No Reason to Exclude Transgender Medical Care

Why should taxpayers and insurance policy holders pay for ANY Transgender health care services?

What this article does NOT mention is who is going to pay the healthcare costs engendered by sex change operations? Or by hormones?

You are basically taking a physically healthy person and either mutilating them or giving them hormones that are known to cause infertility, cancer, stroke, etc. You are creating permanent medical patients. Google "detransition" and see what you find. The stories presented to us through the media's pro-trans, rose coloured glasses paint a prettier picture than the reality.

This article states again and again that all the best medical professionals agree that medical and surgical treatment is the best option for people who identify as trans. This is not true at all, there is considerable debate on the subject and very little long term study. The rationalization is always that trans people will commit suicide if not given the surgery or hormones they desire. However, the longest term study that exists - which studied MtoF trans people in Sweden for 20 years, suggests that the rate of suicide stays high even after transition. So maybe it's not the solution everyone thinks it is.

All people with gender identity issues are not necessarily best served by surgery or hormones. Some people just need to learn to accept themselves the way they are. And if society accepted gender nonconformity, maybe people would feel more comfortable in their own skin. Let's go back to "first, do no harm." Otherwise, what's next? Liposuction for anorexics?

Someone's going to have to explain to me in a clear manner how this constitutes "medically necessary" care, because right now based on what's been presented in this article, it seems like an abuse of the term.

Have a problem? Check your genes. XX and you are female. XY and you are male. There are various anomalies, but get used to your biological self. People make up all kinds of stories about themselves. Perhaps insurance should pay for psychotherapy, but stop telling yourself a weird and expensive story that causes you to want pills and shots and surgery.

Medical insurance generally does not cover breast implants. Neither does it cover penile implants, nor reversal of sterilization, nor vasectomies, nor wigs, nor infertility treatments, nor clothes befitting your most recent surgery. We are accustomed to paying for such things ourselves, and rightfully so.

Really really really wanting a thing is different from having it be medically necessary. If you desire gender reassignment surgery, by all means buy it, but do not pass the costs of doing so onto us heteronormatives.

We work in a very poor neighborhood and it does not help if medicaid does not support gender confirmation surgical procedures. Perhaps state governments should change this policy before making insurance companies to do so.

"transgender-related care is cost-effective in the long run because it generally reduces the likelihood of depression, anxiety and other conditions that take a toll on well-being and productivity"

The only issue I have with this statement, is that I have a close transgender relative who, before she transitioned, wasn't depressed or anxious (or, at least, wasn't on medication), had goals, and was achieving them. After transitioning, she's on medication for depression and anxiety and is unable to hold a job.

This story is all very fine but reality enters the door and turns it all into a nightmare.

Previously a he, Dr. Richard Raskind, top-ranked amateur tennis player became a transgender.

In her book, “No Way Renée: The Second Half of My Notorious Life,” Dr. Richards lists so many regrets…“Better to be an intact man functioning with 100 percent capacity for everything than to be a transsexual woman who is an imperfect woman.”

This is not only a deviant life choice but a deadly one.

Johns Hopkins University pioneered transgendered surgery but due to the high rate of suicide (40%) they stopped.

A Netherlands large-scale 2011 study found treated transgenders had much higher than normal death rates due to suicide, drug abuse, AIDS, etc.

Transgenders need psychiatric help and counseling to accept their physical designation as to who they really are

Without this change transgenders live a life of tragedy or of sexual befuddlement forever.

The real tragic story is that most have appalling endings.

If you look at so-called cis people of both genders, you will see a wide range of external features, not all of which are to their bearers' liking. My question would be why trans people would be entitled to appearance-based surgical treatment and hormones, while the rest of us who may not be satisfied with our appearance, particularly with respect to traits more closely associated with the other gender, i.e., unwanted facial and body hair and unwanted breast development among cis men, would continue to be told that these depressing symptoms are something with which we just have to live. Making cis people subsidize cosmetic surgery for trans people would just add insult to injury, in not only depriving the former of the same care, but also depriving them of additional tax/premium savings that could have been used to pay for their own cosmetic treatment.

I've never seen such an extreme example of one group that makes up less than 0.3% (or 0.003) of the US population getting such a disproportionate amount of column space in US newspapers in such a contracted period of time (say, in the last 6-9 months).

Anybody else feel like we're being manipulated?

I believe "gender confirmation" is a better term than "gender reassignment". This surgery is not cosmetic. I agree with Audrey; it is a matter of life and death.

Also, when is the NYT going to have the discriminatory exclusion removed from its policies?

I am a trans woman and I can tell you that what I live with sits far outside anything not-trans people experience with their bodies. I would like to ask that every put their preconceived notions of what "trans people" are aside and instead listen to us talk about our bodies and how we are affected physically by this.
For myself, when my testosterone is in the normal male range I suffer physically. This is not a "mental problem". My body literally rejects itself. I suffer from horrible scalp problems that medicated shampoo does not fix (this is due to higher skin oil production that occurs when you have testosterone that's in the "male range") I suffer from dry skin that lotions do not fix. My relationship to my sex drive while at male levels of T is...not okay, imagine uncontrollable panic and anxiety and depression that is not "mental" but physical. Emotionally I become aloof and detached, unfocused and cold. It's as if between my brain and body there is a disconnect, and all I can feel are unending physical artifacts resulting from a non-stop panic attack and skin and scalp problems that can't be medicated away. Then there's the knowing that you were born with sex parts that are "not the right ones" and NOTHING will ever change that.
HRT (estrogen) was life-changing for me. My physical problems are mostly gone now. Without access to this option I would have taken my own life two years ago. To say this is "elective" or cosmetic is ill-informed on your part. Please reconsider

Why not grab the bull by the horn and use the words sexual reassignment surgery? One small example of how and why the Times excursion into its discussion of transgender issues is so very incomplete or should I say one sided knowing I will engender a lot of blowback. It is the plain truth, the subject is much broader than the Times very narrow presentation. The discussion is delegitimized when it only features one voice, one attitude, one filter. And I do not mean an oppositional point of view, only a wider more honest one. Those of us looking through a wide angle lens see and are interested in the topic beyond the base civil rights issues and pro trans testimonials. And is it not curious that The Editorial Board has taken up the issue and led a crusade as it has not for many more universal issues facing an exponentially larger segment of humanity. I wonder why the issue has grabbed so many column inches in comparison to all the other injustice occurring day in and day out around the globe.

