirements.

Well, I presented an alternative for you--find a qualified doctor who is willing to both remove my entire vas deferens and pay all of my child support (regardless of anything) for 18+ years in the event that my vas deferens will grow back and an unplanned pregnancy will occur. Indeed, the figurative ball is now in your court.

Like having vaginal sex.

Well, if I will get desperate, I can try taking testosterone replacement therapy, using Viagra, and/or using a penis pump while seeking to feminize my body and face in other ways (such as with the help of laser hair removal and electrolysis, which I plan to do in any case). After all, I am certainly pragmatic in regards to this.

Is there another reason you seem to be so insistent on an orchi?

No, there isn't. While I certainly do want to strongly feminize both my body and my face, I would probably be willing to be more flexible in regards to getting an orchiectomy if we had less strict child support laws here in the United States of America. However, unfortunately this certainly isn't the case in reality:

http://www.childsupportguidelines.com/articles/art199903.html

Indeed, the context of this person's article was so downright repulsive that I even e-mailed this person and told her about how her article (along with many other things) helped inspire me to get surgically castrated. Seriously.

Also, though, there is this:

http://www.salon.com/2013/11/02/make_fatherhood_a_mans_choice_partner/

"Further, the one group of "fathers" the state is willing to exempt from child support are sperm donors, sending the message that it's okay to have a kid and not support it if there was no sex, but if you get some pussy, you are going to pay. Let's not support that model."

Using Anna March's terminology, I want to "get some pussy" without being forced to pay child support for 18+ years afterwards. Indeed, a vasectomy certainly isn't going to guarantee this; rather, only a properly performed surgical castration (orchiectomy) is going to guarantee this. If you have a problem with this, then go blame our current excessively inflexible laws in regards to child support rather than blaming me!

I say this with the highest respect, get to a sex therapist and make sure that there are not some other issues going on.

Will do!

These things are permanent, and what seems like eternity to a young male may seem like utter foolishness to that same male at 30 or 40.  I suspect that any reputable dr. is going to ask you that same question and point out the same inconsistencies in your reasoning.

Let me put it extremely bluntly to you and to anyone else who is or will be willing to listen: I would be more likely to commit suicide than to regret getting surgically castrated. Seriously. After all, I have literally thought about getting surgically castrated for every single day over the last couple of years and I am 100% certain that it is the right and best decision for me. Indeed, I am simply responding to the current excessively inflexible laws in regards to child support in the best possible way. Frankly, if you have a problem with that, then again, please blame the people who came up with these laws instead of blaming me!

Also, though, I just hope that my insurance is going to be willing to pay for my post-castration hormone replacement therapy. After all, the alternative to this would be me permanently experiencing nasty things such as osteoporosis.

[Futurist]

Insurance policies are create by first deciding what they will cover. Next they figure out often they will have to payout then determine how much to charge from that. The policy is iron clad so they don't pay for anything they don't want to and any attempt to get around the contract is considered fraud and you can end up in legal trouble if you try to work around the rules.

OK. Also, though, can't one change/switch one's insurance?

Suicide often isn't covered because somebody could buy a policy and then the next day, kill themselves to provide for their family. Most of the time that clause expires after a few years but not always.

OK.

What you are asking to do is considered very out of the ordinary and if you want insurance to cover it, You first need to see a qualified therapist who can diagnose you for medically approved treatment. Most doctors will not perform surgery without what they consider a valid reason. A clear cut medical reason or a diagnosis from a therapist are valid reasons. That is why so many threads here involve therapy, because the surgeon and Endos need to be sure will will not regret treatment at a latter date. It's also why you should consider therapy as well.

As I previously wrote here--I have scheduled either a counselor or a therapist appointment at my university for December 9. Indeed, I asked for and appear to have gotten an appointment with a counselor or therapist who knows a lot about transgender-related and non-binary related issues.

Also, by "very out of the ordinary," do you mean the sterilization part, the feminization part, or both of these things?

In addition to this, in regards to regret, as I previously said, I would be much more likely to commit suicide than I am to ever regret getting surgically castrated (and I am saying this as a person who loves life ).

A doctor who would preform surgery like this without a valid diagnoses would make me very nervous because they would only be doing it for the money and would not be considering the welfare of the patient.

So what exactly would the diagnosis for me be? Male-to-eunuch gender dysphoria? Male-to-genderqueer gender dysphoria? Something else? If so, then what exactly?

[Futurist]

Also, I would like to point out that the closest cis-woman equivalent of my desire for surgical castration for sterilization purposes would be a cis-woman wanting to get rid of her uterus and/or her ovaries in the hypothetical event of a global abortion ban with no rape exception anywhere worldwide and with no safe way to get a "back-alley" abortion anywhere worldwide.

[Futurist]

Also, I would like to point out that the closest cis-woman equivalent of my desire for surgical castration for sterilization purposes would be a cis-woman wanting to get rid of her uterus and/or her ovaries in the hypothetical event of a global abortion ban with no rape exception anywhere worldwide and with no safe way to get a "back-alley" abortion anywhere worldwide.

Indeed, would any of you say that it would be irrational for a cis-woman in such a hypothetical scenario to want to get rid of her uterus and/or her ovaries? Completely serious question, for the record.

[Dena]

Women tend not to want that hype of surgery unless there is a medical need so you are talking a hypothetical question that there is no point in answering. A woman might get her tubes tied which is a much less invasive operation.

On the other side, you want a life where you can engage in sex with zero risk of a child being born without sexual protection. Have you considered the risk of STD?

[Futurist]

Women tend not to want that hype of surgery unless there is a medical need so you are talking a hypothetical question that there is no point in answering. A woman might get her tubes tied which is a much less invasive operation.

The thing is, though, that this hypothetical scenario appears to be the closest cis-women equivalent to my own desire for surgical castration for sterilization purposes.

On the other side, you want a life where you can engage in sex with zero risk of a child being born without sexual protection. Have you considered the risk of STD?

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.