Insurance company outed me...

[Starscrash]

So I started seeing a psychologist ~4 months ago for psychotic depression, and disclosed that I'd had gender identity concerns since I was (at least) 5 years old.  I was eventually referred to a gender therapist 2 months ago, and I've been seeing him every 2 weeks or so. One thing I've spoken to him about is my mother.  She's incredibly religious, and I've specifically discussed with him the problems that would be involved in coming out to her or my father. 

I'm 20 years old, and a student at university, so I'm still a dependent on my mother's insurance.  I got a call from her today saying that she'd been reading through my billing statements, and my therapist had been using the DSM code for Gender Identity Disorder.  She told me in no uncertain terms that she's kicking me off her insurance, and she won't be paying for my school or medication (including antidepressants and antipsychotics.)

I honestly have no idea what to do now. 

[Purple Pimp]

I'm sorry.   That's freakin' awful.  Did you admit to it on the phone, or could you talk to your therapist and tell her about the situation in hopes that she might inform the insurance company that is was a coding error?  It seems pretty unethical for a mental health professional to put you on record with such a stigmatizing condition if she was aware that your parents were paying for your insurance.  Did she/he stop to think about the possible consequences to you?

Awful.  I hope that you get the help that you need.

Lia

[BlackWolf]

Holy Crap, I'm so sorry. I couldn't even imagine what i'd do if I was in your situation. I'm so sorry...

[Arch]

Jeez...they put the code on your billing statements??!!! FAIL.

I'm with Purple Pimp. Do your best to salvage the situation.

Start evaluating your priorities and needs. Can you take a term or two off until you get your affairs back in order? Do you live with your mother? Is your father in the picture at all?

Sorry so many questions...I'm just concerned, and I'm a chronic problem-solver.

Hang in there, kiddo. I'm sure that you're in shock right now. But that will pass. Even if the worst happens (no financial support from Mom), you'll feel better once you review your options and take some action.

[kyril]

I wonder if that's a violation of HIPAA. Diagnoses are protected medical information. If the billing codes are detailed enough to determine our diagnosis, and if they're disclosed to a third party without your express consent, you might have a legal case.

[Sandy]

And this is how a mother shows her love for her child?  By denying them the help that they need?  It seems so ridiculous that a book of myths could be used in such a hurtful way.

HIPPA regulations were not violated since the policy owner was not the patient but a dependent.  You could have asked the therapist to put a different code in the billing (such as depression or anxiety), but you didn't know.

Talking to your parents and getting these issues in the open is something that you'll have to do sooner or later.  It will be very difficult, I know, but communication is key here.  Unfortunately, there is no magic wand that will make it go away.

-Sandy

[Jasmine.m]

What a bummer... I'm really sorry about your being outed in a such a way. Perhaps give your mom  some time to settle down? Keep us posted on what happens...

HIPPA regulations were not violated since the policy owner was not the patient but a dependent. 

This is true. No privacy laws were violated.

[Starscrash]

I actually did ask him to put depression under the billing code, for this exact reason.  I saw a family counselor when I was 14ish (8th grade,) and came out to them about the whole gender confusion thing.  I'd felt like that since kindergarten, but it got a lot worse around the time I entered middle school and I was having trouble handling it.  I originally thought that that counselor notified my parents (he had pretty clearly expressed discomfort with the whole thing,) but I realized later that it might have been through the insurance.  I know that I mentioned this to the referring psychologist, and I'm almost certain that I mentioned it to the sex therapist as well.  At any rate, I gave him some reason to criticize the group I had seen when I was 14.

As for whether I absolutely confirmed it...no, but I might as well have.  My mom launched into a tirade about how "god has a plan for all of us" and I basically responded that I'd had a really bad day already, and just "couldn't deal with this right now."

And Arch, I don't know if my mom has told my dad, (they're divorced,) but as soon as he finds out, I'm almost certain that that'll be the last time I speak to him.  I've never heard him say any anti trans things per say, but I know that he 100% believes in internment camps for homosexuals, to prevent them from morally degrading society...so yeah, not exactly hopeful with him.

