[WA] Medicaid plan to deny gender-reassignment surgery draws fire

[Kate Thomas]

http://www.realchangenews.org/2006/2006_08_16/genderbender.html

August 17, 2006


Gender Bender
Medicaid plan to deny gender-reassignment surgery draws fire
By ROSETTE ROYALE
Staff Reporter

Here's what Medicaid is willing to pay for, for those confronting issues of gender identity: hormone therapy (HT) and psychotherapy, the latter of which can lead to a clinical recommendation that a patient, for overall health and well-being, should undergo gender-reassignment surgery.

Here's what Medicaid used to pay for, but doesn't want to anymore: gender-reassignment surgery.

Medicaid officials announced in early August they were planning to rework state regulations to ensure the surgeries would be removed from its list of payable services. The announcement upset many working within Seattle's transgendered community.

"Well," says Mo Malkin, executive director of Verbena, a health education/advocacy organization for lesbians, queer women and transgendered individuals, "this is typical: a bad policy to rule out surgeries that allow people to live happy, healthy lives."

The inability to surgically change one's gender — or fully transition, as it's more characteristically known — may result in suicidal feelings for the individual, says Malkin. Having the state pull back and deny payment for surgery, she suggests, will force people to go underground and seek back-alley operations. "If you don't make something legal," says Malkin, "people will find other ways to do it."

Malkin says that if the state is really looking to cut costs, then perhaps it should reconsider its decision. Her experience, she says, has shown that many people who transition with Medicaid's assistance soon are able to get off Medicaid. By sticking with its decision, the state will have to keep paying for those individuals for a long time, she believes.

"Without the ability to transition," says Malkin, "it's actually a higher burden on the state, not a lesser burden."