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Stop Trans* Health-Care discrimination: A Demand to All Major Health Insurance Providers in the United States

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Transgender people are just that—people. We deserve to live our lives with dignity, free from discrimination. In our countries Declaration of Independence it states that: “All men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.--That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, --That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to affect their Safety and Happiness....

Transgender people are not excluded from this document. We all deserve access to needed healthcare including but not limited to Sexual reassignment surgery and Hormone replacement therapy; denial is discrimination.

All health insurance providers should immediately remove restrictions on transgender related health services.

Some transgender people experience dissonance between their subconscious sex -- everyone's internal sense of self as physically male, female, or both -- and their birth sex; those who do not have access to transgender health services can experience clinically significant psychological distress, dysfunction, debilitating depression and, for some people without access to appropriate medical care and treatment, suicide and death are imminent.

If we can get treated properly and have access to medical care, many of us can be fully functioning citizens. That means less of us on disability and public assistance. The poverty rate amongst the Transgender community is at a whopping 73%. That's right 73% of transgender people are way below the poverty line. Why? Because lack of treatment causes Debilitating depression and suicidal tendencies. Sometimes even death.

The following are five major ways that transgender people experience discrimination in healthcare:

1.) “Denial of health insurance coverage, where someone is denied any health insurance on the basis of gender identity.” The Transgender Law Center has documented cases in which health insurance companies and medical providers have denied coverage to transgender people when they became aware of an applicant's transgender status or prior treatment and medical history related to gender transition. In 2007, the American Medical Association declared its opposition to this practice.

2.) Denial of coverage for claims related to gender transition, including claims arising from complications from medical treatment for gender transition.

3.) Denial of coverage for claims for gender-specific care based on the person's gender marker on insurance. For example, a male-to-female person who develops prostate cancer, or a female-to-male person who develops ovarian cancer.

4.) A female to male and male to female being denied coverage for hormone replacement therapy and/or sexual reassignment surgery as medically necessary. (For example, an insurer argues that a medical concern is the direct or indirect result of transgender-related treatment such as hormone therapy.”)

5.) Denial of any coverage by state funded insurance companies.

http://www.hrc.org/resources/entry/health-insurance-discrimination-for-transgender-people">Source 207 major employers

[http://www.hrc.org/resources/entry/corporate-equality-index-2011">Source] and several major universities (Harvard, Stanford, Emerson, U. California, U. Michigan, U. Washington, and U. Pennsylvania) have pro-actively supported comprehensive transgender health care. Transgender people without access to healthcare from these pioneering institutions must not be left behind.

Support from American Medical Association (AMA) [Excerpted fromhttp://www.tgender.net/taw/ama_resolutions.pdf">Source]:

"Whereas, Health experts in GID [Gender Identity Disorder], including WPATH [World Professional Association for Transgender Health], have rejected the myth that such treatments are “cosmetic” or “experimental” and have recognized that these treatments can provide safe and effective treatment for a serious health condition"

"Whereas, The AMA opposes limitations placed on patient care by third-party payers when such care is based upon sound scientific evidence and sound medical opinion"

"Whereas, many health insurance plans categorically exclude coverage of mental health, medical, and surgical treatments for GID, even though many of these same treatments, such as psychotherapy, hormone therapy, breast augmentation and removal, hysterectomy, oophorectomy, orchiectomy, and salpingectomy, are often covered for other medical conditions"

"Whereas, The denial of these otherwise covered benefits for patients suffering from GID represents discrimination based solely on a patient’s gender identity"

"Whereas, Delaying treatment for GID can cause and/or aggravate additional serious and expensive health problems, such as stress-related physical illnesses, depression, and substance abuse problems, which further endanger patients’ health and strain the health care system;"

"RESOLVED, That the AMA support public and private health insurance coverage for treatment of gender identity disorder (Directive to Take Action); and be it further RESOLVED, That the AMA oppose categorical exclusions of coverage for treatment of gender identity disorder when prescribed by a physician (Directive to Take Action)".

Examples of Health Insurance Exclusions:

With these points in mind we find time and time again policies such as this of Blue Cross Blue Shield (BCBS). Below, two major exclusions are listed: [http://www.bcbsvt.com/member/MemberBenefits/benefit_Exclusions.html">Source]:

“7. Services or supplies we determine are not Medically Necessary.”

“58. Treatment leading to, or in connection with, transsexual Surgery."

Exclusion 7 allows denial of access to transgender healthcare when if determined not medically necessary; for some transgender people, services like hormone therapy and surgery are indeed medically necessary.

This type of blanket exclusion needs to be changed.

A personal story related to typical exclusions like Exclusion 58: “Once the company sees any claim for anything GID related your account is flagged and everything will be scrutinized and ultimately denied. It could be a regular counseling session because a person is just so depressed and has nothing to do with the condition, DENIED! It could be a normal preventative screening, DENIED!”

Lack of Trans Healthcare Leads to Loss of Life

The petition’s author writes: “I am so sick of fighting for everything I have and not having the same rights as cis-gendered men, its not fair that I have to exhibit risky behaviors due to lack of money to cover care, and in many cases me risking my life and or wishing death because I will never see myself being able to get the needed care that has been PROVEN to alleviate the symptoms of said condition.”

