My close friend Shane recently began the transition process and described it to me as “overwhelming” and “difficult to achieve.” His parents, although entirely supportive of his transgender identity, could not help much financially with the transition. Without a job — and his parents unable to contribute — Shane wondered how he would pay for monthly prescriptions of hormones, blood work to monitor his health, and eventually surgery.
When Shane decided he wanted to move forward in the transition process, we would brainstorm for hours possible fundraising efforts to raise money for the procedures. Shane did not anticipate such a steep financial hill and struggled to find resources to help him.
“The resources for transgender medical care are less known because of the lack of education and representation of transgender people,” said Shane.
In its current state, adequate transgender healthcare is something only the wealthy can obtain and with 15 percent of transgender people living in poverty , many are left without access to necessary healthcare services.
In late May, the Obama administration ended a 33-year ban on Medicare coverageof gender reassignment surgery, but this only directly affects people 65 because this policy change does not include Medicaid.
Many private companies do, however refer to Medicare as a guide for what should be regarded as necessary covered treatment. According to the Human Rights Campaign, no Fortune 500 companies offered transgender benefits in 2004. By 2012, 28 percent of Fortune 500 companies had transgender-inclusive health insurance benefits.
Nineteen percent of transgender or gender non-conforming persons report being refused treatment by a doctor or other provider because of their gender identity.
The Affordable Care Act includes restrictions against discrimination “based on gender identity or failure to conform to stereotypical notions of masculinity or femininity.” However, this does not secure transgender persons necessary services because it is left up to the states to decide what does and does not qualify as discrimination.
According to the National Transgender Discrimination Survey, 60 percent of respondents who reported having been refused treatment by a doctor or healthcare provider due to anti-transgender bias also reported a lifetime suicide attempt.
No one should ever be denied necessary healthcare services, but most health insurance policies still specifically exclude transgender-related care and services. Procedures such as hormone therapy, transition-related surgery, and/or gender-related mental health services will not be covered. Even if insurance companies do not explicitly exclude transgender-related care or services, patients can still be denied on the basis that the procedures are considered “cosmetic or experimental.”
Discrimination against a patient’s identity, lack of knowledge of necessary health services, and exclusivity from coverage should not be obstacles that exist in today’s healthcare system. Transgender individuals’ healthcare needs are often dismissed, invalidated, and ignored by those who should be helping. The healthcare crisis faced by transgender individuals needs to become a national priority.
For resources in transgender healthcare, visit Trans Health.