State tries to rule out aid for sex-change surgery

[LostInTime]

Article

In a pair of rulings issued last month, a state appeals board ordered Medicaid to pay for two people to travel out of state to undergo sex-change operations. The state estimates the procedures, also known as sex-reassignment surgery, will cost $50,000 to $60,000 each.

"This is very controversial and in need of clarity," said state Medicaid director Doug Porter. "We've decided to make it real crystal clear that it's not a covered service."

But Porter said the state plans to continue covering other services — such as hormone treatment and psychotherapy — for people diagnosed with gender-identity disorders. State officials argue that those treatments are just as effective as surgery but are less risky and far less expensive.

[Sarah Louise]

I must admit, I am not sure why the "state" should pay for our surgery.

Sarah L.

[LostInTime]

Because medical intervention is the only known treatment for transsexuality and that those who have paid into this system deserve to get something out of it.

[Sarah Louise]

It is a difficult and complicated subject.  I have never looked to the state (government) for anything.  I did "pay" to the government when I was drafted and had to serve in the military during the VietNam war, other than that it is just the taxes I pay each year.

I know I grew up with different views of the governments responsibilities, but I would not expect the government to pay for heart surgery, so I guess I don't expect them to pay for my SRS either.

I don't have firm thoughts on this, but as long as we don't have government provided health care, I am not really sure of their responsibility.  Now if I lived in Canada or England my thoughts would be different.

[Rana]

I can remember getting into trouble regarding a post on this subject way back when    .  In Australia you can get medical support for the treatment of an illness.   Sexual reassignment is not considered an illness as such but "cosmetic" and therefore considered not worthy of medical support.  (considered by beaureaucrats & politicians of course)

However, medical support is available for abortions - so that seems to say that pregnancy is an "illness".

Goes to show that Government funded health care is at the mercy of pressure groups & politics - and that the rights/benefits of individuals and the ideas of sense and reason are often not listened to

Rana

[taylor]

From my understanding in the US it is not covered in many cases because it is considered "cosmetic" and I would love to have each male that voted against the state covering this "need" have their penis's removed and then ask them just how "cosmetic" it feels to want it reconstructed!

Peace,

Taylor

[Sarah Louise]

I would love it if Insurance companies would change their policies and start covering TS issues and surgery.

I would have to agree, needing surgery is not just "cosmetic" it is important to our physical and mental health.

Sarah L.

[LynnER]

I wonder if insurance would cover it just because it would cost less than treatment and medication for severe depression for the rest of our lives.................  you think theyd think of that......... but then again as my brother says   "Common sence is anything but"

[LostInTime]

Do not forget that with the exclusion policies even meds for depression can be denied if the treatment is linked to GID.  Once my therapist said she would put GID on my paperwork I have not gone back to see her one on one, only the group thing and that is rare.

[taylor]

Lost,

Please tell me that she does not consider herself a specialist in Trans issues....pleeeaase tell me that!


Peace,

Taylor

[LostInTime]

She does and she is and she has a very valid point for doing what she does:  it frees her of any legal disputes.  A healthcare provider who has paid for GID visits under the guise of something else, when their policy forbids it, could go after her and that would shut down her business.  I know other therapists do not worry about such things but I cannot fault her for staying above board on any interaction.  One may question the action but never her character nor integrity.

I have even recommended her to other T people that I know and one has recently told me that my doing so saved her life.

Her group sessions are $25 for a couple of hours and some lunch.  Good price and one can normally get a bit off of their chest there.  I stopped going because I do not identify with the majority of the other T women who are there.  Many are late transitioners and have worries about spouses, children, body hair, pensions, etc.  I just have the fight with the state on the name change issue and my inability to afford surgery.  She usually holds seperate sessions for f2m and young adult clients.

I hate that I cannot afford to see her one on one but that will not stop me from saying that she is a fine therapist and a terrific person.

[Melissa]

If you pay out of pocket for a therapist like that, then you shouldn't need to worry.

Melissa

[LostInTime]

True, but the point is that if I filed anything from her with my insurance company then I would lose what little coverage I have now since GID is not covered.  I barely have enough cash to eat each month, let alone pay $110+ for an hour session without getting anything back from the insurance company.

[Melissa]

My old therapist charged $135/Hr.  I found a new (and better) on at only $60/Hr since I was paying out of pocket anyways.

Melissa

[taylor]

Lost,

It is not my place to judge her, and if you are fine with what she is doing and it works for you then that is cool.  I do know many reputibable therapists that do not write down the majority of what a client shares with them for several reasons and court is one of them, and insurance ignorance is another. It does not make them a bad therapist, just sensative to these particular issues.  So I guess it is all subjective anyway.

It is all in the coding, and things can be coded various ways to assist a patient in getting their needs met, verses the insurance companies rejecting a persons real needs. This is not just with GID issues but many issues.  I just find it interesting that she does not practice in a manner that I have seen so many top quality doctors that are familuar with this issues practice safely and effectively in favor of the clients needs.  But please don't feel as if I am judging I am just suprised.

Peace,

Taylor


Posted at: August 09, 2006, 11:46:24 PMMelissa,

Can I ask out of pure curiosity what your therapists degree levels are? I am not judging or even thinking to judge, am just wondering what the going rates are for different places in the country with various levels of education etc. Appreciate it!

Peace,

Taylor