05 January 2013

We Won't Come For What They've Built In The Beaver State

Once again, I've Kelli Busey to thank for the latest news about what's available to trans people.

She reports that in order to comply with the state's non-discrimination laws, health-care insurers cannot have riders that categorically exclude all transgender patients.  Also, the state's mandate for coverage of mental health services must also apply to transgender patients.  Furthermore, the designation of a policyholder as male or female can no longer have any bearing on the types of treatments that are covered.  So, for example, a female-to-male who is documented as male cannot be denied coverage for ovarian cancer screening.

So far, it all sounds really good, right?  Then this part will sound, at first, even better:  Insurers cannot deny coverage of treatments for transgender patients if those same treatments are covered for cisgender patients.  Therefore, if an insurer pays for a cis woman's breast reduction to lessen her back pain, it also must pay for the same treatment if it's undergone by a female-to-male transgender.  

Think about that for a moment.  It sounds good until you realize that sex reassignment procedures procedures are not done on cisgender people.  To my knowledge, no cis man has ever asked to have his genitals cut open and reconstructed as a vagina, and no cis woman has ever demanded to have an artificial penis constructed (to the extent it can be done) in place of her vagina.  Also, I don't know of any insurer that pays for cis women's breast augmentations; under the new regulations, they wouldn't be required to do so for male-to-female transsexuals.

But all of this leads to an even slipperier slope:  Insurers could still change their policies as to what they will and won't cover for cis people.  So, an insurance company might decide that it will no longer cover breast or penile implants for anyone, cis or trans.  

Somehow I don't expect to see trans people hitching their wagons to mules for cross-country treks to the Beaver State--not yet, anyway.  


Sophie said...

Might be rather better than you're stating. Surgery for genital reconstruction after a traumatic accident, for example, is normally allowed and might well be taken as a precedent for GRS. And whilst insurance companies could alter terms to cis people, the amount of money involved may be small enough so it wouldn't really be worth doing.

Justine Valinotti said...

Sophie, you make very good points. I hadn't thought of the traumatic accident scenario, though I'm sure people have had genital damage from them.

Now you got me to thinking about women who get surgery to repair mutilated genitals. (Marci Bowers, who did my GRS, also does that surgery free of charge.) I'm sure something like that could set a precedent.

Also, your point about altering the terms to cis people makes sense: After all, there are actually very few of us compared to just about any other group of people. And not all of us choose to have surgery, or even hormone therapy.