Quote from: iKate on May 13, 2015, 11:44:12 AM
And again, we are not medical professionals. We cannot and should not decide what is necessary, even for ourselves. We are talking about permanent changes that can even kill us if not done properly. It can't just be done on a whim, or because we feel that we must have it. Even so, I don't think we should be paying for people's whims and desires. The purpose of insurance is to make you whole. The guy who had his junk burned off in an accident has very obviously suffered a loss.  But someone claiming they are really a woman when they were born with a penis and masculine looking face isn't very obvious. That is why we are evaluated by psychologists, psychiatrists and therapists. This is why the WPATH SOC exists. This is why Harry Benjamin's work is so critical.

Put another way - I have diabetes. I test my blood using a meter and test strips which cost $1 apiece. I use about 400 over a 3 month period. I can't just go to my insurance company and say "here, pay for this" and hand them the receipt for test strips. I had to have my physician prescribe it, and justify it as being medically necessary, namely that I am undergoing treatment and lifestyle management for type 2 diabetes. Once they determine that there is a loss and a means to monitor my condition which is covered, they cover it (without a copay even.)

Your physician does tests, I assume, to determine whether diabetes test strips will make you healthier.

What test can a diagnostician give someone to determine what gender they are?

That's my problem with the Harry Benjamin standards (with all due respect to all the advances he made to transgender care). They assume that someone else is more competent than I am to decide my gender.

After repeatedly having multiple so-called experts pooh-pooh the possibility of my being transgender because I didn't fit their diagnostic narrative, I respectfully claim that this is a dangerous and harmful notion.

I agree with you that medical consultations are 100% needed to decide how safely to administer hormones and correct our bodily anomalies surgically.

But do you really want a system where a professional can tell you that your dysphoria isn't bad enough for treatment that you know you need?

Quote from: suzifrommd on May 13, 2015, 12:00:07 PM
Your physician does tests, I assume, to determine whether diabetes test strips will make you healthier.

What test can a diagnostician give someone to determine what gender they are?

There are well established guidelines in the WPATH SOC. That is the test to use. It is also not set in stone. It is periodically revised.

Look at how far we've come. We used to only treat adults who were ready to kill themselves. Today we treat kids who tell mommy they want to wear a dress.

QuoteThat's my problem with the Harry Benjamin standards (with all due respect to all the advances he made to transgender care). They assume that someone else is more competent than I am to decide my gender.

After repeatedly having multiple so-called experts pooh-pooh the possibility of my being transgender because I didn't fit their diagnostic narrative, I respectfully claim that this is a dangerous and harmful notion.

I agree with you that medical consultations are 100% needed to decide how safely to administer hormones and correct our bodily anomalies surgically.

But do you really want a system where a professional can tell you that your dysphoria isn't bad enough for treatment that you know you need?

You are saying essentially that we cannot determine whether someone needs treatment for a psychiatric or mental condition, because we can't draw blood and determine "fer sure."

I disagree. I think that with enough evaluation by mental health professionals we can determine to a good degree.

Is it 100% accurate? No, but nothing really is.

Quotesomeone else is more competent than I am to decide my gender.

But as some people have found out, they needed a professional to figure out that they had gender dysphoria, and that it is real.

In any case, we are talking about paying for it from public or insurance company funds, and I cannot simply support the basis for what is essentially cosmetic surgery (FFS) without it being an actual need.

Remember, there are tons of trans women who are totally happy with themselves, some get GRS plus hormones and nothing else. Some get hormones and nothing else.  Some get absolutely nothing and simply live as women.

If we changed it to a system where people could simply ask for coverage for FFS and have it paid for no questions asked, then that is no longer insurance. It's not even welfare.

Quote from: iKate on May 13, 2015, 08:43:27 AM

Nearly all cis women have vaginas and none of them have penises.
Not all cis women have fully feminine faces.

...
That said, FFS should be covered on a case-by-case basis. BTW, so should GRS/SRS/GCS. Case-by-case meaning that it is needed to make you whole, and not just a desire or want because you want to enhance yourself.

You are aware, I assume, that the differences in the forms of external male and female genitalia, unlike the reproductive organs, are essentially cosmetic, driven by hormones? 

I agree with your last paragraph.  Determinations should always be case by case.  I also think you framed several concepts precisely right, particularly that treatment is to alleviate GD and to make you whole. 

I REALLY dislike the arguments around what makes or does not make one a woman.  If the womanhood is in question, go get therapy.  Otherwise, this is about GD.

Quote from: iKate on May 13, 2015, 08:43:27 AM...Insurance coverage's purpose is to make you whole, and recover from a loss. ...

Not to quibble, but I'll quibble. 

Insurance is a risk transfer contract.  Whether or to what degree it makes you whole or covers loss is in the details.  Having insurance can work against your interests in some instances, too. 

Quote from: LeaP on May 13, 2015, 02:46:15 PM
You are aware, I assume, that the differences in the forms of external male and female genitalia, unlike the reproductive organs, are essentially cosmetic, driven by hormones? 

I agree with your last paragraph.  Determinations should always be case by case.

In a way yes but I've never heard of any cis woman with a penis.

Quote from: iKate on May 13, 2015, 02:47:06 PM
In a way yes but I've never heard of any cis woman with a penis.

That's a tautology. If she has a penis she's either intersex or trans.

Quote from: Dee Marshall on May 13, 2015, 02:51:35 PM
That's a tautology. If she has a penis she's either intersex or trans.

Precisely.

If she has a natal vagina she's a cis woman.