I am looking into electrolysis and other procedures for my transition, but it's a trend for these procedures to be denied as they are not medically necessary, and only cosmetic; while sexual reassignment surgery is medically necessary and not cosmetic. I'm trying to make a case to my insurance on why these procedures are medically necessary and not cosmetic, by comparing them to SRS.
What constitutes SRS as medically necessary? (Playing devil's advocate here:) Can't it be said that changing your genitals to look like something else is only cosmetic. We can live the rest of our lives with the current genitals we have, assuming they're not infected.
For me, I'd think electrolysis and facial feminization surgery are more necessary, as they affect the outward appearance seen by the general public, while genitals are only seen by you and your partner. In my opinion, it is more necessary for my mental health to pass in a public setting, than in a private setting.
What are your thoughts on any and all of this?
Um I think your stretching it
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You may want to refer your insurance company to the WPATH Standards of Care (http://www.wpath.org/uploaded_files/140/files/Standards%20of%20Care,%20V7%20Full%20Book.pdf). Here's what they have to say about these "other" surgeries:
Although most of these procedures are generally labeled "purely aesthetic," these same operations in an individual with severe gender dysphoria can be considered medically necessary, depending on the unique clinical situation of a given patient's condition and life situation.
So they get it, but it sucks that the rest of the health care industry hasn't caught up.
In England, they did a study on people who had had cosmetic surgery, and overall it actually has a 65% regret rate, with only 28% pleased with the results.
SRS actually on average improved the quality of life, self-image, mental happiness, bodily satisfaction, and self-reported levels of anxiety in trans people in just about every study done on it. Regret rates are almost always below 10%, and usually related to complications rather than actually feeling like the surgery was wrong for them, with people who are "satisfied" or "very satisfied" with it usually being around 80%. Clearly SRS is not just cosmetic, even though it basically is just changing the appearance of something. It really does correct an underlying feeling of wrongness in trans people, while normal cosmetic surgery does not generally "correct" anything in cis people.
Ummm... obvious reasons? Srs is the most important step t a lot. However it is all important, so I dont think we should start complaining.
Quote from: bxcellent2eo on February 25, 2015, 03:45:47 PM
I am looking into electrolysis and other procedures for my transition, but it's a trend for these procedures to be denied as they are not medically necessary, and only cosmetic; while sexual reassignment surgery is medically necessary and not cosmetic. I'm trying to make a case to my insurance on why these procedures are medically necessary and not cosmetic, by comparing them to SRS.
What constitutes SRS as medically necessary? (Playing devil's advocate here:) Can't it be said that changing your genitals to look like something else is only cosmetic. We can live the rest of our lives with the current genitals we have, assuming they're not infected.
For me, I'd think electrolysis and facial feminization surgery are more necessary, as they affect the outward appearance seen by the general public, while genitals are only seen by you and your partner. In my opinion, it is more necessary for my mental health to pass in a public setting, than in a private setting.
What are your thoughts on any and all of this.
Quote from: Carrie Liz on February 25, 2015, 04:22:44 PM
In England, they did a study on people who had had cosmetic surgery, and overall it actually has a 65% regret rate, with only 28% pleased with the results.
SRS actually on average improved the quality of life, self-image, mental happiness, bodily satisfaction, and self-reported levels of anxiety in trans people in just about every study done on it. Regret rates are almost always below 10%, and usually related to complications rather than actually feeling like the surgery was wrong for them, with people who are "satisfied" or "very satisfied" with it usually being around 80%. Clearly SRS is not just cosmetic, even though it basically is just changing the appearance of something. It really does correct an underlying feeling of wrongness in trans people, while normal cosmetic surgery does not generally "correct" anything in cis people.
Thank you for this. Numbers are good. Can you cite these sources for me, please?
Cosmetic Surgery Regrets Study: http://www.dailystar.co.uk/fashion-beauty/380887/Cosmetic-surgery-regrets
Just about every study ever done on SRS: http://transascity.org/quality-of-life-in-treated-transsexuals/
(pretty much every study which said that quality of life was lower was comparing post-SRS trans people to cisgender controls, rather than pre-op trans people.)
The problem with all the studies showing that a high percentage of people regret cosmetic surgery is that from our point of view, they're looking at the wrong group. Those studies are looking at people who are normal in appearance, but want to look better for reasons of vanity. This assumes, a priori, that the surgery is in fact cosmetic and not medically necessary.
I suspect that the results would be very different if they studied people on whom plastic surgery was done to correct a congenital defect or an abnormality resulting from an injury; I think a sample of people who had surgery to correct facial deformities would have far fewer regrets about it.
It seems to me that the latter group is more akin to MTFs who need facial feminization surgery, or FTMs who need liposuction around their hips and thighs. For many of us, these procedures are needed to correct things which are, in effect, congenital deformities.
It's a matter of a deep level of self- and social acceptance, not one of vanity.
Same reason why surgery to correct a serious injury is medically necessary.
Everyone deserves to be whole.
That's exactly the point of showing the study of healthy people who have cosmetic surgery for complete reasons of vanity, and the regrets involved. It shows that SRS and FFS very clearly are NOT just cosmetic surgeries that people elect to have on a whim.
I think the GRS is considered necessary because it produces a functional change that gives you the, er, apparatus of the other gender. Your body is then physically aligned with your gender identity, so you can therefore no longer be suffering gender dysphoria. Your condition has been fully treated, so you're in the same boat as a cis person who finds themselves unattractive.
That first paragraph is in the perspective of those who make the rule, I am not saying that is a reasonable view by any means! However, I am not sure how the difference between necessary and cosmetic can be defined. I don't know where the line should be. So there's a certain logic to the distinction.
BA/FFS = vanity
GRS/SRS/GCS = sanity
Quote from: jeniI think the GRS is considered necessary because it produces a functional change that gives you the, er, apparatus of the other gender. Your body is then physically aligned with your gender identity, so you can therefore no longer be suffering gender dysphoria. Your condition has been fully treated, so you're in the same boat as a cis person who finds themselves unattractive.
The difficulty with this is that gender dysphoria doesn't only relate to primary sexual characteristics, i.e. genitals. Top surgery for FTMs makes this very clear; breasts are a secondary sexual characteristic, yet for many FTMs, they, rather than our genitals, can be the major focus of our dysphoria. Top surgery is now generally accepted as medically necessary for many FTMs -- it's just as much gender reassignment surgery as is bottom surgery. As I understand it, for many MTFs, the masculinization of the face which takes place during puberty (also a secondary sexual characteristic) can also be a major trigger for dysphoria. By this logic, it should be (and is, by the WPATH standards) treated as medically necessary GRS for those individuals.
