Who Pays for Sex Reassignment Surgery?
“They don’t ‘cut it off!’ It just becomes an innie instead of an outtie.” – Felicity Huffman as Bree Osbourne in Transamerica
Denise Lavoie, an Associated Press Writer in Boston reported on the case of a Transgender Inmate Seeking a Sex Change. She writes, “Wearing lipstick, a scooped-neck sweater and nearly waist-length hair, the witness cried while describing what it feels like to be a woman trapped inside a man’s body. ‘The greatest loss is the dying I do inside a little bit every day,’ said Michelle Kosilek, an inmate who is serving a life sentence for murder.”
“Kosilek was Robert Kosilek when he was convicted in the killing of his wife. In 1993, while in prison, she legally changed her name to Michelle. Since then, Kosilek has been fighting for the state Department of Correction to pay for sex-change surgery, which can cost from $10,000 to $20,000. After two lawsuits and two trials, the decision now rests with a federal judge.”
“Kosilek’s case has become fodder for radio talk shows, often provoking outrage among callers on topic of whether the state should pay for a convicted murderer’s sex-change operation. The case is also being closely watched by attorneys and advocates across the country who say Kosilek is an example of the poor treatment transgender inmates receive in prison.”
Ramon Johnson at Gaylife.About.com offers this commentary. He writes, “No one likes to feel trapped- in a bad job, a bad place or a bad situation. Imagine feeling trapped in your own body. The pain of living in heterosexual situations while suppressing same gender loving feelings is destructive enough.”
“For biological men that feel like a woman trapped in a man’s body (or vice versa), the pain and internal conflict is often unbearable. Sex reassignment surgery (often, but less appropriately, called gender reassignment surgery) is the only option for those with psychological and emotional identities trapped in the wrong physical body.”
“Our psychological and emotional identities should match our physical makeup; and for most seeking reassignment- surgery is a need not a want. So, who should cover the cost? Is the burden of sex reassignment a public obligation or solely that of the individual? Or, should the expense be shared?”
What do you think? Should taxpayers have to pay for these operations?
In the State of Washington, Medicaid officials are taking steps to end publicly funded sex-change surgeries. Fox News reports, “While the disorder has been recognized for more than two decades by the American Psychiatric Association, few government or private insurance programs pay for treatment.”
“Washington is one of a few states where sex-change surgeries have been covered. The number here has been small: six during the past 15 years. Medicaid officials said the state has paid for two sex-change surgeries since 2000, at a total cost of about $113,000.”
Most transgender individuals have to save for years in order to afford an operation. I can see if some think a felon doesn’t deserve a state-funded operation, but what about law abiding citizens? Anyone care to comment on the subject?
Tough questions asked- convoluted answers to follow.
As for paying for sex changes of convicted inmates- I do not agree with this as public policy. I understand and to me its a given that transgendered people feel trapped in their own body. But if they are jailed- they are trapped. Period. Freedoms and choices are lost. And I also wonder if in the jail environment, perceptions as to who one really is- change. If someone is made to be some toughie’s punk for long enough- would they rather consider a sex change and potential transfer to a woman’s facility just to get out of it? Too many issues to get into…
As for folks in the “real” world- I am really torn. I work for an insurance company. Gender re-assignment is considered a contract exclusion and never covered under any of our current contracts. As to whether I feel it’s right or wrong- I’m not sure. Granted, the overall numbers of those seeking reassignment surgery are low, but its still an added cost. When you factor in how much it will affect the bottom line- would this mean more people uninsured due to higher insurance premiums? But then, what about the happiness and productivity of those denied the surgery? Depression is one of the key drivers of missed work days and therefore overall production. What would the “break even point” be financially? Or is it more important to us as a society to have happier, more self realized citizens? I want more people self actualized- but not at the expense of others not getting any insurance benefit due to high premiums. I am not a numbers cruncher for health insurance- I am “just a nurse”- but I have a general understanding of how it all goes down.
The Medicaid question really gets hard for me to answer. If the people seeking transgender surgery become happier, more productive members of society because they’ve had the surgery on my (taxpayer) dime and ultimately get off Medicaid onto some other insurer- it becomes “break even” in no time at all.
Before anyone jumps on me for my answers- I do have some (albeit minimal) experience in this. A dear family friend has a son who was born a daughter. My somewhat masculine life partner helped him get through the tough times of determining if this was just butchness or true gender dissonance. The family, to this day, feels we were key moreso than the psych care involved- since we were so open and honest in our discussions. Oh- and I used to be a youth advisor for a GLBT program, so I had resources to help them too.
