Last year, an independent Health and Human Services Panel was formed to tackle the complex situation surrounding sex-reassignment surgery and Medicare. Medicare has denied the coverage of gender affirming surgeries based on a 1981 study that suggested such surgeries were risky and potentially dangerous. Trans activists claim that private insurers have also been slow to cover such procedures based on the same, dated guidelines. The panel will soon hand down its ruling reconsidering the guidelines that Medicare now follows. While the ruling will not force Medicare to begin covering SRS, it is expected to heavily influence a future lift of Medicare’s ban.
On December 2, 2013, a 10-page ruling by the HHS Department’s Appeals Board stated that the current reasoning behind the ban is no longer complete. It goes on to say that many studies have shown the potentially life-saving effect that Sex-Reassignment Surgery and Hormone Replacement Therapy can have on individuals that are suffering from severe gender dysphoria. The American Psychological Association (or AMA) has publicly supported covering Sex-Reassignment Surgery and sees it as treatment for gender identity disorder (or GID).
The recent shift in attitude was sparked by a lawsuit filed by the ACLU, Gay & Lesbian Advocates & Defenders, and National Center for Lesbian Rights. The lawsuit was centered around a senior army veteran, Denise Mallon, who was prescribed SRS by her doctors to alleviate her extreme gender dysphoria. Critics have tried to obstruct a change in Medicare’s guidelines before, however, and much confusion regarding transgender people still widely exists in America.
Some states have begun to require private insurers to cover sex-reassignment surgery. Psych Central mentions the impacts of gender dysphoria on an individual’s functioning, saying that the occurrence can cause a severe hindrance to a person’s social or occupational well-being.
Transgender headlines have reached national news in the last few years due to prominent figures coming out as trans or speaking up for trans rights. Janet Mock, a transwoman of color and author of Redefining Realness, was recently involved in a controversy involving the now-cancelled Piers Morgan show in which Morgan employed what was deemed to be offensive and entitled language when interviewing Mock. Laverne Cox, star of Netflix series Orange is the New Black, has received a lot of attention for her articulate speeches that direct attention toward the struggles faced by transwomen and her involvement with the Cece McDonald case. Chelsea Manning also came out as a transwoman after being convicted in July of 2013 for violations against the United States when she, then going by the name Bradley Manning, released a host of classified military documents.
Transfolk are at a much higher risk than others of homelessness, violence, sexual assault, harassment, poverty, and housing or employment discrimination. While a large portion of the population is transgender, meaning they experience some sort of discontent with their gender and the roles normally associated with their gender, a smaller percentage undergo sex-reassignment surgery. For those who do choose HRT and SRS, treatments may be life saving as transfolk commit suicide at a rate much higher than the average American. With the reevaluation of long-outdated Medicare guidelines, transfolk may have better access to the treatment and healthcare they require to lift their quality of life.
By: James Ryder