Quote from: Muffinheart on February 25, 2015, 10:20:13 PM
BA/FFS = vanity
GRS/SRS/GCS = sanity
As someone with little issues with my genitals, I could say that SRS is for vanity.. But I acknowledge that I'm not everyone, for some it is very needed. A BA, on the other hand, would be beneficial to me due to the poor natural ones I've acquired from hormones, both in terms of my mental health and peoples perceptions of me.
If you have FFS you are still you, you just look more girly in the face. If you have electrolysis you are still you, you just don't shave. If you have SRS you give up the ability to reproduce for the rest of your life and nearly all government agencies (as well as society in general) will recognize the new genitals for the purposes of identification, marriage, etc. There is a huge difference between that one operation and anything else one can do to alter their physical body.
Quote from: Tysilio on February 25, 2015, 11:09:17 PM
The difficulty with this is that gender dysphoria doesn't only relate to primary sexual characteristics, i.e. genitals. Top surgery for FTMs makes this very clear; breasts are a secondary sexual characteristic, yet for many FTMs, they, rather than our genitals, can be the major focus of our dysphoria. Top surgery is now generally accepted as medically necessary for many FTMs -- it's just as much gender reassignment surgery as is bottom surgery. As I understand it, for many MTFs, the masculinization of the face which takes place during puberty (also a secondary sexual characteristic) can also be a major trigger for dysphoria. By this logic, it should be (and is, by the WPATH standards) treated as medically necessary GRS for those individuals.
Oh, I agree that it's problematic. I'm not arguing that the rules are the way it should be. I just don't know where the line between cosmetic and medically necessary needs to lie. For cis people, there's a fairly clear difference between cosmetic and reconstructive. There's not a great analog for trans people, though, because you're not restoring something to its original state.
I think a better solution would be for the insurance companies to at least respect the standards for what is needed and get rid of trans exclusions. Medically necessary should be the end of it: if it's necessary, it needs to be covered. That doesn't solve the problem, because it's a quagmire to define necessary, but we could do without the insurers unilaterally deciding to disregard what the medical communities come up with.
Part of that could be because most mtf gain breasts from hormones. If they didn't then BA would be just as medically necessary IMO.
Quote from: jeni on February 26, 2015, 08:43:30 AM
Oh, I agree that it's problematic. I'm not arguing that the rules are the way it should be. I just don't know where the line between cosmetic and medically necessary needs to lie. For cis people, there's a fairly clear difference between cosmetic and reconstructive. There's not a great analog for trans people, though, because you're not restoring something to its original state.
Actually, with FFS, yes you are. Unlike boobs or hips, the face's bone structure isn't feminine because it's been affected by estrogen, it's feminine because it hasn't been affected by testosterone. Testosterone causes the brow ridge, causes the bigger chin, causes the angularity and the Adam's Apple, while estrogen really doesn't do anything to the face's bone structure. So in a way, FFS actually is reconstructive surgery. It's taking your face and trying to revert it to the state it was previously in before testosterone un-feminized it.
Quote from: lovelessheart on February 25, 2015, 06:19:47 PM
Ummm... obvious reasons? Srs is the most important step t a lot.
I disagree.
SRS is at the very bottom of my list, and a lot of trans women do not have SRS.
In my opinion, HRT is the most important to most that medically transition.
Quote from: ImagineKate on February 26, 2015, 12:11:47 PM
I disagree.
SRS is at the very bottom of my list, and a lot of trans women do not have SRS.
In my opinion, HRT is the most important to most that medically transition.
Respectfully, I disagree.
I know of a few trans living full time, great jobs, great life, but never started HRT. One, because of a bad liver, the other because her doctor suggested she might have a few extra pounds. I also know of another who's been an airline stewardess for years with a major airline, never been on hormones.
I am also of the belief, from someone who's been on hormones six full years, hormones do not make me a woman. They did not mold me into who I am. They didn't define my character or magically make me more sensitive. Hormones were a nice addition to my transition, but had i for some reason been denied access to them, I still would have transitioned.
Hormones, In opinion are not the magic ingredient to transition, but they don't hurt for some.
I think one of the issues as to why facial feminization, electrolysis aren't covered is because, for those aspects, there is no standard as to what is feminine or masculine enough. We can't argue that cis women don't have facial hair, because some do. Same with adams apples, or masculine noses, etc.
Quote from: Carrie Liz on February 26, 2015, 11:32:24 AM
Actually, with FFS, yes you are. Unlike boobs or hips, the face's bone structure isn't feminine because it's been affected by estrogen, it's feminine because it hasn't been affected by testosterone. Testosterone causes the brow ridge, causes the bigger chin, causes the angularity and the Adam's Apple, while estrogen really doesn't do anything to the face's bone structure. So in a way, FFS actually is reconstructive surgery. It's taking your face and trying to revert it to the state it was previously in before testosterone un-feminized it.
While that's all true, I think it's quite a bit different from ordinary reconstructive surgery. Assuming a normal adolescence, there was never a mature female facial structure to reconstruct. Not that I don't like your reasoning! FFS *should* be covered if it's needed.
Quote from: Muffinheart on February 26, 2015, 12:35:12 PM
Respectfully, I disagree.
I know of a few trans living full time, great jobs, great life, but never started HRT. One, because of a bad liver, the other because her doctor suggested she might have a few extra pounds. I also know of another who's been an airline stewardess for years with a major airline, never been on hormones.
I am also of the belief, from someone who's been on hormones six full years, hormones do not make me a woman. They did not mold me into who I am. They didn't define my character or magically make me more sensitive. Hormones were a nice addition to my transition, but had i for some reason been denied access to them, I still would have transitioned.
Hormones, In opinion are not the magic ingredient to transition, but they don't hurt for some.
That's why I said, "of those who medically transition."
Among all transitioners, it's RLE.
Quote from: Muffinheart on February 25, 2015, 10:20:13 PM
BA/FFS = vanity
GRS/SRS/GCS = sanity
WPATH disagrees with a BA being vanity (emphasis mine):
QuoteWPATH's Clarification on Medical Necessity of Treatment, Sex Reassignment, and Insurance Coverage for Transgender and Transsexual People Worldwide:
http://www.wpath.org/site_page.cfm?pk_association_webpage_menu=1352&pk_association_webpage=3947
Medically necessary sex reassignment procedures also include complete hysterectomy, bilateral mastectomy, chest reconstruction or augmentation as appropriate to each patient (including breast prostheses if necessary), genital reconstruction (by various techniques which must be appropriate to each patient, including, for example, skin flap hair removal, penile and testicular prostheses, as necessary), facial hair removal, and certain facial plastic reconstruction as appropriate to the patient.
"Non-genital surgical procedures are routinely performed... notably, subcutaneous mastectomy in female-to-male transsexuals, and facial feminization surgery, and/or breast augmentation in male-to-female transsexuals. These surgical interventions are often of greater practical significance in the patient's daily life than reconstruction of the genitals." [3]
[3] Monstrey S, De Cuypere G, Ettner R,.(2007) . Surgery: General Principles. In Ettner R et al (eds) Principles of Transgender Medicine and Surgery. New York:Haworth Press:2007.p.90.
