Thursday, June 19, 2008

AMA Supports Transgender Care, Hormones, Sex-Reassignment Therapy

From PageOneQ:
The American Medical Association is calling on health insurers to cooperate with doctors in providing proper care to meet transgender patients' needs.

Resolutions 114, 115 and 122 were passed by the AMA's House of Delegates at its annual conference in Chicago, which concludes today. Noting that Gender Identity Disorder is an internationally recognized medical condition, the Delegates highlight the need to combat the emotional pain and physical incongruity associated with gender dysphoria with proper access to mental health services, hormone treatments, and surgical procedures.

The National Center for Transgender Equality has hailed the resolution. "America's physicians," said NCTE Executive Director Mara Keisling, "are saying that transgender people, like all others, deserve competent medical care based on what individual doctors and their patients determine is healthiest for each person." American Medical Association: Stop discriminating against transgender patients

You can read those resolutions in Word format here: 114, 115, 122.

More from PageOneQ:
The AMA asserts that when discriminatory financial barriers are placed between the transgender community and proper health care by dismissing treatments as "cosmetic" or "experimental," even when covered for other patients with other recognized medical conditions, more expensive problems can develop as a result, such as depression, substance abuse problems, and stress-related illness.

"Doctors and patients, not insurance companies, should be making those choices," Keisling added. "We are so glad that the AMA has taken a leadership role against the rampant discrimination that transgender people have faced for so many years in receiving appropriate medical care and equitable insurance coverage."

Just for fun, I'm going to paste one of the resolutions in here. This one is 122, titled Removing Financial Barriers to Care for Transgender Patients.
Whereas, Our American Medical Association opposes discrimination on the basis of gender identity; and

Whereas, Gender Identity Disorder (GID) is a serious medical condition recognized as such in both the Diagnostic and Statistical Manual of Mental Disorders (4th Ed., Text Revision) (DSM-IV-TR) and the International Classification of Diseases (10th Revision) , and is characterized in the DSM-IV-TR as a persistent discomfort with one’s assigned sex and with one’s primary and secondary sex characteristics, which causes intense emotional pain and suffering ; and

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 ; and

Whereas, The World Professional Association For Transgender Health, Inc. (“WPATH”) is the leading international, interdisciplinary professional organization devoted to the understanding and treatment of gender identity disorders , and has established internationally accepted Standards of Care for providing medical treatment for people with GID, including mental health care, hormone therapy and sex reassignment surgery, which are designed to promote the health and welfare of persons with GID and are recognized within the medical community to be the standard of care for treating people with GID; and

Whereas, An established body of medical research demonstrates the effectiveness and medical necessity of mental health care, hormone therapy and sex reassignment surgery as forms of therapeutic treatment for many people diagnosed with GID; and

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 ; and

Whereas, Physicians treating persons with GID must be able to provide the correct treatment necessary for a patient in order to achieve genuine and lasting comfort with his or her gender, based on the person’s individual needs and medical history ; and

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

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; and

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

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; therefore be it

RESOLVED, That our American Medical Association support public and private health insurance coverage for treatment of gender identity disorder (New HOD Policy); and be it further

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

Fiscal Note: Staff cost estimated at less than $500 to implement.

9 Comments:

Anonymous Anonymous said...

"discriminatory financial barriers are placed between the transgender community and proper health care by dismissing treatments as "cosmetic" or "experimental," even when covered for other patients with other recognized medical conditions, more expensive problems can develop as a result, such as depression, substance abuse problems, and stress-related illness."

Couldn't the same be said about all cosmetic surgery? People want to be something other than they are and these "expensive problems" could result if they don't get these fantasies fulfilled? What's the difference with gender wish-fulfillment and other kinds of wish-fulfillment?

June 19, 2008 2:26 PM  
Blogger Dana Beyer, M.D. said...

Do you know how to read? Did you read the resolutions in their entirety, or do you simply not care about anything other than your own fantasies?

June 19, 2008 3:39 PM  
Anonymous Derrick said...

This is why transpeople need protections under the law, AnonBigot:


Video Shows Transsexual Being Beaten
Department, FBI Investigate Officer's Actions
Memphis police are investigating the suspected beating of a transsexual that was caught on tape by a surveillance camera in their own building.

Here: http://video.nbc4.com/player/?id=266943

June 19, 2008 4:30 PM  
Anonymous Anonymous said...

