Self-Organizing Man

Why Diagnosis is a Good Thing

March 23, 2005 – 9:27 am

These days it is fashionable for transgender activists to declaim against the medical system and declare that all transsexuals should receive medical access on demand.

Yes.  Anyone who wants hormones or surgeries should have access to them.  End of discussion.

But if I want my insurance company to pay for these needs, I need a diagnosis. 

In the world of insurance companies:

diagnosis = icd9 code=covered benefit=patient gets what they need

Transgender activists screaming they don’t need a medical diagnosis are correct.  They don’t need a diagnosis since they are not seeking medical services.

Transsexuals are.  For transsexuals a diagnosis is absolutely necessary for insurance reimbursment.  With a diagnosis many, many more transsexuals could access hormones and surgeries via insurance coverage.

Without a diagnosis, transsexuals need to work five jobs to be able to pay for services they need.  Sometimes their wages are so low they never receive these services at all.

Is the system flawed? Check.
Is changing genders wrong? No.
Are insurance companies gatekeepers?  Yes.
Are are all businesses abot making money? Last time I checked.
Is this cool?  No.  It isn’t cool to make money off people’s health.

But that is the REALITY in America.  And I am ONLY interested in REALITY.

And the REALITY is, transsexualism is very, very, very, very expensive.

For me here are some costs had I paid out of pocket:

Therapy to receive diagnosis: $1,000
Doctor visits to obtain hormones: $250/visit
Bloodwork: $200-$750
Hormones (I use androgel) for six months: $1300
Top Surgery: $9700
Revisions: $1500
Bottom surgery (includes visits to doctor, tests, and surgeries): $25,000

(Any transgender activists out there with $40,000 for some transsexual in need?  Didn’t think so.)

But with healthcare coverage and a diagnosis, my total out of pocket expenses were:

doctor visits, blood work: free
hormones (androgel) six months: $28
top surgery: $7700
revisions and other visits: free
bottom surgery: $100

Yes, the therapy I endured was gross. The therapist who rendered the second opinion disgusted me.

But the diagnosis and healthcare coverage saved me about $30,000 (and that doesn’t include ongoing doctor visits, blood work and hormones).   I was able to have surgeries in my town, not fly off to some destination surgery spot for the priviledge of recovering in a hotel room nowhere near my primary care physician.

The whole process is a game, I know.  One I want all transsexuals to win.  So:

Remove all transsexual exclusions from all healthcare plans across the country.
Reduce the therapeutic requirements for a diagnosis of transsexualism to the barest minimum needed by insurance companies to assuage their fears of lawsuits.

Thoughts?