However, the insurance companies have not caught up to the standard. Take Aetna, for example:
QuoteClinical Policy Bulletin:
Gender Reassignment Surgery
http://www.aetna.com/cpb/medical/data/600_699/0615.html
"Rhinoplasty, face-lifting, lip enhancement, facial bone reduction, blepharoplasty, breast augmentation, liposuction of the waist (body contouring), reduction thyroid chondroplasty, hair removal, voice modification surgery (laryngoplasty or shortening of the vocal cords), and skin resurfacing, which have been used in feminization, are considered cosmetic. Similarly, chin implants, nose implants, and lip reduction, which have been used to assist masculinization, are considered cosmetic."
Ainsley, Yep I agree.
Fyi, for those living in Ontario:
What kinds of surgical body changing procedures does OHIP cover for approved sex reassignment surgery?
Male to Female Sex Reassignment Surgery
• Vaginoplasty - removal of male genitals, construction of vagina, labia, clitoris
Female to Male Sex Reassignment Surgery
• Mastectomy - removal of breasts and chest reconstruction
• Metoidioplasty/Phallopasty – (two different options) freeing of the clitoris and construction of
testes, or removal of female genitals, construction of male genitals
• Hysterectomy - removal of uterus and ovaries upon recommendation by GIC at CAMH as
part of transition.
Are there body changing procedures that are not covered by OHIP?
OHIP does not provide coverage for the following procedures:
• Breast implants
• Facial surgeries such as lip augmentation, lip reduction, jaw shortening, rhinoplasty (nose
reshaping)
• Neck or vocal chord surgery
• Hair transplants
• Electrolysis (removal of beard or body hair)
• Male chest contouring unless part of a mastectomy procedure
• Liposuction
Well thats only because a lot of trans women cant afford srs. Not because they dont want it. Its obvious due to the fact that for safety reasons as well. If you get rape with male genitalia by a man who isnt aware, that could end a lit worse than if you had srs. Imo
Quote from: ImagineKate on February 26, 2015, 12:11:47 PM
I disagree.
SRS is at the very bottom of my list, and a lot of trans women do not have SRS.
In my opinion, HRT is the most important to most that medically transition.
Quote from: Muffinheart on February 26, 2015, 01:54:01 PM
Fyi, for those living in Ontario:
It is the same (or extremely similar) in Nova Scotia, too.
Quote from: jeni on February 26, 2015, 06:39:42 PM
It is the same (or extremely similar) in Nova Scotia, too.
Nova Scotia too? Nice, I used to live in Halifax
So GRS is now offered in BC, Alberta, Ontario, Quebec, PEI and NS - kewl
Yep, I think NS just added it within the last year. Convenient because we'll hopefully be moving there soonish. ("Free" GRS isn't the reason we're going there, but it did kinda put an end to wondering if it was the right place to go...)
I'm so moving to Canada someday! :) Sounds awesome.
I just want to cry when I see someone post something like this.
Why is SRS "medically necessary," and not "cosmetic?"
All the years I mean years we been fighting to get GCS declared to be medically necessary.
Sigh!
Not many under stand that it could take just one person who presses the cosmetic issue back to insurance companies and they will turn right back to the Not covered.
Sigh!
:eusa_wall:
Watch what you wish for. Might be standing outside looking in again.
5 years of having a medically necessary prescription for GCS i sent in to my insurance company every year. Just to get the letter saying it is cosmetic and not covered under our exclusion for cosmetic surgery every single year.
:icon_cry:
Sigh!
Quote from: mrs izzy on February 26, 2015, 09:23:39 PM
I just want to cry when I see someone post something like this.
Why is SRS "medically necessary," and not "cosmetic?"
All the years I mean years we been fighting to get GCS declared to be medically necessary.
Sigh!
Not many under stand that it could take just one person who presses the cosmetic issue back to insurance companies and they will turn right back to the Not covered.
Sigh!
:eusa_wall:
Watch what you wish for. Might be standing outside looking in again.
5 years of having a medically necessary prescription for GCS i sent in to my insurance company every year. Just to get the letter saying it is cosmetic and not covered under our exclusion for cosmetic surgery every single year.
:icon_cry:
Sigh!
I'm not saying SRS shouldn't be medically necessary, I'm only trying to find out why insurance companies consider it as such, so those arguments can be applied toward other procedures, not currently covered.
It is highly unlikely that you will be successful at this task you've set yourself as a goal. If I am not mistaken I remember you posting in the FFS section about you living in the Bay Area and having medi-cal. I almost commented then but I didn't want to because I didn't want to burst your bubble and be a Debbie downer. I am originally from Cali and worked in a specialist medical provider's office in so cal for years before moving to the UK. And medi-cal had a very bad reputation for coverage of procedures. We did sometimes take medical patients but truly just to fill in an empty bed if there was any. Medical is well known for underpaying providers the amounts they request. This may have all changed by now as it has been maybe 6- 7 years since I managed that office. So do investigate first but if things are anything like back then my advice would be above all to try and figure out a way to switch insurance provider or accept a switch if your employer is offerinig it. In the amazing case that you were able to jump through all the hoops, and had the great luck of finding a psychiatrist to back all your arguments in paper and signed saying that it is absolutely necessary for your mental health to have these procedures done.and your insurance accepted. The only FFS surgeon I have ever heard of accepting an insurance funded patient, is Zukowsky in Chicago area, so don't plan to stay within the Bay Area for this if you were able to make it happen.
Asking the question of why is SRS medically necessary and not cosmetic? Is, in my opinion. A confusing way of asking people for what you want to know. Because it sounds like you're questioning the validity of GRS as a necessary surgery. I do however, understand what you're asking.
There is several studies backing up the validity of GRS as an effective surgery to alleviate gender dysphoria. So another reason why the question you are asking is wrong, is because nobody has to prove the medical necessity of GRS anymore. It has already been proven, by statistics and different studies.
What you WOULD need is yes, some serious and probably extensive evidence that FFS and BA are absolutely necessary to your everyday life and for your mental health. Have in mind the person I read about having had FFS paid for by her insurance, was. Very masculine pre Ffs, this could be a requirement and I am sure one that many would not meet (as uncomfortable as they might be with certain features) I am assuming continued assessment by a psychiatrist/ psychologist/therapist with considerable and lengthy (maybe a year or 2) evidence in regards to this issue and how it affects your daily life etc etc would be likely necessary steps to hand to a lenient and flexible insurance provider to consider you seriously, obviously, you would need the full backing of said psych. And they would have to do so in paper. You might have to fight back and forth and eventually as I said. If successful, you go to a provider who is willing to bill your insurance. Don't take my comments and possible scenarios word by word, I am only going by what knowledge I have in the subject.
