I’m fairly confident that if we gave the key players of the insurance industry surprise overnight sex reassignment surgery, a sizable majority of them would deem changing back to match their internal gender “medically necessary.”
What am I talking about? Well, I’m glad you asked. You see, in order to get sex reassignment surgery, you need a letter from a psychiatrist explaining that it is necessary to your mental health and emotional well-being that your body be altered to match your internal gender. That seems perfectly reasonable, right? I mean, sure it means you have to jump through a lot of hoops, but at least it means the medical field recognizes that what you’re doing is medically necessary.
Unless, of course, you include the insurance industry.
You see, according to most insurance companies, sex reassignment surgery is “elective” and “not medically necessary.”
See, I’m confused. Because I thought in order to get sex reassignment surgery in the first place, you had to prove that it was medically necessary?
In all seriousness, I see two realistic alternatives here to resolve the contradiction:
1) The medical field continues to consider this a medical procedure necessary to the patients’ well-being, in which case it should be deemed medically necessary and covered by insurance.
2) The insurance industry continues to consider this an elective procedure, meaning that if the patient can afford it they can have it performed at-will, without jumping through any hoops, merely by giving their informed consent. (The drawback to this is that it would not help low-income transpeople like myself, but at least it wouldn’t be so transparently hypocritical.)
Really, actually changing both of these elements (covering it with insurance and making it require only informed consent) makes a lot more sense to me than the way it is right now. But what do I know? I’m not privy to the advanced medical knowledge that explains why sex reassignment surgery is both medically necessary and not medically necessary at the same time.
In all seriousness, given all the available psychological research about transpeople, it’s pretty clear that Option #1 (or my super secret Option #3 that I didn’t even number) is the way to go. It has been made clear that transitioning is vital to the mental health and emotional well-being of most MTF and FTM transpeople. That’s what I call “medically necessary.”