The Costs and Care for the LGBTQ+ Community:
America Denies Transgender People Healthcare
Every day, millions of people struggle with finding proper healthcare to ensure protection for their overall health. For people of the LGBTQ+ community especially, access to plans and services has long been denied.
Those who want to affirm their gender identity by transitioning physically can face some difficulties when it comes to dealing with insurance plans. Healthcare.gov states that “many health plans are still using exclusions such as ‘services related to sex change’ or ‘sex reassignment surgery’ to deny coverage to transgender people for certain health care services.” This exclusion varies by state.
Transitioning can be very expensive, and not having insurance to help cover the costs can be detrimental. In Pennsylvania, the Philadelphia Center for Transgender Surgery provides estimates for procedural costs depending on what kind of service the patient desires. A female to male transition estimates a cost of $124,400. A male to female transition costs significantly higher, estimated at $140,450.
Although there are insurance companies that do not cover reassignment surgery, there are other options for people to help them undergo the process. Medicaid insurance is a state insurance that provides care for those who are 65 years or older, families with low income, women who are pregnant, those who have a disability and more.
“I’d say [I was] very fortunate,” Robyn Suchy, an LGBTQ+ individual who underwent reassignment surgery, said. “I learned a lot about medical insurance and Article 1557 under the American Counseling Association and the different ways states have opted in and out of Medicare.”
According to Medicare.com, “Medicare Administrative Contractors determine coverage of gender reassignment surgery on an individual claim basis.” This means that Medicare insurance may cover the surgery if the patient’s doctor or healthcare provider can determine that it is a medical necessity.
“D.C. opted into Medicare in such a way that my insurance was required to cover my transition related care,” Suchy said. “I still ended up paying over $5,000 out of pocket, but they covered, you know, 90 percent of it.”
Ashton Trent, a female to male transgender individual, went through the process of having top surgery while on Medicare. “Because there’s not any place local that accepts state insurance, I had to actually travel to Maryland to get surgery done but state insurance actually still covered it,” Trent said.
Since 29 percent of transgender people live in poverty, compared to 14 percent of the general population, according to the National Center for Transgender Equality, being able to not only access but afford healthcare is so extremely crucial. This gives people the reassurance that they are going to be covered during their transitional process so that they can go through the process worry-free.
By Anna Laquintano