So all in all, the question you wanted to ask is: how can I convince my health insurance that what they consider cosmetic procedures are actually medically necessary for me? ... We have to ask the right questions to get the right answers!
Being in the UK, and appreciating that there will be differences between countries, I have known of cis and trans females being covered for a BA , after a 2 year process of continuous therapy in which they communicate to their therapist how negatively their look is affecting their mental health and daily lives. In these cases, it has to be obvious to all of the medical professionals involved that there is under-development apart from the above stated unhappiness.
I hope that there might be any info I've given you that might be of use to yourself for the future and that you don't consider this a negative post. It isn't meant to be. It is meant to be helpful and not detrimental.
Best of luck
Quote from: calicarly on March 01, 2015, 04:33:37 PM
It is highly unlikely that you will be successful at this task you've set yourself as a goal. If I am not mistaken I remember you posting in the FFS section about you living in the Bay Area and having medi-cal. I almost commented then but I didn't want to because I didn't want to burst your bubble and be a Debbie downer. I am originally from Cali and worked in a specialist medical provider's office in so cal for years before moving to the UK. And medi-cal had a very bad reputation for coverage of procedures. We did sometimes take medical patients but truly just to fill in an empty bed if there was any. Medical is well known for underpaying providers the amounts they request. This may have all changed by now as it has been maybe 6- 7 years since I managed that office. So do investigate first but if things are anything like back then my advice would be above all to try and figure out a way to switch insurance provider or accept a switch if your employer is offerinig it. In the amazing case that you were able to jump through all the hoops, and had the great luck of finding a psychiatrist to back all your arguments in paper and signed saying that it is absolutely necessary for your mental health to have these procedures done.and your insurance accepted. The only FFS surgeon I have ever heard of accepting an insurance funded patient, is Zukowsky in Chicago area, so don't plan to stay within the Bay Area for this if you were able to make it happen.
This is what I've been told before. But with research, writing lots of papers on this, getting psychs to back me, and many appeals, I'm hoping to not only get FFS and Electrolysis, but set a precedent so others can get it as well.
Quote from: calicarly on March 01, 2015, 04:33:37 PMAsking the question of why is SRS medically necessary and not cosmetic? Is, in my opinion. A confusing way of asking people for what you want to know. Because it sounds like you're questioning the validity of GRS as a necessary surgery. I do however, understand what you're asking.
There are several studies backing up the validity of GRS as an effective surgery to alleviate gender dysphoria. So another reason why the question you are asking is wrong, is because nobody has to prove the medical necessity of GRS anymore. It has already been proven, by statistics and different studies.
Actually, these studies are what I need. I need to see why GRS is necessary, because almost all of the reasons for GRS can be applied to every other medical procedure generally required by transgender patients.
Quote from: calicarly on March 01, 2015, 04:33:37 PMSo all in all, the question you wanted to ask is: how can I convince my health insurance that what they consider cosmetic procedures are actually medically necessary for me? ... We have to ask the right questions to get the right answers!
If I asked that, I'd more than likely get an answer saying that it's impossible, or "good luck with that."
Quote from: calicarly on March 01, 2015, 04:33:37 PMI hope that there might be any info I've given you that might be of use to yourself for the future and that you don't consider this a negative post. It isn't meant to be. It is meant to be helpful and not detrimental.
Best of luck
Thank you much, your post has been helpful.
I think it really depends how you live your life as a trans woman. Some freely and openly exposes themselves about their identity therefore would not have the same views of seeing srs as a sanity but vanity but for those who was and is always seen or known to be a female for always hiding what they are, they would call srs a surgery for purposes of sanity and to match up with how they're living their life.
As for breast augmentation and facial reconstruction, it could go both sanity or vanity. If you got into a car accident and your face was messed up then it would be medically necessary to have FFS same for breast, if you have breast cancer and got mastectomy, it would be your choice to get breast implants to reshape both breast.
You could choose to refuse to have ffs, ba, or srs if you're sacrificing finding a certain type of love and relationship but you can choose to get it if you plan to live stealth all your life.
At least that's the way I see it.
I feel like there is argument for "harm done" in the case of major surgeries: a cis woman whose chest is mangled by some horrible accident is considered well within her rights to get plastic surgery to repair the damage. If she also happens to chose to request a different size and appearance, well she is already requiring surgery so who would really see much issue with this? (Aside from religious views on how God wants her to live horridly mangled or not survive and accident which I feel are obviously exempt.) A transwoman in the case of breast augmentation can also be considered, in my view and many companies, as equally harmed by being denied this kind of surgery, whereas a cis-woman seeking to augment her chest is cosmetic. Her breasts exist and have not been damaged, even if in her mind she has always seen herself as a larger cup size.
A women, whether trans or cis can be suffering from facial hair. I can see how in many traswomen's cases, they have much more difficult facial hair than even the hairiest bearded cis-woman. But I think in either case it can be said that shaving removes the hair 'effectively' even if it truly does not. Personally I haven't heard of any cis-woman being able to write off electroylosis as a necessary procedure, but I still think in severe cases, whether cis or trans it is humane to assist a women with hair removal in a place that is fairly unusual for a woman to be excessively hairy. I suspect there's a lot of concern for abuse as many people have unwanted hair in our societies and they don't want to pay up for a total vanity procedure. It's a case of bad apples spoiling the bunch, or rather some people trying to abuse the system and get something for reduced cost that they may not actually need, or decide soon after they did not need? This is a lot of conjecture on my part... :C
WPATH has the right of it, that each situation should be clinically evaluated and assessed from there and that FFS or BA can be medically necessary in certain circumstances.
The problem is that we are a small group and the insurance companies would rather screw us over for a few more bucks than take proper care of us. This is yet one more example of the failure of private health care in the United States, versus having a national health care system.
So unless/until the insurance companies in the United States catch up to current medical standards, we're stuck with what we have. You may win the argument that FFS or BA or electrolysis is medically necessary, for yourself, but it will be a one-of sort of decision and won't really help anyone else. Basically, they may look at it and decide legal costs of fighting you are higher than just giving you the coverage - a cruel and sadistic way to make such decisions, but that's what happens when you build an entire country around profit motive.
In the end, bxcellent2eo (and everyone else) has all the options and opportunities to go to the court with insurance company and prove her point.
