Susan's Place Transgender Resources

Community Conversation => Transitioning => Facial feminization surgery => Topic started by: anjaq on October 24, 2017, 06:53:06 AM

Title: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: anjaq on October 24, 2017, 06:53:06 AM
Hi
I have a consultation this week with a doctor who is there to assess my need to get FFS. My face is rather androgynous and probably each part in itself is in a "female range" but overall it looks too masculine in my perception and FFS surgeons did recommend several procedures to improve this.
However I would like to attempt to either get this covered by insurance (unlikely) or at least try to make it tax deductible by declaring it a medical procedure. The doctor wis there to assess if it is a medical or cosmetic surgery.

Can someone give me any tips what to do in such a consultation to emphasize my need to FFS as a medical procedure? Basically I will have to "not pass" based on my face, mostly. I already decided to get my hair into a ponytail and use a hairband to fix my bangs into the rest of the hair, so the face is exposed, including the hairline. What else could I try? Not sure it makes sense to do something with clothes or Makeup...

Thanks
Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: AnonyMs on October 24, 2017, 06:54:30 AM
Go doctor shopping until you find one?
Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: anjaq on October 24, 2017, 07:48:02 AM
I can try that - but officially it has to be that doctor as she is responsible for the evaluation in this district. I can try finding someone else and claim to the tax collectors that I did not know it or that I just moved, maybe, but its less likely to be accepted, even less likely is. that they could accept any non government doctors letters of support.

I should not complain about this, but at this point I have a hard time convincing people that I need a FFS - most people - cis and trans - would tell me that I dont need it.
Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: reborn on October 24, 2017, 09:43:51 AM
Facial dysphoria has nothing to do with your ability to pass. You have to convince your doctor
that you see a man in your hairline, in your nose, in your forehead and so on.
Tell her that you have seen surgery computer simulations and that you can only accept your face that way. Dysphoria and medical need of surgery has nothing to do with what you look like.




















Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: AnonyMs on October 24, 2017, 09:50:31 AM
Get a psych to back you up on it.
Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: Complete on October 24, 2017, 12:33:30 PM
Or....you could just pay for it yourself.
Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: Angela Drakken on October 24, 2017, 01:33:57 PM
Quote from: Complete on October 24, 2017, 12:33:30 PM
Or....you could just pay for it yourself.
Easier said than done for say probably 90% of transgendered women.
Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: Complete on October 24, 2017, 02:33:48 PM
Quote from: Angela Drakken on October 24, 2017, 01:33:57 PM
Easier said than done for say probably 90% of transgendered women.

Where does it say this is easy?
Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: anjaq on October 24, 2017, 04:35:39 PM
I can pay myself, but I would rather keep some of my financial reserves if possible. I dont feel it is justified to pay a luxury tax for cosmetic surgery when the surgery is more a medical issue. I would not want this surgery now if I had not been born "trans", which is a medical condition.
Besides - I know people buy Porsche sports cars and get a tax refund for that because they declare it as being needed for their company, so I dont think it is fair that I have to pay full taxes for a surgery that is for sure much less of a luxury than a Porsche
Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: Complete on October 24, 2017, 06:19:54 PM
That is your opinion to which you are surely entitled. All you have to to do is conform to existing laws rules & regs.
Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: elkie-t on October 24, 2017, 09:37:14 PM
Take a feminization app photo with you and show it to the doc. And try to explain how you see your old self without those critical enhancements...


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Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: Complete on October 24, 2017, 09:59:40 PM
So l am 70 years old, and l would feel really great,  (not really, l already feel great),  but just saying. ...I want to look 20 or 30 years younger. I'd rather spend other people's money than my own, so can (should) l get a face lift too, so l can feel better about myself? Maybe do the app thing and insist l really really need it so my insurance will pay for it with your money? Wow! What a great idea! Hmmm..???
Not being facieous here, just  examining the logic. Kinda like the doctor you want to (kinda) fool into writing you a letter.
Oh, and BTW, aging is a medical condition.
Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: AlexisRene on October 25, 2017, 12:23:33 AM
Quote from: Complete on October 24, 2017, 09:59:40 PM
So l am 70 years old, and l would feel really great,  (not really, l already feel great),  but just saying. ...I want to look 20 or 30 years younger. I'd rather spend other people's money than my own, so can (should) l get a face lift too, so l can feel better about myself? Maybe do the app thing and insist l really really need it so my insurance will pay for it with your money? Wow! What a great idea! Hmmm..???
Not being facieous here, just  examining the logic. Kinda like the doctor you want to (kinda) fool into writing you a letter.
Oh, and BTW, aging is a medical condition.

