The CDC Catches Up

If you are transitioning from male to female, you may have discovered something I've learned:  The world of medicine was created by and for males.

If you didn't already know that, you will understand it when you climb into the "stirrups" for your first vaginal examination--if you hadn't already learned it from getting a mammogram.  That machine they use is almost as tortuous as the stirrups, and both devices were invented by, ahem, men!

Still, you need to do both.  OK, I'll admit:  I'm overdue for a mammogram.  But at least I'm procrastinating because of the unpleasantness of the experience, not because I can't pay for it. Or, more precisely, I don't have to pay for it.  That makes me one of the lucky ones.  Lots of other trans women--both pre- and post-op--don't have insurance policies that cover their mammograms or access to any medical provider who does them for free.  

One reason for that lack is the Centers for Disease Control and Prevention (commonly known as the CDC) provided free screenings only to those designated as females at birth.  Even those of us who have had surgery weren't provided with examinations from the CDC. And other health care providers, insurers and related organizations take their cues from the CDC.

However, last week, the CDC changed its policy after a trans woman in Colorado sued.  

One would think it shouldn't have come to that.  After all, one would expect that the folks at the CDC would be conversant in current research and literature.  According to decades' worth of investigation and practice, trans women who are taking estrogen are at a higher risk of breast cancer than they were before starting treatments, though their risk is not as great as that of "born" women.  And our risk of breast cancer increases after our surgeries.

 

Appealing For Care

Transgender health care isn't simply a matter of finding "sensitive" providers, as important as that is.  Rather, it is a matter of having our needs met.  In that sense, health care for us is no different from what it is for everyone else.  However, getting that care can be, to put it charitably, an adventure for some trans people.

Such was the case for Beth Scott of New Jersey.  She has just successfully appealed her health insurance company's denial of coverage for a mammogram she had nearly two years ago.  An official of the company, Aetna, apologized to Ms. Scott, saying, "[W]e have determined that the eligibility of the claim and plan benefits were misinterpreted." 

So what, exactly, was "misinterpreted"?  Well, Ms. Scott's plan, like most others, denies coverage for transgender care, including surgeries.  Apparently, someone thought that "transgender care" included Ms. Scott's mammogram, which she underwent under her doctor's recommendation.

I also have undergone mammograms my doctor recommended.  Fortunately for me, mine are paid for.  However, before I had my surgery--and before I had my current plan--I went one of the free mobile clinics that offers them.  Taking estrogen puts trans women at a greater risk for breast cancer, just as it does for cis women.  Although I wasn't, and have never been, what most people would call "rich," I gave a donation to the organization that provides the free mammograms.  (I still donate to them.)  In that clinic, I saw some destitute women--trans as well as cis--as well as some who looked as if they could have gone elsewhere.  I figure that I'm still better off than they are--or Ms. Scott is.