Do I think it would be nice to have FFS covered by insurance as a necessary treatment? Yes. Definitely. Do I think it is a medical necessity? No, because it isn't. Some biological women also have very masculine face, and ugly big noses, and prominent brow ridges.... (some even get misgendered constantly) shouldn't they also be allowed to have their surgical treatment covered by an insurance? Because, you know, they also deserve to look more beautiful, and more feminine, and more close to the idealistic perfection by modern day aesthetic standards... Where do you draw the line, who should have it for free, and who should not? Why would someone who has more prominent masculine features be allowed to have it covered, compared to those who don't have to do it because of "passing" reasons, and only want to have it because they want to improve their self-image and relationship with a mirror reflection. Isn't that a LOT more important to how others percieve you, and if they gender you correctly? And most people who would need it the most (heck, I would pay for them if I would be a millionare...), say that they don't need it and don't want it, because they are passing most perfectly in their opinion... hairstyle/wigstyle and correct make-up skills is enough for them to feel comfortable in everyday situations. Shouldn't that then apply to everyone else? If you know how do master level facial contouring, even the biggest ugliest nose isn't a problem anymore (apart from side profile)... and who need a brow lift, if you can just pluck your eyebrows from under, and you're good to go. 5 minute work eyebrow lift, which can save you 5000$ + hospital fees, + hotel for 10 days, + flight costs .... If that kind of silly things work for some people, than why it wouldn't for other? Despite all the amazing benefits of facial feminization surgery, it obviously isn't necessary, and because of that it can't be expected to be treated as such by an insurance companies.
Is electrolysis really necessary, when a LOT of people happily shave everyday, and apply a ton of foundation and concealers ond other silly tricks with lipstics, etc to hide a beard shadow? It doesn't seem to bother them, as they have no problem doing so, and if they can live full-time while doing so, why couldn't you? It did bother me, and I did 90% of laser hair removal BEFORE I started "living full-time", because I didn't want any of that sticky ->-bleeped-<- on my face, and I shurely didn't want to shave everyday.
I hope anyone who is trying, manages to get a FFS covered, and I hope it comes along with an opportunity to have it with a capable surgeon. Good Luck!
My understanding, and I try to break it down logically, the goal is to be accepted as a female by one's self and society. The goal is to be as close to a cis woman as possible.
Not all cis women have large breasts and some have faces that aren't 100% feminine (according to societal perception and natural instinct). A significant number of cis women have flat chests. However nearly all of them have vaginas. Almost none of them have penises. For a cis woman with a flat chest to get a BA or a "manly" face to get a facelift it is classified as cosmetic surgery.
This seems to be the rationale (as it seems to me anyway) behind the guidelines of covering GRS/SRS as medically necessary whereas FFS/BA/VFS/lipo etc is not.
Quote from: mrs izzy on February 26, 2015, 09:23:39 PM
I just want to cry when I see someone post something like this.
Why is SRS "medically necessary," and not "cosmetic?"
All the years I mean years we been fighting to get GCS declared to be medically necessary.
Sigh!
Not many under stand that it could take just one person who presses the cosmetic issue back to insurance companies and they will turn right back to the Not covered.
Sigh!
:eusa_wall:
Watch what you wish for. Might be standing outside looking in again.
5 years of having a medically necessary prescription for GCS i sent in to my insurance company every year. Just to get the letter saying it is cosmetic and not covered under our exclusion for cosmetic surgery every single year.
:icon_cry:
Sigh!
Thank you Izzy,
I am still there and in a frustrating appeal process to get an orchiectomy that Kaiser has stated is "cosmetic" based on their trans exclusionary rider. While individual practitioners and providers may support the WPATH standards the insurance industry is a powerful and $$ oriented dinosaur that needs the real makeover. And then extinction sounds like a fitting end too.....;-)
Quote from: ImagineKate on March 30, 2015, 11:21:26 AM
My understanding, and I try to break it down logically, the goal is to be accepted as a female by one's self and society. The goal is to be as close to a cis woman as possible.
Not all cis women have large breasts and some have faces that aren't 100% feminine (according to societal perception and natural instinct). A significant number of cis women have flat chests. However nearly all of them have vaginas. Almost none of them have penises. For a cis woman with a flat chest to get a BA or a "manly" face to get a facelift it is classified as cosmetic surgery.
This seems to be the rationale (as it seems to me anyway) behind the guidelines of covering GRS/SRS as medically necessary whereas FFS/BA/VFS/lipo etc is not.
Not quite-the goal is to be comfortable with your body, and I think that varies from person to person. I'd argue that for some people, BA is TOTALLY necessary. I can't even look down anymore without feeling incredibly triggered. I don't want to *appear* female; I want to actually have a female body. And there are some physical traits that are undeniable masculine about my body. FFS too-if you have a male facial structure, and you can't look in the mirror without wanting to scream (once again, that's how I feel) then I suppose it is something that I need. We can all only speak from personal experience of course; and a substantial part of my desire to have this is being able to find a place in our very unfriendly world. But, it's also what I'd need to feel comfortable. I don't think any one individual can decide what should be done, because each person here has a different set of needs. Personally, ideally I'd have FFS (for safety as well as dysphoria), BA (just dysphoria), and SRS (safety and dysphoria again)-in that order of priority. There are others who would put SRS first, and it's up to them. I think we all are striving to be comfortable; insurance should cover whatever is necessary to achieve that psychological peace of mind that we are aiming for by transitioning in the first place.
Quote from: bxcellent2eo on February 25, 2015, 03:45:47 PMFor me, I'd think electrolysis and facial feminization surgery are more necessary, as they affect the outward appearance seen by the general public, while genitals are only seen by you and your partner. In my opinion, it is more necessary for my mental health to pass in a public setting, than in a private setting.
I agree with you, and if I do have srs, the order will be 1-laser 2- ffs 3- srs. It's not as important as the first two, but it's considered a medical necessity because people have dysphoria about their genitals (me comprised), and some people might even go as far as something like self-mutilation or injuring their genitals because of that, I mean I thought about it too when I was little, because I hated it so much.
Though, some people don't need to feel "whole", at all like some people suggest here, and they shouldn't be ashamed of that, we are all different, I know plenty of trans women who don't want srs, I think they should have the option of having another procedure be considered a medical necessity...
Quote from: androgynouspainter26 on March 30, 2015, 05:35:16 PM
Not quite-the goal is to be comfortable with your body, and I think that varies from person to person. I'd argue that for some people, BA is TOTALLY necessary. I can't even look down anymore without feeling incredibly triggered. I don't want to *appear* female; I want to actually have a female body. And there are some physical traits that are undeniable masculine about my body. FFS too-if you have a male facial structure, and you can't look in the mirror without wanting to scream (once again, that's how I feel) then I suppose it is something that I need. We can all only speak from personal experience of course; and a substantial part of my desire to have this is being able to find a place in our very unfriendly world. But, it's also what I'd need to feel comfortable. I don't think any one individual can decide what should be done, because each person here has a different set of needs. Personally, ideally I'd have FFS (for safety as well as dysphoria), BA (just dysphoria), and SRS (safety and dysphoria again)-in that order of priority. There are others who would put SRS first, and it's up to them. I think we all are striving to be comfortable; insurance should cover whatever is necessary to achieve that psychological peace of mind that we are aiming for by transitioning in the first place.
