Therapy is really the worst idea ever.

[Jean24]

Gender dysphoria is a very specialised area of treatment for medical professionals. My GP had no experience or knowledge of it at all. He needed the backing of a trained professional gender therapist to be able to prescribe me the meds I needed. I don't find this AT ALL an unreasonable demand.
Also, surgeons carrying out srs operations need the backup of trained professional gender therapists, so they can be (somewhat) sure that this person who they don't have the time to see regularly over months, really is the right recipient for such serious and life-changing surgery. The surgeons don't want to be sued by patients who later decide their surgery was a mistake.
What about the person who 'fails' all those so-called physical tests you listed? Should they be turned away as "not trans"?
I'm sure I'd fail a few of them!
I'm not rich, I went private (here in the UK) and self-funded all my treatment. I just had to save up for something I knew I really needed.

They may be doctors but when they don't know, they use the handbook that other doctors use. That's what my new GP did last year when I first came to her and told her that I was trans and asked her to take over my prescriptions. She checked on the intranet at her clinic to verify the correct dosages and off we went.

As for the surgeons I don't think you can sue them for anything that isn't a complete botching anyway. And if someone fails ALL of the physical tests, give that person to a doctor or therapist for additional vetting to see why their symptoms don't match up and for extra certainty. That all or nothing mentality is what social conservatives use against us with their chromosome/genitalia arguments. Fortunately the healthcare system has evolved beyond that because quite frankly it never answers questions such as "Why are you transgender and showing none of the symptoms?" not some "No treatment for you!" or other absolutist bs answer.

[becky.rw]

I'm getting more confused.  You're poor, and first choice on the script that you did get was Lupron.

You've been in hospital twice, admitted on order, psych, and you let them discharge you, both times without what you needed, even though willing to lie and are poor??    Did they point a gun at your head and yell "get out" or something?

Your text is a very mixed message that alternately blames therapists and insurance providers for your difficulties, but you admit that you DID get a script, a script for an injectable no less.

Ok, so here's what I draw from this, you are really campaigning for fair medical services available to all without regard to ability to pay, for pretty much all humanly experienced medical problems.    That is called an NHS. (I want one in the US too, different story)  The US had a debate about such a thing, and the Democrats caved on the once in a lifetime opportunity to pass it.   That won't happen again in our lifetimes most likely. 

So, we have cheap-ish private insurance with mediocre defined benefits, massive deductibles, and very limited drug menus.  Or you can pay more ($20k+/year), and have good insurance and a fairly large deductible, and wide drug menus with some specific holds.   What is true is that you pay.   Its just a question of who you pay too.   In your case, there is no way a private insurer can offer an inexpensive plan that offers coverage for Lupron, especially as a first option on an HRT.   Its simply not possible.

You want what the left failed to deliver, and thus can not have; and failing that, want what is impossible, and thus, can not have that either.

We don't have an NHS, and you can not make an affordable ACA plan that covers Lupron for your use outside of the cases for folks who have demonstrably horrible side effects from cheaper alternatives.

At that point, its irrelevant what the therapist says, or does.  You've already proven you CAN get a script for hormones through the system; its just that the therapist can not cause your insurance company to pay for something the insurance company can not afford to pay for without doubling your premium.

In the end, you're poor in the most capitalistic, ruthless country on the planet.   Harsh recommendation?  Stop being poor if you want to transition on the luxury side of the cruise ship.

[Jean24]

I'm getting more confused.  You're poor, and first choice on the script that you did get was Lupron.

You've been in hospital twice, admitted on order, psych, and you let them discharge you, both times without what you needed, even though willing to lie and are poor??    Did they point a gun at your head and yell "get out" or something?

Your text is a very mixed message that alternately blames therapists and insurance providers for your difficulties, but you admit that you DID get a script, a script for an injectable no less.

Ok, so here's what I draw from this, you are really campaigning for fair medical services available to all without regard to ability to pay, for pretty much all humanly experienced medical problems.    That is called an NHS. (I want one in the US too, different story)  The US had a debate about such a thing, and the Democrats caved on the once in a lifetime opportunity to pass it.   That won't happen again in our lifetimes most likely. 

So, we have cheap-ish private insurance with mediocre defined benefits, massive deductibles, and very limited drug menus.  Or you can pay more ($20k+/year), and have good insurance and a fairly large deductible, and wide drug menus with some specific holds.   What is true is that you pay.   Its just a question of who you pay too.   In your case, there is no way a private insurer can offer an inexpensive plan that offers coverage for Lupron, especially as a first option on an HRT.   Its simply not possible.

You want what the left failed to deliver, and thus can not have; and failing that, want what is impossible, and thus, can not have that either.

We don't have an NHS, and you can not make an affordable ACA plan that covers Lupron for your use outside of the cases for folks who have demonstrably horrible side effects from cheaper alternatives.

At that point, its irrelevant what the therapist says, or does.  You've already proven you CAN get a script for hormones through the system; its just that the therapist can not cause your insurance company to pay for something the insurance company can not afford to pay for without doubling your premium.

In the end, you're poor in the most capitalistic, ruthless country on the planet.   Harsh recommendation?  Stop being poor if you want to transition on the luxury side of the cruise ship.

Your confusion on the hospital stays doesn't make any sense whatsoever. Like I was supposed to stay there until they gave me free medication? Ha, okay.

Having a script after 6 months that costs thousands of dollars thanks to a system that discriminates against poorer patients is awful. And now I have to go through it again because of way the system is set up. Here's an idea: Wait to take your next medication for 6 months. You're not going to do it but you'll poke fun at people who face that reality when insurance companies and therapists play gatekeeper and fax tag between each other. Be pessimistic and/or hate the left all you like but they got us further than anyone else did. Also politics isn't your strong suit, left wing ideas recur until they get passed.

Your points are all moot as they only look at the end result and skip over all of the hardship (key word there, being the point of this whole conversation) people have to endure to get their medications if they're not as wealthy as other people.

In the end you're pretending there isn't a problem where there is one for many transgender people. Harsh recommendation? Take your head out of your butt lol because you have some #$% backwards opinions. You'll not shut me up either but I'd like it very much if you could be more dismissive

[becky.rw]

First, an apology, I'm evading something painful to think about, and I was taking it out on your argument....  Seriously, I'm sorry.  There was no call for my text to be harsh in that fashion.

To the issue...

I'm pretty sure I described that there is a problem; that I am in favor of an NHS; but that I also understand what happened a few years ago in US politics, and have accepted that the current flawed system is as good as its going to get with regard to medical coverage in the US for quite some time to come.    I AGREE with you about the injustice of the poor being offered substandard care in the US; and the torturous way it is pretend-offered and then made impossible to acquire is darn right malevolent and I'd like it changed.

On the hospital point, that's exactly what I WOULD have done.  They couldn't have pried me out of the place till there was a lump in my butt/thigh for a good three months of anti-androgen.   In fact, the only harmful thing in my mind about such, is the admittance mark; I'd stay for a month if it would collect the "prize".    I do get that it is somewhat unfair of me to make a judgement on this, but I think you missed a couple easy opportunities to get proper care.

All that said, what I wish were true, is NOT true.    Our system is unjust, and it will stay unjust for many, many years to come.    You can still make it work, but taking it out on a therapist who has no control of your insurance company does not seem fair either.

[V M]

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V M