HHS lifts the Medicare ban on gender-confirming surgery

Just in time for LGBT Pride Month: The Department of Health and Human Services has lifted the national policy barring Medicare from paying for gender-confirming surgery. Decisions will still be left up to regional administrators, but claims will be subject to individualized review and will no longer be automatically rejected for gender-related procedures, just like any other medical procedure. The blanket exclusion will be fully lifted by June 30.

[The ACLU, the National Center for Lesbian Rights, and Gay and Lesbian Advocates and Defenders] brought the challenge to Medicare’s trans-exclusive policy on behalf of transgender woman and Army veteran Denee Mallon. “This decision means so much to me and many other transgender people,” the 74-year-old Mallon said in a statement today. “I am relieved to know that my doctor and I can now address my medical needs, just as other patients and doctors do.”

The change puts national Medicare policy in line with laws in California, Colorado, Oregon, Vermont, and the District of Columbia requiring that private insurance providers provide coverage for medically necessary gender transition-related treatment, including surgery.

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13 Responses

  1. Donna L
    Donna L June 5, 2014 at 4:47 pm |

    I wonder how many people know that the ban wasn’t always there: it went into effect about 30 years ago, primarily thanks to the efforts of the completely loathsome Janice Raymond.

    1. Sharon M
      Sharon M June 5, 2014 at 8:47 pm |

      Ok I just Googled her and currently am speechless. Another example of how you can be liberal and still be a dangerous bigot.

      1. bookshopcat
        bookshopcat June 5, 2014 at 10:00 pm |

        [Content note: gross TERF behaviour]

        She’s not a liberal at all- ‘violent fundamentalist’ is more like it, and actually, now that I think of it, I can’t remember ever encountering a TERF who didn’t object loudly to being called a liberal. They also have no problem collaborating with right-wing conservatives, open homophobes and proud misogynists who are attacking trans women and girls, so there’s that too. I mean, basically they’ll throw anyone under the bus if they think it’ll help them. (Not that this eat-your-own approach necessarily has anything to do with liberalism or conservativism, but it’s definitely something to note.)

        Interestingly, I heard a while ago that JRay only started hating on trans women after Sandy Stone turned her down- haven’t confirmed this independently yet but it’s the sort of misogynist bullshit that I see from TERFs on a weekly basis, so I won’t be surprised when it turns out to be true.

        1. Sharon M
          Sharon M June 5, 2014 at 11:08 pm |

          That makes more sense. I don’t know why I assume some of the stuff I do. I remember the second wave feminists joining hands with the religious right in the eighties very well and being disgusted. That is very interesting about Sandy Stone.

        2. Donna L
          Donna L June 6, 2014 at 12:15 am |

          Interestingly, I heard a while ago that JRay only started hating on trans women after Sandy Stone turned her down-

          This doesn’t ring true to me at all, and bears no resemblance to any story I’ve ever heard. It sounds way too suspiciously like the trivializing “all notorious homophobes are really self-hating gay people” notion. As if Raymond’s hatred can be dismissed as something that was just personal. Besides, from everything I’ve ever read, Raymond was always a disgustingly transphobic POS, and this story doesn’t make much sense in the context of the timeline of what happened; see http://en.wikipedia.org/wiki/Sandy_Stone_%28artist%29

        3. Sharon M
          Sharon M June 6, 2014 at 7:17 am |

          Gah. DonnaL apologizes you’re right: it sounds too much like the old self hating homophobe.
          *reads the link* smh.

  2. trans_commie
    trans_commie June 5, 2014 at 5:13 pm |

    [CN: dysphoria]

    This is wonderful news for me. I have been feeling increasingly dysphoric due to not having GRS, and the thought of not being able to afford it is very upsetting to me. I probably won’t ever have enough money for GRS with the way my life is going these days, but at least it gives me some hope.

    1. Sharon M
      Sharon M June 5, 2014 at 8:49 pm |

      Hugs if you want them trans_commie.

  3. Donna L
    Donna L June 5, 2014 at 8:58 pm |

    you can be liberal and still be a dangerous bigot.

    Janice Raymond would be horrified if you called her a liberal. She is, and always has been, a proud self-styled radical feminist, in the most rigid, pitiless, and totalitarian sense of that word conceivably possible.

    1. Sharon M
      Sharon M June 5, 2014 at 10:09 pm |

      “Pitiless” is an excellent way to describe rad-fems.
      I was bored, poked around some and found this post about her: after flying all the way out there, Raymond was banned from speaking on a panel in Norway. Good.

      http://www.dyssonance.com/raymond-responds/

  4. PrettyAmiable
    PrettyAmiable June 6, 2014 at 1:05 pm |

    This is a little besides the point, so please let me know if I should take this to spillover, but this is the first time I heard it referred to as gender confirmation surgery (as opposed to reassignment) – I LOVE that terminology. Does anyone know if it’s regional or catching? Confirmation sounds more in line with what the procedure is doing.

    1. Li
      Li June 9, 2014 at 9:36 pm |

      It’s used in Australia, so it’s not just regional. For the record my community tends to use “transition-related surgeries” or for specificity “top/bottom surgery” rather than either of the confirmation/reassignment terms. Especially as a catch-all term, since the former covers things like facial surgeries, mastectomies and other procedures. Obviously the later are pretty informal though.

  5. Anon21
    Anon21 June 9, 2014 at 6:13 pm |

    Does this change also affect Medicaid? I would imagine the need would even be more acute there, since beneficiaries are by definition low income, and thus presumably unlikely to be able to afford noncovered procedures.

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