What makes your "need" for a BA and FFS different from that of a cis woman? Nothing. Cis women have the same issues - they don't like how they look and they figure surgery could make them look better.
And yes I would like insurance to cover everything but see above, they would have to cover it for everyone, cis women included because the need is the exact same. You can be a woman without big breasts and an unattractive face. Cis or trans. This is not going to happen because plastic surgery to enhance your appearance is a luxury, not a necessity.
And the goal is to be comfortable with your body? Really? Sounds like every man and woman would have elective plastic surgery covered by insurance. Is that correct?
Quote from: ImagineKate on March 30, 2015, 06:17:18 PM
What makes your "need" for a BA and FFS different from that of a cis woman? Nothing. Cis women have the same issues - they don't like how they look and they figure surgery could make them look better.
And yes I would like insurance to cover everything but see above, they would have to cover it for everyone, cis women included because the need is the exact same. You can be a woman without big breasts and an unattractive face. Cis or trans. This is not going to happen because plastic surgery to enhance your appearance is a luxury, not a necessity.
And the goal is to be comfortable with your body? Really? Sounds like every man and woman would have elective plastic surgery covered by insurance. Is that correct?
Well you're acting like the only goal in transitioning should be to culturally assimilate with the rest of the world in a female gender role, and that's not what I personally want. I'm transitioning so that I can feel comfortable with who and what I am.
Quote from: androgynouspainter26 on March 30, 2015, 06:20:56 PM
Well you're acting like the only goal in transitioning should be to culturally assimilate with the rest of the world in a female gender role, and that's not what I personally want. I'm transitioning so that I can feel comfortable with who and what I am.
There are a lot of cis girls who feel unattractive. Should their surgery be covered?
Quote from: ImagineKate on March 30, 2015, 06:25:03 PM
There are a lot of cis girls who feel unattractive. Should their surgery be covered?
It's not about feeling unattractive though. It's about correcting male traits. Just as a penis is a trait that should not be on my body, my brow bossing is the same. Facial features are as biologically sexed as our genitallia are, and for some people (like me) having a male face can really trigger a lot of dysphoria.
Quote from: androgynouspainter26 on March 30, 2015, 06:31:19 PM
It's not about feeling unattractive though. It's about correcting male traits. Just as a penis is a trait that should not be on my body, my brow bossing is the same. Facial features are as biologically sexed as our genitallia are, and for some people (like me) having a male face can really trigger a lot of dysphoria.
But can you give me an objective standard as to what is a male face and what is a female face? Or male size boobs and female size boobs?
Yes, actually, there are scientific traits that determine what gender a face is recognized as. There are specific dimensions that are considered male, and specific dimensions that are considered female. Besides, if someone had a big ugly growth on their neck that wasn't cancerous but still quite intrusive, insurance would cover it. It's not about feeling pretty, it's about seeing a person of the appropriate sex staring back at you. This is something I feel dysphoric about, and I believe I should have the right to change it because it causes me significant distress on a daily basis.
Quote from: androgynouspainter26 on March 30, 2015, 06:35:38 PM
Yes, actually, there are scientific traits that determine what gender a face is recognized as. There are specific dimensions that are considered male, and specific dimensions that are considered female. Besides, if someone had a big ugly growth on their neck that wasn't cancerous but still quite intrusive, insurance would cover it. It's not about feeling pretty, it's about seeing a person of the appropriate sex staring back at you. This is something I feel dysphoric about, and I believe I should have the right to change it because it causes me significant distress on a daily basis.
But you say you "need" FFS yet people here tell you you pass. How is that an objective standard? That seems pretty inconsistent.
Quote from: ImagineKate on March 30, 2015, 06:49:31 PM
But you say you "need" FFS yet people here tell you you pass. How is that an objective standard? That seems pretty inconsistent.
Well, to be fair you could put Jay Leno in a blond wig and half the gals here would tell him he passed...
I feel dysphoric about my face. Not self concious-dysphoric. If the goal of transitioning is to alleviate dysphoria, then I think it constitutes a totally legitimate part of my transition.
Quote from: androgynouspainter26 on March 30, 2015, 06:51:32 PM
Well, to be fair you could put Jay Leno in a blond wig and half the gals here would tell him he passed...
I feel dysphoric about my face. Not self concious-dysphoric. If the goal of transitioning is to alleviate dysphoria, then I think it constitutes a totally legitimate part of my transition.
But why isn't it covered for cis women?
Quote from: androgynouspainter26 on March 30, 2015, 06:51:32 PM
...I feel dysphoric about my face. Not self concious-dysphoric. If the goal of transitioning is to alleviate dysphoria, then I think it constitutes a totally legitimate part of my transition.
Then I would have to agree with you.
Quote from: ImagineKate on March 30, 2015, 07:11:30 PM
But why isn't it covered for cis women?
Because cis women do not experience gender dysphoria.
Quote from: ImagineKate on March 30, 2015, 06:25:03 PM
There are a lot of cis girls who feel unattractive. Should their surgery be covered?
In some cases, under the Australian system, a BA can be covered, at least partly, but only when it causes significant psychological distress.. It's rare, but it does happen. Breast reductions are also covered here, mostly for other health reasons.
Quote from: androgynouspainter26 on March 30, 2015, 07:13:18 PM
Because cis women do not experience gender dysphoria.
I would say that isn't true.
Dysphoria is basically dissatisfaction.
And there was one cis woman who came on here asking for advice for plastic surgery because she felt that people didn't view her as a woman.
Quote from: kelly_aus on March 30, 2015, 07:27:23 PM
In some cases, under the Australian system, a BA can be covered, at least partly, but only when it causes significant psychological distress.. It's rare, but it does happen. Breast reductions are also covered here, mostly for other health reasons.
Agreed, but as you said it is rare, not the norm. As far as I know in the USA it is covered only to reconstruct it after mastectomy or similar but not for other reasons.
Quote from: ImagineKate on March 31, 2015, 05:21:19 AM
I would say that isn't true.
Dysphoria is basically dissatisfaction.
And there was one cis woman who came on here asking for advice for plastic surgery because she felt that people didn't view her as a woman.
No. It's not just dissatisfaction. If dissatisfaction is the only reason you're doing this, perhaps you should re-examine your transition goals, and ask yourself why you're doing this, because dyphoria is a whole lot more than petty dissatisfaction.
Quote from: androgynouspainter26 on March 31, 2015, 10:06:12 AM
No. It's not just dissatisfaction. If dissatisfaction is the only reason you're doing this, perhaps you should re-examine your transition goals, and ask yourself why you're doing this, because dyphoria is a whole lot more than petty dissatisfaction.