Given the fact that bloggers on this site have been up in arms over the fact that opponents of Bill 23-07 point to the fact that Gender Identity Disorder (GID) exists, I guess I should now assume that the bloggers here would be absolutely, positively INCENSED at the American Medical Association for recognizing the existence of GID!! C'mon everyone!! Let's rally against the AMA for their sheer folly at recognizing GID!!

June 19, 2008 4:31 PM  
Anonymous Anonymous said...

"Do you know how to read? Did you read the resolutions in their entirety, or do you simply not care about anything other than your own fantasies?"

Read it all.

Could you be specific about which part of the resolution you'd like to misconstrue?

June 19, 2008 6:29 PM  
Anonymous svelte_brunette said...

Anonymous said:

“Given the fact that bloggers on this site have been up in arms over the fact that opponents of Bill 23-07 point to the fact that Gender Identity Disorder (GID) exists, I guess I should now assume that the bloggers here would be absolutely, positively INCENSED at the American Medical Association for recognizing the existence of GID!!”

No, bloggers here have NOT been up in arms about opponents pointing out “the fact that GID exists.” Bloggers here are incensed about misleading and derogatory statements like this from CRG’s “Talking Points” bulletin (still available at their website):

“Gender Identity Disorder” is classified as a mental disorder by the American Psychiatric Association. Legal protection against discrimination based on mental illness is not provided for any other disorder, and there is no rational explanation why it should be offered for this one. Those who wish to assume a “gender identity” contrary to their biological sex are in need of mental health treatment to overcome such disturbed thinking, not legislation to affirm it.”

This paragraph clearly states that people like me suffer from “disturbed thinking” and I’m in need of “mental health treatment,” probably after they take me away drooling and sedated in a jacket with arms that tie at the back. It makes no mention of the fact that the medically recommended treatment program (in place for nearly six decades) for GID actually includes having a sex change operation. Nor does it mention that people like me are NOT locked up in institutions for years and medicated into a stupor, but instead re-integrated into society in the appropriate gender with the help of hormones, surgery, and yes, therapy – often to overcome the consequences of major losses like family, loved ones, a job, etc., as well as overcoming years of physical and emotional abuse from people that find it necessary to “correct” effeminate behavior in young boys by harassing them, calling them names, and beating them senseless.

The above paragraph also fails to point out the fact that if a person expressing symptoms of GID also expresses symptoms of psychosis, multiple personality disorder, or other co-morbidity issues, they will be denied treatment for GID. The only people that are allowed to go through the entire process set forth in the internationally recognized Harry Benjamin Standards of Care are those that have proven they are indeed mentally stable and can suitably cope, and indeed actually function better with such a life-altering change.

The CRG’s sentiment expressed in the above paragraph is not limited to that flier, but was also expressed by their petition collectors, and repeatedly by Annoying Anonymi here. We are incensed about the fact that the CRG is using this misleading propaganda to frighten the public into trying to take away protections from discrimination in housing and employment.

My mental health and abilities have been evaluated by a number of doctors over the last decade, all with positive (and normal) results. I’d be happy to take a few more tests, and publish the results here on this blog – if Theresa Rickman and Ruth Jacobs will do the same. I’m quite sure that my results will have nothing to be ashamed of, and it might be an interesting comparison.

Peace,

Cynthia

June 19, 2008 11:17 PM  
Anonymous svelte_brunette said...

Anonymous said:

“Couldn't the same be said about all cosmetic surgery? People want to be something other than they are and these "expensive problems" could result if they don't get these fantasies fulfilled? What's the difference with gender wish-fulfillment and other kinds of wish-fulfillment?”

And:

“Could you be specific about which part of the resolution you'd like to misconstrue?”

I have been pondering the motivations behind statements like this. How does an Anonymous who manages on the surface to sound so reasonable and maintain the façade of a rational argument so easily defenestrate any and all medical information relevant to the discussion? Surely he is cognizant of the fact that his attitude and choice of words is bound to provocate a heated response. Perhaps that is what he is looking for.

There’s a 25 year old twit where I work that would do this sort of thing. He’s quite convinced of his omnipotence and has generous serving of arrogance to round out his glowing personality. He once responded to a company wide e-mail in a way designed to bolster his self image of supreme intelligence. I responded to this e-mail by pointing out a fatal flaw in his logic. He couldn’t look me in the eye for a week after that. However, this guy doesn’t have an attention span long enough maintain the kind of dialog our Anonymous has over these past months, so I can’t readily place him in the same category.

