Re: The Mental Health Issue?

[Berliegh]

......In London, England, U.K NHS......Gender Dysphoria is unfortunitely seen as a mental health issue and comes under the mental health banner. But in Scotland it's seen as something else (sexual and emotional health) so I wondered what banner it comes under in the U.S.A and other countries?

Psychiatrists in the U.K can play on this and ultimately use it against you and refer to you as a 'Mental Health Patient'. I find this quite damaging that your mental health should be in question especially if you are a very level headed and stable person. 

[tinkerbell]

Under the APA (American Psychiatric Association) and the DSM (Diagnostic and Statistical Manual of Mental Disorders), transsexualism is considered a psychiatric disorder.  I know many people disagree with this, but so far this is how it is.  Perhaps when the DSM is updated in 2011, things will change...I don't know.

tink

P.S.  Yeah, I'm insane.  Not because of my TS'im, but because that's how I naturally am.  

[Ell]

P.S.  Yeah, I'm insane.  Not because of my TS'im, but because that's how I naturally am.   

yeah i know, sweetie. 

[Wing Walker]

As I recall, DSM IV lists transsexuality (I despise the word "transsexualism") now lists it as a disorder.  In 2006 I heard that Aetna, a large provider of group health insurance in the U.S. will pay for the surgery, *provided the employer has this provision in its group insurance contract and offers it as a benefit.*  I don't know which U.S. firms have done this.

Most people don't give a hoot if a health plan provides abortion services, psychotherapy, or facial surgery to correct a problem like drooping eyelids, but I have found that some plans will not cover visits to a doctor if the visit has anything to do with being TS.  Often the doctor will make the diagnosis "confusion."  Same with hormones.  OK for any reason not related to transsexuality.

Please let me know if this is still correct.

Wing Walker

[seldom]

You are right wingwalker.

With regards to how its actually treated by doctors and mental health professionals Berleigh, the DSM is by in large ignored and its treated as a "gender and sex issue".  Very few doctors or mental health professionals like the DSM at this point.

Basically speaking the UK is very much behind the US in some regards.  The biggest one is the fact that nobody can block treatment and they do not consider it a mental illness anymore, even though the diagnosis in the DSM suggests it is.  Its a confusing state.

Basically it is very rare somebody will be blocked from HRT or Surgery if they jump through the hoops, and it is honestly not very arbitrary.  Also taking the LGBT clinic system has taken on HRT and therapy in many large cities for TS, everything has become very patient directed, less about thinking your mentally ill, etc.

Pretty much as it stands the US is a bit more trans friendly in the treatment approach.  No forced RLE for HRT (which is common in the UK), no clinical treatment as one is insane, and generally its patient directed.  Basically you do things when YOU want to, not when the doctor wants to.  Even the SoC are begining to be seen as more of a guideline than anything.

Basically Berliegh psychiatrists no longer play on this as you are suggesting, in the US it is very close to what you are suggesting its like  in Scotland, at least in practice. 

[Wing Walker]

Hi, Amy,

You're quite correct about how transitions and GRS are handled in the U.S.  The HBIGDA standards of care have fallen from yardstick to guideline, things move at the patient's speed, and a RLE period is between one and two years before any reputable surgeon will consider doing it.

Now to get GRS covered by every insurance carrier in the States...

Stay well.

Wing Walker

[seldom]

Hi, Amy,

You're quite correct about how transitions and GRS are handled in the U.S.  The HBIGDA standards of care have fallen from yardstick to guideline, things move at the patient's speed, and a RLE period is between one and two years before any reputable surgeon will consider doing it.

Now to get GRS covered by every insurance carrier in the States...

Stay well.

Wing Walker

Actually Wing, there have been recent cases where the SoC were ignored completely.  The standards outline one year of RLE for SRS, I know people who have done it in less, with US surgeons.  They do require you to be living full time and been on HRT for approximately a year though.
The reason why the SoC are being basically disintegrated as far as the time limits is largely because Thailand does not apply the SoC. They require one year of HRT, and that is really it for many Thai surgeons.  Thus it becoming more of a guideline in the US.

Even the three months of therapy is no longer required in some places for HRT (California).

Alot of the time limits were chosen arbitrarily, and will more than likely be abandoned with any changes to the SoC, especially since the main supporters of the timelines have left the organization. 

[Lisbeth]

As I recall, DSM IV lists transsexuality (I despise the word "transsexualism") now lists it as a disorder. 

Diagnostic code 302.85

Or if you use the ICD-10 instead of the DSM-IV, it's F64.0

[Berliegh]

You are right wingwalker.

With regards to how its actually treated by doctors and mental health professionals Berleigh, the DSM is by in large ignored and its treated as a "gender and sex issue".  Very few doctors or mental health professionals like the DSM at this point.

Basically speaking the UK is very much behind the US in some regards.  The biggest one is the fact that nobody can block treatment and they do not consider it a mental illness anymore, even though the diagnosis in the DSM suggests it is.  Its a confusing state.

Basically it is very rare somebody will be blocked from HRT or Surgery if they jump through the hoops, and it is honestly not very arbitrary.  Also taking the LGBT clinic system has taken on HRT and therapy in many large cities for TS, everything has become very patient directed, less about thinking your mentally ill, etc.

Pretty much as it stands the US is a bit more trans friendly in the treatment approach.  No forced RLE for HRT (which is common in the UK), no clinical treatment as one is insane, and generally its patient directed.  Basically you do things when YOU want to, not when the doctor wants to.  Even the SoC are begining to be seen as more of a guideline than anything.

Basically Berliegh psychiatrists no longer play on this as you are suggesting, in the US it is very close to what you are suggesting its like  in Scotland, at least in practice. 

Amy, The NHS psichiatrists in London, U.K denied me a referral for GRS without providing an explanation. I have complied with both the HBSOC and all protocols and have completed 5 years RLT. I have not been given an explanation as to why this was refused even with me asking them many times........

.....am I going to fight these people in the courts...you bet...

[tinkerbell]

I heard that Aetna, a large provider of group health insurance in the U.S. will pay for the surgery, *provided the employer has this provision in its group insurance contract and offers it as a benefit.*  I don't know which U.S. firms have done this.

Yes AETNA has a policy.  Here it is:


http://www.aetna.com/cpb/medical/data/600_699/0615.html


However, no one (I know) who is TS and has this type of insurance coverage has benefited from it so I don't know.  Having this insurance company approve your surgery based on this policy seems to be..well....impossible.  Hence, get all the facts before assuming that they will pay for your SRS.

tink