>>> Call to Action <<<

Take a step that will change the face of healthcare and the quality of life for transwomen and transmen everywhere. Being transgender is not a choice. Denying transgender people healthcare and insurance coverage for needed healthcare should no longer be a choice.

>>> Add Your Voice <<<

This is the reality of the situation and its time we take action. Anyone with more solid facts you would like to add or any of you that were denied by insurance please feel free to write segments of your denials and/or facts in your additional comments when signing this petition.

10,000 signatures will wake the CEOs up in the middle of the night.

If this is as important to you as it is for the petition’s author and so many others please take the time to sign and pass this along.

Thank you all!

To:

A Demand to All Major Health Insurance Providers in the United States, All US health insurance entities

President of the United States

U.S. Senate

U.S. House of Representatives

I just signed the following petition addressed to: All major insurance carriers in the united states.

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Stop Transgender Health-care discrimination

For a long time the topic of being transgender was something seen as taboo but as it gains more needed traction many medical entities are starting to see that in fact being transgender is NOT a mental illness but a medical condition no different than FAI, heart diseases, or more commonly asthma. But as it has been seen time and time again companies blatantly put discriminatory exclusions to care within 75% of their policies made available to the general public. Making obtaining proper healthcare such as even regular physicians visits nearly impossible for many all because the care is deemed as transition related and immediately kicked back as denied!

Here you can read a complete PDF of what the American Medical Association has said and believes is truth in the matter:

http://www.tgender.net/taw/ama_resolutions.pdf

Taking points from the AMA exclusively:

"Whereas, GID, if left untreated, can result in clinically significant psychological distress, dysfunction, debilitating depression and, for some people without access to appropriate medical care and treatment, suicidality and death"

"Whereas, Health experts in GID, including WPATH, have rejected the myth that such treatments are “cosmetic” or “experimental” and have recognized that these treatments can provide safe and effective treatment for a serious health condition"

"Whereas, The AMA opposes limitations placed on patient care by third-party payers when such care is based upon sound scientific evidence and sound medical opinion"

"Whereas, many health insurance plans categorically exclude coverage of mental health, medical, and surgical treatments for GID, even though many of these same treatments, such as psychotherapy, hormone therapy, breast augmentation and removal, hysterectomy, oophorectomy, orchiectomy, and salpingectomy, are often covered for other medical conditions"

"Whereas, The denial of these otherwise covered benefits for patients suffering from GID represents discrimination based solely on a patient’s gender identity"

These above points gain traction but this point lastly is the biggest one of them all and should be read VERY clearly;

"Whereas, Delaying treatment for GID can cause and/or aggravate additional serious and expensive health problems, such as stress-related physical illnesses, depression, and substance abuse problems, which further endanger patients’ health and strain the health care system;"

The conclusion within the AMA:

"RESOLVED, That the AMA support public and private health insurance coverage for treatment of gender identity disorder (Directive to Take Action); and be it further

RESOLVED, That the AMA oppose categorical exclusions of coverage for treatment of gender identity disorder when prescribed by a physician (Directive to Take Action)"

With these points in mind we find time an time again policies such as this of BCBS, I will only list 2 major exclusions you can read in full here:

(http://www.bcbsvt.com/member/MemberBenefits/benefit_Exclusions.html):

"In addition to the specific exclusions listed elsewhere in your Contract, the following General Exclusions apply:

7. Services or supplies we determine are not Medically Necessary.

58. Treatment leading to, or in connection with, transsexual Surgery."

In question to exclusion 7, who is making these determinations when sound evidence has been shown that transgender treatment is as medically needed as getting me my inhaler? Are these people within the corporate areas even qualified to make sound medical determinations based on notions of many prehistoric unethical medical practices? Are they even medical professionals that truly know and understand the workings of GID and everything the condition truly entails? Or are these pencil pushes half-way reading their own rules and saying no on a bias?

As well in question to exclusion 58, let me tell you from personal experience once the company sees any claim for any thing GID related you account is flagged and everything will be scrutinized and ultimately denied. It could be a regular counseling session because a person is just so depressed and has nothing to do with the condition, DENIED! It could be a normal preventative screening, DENIED! Thanks to exclusions 7 and 58 this company is still going around what has CLEARLY been stated by the AMA as unethical in any medical approach.

I am so sick of losing good friends and people I consider as close as family to depression, risky behaviors due to lack of money to cover care, and in many case them taking their life because they never see themselves being able to get the needed care that has been PROVEN to alleviate the symptoms of said condition.

So I ask you all to come to my aid and take a step that will change the face of healthcare for transgender men and women everywhere. Just as we are working men and women and further more American tax paying citizens why is it possible that some of the leading corporations as well as the US Government and independent states are not shunned for openly discriminating against us?

Many people think this is a choice but let’s ask our self, did you choose to have the medical conditions you have? Or did you choose to make sure they were corrected so you could live a life that was of good quality?

This is the reality of the situation and its time we take action. Anyone with more solid facts you would like to add or any of you that were denied by insurance please feel free to post segments of your denials and/or facts in your additional comments when signing this petition.

One voice stirs the secretary’s nerves, 10,000 with wake the CEO up in the middle of the night. If this is as important to you as it is for me and so many others please take the time to sign and pass this along.

Thank you all.

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Sincerely,

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