I was referring to the dictionary definition.
No comment about the cis woman who came here seeking advice on ffs?
Quote from: ImagineKate on March 31, 2015, 10:07:21 AM
I was referring to the dictionary definition.
No comment about the cis woman who came here seeking advice on ffs?
The cis woman did not have gender dysphoria. She did not require treatment for gender dysphoria. Why are you so against the idea of me being able to access the surgeries I'd need to feel comfortable?
If we will provide someone with free reconstruction post mastectomy, how come we can't get our chests reconstructed? I lost mine to biology, not surgery, but it's the same thing. Should be the same thing.
Quote from: androgynouspainter26 on March 31, 2015, 10:12:31 AM
The cis woman did not have gender dysphoria. She did not require treatment for gender dysphoria.
She actually said the reason for her seeking surgeries is because people did not refer to her as "ma'am" or "miss" while they did that to others. It's something we as transgender people experience, actually. So while not male to female gender dysphoria, it is dissatisfaction with her gender presentation.
QuoteWhy are you so against the idea of me being able to access the surgeries I'd need to feel comfortable?
I am not really. I too would like my surgeries covered by insurance, it is costing me quite a bit out of pocket and I have to make some sacrifices and forego some things and save my money (and I am ineligible for tax breaks on medical expenses). However, the debate here is the rationale behind some surgeries being "medically necessary" and some being "cosmetic." And in your case specifically with some non-surgical changes you "pass" as a woman. In my opinion, and the opinion of some others, you don't really need the surgery, so it is not really "medically necessary." However, you are saying that you don't feel comfortable unless you have these surgeries. What I am asking is, what exactly makes you different from any other woman who doesn't feel comfortable in her own body? I think this is a very valid question, and is a question asked not only by insurance but by Governments who fund universal healthcare at taxpayer expense. It is not and shouldn't be a free-for-all where you can get anything you want. If it is being paid for by others they have a right to ask if it is necessary, and the truth is that anyone can justify anything as being necessary.
Note that there are trans women who absolutely need the surgery, such as those who absolutely cannot look anything like a woman. But I do not see that in your case and in reality those seem to be few and far between.
Quote from: ImagineKate on March 31, 2015, 10:19:25 AM
I too would like my surgeries covered by insurance, it is costing me quite a bit out of pocket and I have to make some sacrifices and forego some things and save my money (and I am ineligible for tax breaks on medical expenses).
Emphasis, mine. Why, may I ask, are you not eligible? H&R Block told me last year to claim the money I spent on medical expenses that exceeded 10% of my income. Is there a caveat to the expense claim?
Quote from: ImagineKate on March 31, 2015, 10:19:25 AM
She actually said the reason for her seeking surgeries is because people did not refer to her as "ma'am" or "miss" while they did that to others. It's something we as transgender people experience, actually. So while not male to female gender dysphoria, it is dissatisfaction with her gender presentation.
I am not really. I too would like my surgeries covered by insurance, it is costing me quite a bit out of pocket and I have to make some sacrifices and forego some things and save my money (and I am ineligible for tax breaks on medical expenses). However, the debate here is the rationale behind some surgeries being "medically necessary" and some being "cosmetic." And in your case specifically with some non-surgical changes you "pass" as a woman. In my opinion, and the opinion of some others, you don't really need the surgery, so it is not really "medically necessary." However, you are saying that you don't feel comfortable unless you have these surgeries. What I am asking is, what exactly makes you different from any other woman who doesn't feel comfortable in her own body? I think this is a very valid question, and is a question asked not only by insurance but by Governments who fund universal healthcare at taxpayer expense. It is not and shouldn't be a free-for-all where you can get anything you want. If it is being paid for by others they have a right to ask if it is necessary, and the truth is that anyone can justify anything as being necessary.
Note that there are trans women who absolutely need the surgery, such as those who absolutely cannot look anything like a woman. But I do not see that in your case and in reality those seem to be few and far between.
Because it induces dysphoria. That's all there is to it. Dysphoria is not the same thing as a spoiled girl feeling like the ugly one at the dance. It's a physical pain. I don't want FFS so everyone will see me as a girl or some BS, though the safity it'll afford me does come in. I want it so I can look in the mirror without throwing up.
Quote from: ainsley on March 31, 2015, 10:28:28 AM
Emphasis, mine. Why, may I ask, are you not eligible? H&R Block told me last year to claim the money I spent on medical expenses that exceeded 10% of my income. Is there a caveat to the expense claim?
My medical expenses in a given year will probably never exceed 10% of our household income. It sucks because we've done some expensive procedures including IVF and other stuff not covered by insurance. But I'm not really complaining, I can afford it plus insurance covers some stuff like the drugs and monitoring so that knocks down the expense somewhat.
Hi friends
Everyone has an opinion and expressing an individual opinion is fine, but let's make sure to keep the conversation civil and not let it devolve into idle circular bickering
Thank you
V M
I don't think FFS is cosmetic, I mean for some people it can be cosmetic, like for lip injections considered part of ffs, no I'm sorry but there are many of women with small lips, so maybe some procedures can be considered cosmetic, but other procedures are not. I do feel dysphoric about my chin, there are times I don't want to show my chin, I would wear a burqa (I actually did sometimes but I figured that people would look at me more that way, and I felt uncomfortable), and the same goes for other male feature I see in my face, and it's hard to have a standard FFS as you said, but some features like the brow bossing, it's something very masculine that we feel dysphoric about. It's not that I want to be prettier, I just want to look like a female, and some features do induce dysphoria to some people... We are all different and have different dysphoria. I might want to have srs, but some other trans woman might not want to have srs, and thankfully here int he us in most of the states you don't need srs to change your gender mark. I also think laser or electrolysis at least of facial hair should be covered, that's something really dysphoric, I really don't know any trans women who would want to shave for the rest of her life, that's just crazy. I really don't understand american insurance that much anyway, because I just moved here 2 years ago, but would an insurance pay for your srs or ffs if done overseas?
Also I know Raiden Quinn had ffs and paid it with insurance (probably not completely), I forgot what states she said she lived in, but she had Dr. Z, and I think other girls in the forum had insurance pay for ffs, so hopefully that will change, and more health insurance will cover ffs. Also when Raiden on youtube talked about her surgery, she did separate the cosmetic to the essential ffs portion that made her feel dysphoric, and I do agree with her, I mean some part of FFS are cosmetic, while other parts of FFS aren't.
Yeah this whole debate at least in regards to grs being a cosmetic procedure is a bit off putting since its a major surgery one of the most traumatic surgeries a person can endure. I think it should be covered universally for every one of us just like in the UK or in Canada. FFS and breast augmentation should be done on a case by case basis and like with ffs what specific surgeries would be covered, like the forehead and nose vs the chin/jaw, should the entire cost be covered? If the testosterone effects were very heavy on the face then shouldn't it be argued that said trans woman should get it all covered? I mean like i said this should be handled in a case by case basis since not everyone needs extensive work done but here's another example, say if said trans woman wanted more work done than what she was approved for, then their should be a process in place with the insurance so she can get the extra work covered if she really felt she needed it.