A commendable piece. Transition-related health care is medically necessary, period. It’s even better if this kind of care is available to young people in a supportive, non-judgmental environment, and if it’s free for those who lack insurance, or whose insurance doesn’t cover the care.

That transition-related care is medically necessary is not a “lefty” belief. It’s my professional opinion as an adolescent medicine specialist with more than 30 years of medical experience, and the opinion shared by every prominent medical association in the country.

We fear what we don’t understand, and for many people, that’s the needs of transgender youth. But instead of letting fear exclude people in need from medically necessary care, let’s extend our medicine and our love to all.

It has been said by many that the desire to become transgendered is not a mental illness and we know that it not a physical illness so why would be expect any health insurance to pay for any "treatment "?

The one major thing I think many people are forgetting is that transgender people pay their insurance premiums just like you or I do. So they are entitled to medically necessary care just the same as you are. And you know what, I would much rather have my premiums increase because my insurance (which it already does) covers transgender health because these people can't help it; this is who they are, how they were born, and no more a lifestyle choice than a heterosexual woman's "choice" to be straight or an African-American man's "choice" to be black.

Also, to be brutally honest, I would much rather my insurer take care of transgender people before they help out the obese man who has eaten himself into type II diabetes, and the idiot who puts his loaded handgun into his pants and it blows off his nether regions...those are very real choices, but no one would ever choose to have gender dysphoria.

I, also, am suffering from "depression, anxiety and other conditions that take a toll" on my well-being and productivity. In short, I'm 78 and look old, old old. So old that I can't disguise my age, such that even though I'm running and weight training regularly and never even have a cold, the wrinkles and crinkles and droops and spots are all over the place. So the jobs are all going to younger applicants.

I need lifts and tucks and whatever's going these days to transform my body to that of a young woman. (Well, somewhat young, then.) But Medicare won't pay for it.

It's not reasonable to refuse medical treatment that would allow me to once again be an employed, productive, tax-paying citizen. It's not reasonable that I have to fight every day against self-destructive behavior because I'm forced to live in a body that I don't identify with.

Reassignment surgery is just tip of iceberg. Next comes uterus transplants and sperm and egg made from stem cells so that people can try to reproduce as the other sex.

But there is no right to reproduce as the other sex, and no benefit or need, so we should ban it.

Another problem with government's intrusion into health insurance markets. One can argue the moral, ethical and practical issues of this either way. That is why the conclusion should not be imposed upon us by government. If the health benefits of these treatments are cost-justified, a free insurance market would cover them. If many opposed payment for such treatment, a free market would have plans that excluded such patients from the risk pool. When government takes over, it imposes its will on everyone. Is it any wonder that we are more polarized than ever before. Generally, I am willing to let people be whatever they want to be, as long as I do not have to pay for it. Unfortunately, progressivism is all about taking away freedom and making progressive views mandatory.

I was surprised to read the medical community in the US supports what is described as transgender care. I just wonder about self-interest - we have well-paying specialties involved here. And I wonder about any treatment involving surgery/money/drugs for life. And what about kids? When do we start this? I don't know about this.

As the parent of a transgender child, I can attest to the difficulty of getting appropriate and affordable medical care--and I am a nurse with numerous medical contacts. Finding a therapist was relatively easy, and that treatment was covered under my medical insurance. Nothing else could proceed until my child had the diagnosis of gender dysphoria. Once that diagnosis was confirmed, though, insurance paid for little. There were only two doctors in town who even saw transgender patients, and they had very different treatment regimens (and neither took insurance, as nothing was covered).

The costs for hormone replacements were covered for some medications for both men and women, and some only for women. What worked best for the patient was not a consideration, and costs for the daily medications ran into hundreds of dollars per month.

If you have suffered through a child's depression an suicidal ideation because the gender presented does not match the gender identified with, you, too, would pay any cost, regardless of the unfairness of it. It is time to treat gender dysphoria as the very real disorder it is, and ensure that people suffering from this access treatment that is affordable. I pay plenty for health insurance for my family. I do not need to pay for necessary treatments as though my family were uninsured.

I've never liked my nose, and it's been distressing me. I find it difficult to feel confident, make friends, find romantic partners, and aspire to jobs the make the most of my talents.

Where's my insurance subsidy?

The reason is that it is expensive and elective. Plastic surgery for the left.

Pay for it yourself, not on the (rapidly becoming more expensive) premium dollars of other insureds.

I think people have a right to have this surgery, but as a priority it is far behind saving lives and stuff like repairing broken bones. Or dental care for all. As for "living in a body you don't identify with," there are many budding athletes and actors who feel likewise but are not subsidized. There needs to be more rationality here, including inclusion in health plans and asking people who want transgender procedures to bear part of the cost.

If Transgenders should be given medical financial assistance to reach their physical goals, women who are devastated by the size of their breasts, or men who cannot live with size of their penises should also receive reasonably priced medical care covered by their insurance. Indeed, all plastic treatments for patients who need to make a change should be covered by insurance. To not do so appears to me to be discriminatory.