[Arch]

Cripes, Starscrash. I'm so sorry about BOTH of your parents.

Let me tell you something, though. If your parents cut you off, that makes your life difficult, but you can manage. Trust me, a lot of us have been in similar circumstances. And we're all here to support you.

[Starscrash]

Also, Sandy, I understand that if I do go through transition, coming out is going to be something that has to be done.  After talking to my therapist though, and with his expert insight, I really wanted to explore first whether I really am trans.
I have a genetic condition, but phenotypically, I'm male.  I've always felt like something was off, but most of the time, it's just something that's "there."  I'm not happy about being male, and I don't like playing the male part, but it's something I can deal with.  Occasionally though, there's just this wave that comes along where all of the sudden, I just can't do it anymore.  Everything feels awful, and it becomes the only thing I can focus on.  Every waking moment is consumed with just this horrible feeling that it's not okay, and that it needs to fix things..but then a few weeks, maybe a few months later, I return to the status quo.  And when I return, I inevitably feel that I'd be happier as a woman, and that I'm missing out...but that's it's not something that I absolutely need to function.

My therapist wanted to explore that (and I agree) because he says that in his experience with GID individuals, the feeling of a need to be the correct gender is persistent, and doesn't go through the waves that I related to him.  It's really hard sometimes, but I obviously want to be sure that this is the right choice, and if I don't fit what he describes as GID, I'd want to make sure something else isn't going on that could be addressed, so that I don't end up transitioning and finding out years later that it was (just to use an example) a hormone irregularity, that once corrected, made me realize I'd made a huge mistake. 

I wanted to wait to come out until I was sure it was something I was going to do.  My sister already knew and she's been as supportive as she can, but I don't want to risk losing all ties to my mom, dad, extended family etc. if it's not absolutely what I'm going to do. 

[Sandy]

Star:

I don't want to go against what a trained therapist would say, but I think that your feelings are not that unusual.  The ebb and flow of the feelings may go hand in hand with the depression.

Chronic, clinical depression is also another byproduct (I wouldn't say symptom), of GID.

Many people go through cycles.  It's referred to as purging.  We'll try to purge our feelings, our desires, and sometimes entire wardrobes, and attempt to extract those feelings through force of will alone.  In many cases it can be put in the background for years, but for many, the feelings return and start the whole cycle over again.

Following through with an endocrinologist is a perfectly logical idea.  Besides, if you ever decided to go on HRT, then you'd have to see an endo in the first place.

Through your counselling to this point, you've probably found out that this is a one-way trip, so examining every other possibility is certainly the right way to go.  Every one of us will tell you that if there is any other way of avoiding transition, then do that.  It is literally the hardest thing a human being can do in modern society.

That may be one of the ways that you can approach this with your mother.  That you want to find out if this is a something that is related to your genetic condition and you want to try to find ways of treating it.  That is certainly true.

Also, you may want to mention that this has nothing to do with sexual orientation.  As you may know, sexual orientation is about who you are attracted to and gender identity is how you view yourself.  She may be, and probably is, confusing this with being gay.  And that may have been what set her off.  That is a completely separate issue.

If your mother recommends faith based, or reparative therapy, know that it will be based completely on a biblical approach to healing and will try to "pray the gay away", even though this is not a "gay" issue.  Whether or not you go there is completely up to you, of course, but try to continue your other therapy as well if at all possible.

I wish you all the best in this, Star, and know that you have many friends here and that you can always talk to us about your feelings and we will not judge you.

-Sandy

[Samantha_Peterson]

If your mother tries to say that "god has a plan for all of us" again then you should ask her "well what if this is god's plan for me?"

Also, I have read the bible several times even though I am not religious and I have found nothing agains transgenders. And if your parents cannot accept that then you should tell them to read Romans 14:13 (Therefore let us stop passing judgment on one another. Instead, make up your mind not to put any stumbling block or obstacle in your brother's way.)