Who are you to judge? Did you even read the original post?

A. She said it was UNLIKELY insurance would cover it. In other words, it is not the primary objective.
B. However, would like to write it off as a tax deduction after paying for it with her own money.

Are you really this judgmental over another persons tax deduction that may or may not live in the country you are from?
Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: anjaq on October 25, 2017, 02:47:48 AM
@elkie-t - I will bring a VFFS simulation by Alexandra. But the critical part is to somehow show that this is really needed and not just to make me feel a bit better.

@Complete - First of all, ageing is a condition that affects everyone, while being born trans is something that affects very few. To be a bit over the top, I could also say why should a person who cannot walk properly get a prothesis or walking aids - she can as well just hobble her way to the next store to get food. I know, most likely you are from the USA or some other brutal country that basically puts everyone in charge of their own well-being and does provide little in terms of social security and healthcare. But consider two things for a moment: I pay roughly 50% of my income in taxes and social insurance. I pay about 800 EU a month in health insurance. All of this is mandatory and I cannot just say I keep that money for FFS. If I would pay a tax rate that is similar to the one in the US, I probably would be able to pay for FFS just from the money I would save from the taxes within a few years.

I think it is legitimate that in such a situation, at least a tax cut for the expenses of a surgery that has a medical background (again, if I was born cis, I would not need such a surgery) would be fair. I am not asking for anyone to give me tax cuts for getting Botox or Lip fillers or a facelift, but for a surgery that removes what testosterone did to my face in puberty. It may not be as severe as with some people who basically have no chance to "pass" without FFS, but it still is the same reason.
Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: anjaq on October 29, 2017, 06:17:31 AM
Update - the evalutation went well. Luckily the doctor there was a woman and able to use a bit of empathy and accepting my view and need. She accepted that I would not spent 30000 EU and take a couple of risks on something that I would not really feel the strong need to do and that I would suffer without doing it. She said that while she sees little things that would prompt her to call me male, she read the docutments I gave her about what FFS is and why it is done and mostly accepted my view of things. Very much unlike a doctor I went the day before for a different issue and to which I mentioned the FFS and he was basically totally opposed to it, telling me I should seek psychotherapy instead because HE does not see anything masculine about my face and thus I should not worry. Why do me always thing they are the center of the world?
Anyways - I am waiting for the final result now. But it looks positive that at least part of the FFS will be tax deductible - they may however cut out one or two procedures, particularly I suspect hair transplants and maybe rhinoplasty will be questioned - but we have to see.
Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: elkie-t on October 29, 2017, 09:05:15 AM
God is not without some mercy, a girl is not without occasional luck.


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Title: Re: Facial evaluation for insurance/tax deduction - how to "not pass"?
Post by: Justarandomname on November 06, 2017, 02:45:43 AM
Quote from: Complete on October 24, 2017, 09:59:40 PM
So l am 70 years old, and l would feel really great,  (not really, l already feel great),  but just saying. ...I want to look 20 or 30 years younger. I'd rather spend other people's money than my own, so can (should) l get a face lift too, so l can feel better about myself? Maybe do the app thing and insist l really really need it so my insurance will pay for it with your money? Wow! What a great idea! Hmmm..???
Not being facieous here, just  examining the logic. Kinda like the doctor you want to (kinda) fool into writing you a letter.
Oh, and BTW, aging is a medical condition.

I am not sure why are being so negative and confrontational but it seems you are not very familiar with WPATH standards.

Below is a quote from WPATH regarding medical necessity for transwomen.
http://www.wpath.org/site_page.cfm?pk_association_webpage_menu=1352&pk_association_webpage=3947 (http://www.wpath.org/site_page.cfm?pk_association_webpage_menu=1352&pk_association_webpage=3947)

Quote"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."