Making a case

[Nuuni]

My counselor has suggested I start putting together a case for SRS to be covered. I had not even started research because I did not think that was even possible, and I am not quite sure what a panel of clueless cis people are going to be expecting to hear, or what points I should be covering. Does anybody have any ideas what I should be mentioning?

[SadieBlake]

Key words are "medically necessary", the WPATH 7 standard of care is a simple and straightforward document which also makes it clear that as guidelines most or all of its recommendations may be waived according to medical necessity. So e.g. my insurance company on paper requires rle to consist of a year with "no returning to assigned gender". This is obviously inappropriate for non-binary people or people like me who don't plan on passing post op and they indicated to me on the phone that they recognized their official guidance was out of date.

The other thing I think would be having your letters in place (proof of medical necessity) and maybe a surgeon picked out. That's the supporting documentation, beyond that you ought not to need to say much. One of the surgeons I was considering required letters from my PCP and endocrinologist in addition to the two therapists. I doubt the insurance people ever saw those however my insurer did require my PCP make a referral for the surgery itself.

[Dena]

The are not clueless but instead look at the documentation to ensure fraud isn't involved and that normal treatment has been followed. In my transition, that meant therapy, RLE, HRT and at least half my facial hair removed. The letters were necessary for surgery and the insurance company didn't pay until after the surgery so you needed the cash for the surgery. The rules are a bit more relaxed now and things like facial hair removal aren't part of the requirement. Just collect and document what you have done toward your transition then review it with your therapist.