I honestly think the above is what needs to change with insurance here in the states. I think it would help minimize the depression/suicide rate with our community. A lot of the inner turmoil we face with our dysphoria is the physical stuff. Not having the funds nor the insurance to be able to get this stuff covered is disheartening and crippling even.
Quote from: Lady_Oracle on April 01, 2015, 02:36:52 AM
Yeah this whole debate at least in regards to grs being a cosmetic procedure is a bit off putting since its a major surgery one of the most traumatic surgeries a person can endure. I think it should be covered universally for every one of us just like in the UK or in Canada. FFS and breast augmentation should be done on a case by case basis and like with ffs what specific surgeries would be covered, like the forehead and nose vs the chin/jaw, should the entire cost be covered? If the testosterone effects were very heavy on the face then shouldn't it be argued that said trans woman should get it all covered? I mean like i said this should be handled in a case by case basis since not everyone needs extensive work done but here's another example, say if said trans woman wanted more work done than what she was approved for, then their should be a process in place with the insurance so she can get the extra work covered if she really felt she needed it.
I honestly think the above is what needs to change with insurance here in the states. I think it would help minimize the depression/suicide rate with our community. A lot of the inner turmoil we face with our dysphoria is the physical stuff. Not having the funds nor the insurance to be able to get this stuff covered is disheartening and crippling even.
Exactly. If I had access to these surgeries, I can't tell you all how much better I'd be feeling. I'm in the middle of a pretty bad spot right now because my dysphoria has become so all-consuming that I can barely leave my dorm room. I think FFS could help me get my life back. My face has been ravaged by the effects of testosterone, and having to see those "scars" every time I look in the mirror and having other people see those scars is really painful for me. I mean, the woman I'm sitting next to while waiting to be called in for jury duty-I'm pretty sure she thinks I'm a guy. That hurts a ton. I'm trying not to cry. If FFS could save me from this, I'd say in a heartbeat it's medically necessary. As is, either I'm going to have my parents pay for it or detransition because I've realized there is simply no way for me to pay for it.
Dysphoria is psychological distress... gender dysphoria means it is a psychological distress caused by on ones birth assigned gender and everything related. Many biological women feel severe psychological distress because of their facial features or body. If insurance company would cover FFS for transsexual women, THEY MUST also cover plastic/reconstructive/aesthetic surgeries for all other women who feel psychological distress because of their facial features. And should this only be applied to transsexual women, and biological women, or should it also apply to all other transgender women and individuals? What if someone is androgynous, not really transsexual, but he/she also feel psychological distress because of their facial features? Shouldn't they also have FFS or other type of facial surgery for free, like everybody else? Or maybe a crossdresser, who sometimes identify as man, and sometimes as woman, and then feels psychological distress because of their masculine facial features, which cause them psychological distress while going out in full femme mode, and gets misgendered, and verbally attacked, and stared at, just like many of you here do. Shouldn't then they also have some sort of facial surgery covered by an insurance company? Where do you draw the line? You have women with brow bossing, I hear it all the time here on this forums, that Jennifer Lopez or someone else has worse brow bossing than most people who do kindly ask for a honest opinion, and gets a Jennifer Lopez comparison as an example, and claim supported with a link to the picture. Or the same happens with jaw, as Mrs. Jolie has a wider and more masculine jaws than 75% of members here... truth is, many biological cisgender women have masculine facial traits and features, and if you have it, you can't really claim that you would be the only women with prominent brow bossing and wide jaws in the world, and because of that you must have a FFS for free, to fix all that, so you can feel better and more female while looking in the mirror...... My point is... how do you draw the line, and make a rules that would work for everybody? Well, you can't... Like everybody else, all of you have a chance to take a legal route, and prove your points on the court, and hopefully have an insurance cover it. Or you can, instead of putting time and money for legal costs, work hard and pay for your FFS (just like everybody else does).
Quote from: mmmmm on April 01, 2015, 08:50:39 AM
Dysphoria is psychological distress... gender dysphoria means it is a psychological distress caused by on ones birth assigned gender and everything related. Many biological women feel severe psychological distress because of their facial features or body. If insurance company would cover FFS for transsexual women, THEY MUST also cover plastic/reconstructive/aesthetic surgeries for all other women who feel psychological distress because of their facial features. And should this only be applied to transsexual women, and biological women, or should it also apply to all other transgender women and individuals? What if someone is androgynous, not really transsexual, but he/she also feel psychological distress because of their facial features? Shouldn't they also have FFS or other type of facial surgery for free, like everybody else? Or maybe a crossdresser, who sometimes identify as man, and sometimes as woman, and then feels psychological distress because of their masculine facial features, which cause them psychological distress while going out in full femme mode, and gets misgendered, and verbally attacked, and stared at, just like many of you here do. Shouldn't then they also have some sort of facial surgery covered by an insurance company? Where do you draw the line? You have women with brow bossing, I hear it all the time here on this forums, that Jennifer Lopez or someone else has worse brow bossing than most people who do kindly ask for a honest opinion, and gets a Jennifer Lopez comparison as an example, and claim supported with a link to the picture. Or the same happens with jaw, as Mrs. Jolie has a wider and more masculine jaws than 75% of members here... truth is, many biological cisgender women have masculine facial traits and features, and if you have it, you can't really claim that you would be the only women with prominent brow bossing and wide jaws in the world, and because of that you must have a FFS for free, to fix all that, so you can feel better and more female while looking in the mirror...... My point is... how do you draw the line, and make a rules that would work for everybody? Well, you can't... Like everybody else, all of you have a chance to take a legal route, and prove your points on the court, and hopefully have an insurance cover it. Or you can, instead of putting time and money for legal costs, work hard and pay for your FFS (just like everybody else does).
Getting these things covered in court is not realistic. It's worked only once. And not everyone has the opportunities required to pay for their own FFS. "Working Hard" does not equate to finding 40k of disposable income. You had your parents pay for FFS, right? Not everyone is so lucky as to have access to these kinds of resources. You have to think about people who are in my situation. What do you think I should do? I'm a full time theatre student and it's too late for me to change my major. After I graduate-what am I supposed to do? Finding a job that pays more than minimum wage even with a college degree in this country is hard. Be a waitress for twenty years? Sex work? Being realistic, your options if you are a trans women who does not pass are few and far in between. Just keep in mind that for me, insurance might be the only way for me to ever afford any kind of surgery. It made a huge positive difference in your life, no? What about me? What am I supposed to do?