Many transgendered people are so financially disadvantaged that it doesn’t surprise me that some would both end up in jail (possibly for prostitution) and not be able to afford the surgery they need. Withholding that surgery for cases that a psychiatrist working with the individual agrees is necessary is the equivalent of society punishing someone for a crime they forced that person to commit. In the Netherlands, where everyone has healthcare, the government will pay for reassignment surgery in the same way that if you’re one of the lucky in this country that has an HMO rather than just crossed fingers, you’d be able to have your tonsils out. Another question is, what can we do to keep transgendered people out of jail? How can the queer community support those that are often even ostracized by fellow gays and lesbians?
i am totally against this situation,i have to save up and work hard to get what i wanted and i didnt have to depend on any government aid,it would be nice to get some kind of help from the government aid,just like other people who pop babies every year to get help from the government which the government get that help from tax payers like me,but i dont expect other people to cover all my expenses for my surgery,i think its unfair that this felon should feel that his dilema should be the tax payers concern/problem and i dont think that this felon should be granted for it ,if anything the prison situation should have some kind of program for this person to be able to work and earn the money this person needs for the operation,i think thats fair.
i know a lot of transgenders that worked hard to get what they want even if they knew it could cost their lives.
i think ,that they should refuse the request of granting this persons appeal ,cuz this matter is unjustifiable.no offense,ive been there and i worked hard for it and i think he should do the same,he should’ve thought of who he really is before he thought about killing his wife.
I am a MTF Pre-operative individual. I have been fighting with this issue since I was seven years old. Nothing new to all of out there that are TG… You have probably lived the same life that I have.
I am also an epileptic, suffer from extreme mood swings and have been diagnosed with Bi-polar Disorder. I have also had three head injuries, all of which are connected to GID or Personality Disorder. In my particular case, I feel that it is my Insurances responsibility to pay for my surgery. Since the GID is related to other symptoms that I am presently Retired (Disability) on, they, the Ins companies should cover the cost.
I am a MtF scrimping and saving every penny to be able to afford my srs, no way should the government pay for an inmates surgery, they should put pressure on the insurance companies to pay for our surgery.
I don’t know if anyone comes here anymore or not, but I live in Alberta Canada, and the province is going to pay for the whole works! All free for me, i’m going mtf very soon.
i am a MtF and want a sex change. and fill that we have stand and fight the health care providers. so we do not have rob what we need to live. to have are sex change operations. and be able to live in the body we want to be in. be couse we are not mental ill. we were just born in the wrong body. that why we fill like the way we do about are self. not becouse we have mental ill.
I’ve recently discovered myself to be TG. All my life, I’ve wrestled with feelings that I was told were wrong. Ignored them, shunned them, locked them away. I even enlisted, hoping the feelings would subside. Finally, after being on my own (I’m 20 years old) for a while, I’ve discovered the woman inside that’s been screaming to come out since I was six years old. I even have a partner that supports my decision.
Yet, my day will not come for quite some time. My job pays just enough to cover bills. I’m ‘poor’.
Ever single day I think about how nice it would be to either:
A) Find a job where I can save up, and pay for my own SRS.
B)Find some way to receive help in paying for SRS.
In my opinion, yes! Convicted felons lose rights once sent to prison. They shouldn’t have committed their crimes.
Those of us that are ‘on the outside’, work daily, and still can’t pay for surgeries SHOULD have some help! No, maybe not every last penny, but something! I know that if I could receive help, my value as a citizen would rise. I’d be much happier, and feel as if I owed society. This would drive me to be a better citizen, a better person.
I think the key phrase is “medically necessary.” Murdering someone should still not deprive you of your basic human rights, which are granted by your status of being a human being. A transgender criminal receiving SRS is no different than a criminal caught in a bad fire and needing skin transplants and cosmetic surgery. In both cases the status and health of the individual is severely impacted and needs surgery & treatments to help rectify. In neither case should the surgeries be considered unneccessary or optional; leaving a woman with a biologically male body can be as torturous as leaving a burn victim without new skin.
I do not agree with paying for a convicted criminals sex change operation ! He did not decide to change until after he was sentenced to prison ! He wants the sex change so that he wil not appear as a man while having sex ! The prison systems are getting to be a joke with convicts being treated like high class citizens ! They broke the law ,and they expect the taxpayers to flick the bill ? I have been diagnosed as having Gender Identity Dosorder , but I would have to pay for it myself ! The insurance companie refused me because they said it was cosmetic and an elective surgery !I have worked all my life without having anyone give me a handout ! Now that I have got past the denial stage , I have to figure out how I am going to pay for it ! My need is not sexual , mine is psychological ! I have known that I was different than all the boys my age when I was 8 ! I am the one that has suffered all my life in the wrong body !Nobody helps me !