I have found that with most religious people if you can show yourself to be understanding of them and their religion then they will think more on what it means for you.

[RAY]

that's terriable ! you got enough problems coping and need help. Hope you have a gender support group at your school.

[Arch]

If you have a genetic condition that would explain your situation, why can't your mother accept that? Seems to me that this is the sort of smoking gun that so many otherwise-transphobic people are always complaining that most of us trans people don't have. That is, people will accept an obvious chromosomal anomaly but not the vague gender-identity-in-the-brain theories that don't yet have an easily identifiable physical cause. So many people feel that if a physical cause can be pinpointed, that's acceptable; but if it's "all in your head," then you're just plain nuts or willfully violating nature or religion or both.

Your mother must be really hard core.

[Scribbled101]

That in and of itself is incredibly depressing that your parents would basically say "This isn't the answer that we wanted, so we're gonna take away the means to get that answer until we get the one we want."

Which, I am almost put in the same boat in the means that my parents feel that all things will work themselves out if you turn to religion and just forget about 'finding out who you are.' (Which, in their case, means 'finding out' I'm a normal heterosexual male with no problems and a great career)

Really, if you were diagnosed as such, get your parents to talk to your therapist AND your gender counselor so they can see what's going on from a PROFESSIONAL.

Wish you the best of luck and I hope things work out for you.

[Dana Lane]

I wonder if that's a violation of HIPAA. Diagnoses are protected medical information. If the billing codes are detailed enough to determine our diagnosis, and if they're disclosed to a third party without your express consent, you might have a legal case.

This is the first thing that popped into my mind. HIPAA violations are SERIOUS! They could get fined a lot of money. I would nail their balls to the wall.
Post Merge: April 19, 2010, 04:31:30 AM

And this is how a mother shows her love for her child?  By denying them the help that they need?  It seems so ridiculous that a book of myths could be used in such a hurtful way.

HIPPA regulations were not violated since the policy owner was not the patient but a dependent.  You could have asked the therapist to put a different code in the billing (such as depression or anxiety), but you didn't know.

Talking to your parents and getting these issues in the open is something that you'll have to do sooner or later.  It will be very difficult, I know, but communication is key here.  Unfortunately, there is no magic wand that will make it go away.

-Sandy

I am pretty sure HIPAA consent is separate from the policy holder. Who knows if there was an actual violation or not but HIPAA is supposed to protect against this very thing. Disclosure of your medical condition without your consent.

[shanetastic]

I didn't read all the replies in here but I may advice something just sorta oddball here. . .

Since your mother is obviously not willing to accept you I say lie to her and just say the therapist made a mistake and coded it as something else and that you only have depression.  I know it probably won't work but it's worth a try.

And secondly I would call that therapist and talk with her and in short just be like "wtf" because your mom was obviously going to read the statement from insurance.  Maybe she could figure something out since she was the person who got you in this instance.  Normally when my therapist bills come she codes it under depression and it does show up on my parents paper statements they get from insurance (i'm under my moms insurance too)

Good luck and I hope you can figure this out.

[Starscrash]

Just thought I'd post an update...
I basically downloaded all the treatment information regarding GID, and showed her the list of medications I'd taken, and showed her that there was no overlap whatsoever.  She's not entirely convinced, but is at least talking to me.  She's insisting on attending my psychology appointments with me now, so I don't really know what I'm going to do about the dysphoria.  I was really hoping to transition in college, but that obviously won't be able to happen now : \. 

[Arch]

She's insisting on attending my psychology appointments with me now, so I don't really know what I'm going to do about the dysphoria.

Ouch. How does she expect you to make any headway if she's in the room?

I expect she doesn't.

You might need to prepare for a different life path. If you're not working, find a job or start looking into disability if your condition allows for that. If you're a full-time student, you might need to cut back to part time, or withdraw temporarily.

At least she hasn't cut you off entirely, but do you really want her controlling your life like this?

Hugs.