Susan's Place Transgender Resources

I recieved the below in an email and I wonder how much it will really effect  health insurance coverage for us; I know it is rather long but think it is worth a read.


NCTE Applauds the AMA Call for "Removal of Financial Barriers to
Care for Transgender Patients"

The American Medical Association (AMA) passed a resolution yesterday
calling for "public and private health insurance coverage for
treatment of gender identity disorder as recommended by the
patient's physician." The declaration, known as Resolution
122, "Removing Financial Barriers to Care for Transgender Patients,"
was passed by the House of Delegates - AMA's primary decision-making
body - at its annual conference in Chicago.

Resolution 122 affirms the effectiveness of medical treatment for
transsexuals and the right to appropriate treatment. It also names
as discriminatory the categorical denial of health insurance
coverage for psychotherapy, hormonal and surgical treatments for
transgender patients, and reiterates the AMA's opposition to
discrimination based on gender identity. The full text of the
resolution is below.

"America's physicians are saying that transgender people, like all
others, deserve competent medical care based on what individual
doctors and their patients determine is healthiest for each person,"
noted Mara Keisling, Executive Director of the National Center for
Transgender Equality (NCTE). "Doctors and patients, not insurance
companies, should be making those choices. We are so glad that the
AMA has taken a leadership role against the rampant discrimination
that transgender people have faced for so many years in receiving
appropriate medical care and equitable insurance coverage,"

Health insurance coverage has been made into prominent national
issue recently thanks in part to a three year campaign by the AMA.
NCTE has prioritized ending health insurance discrimination against
transgender people.

RESOLUTION 122
Subject: Removing Financial Barriers to Care for Transgender Patients

Whereas, Our American Medical Association opposes discrimination on
the basis of gender identity; and
Whereas, Gender Identity Disorder (GID) is a serious medical
condition recognized as such in both the Diagnostic and Statistical
Manual of Mental Disorders 4th Edition (DSM-IV) and the
International Classification of Diseases (10th Revision); and is
characterized in the DSM-IV as a persistent discomfort with one's
assigned sex and with one's primary and secondary sex
characteristics, which causes intense emotional pain and suffering;
and

Whereas, GID, if left untreated, can result in clinically
significant psychological distress, dysfunction, debilitating
depression and, for some people without access to appropriate
medical care and treatment, suicidality and death; and

Whereas, The World Profession for Transgender Health, Inc. (WPATH)
is the leading international, interdisciplinary professional
organization devoted to the understanding and treatment of gender
identity disorders, and has established internationally accepted
Standards of Care for providing medical treatment of people with
GID, including mental health care, hormone therapy, and sex
reassignment surgery, which are designed to promote the health and
welfare of persons with GID and are recognized within the medical
community to be the standard of care for treating people with GID;
and

Whereas, An established body of medical research demonstrates the
effectiveness and medical necessity of mental health care, hormone
therapy, and sex reassignment surgery as forms of therapeutic
treatment for many people diagnosed with GID; and

Whereas, Health experts in GID, including WPATH, have rejected the
myth that such treatments are "cosmetic" or "experimental" and have
recognized that these treatments can provide safe and effective
treatment for a serious health condition; and

Whereas, Physicians treating persons with GID must be able to
provide the correct treatment necessary for a patient in order to
achieve genuine and lasting comfort with his or her gender, based on
the person's individual needs and medical history; and

Whereas, Our AMA opposes limitations placed on patient care by third-
party payers when such care is based upon sound scientific evidence
and sound medical opinion; and

Whereas, Many health insurance plans categorically exclude coverage
of mental health, medical, and surgical treatments for GID, even
though many of these same treatments, such as psychotherapy, hormone
therapy, breast augmentation or removal, hysterectomy, oophorectomy,
orchiectomy, and salpingectomy, are often covered for other medical
conditions; and

Whereas, The denial of these otherwise covered benefits for patients
suffering from GID represents discrimination based solely on a
patient's gender identity; and

Whereas, Delaying treatment for GID can cause and/or aggravate
additional serious and expensive health problems, such as stress-
related physical illnesses, depression, and substance abuse
problems, which further endanger patients' health and strain the
health care system; therefore be it

RESOLVED, That our American Medical Association support public and
private health insurance coverage for treatment of gender identity
disorder as recommended by the patient's physician. (New HOD Policy).


The National Center for Transgender Equality is a national social
justice organization devoted to ending discrimination and violence
against transgender people through education and advocacy on
national issues of importance to transgender people. The National
Center for Transgender Equality is a 501(c)3 organization. For more
information, please visit www.nctequality. org.

Heck, I have insurance and today couldn't convince a doctor to book an appointment with me even though they take my insurance (confirmed TWICE by the insurance company) AND I had a referral.  AND I even offered to pay out of pocket until I could get paperwork from the insurance company for them.

No dice.

I'm glad to see this though.  I hope it makes things easier for people to get the treatment they need.

Jay

Quote from: Tasha Elizabeth on June 18, 2008, 05:31:16 PM
i foresee "pre-existing condition" exclusions

I absolutely hate insurance companies.  Why can't doctors make the decision on whether someone can have treatment or not?  Insurance companies are the biggest scam going!   ???  Just like my lower NEEDS to be moved forward because it has detrimentally affected my bite.  My orthodontist said that he wouldn't feel comfortable fitting me with braces without the lower jaw being moved forwrad, yet Aetna won't cover it......well.......most of the oral surgeons in Kentucky don't participate with Aetna (big red flag).  This is why I feel we need universal health coverage.  The overall care might not be as good.  Waiting lines would be much longer.  But at least SOMEONE would be able to work on my jaw.   :'(

Aeron

Most insurance will not cover things that are considered cosmetic. They do in many cases cover therapy. I suggest you start there even if it is not a therapist who specialist in GID, you could use the foresight. Next is a job and schooling. Education is very important. My transition cost 100k out of pocket.

http://www.stanfordalumni.org/news/magazine/2008/mayjun/farm/news/transgender.html

While this is exciting, I have to wonder ... does the AMA have any real power? Reading resolution it sounds more like they're simply recommending a course of action with no power of thier own to make anything happen.

I guess I'm very ignorant about what exactly the AMA does. Anyone care to enlighten me? Would this give my Dr grounds to recomend treatment not normally covered by my insurance?

ttfn:Holly

Basically the AMA controls medical schools. It determines the qualifications and number of doctors in practice. It keeps the number low so not to have too many that way demand exceeds supply keeping the pay of doctors high. Insurance is the other side always looking for ways to reduce costs. Between the two paperwork is the biggest cost of a visit to the doctor. For insurance to cover addition services the cost to each person insured will go up. It is now at the point that many can not afford insurance. If costs of GID are added to services provided by insurers than more will drop insurance and the premiums will go higher. The only way they will drop is to have the AMA increase the numbers graduating from medical school.

While I agree with what you're saying as far as the costs of GID go, if we had universal coverage we would probably still at least have coverage for things GID-related (and the things that I need, like moving my lower jaw forward).  With universal coverage, I bet you'd see an increase in the number of doctors, whether the AMA likes it or not.  Salaries for doctors might not even drop as you're suggesting, our "taxes" would absorb all that.  They do for everything else..mostly.

Aeron

There has always been a clear cut distinction between what is needed and what is cosmetic.  So HRT could be covered, some SRS, but FFS no way.