Gender, Hormones, and Health Insurance: “We Don’t Cover That!”
Back when I actually had health insurance I used to get these elaborate monthly account statements from my endocrinologist. I could never figure them out. They were page after page of debits, credits and adjustments. I just used to go to the last page and write a check for whatever it said next to “Pay This Amount.”
What I did understand was that my doctor’s staff was playing an elaborate cat and mouse game with my insurance provider to get as much of my expenses covered as possible. (It’s amusing: the first page of my chart lists my diagnosis as “M to F TS.” The monthly statements always listed my diagnosis as “hormonal imbalance.”)
But there was one thing they couldn’t get my insurer to pay for: estrogen. (And that’s the most expensive part of Hormone Replacement Therapy.) My particular regimen (before surgery) consisted of an anti-androgen (Spironolactone) and an estrogen (Estradiol Valerate Injectable).
My health insurance covered the Spironolactone. (It’s commonly prescribed as a hypertension medicine.) It didn’t cover the estrogen. (Why ever would a man be given estrogen injections?! Why: because he’s a Transsexual she and the insurance industry thinks it’s OK to discriminate against those people.)
To add insult to Injury, the Spironolactone was the inexpensive part of the protocol. One refill cost $16 or $17 and lasted a month. The Estradiol, which I still receive an injection of every other week, comes in a little vial the contents of which last three months. That tiny little vial costs $229 at your local CVS! I’ve been taking it for three years and the protocol has me taking this for the first 12 months after surgery. (Five more months to go.)
Don’t worry; there are ways to do this hormone thing more inexpensively than I have done it.
But first, I want say a few things to you up front about this topic. (And do understand that I am not a doctor.)
Do this under medical supervision: These things are powerful and dangerous. (They tell your DNA what switches to turn on and off.) If used improperly they can kill you. (You want that doctor’s care and prescriptions.)
Herbal hormones: They don’t work. I have heard reports of users having heart attacks and strokes from some of the non-prescription hormones that are marketed to the Transgendered.
Black market hormones: Don’t even think about it. (You don’t know what you’re getting.)
That said buying through mail order compounding pharmacies and internet suppliers can be cheaper than going to your local pharmacy. I don’t do it, but I know plenty of people who do. If you “google” the terms “hormones” and “transgender” you will find a whole slew of them.
If you are going to do this, make sure you check them out thoroughly. Deal only with known and reputable suppliers. (Your doctor and his or her staff can probably help you here.)
I went searching and found some links for you that might be helpful here:
- Transgendercare.com (This one will give you a nice overview of HTR.)
- Sexuality.org (This one has a good Hormone FAQ.)
- Genderlife.com (They have a forum where this topic is discussed.)
The further into my journey I get, the issue of health insurance for the transgendered looms larger and larger. It is so vitally important and yet the insurers refuse to cover most of the basic needs that are unique to us. The more I experience it and ponder it the more I have come to believe that it represents a bigoted systematic effort to persecute and discriminate against us.
How is this any different than the pre-civil rights era America where it was socially acceptable to deny service to African Americans in stores and restaurants and make them sit in the back of the bus?
The answer: it is no different.
What does it say about us as a people and a society when some of us are forced to lie about our gender identity in order to obtain medical care? What message does this send to the world: that dishonesty is rewarded and honestly punished? That in a nation where people of all backgrounds, races and ancestries came together earlier this month to elect an African-American President of the United States it is still acceptable to discriminate against and marginalize the Transgendered?
Very well Mr. President-Elect, I bought into your “Change We Can Believe In” mantra. I voted for you.
Now, I have a question for you: Are We Included?
What do you think?
Photo credit: stock.xchng.