There is also the theory that he’s trying to upset someone enough to make a totally irrational comment that can be used in CRG’s propaganda campaign. They’ve used a comment or two from Dana already, and they have her on tape too, spinning it as “tranny insanity.” I think this is eminently possible, but so far it hasn’t yielded a whole lot of quotes – at least that they’ve put on their posters so far. Maybe they’re saving them all up for later. This doesn’t seem to be a time-effective way to generate propaganda when they seem so good at making it up all on their own.

Scratching my head some more, I think I finally got the clue I needed from the reference to “fantasies fulfilled.” It reminded me of another one of my co-workers, a manager in his mid-forties who had a school boy crush on one of the other female engineers where I work. He’s married, but that didn’t stop him from acting like an 8 year old pulling the pigtails of the classmate he fancies but can’t figure out how to engage. My friend had told him on numerous occasions to stop, but he didn’t, and it was beginning to border on sexual harassment. She discussed this with me on several occasions and I told her exactly what she needed to say and how to say it, and what he would say in response. The next time he did it both of them were standing outside my cubicle and I just looked at her with the “what are you waiting for?” visage. She turned back to him and told him what we had discussed, and he countered as I predicted, but he stopped.

So Anon, let me first say that it’s perfectly o.k. to be attracted to transwomen. As Emproph likes to point out, some of us are quite stunning. Although we’re not all as gorgeous as Candace Cayne, (http://www.prphotos.com/store/category.cgi?item=JTM-031125&type=store&ps=1&start=0) we have a lot to offer the world. However, you do need to have a more subtle approach when dealing with us. The prepubescent approach you’re using now simply isn’t going to gain traction with sophisticated women like Dana, Maryanne, or myself. (Oh, and Maryanne is married anyway.)

I know you probably have a lot of questions about transwomen and dating but are afraid to ask. Fortunately many of these can be answered by perusing the TSGirlfriend website. I recommend starting here: http://www.tsgirlfriend.com/find-new-girlfriend.html. They even have a chat room you can go to. Keep in mind though they have strict room monitors that will boot you out quickly and permanently for the kinds of comments you routinely make here. You should probably just listen for a while to get the flow of the conversation and see what is acceptable and what is not. If you’re still not sure what to do or have questions, just let me know, I’d be glad to help.

Good luck and happy hunting!

Peace,

Cynthia

June 20, 2008 10:06 AM  
Anonymous Veronica said...

As a M2F transsexual who filed civil rights complaints against a large aerospace design and manufacturing company in Cedar Rapids, IA - ONLY M2F patients are excluded for medical treatment for GID. EVERY health insurance company not only covers sex-reassignment surgery for F2M patients, but it is the most common health care expense covered by any insurance carrier. Rather than calling it :Sex-reassignment surgery, the more proper terminology would be genital surgery. A letter from one's surgeon written on the Doctor's stationary, specifying that he/she performed genital surgery on at on is sufficient documentation to have one's gender changed on their birth certificate in virtually all of the 50 States in the United States of America. No details are required.
The most commonly covered surgery in the United States is a full historectomy, i.e., historectomy and salpingo oophorectomy. According to Blue Cross/Blue Shield, over 40% of all female patients undergo these procedures by age 50. In addition, Blue Cross/Blue Shield also states that over 80% of these surgeries are NOT MEDICALLY NECESSARY. Most common reason given is that the surgeries are performed for either the doctor's or the patient's convenience. So, the only difference between a full hysterectomy and F2M 'sex-reassignment'surgery is a written letter from the patient's doctor. The surgery is the same, the outcome is the same. Due to the relative ease of obtaining a hysterectomy, such as complaining about 'pelvic pressure', the insurance company does not require that the intention of the patient to undergo the surgery need not be specified. However, for a M2F patient, even a request for pre-approval of a bilateral orchiectomy raises flags immediately. In this case, the intention of the patient for having that procedure is essential in order to have the surgery approved. If the patient has a feminine first name, the surgery is not a covered expense.
By the way, the Iowa Civil Right's Commission has not yet even screened my complaint - over three years after it was filed. State directives requires that it be done within 120 days of filing. Even though gender identity was added to the State's Civil Rights Act as a 'protected category', it doesn't appear that the State of Iowa is willing to enforce the law prohibiting a company from discriminating against an employee in either their employment practices or their benefits program.

April 22, 2011 5:24 PM  
Blogger sarah elton said...

An established body of medical research demonstrates the effectiveness and medical necessity of mental health care, hormone therapy and sex reassignment surgery as forms of therapeutic treatment for many people diagnosed with GID. www.rx247.net/coumadin.html

October 18, 2012 3:20 PM  

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