Very recently, the state of Oregon
has passed a law saying that by October 1, 2014, the Oregon Health Plan (OHP)
will have to provide equal benefits for transgender Oregonians. This includes mental
healthcare, hormone treatments, and evaluations. Transgender people will have
the same benefits (and restrictions) as
non-transgender individuals of the
same identifying gender.
The new law, the first of its kind,
establishes the following mandates, as outlined by the Basic Rights Oregon
Organization:
·
Health insurers may not categorically exclude
transgender patients from coverage.
·
Health insurers must provide coverage and
cannot deny coverage of treatments for transgender policy holders if the
same treatments are covered for other policy holders.
·
Health insurers may not deny treatment on the
basis of a policy holder’s actual or perceived gender. That means that all
policy holders can rely on annual exams, cancer screenings, and gender-specific
health care, regardless of their gender on file.
·
The statewide mandate for coverage of mental
health services must apply to transgender patients.
While Oregon is the first state in
the U.S. to pass a law like this, there are a few other instances in which
transgender people have been guaranteed nondiscriminatory healthcare. For example,
the Affordable Care Act (ACA) has a nondiscriminatory clause based on gender
identity. However this only protects transgender people against denial of
coverage and disparities in rates. It does not require insurance companies to
provide transition-related services. In July 2012, San Francisco moved to
provide transition-related services to Healthy San Francisco, a healthcare
program for uninsured residents. Unfortunately, implementation of this law has
been slow.
Puberty-suppressing treatments will also be made
more accessible, which is crucial for many people’s transitions. For
transgender youth in particular, puberty is a dreaded event with a timestamp
attached. Pre-pubescent youth questioning their gender identity usually want to
stage off puberty for the time being so they can figure things out before their
bodies begin to change. Once they begin puberty, it is much more difficult to
physically transition (but not completely impossible). Because of this, many
questioning youth choose to begin puberty-blocking hormones, which
simultaneously buy the adolescents time and also “spare the young teenagers the
angst of developing secondary sex characteristics that feel terribly wrong to
them” (Padawer). Counseling can also be critical for helping people make sense
of their feelings before making a decision. Both of these resources will be
available to transgendered people in Oregon under this law.
Here is a photo of a woman’s transition with the help of
hormone treatment. As you can see, hormone treatments drastically affect a
person’s appearance, and help them become the person they want to be.
This monumental decision has
personal significance for my family and me. My sister is a trans-female,
meaning she has transitioned from male to female. She always remembers feeling
a disconnect between how society perceived her (as male) and how she perceived
herself (as female). For Lark, her transition has been about correlating her
external identity with the internal identity she has always held. Since “coming
out,” she has faced seemingly insurmountable discrimination and hate from
others, including from the U.S.’s healthcare system. Before she saved up enough
money to change her name and gender on her driver’s license, she had trouble at
doctors’ offices. Furthermore, she has to pay a large monthly fee for hormone
treatments. These medications are just birth control, which I get free through
insurance every month because I am anatomically female. Yet the treatments my
sister so desperately wants in order to become who she is has to be factored
into her monthly budget. This is the very definition of discrimination. So why
is it just now being (very slowly) addressed?
I would
argue that transgender people have a harder time being accepted by society than
others in the LGBTQIA community. Would you agree? Why?
Furthermore,
I should add a disclaimer that I am a huge advocate for a universal healthcare
system in the U.S. Is there anyone who does not believe in universal
healthcare? And if you don’t, do you think that transgender people deserve
these benefits, or do you think the way it is now (in most states) is
nondiscriminatory? I would really enjoy your insights if you don’t mind
sharing!
-Grace M.
Sources:
It's really unfortunate that a lot of the time sexual health isn't considered a standard aspect of health care. It's bad enough that coverage is so minimal in regards to other medications, treatments, etc, but for products like birth control and hormones, you really don't have many options when it comes to health care. Even worse, society has these expectations of what you're supposed to look like or how you handle your body, yet health care providers make things like birth control and hormones highly inaccessible at times, preventing people from trying to reach the status quo or simply feel comfortable with their bodies. I'm glad that Oregon is taking steps to address this issue.
ReplyDeleteOn the question of whether transgendered individuals have more difficulty being accepted, I agree with you. Acceptance comes hand in hand with understanding, and to most individuals the concept of someone feeling that they're the wrong gender is absolutely foreign. I myself included. So if you don't mind me asking, do you have any insights into how these feelings form and how it feels? Is it something that one is born with, something that slowly develops over experiences, or what? Do they feel disembodied, as if watching the progression of someone else living; maybe more of a general 'wrongness'? What's up?
ReplyDelete-Miggy G-
Thank you for asking that question! To be perfectly honest, I do not have an exact answer. If there is one thing we have learned in this class, it is that there is so much variance in gender and sexuality, that it is impossible to say that transgender peoples' experiences are identical. There are some stories of 2-year-old (anatomical) boys who insist on sitting down to pee and on wearing pink dresses. There are other stories of people not transitioning until they're 40 years old. It all depends on so many factors. I can only tell you that from what I have read and from what my sister has shared with me about her experiences. My sister describes it as feeling conflicted with how others treated her (as a boy) and with how she thought others should treat her (as a girl). She perceived herself to be a girl, and didn't understand why others did not perceive her in that way. It is so hard for non-transgender people (myself included) to imagine what this would feel like; gender is so ingrained into every aspect of our daily lives that it is hard to think of yourself as something other than who you are. Re-read that last sentence. Society is making transgender people think of themselves as something they're not. They just know that they are not the gender everyone else perceives them to be. If everyone thought I was a boy, treated me like a boy, expected me to act like a boy, it would be so difficult, because I am just not a boy. It's so hard to explain to people, because it is just intuitive. I know I am a girl, I just know it. My sister just knows she is a girl, she just knows it.
ReplyDeleteThere is a lot of debate with regards to the origin of transgenderism. Many researchers think a miscommunication happens in utero in which the brain develops according to one gender and the anatomy develops according to the other. Being transgender has nothing to do with how they were raised or any other external factors. Nor is it an illness. It is an identity.
If you are interested, I highly recommend this article. It does a great job of explaining a lot of things.
http://www.nytimes.com/2012/08/12/magazine/whats-so-bad-about-a-boy-who-wants-to-wear-a-dress.html?pagewanted=all&_r=1&
I am really glad you decided to address the struggle for healthcare equality and recognition for transgender individuals. This is a topic I have been wondering about a lot recently since government rulings on health care have held such a spotlight in national news and media recently. I think it is crazy that while there is so much discussion taking place and being broadcasted by our many sources of media, that the rights of transgender people are never addressed in any substantial way during these discussions. The government and the voters of this country who are given a voice that reaches all corners of the nation are constantly debating issues of rights for gay and lesbian families, abortion and birth control coverage for people born female and so on, but transgender rights to transition coverage and even gender-specific coverage for the gender they identify with is not given a strong or weighty voice. I think that this does speak to a reality of discrimination against transgender individuals that reaches deeper than that faced by other members of the LGBTQ community. Thanks for all the helpful and well presented info Grace!
ReplyDeleteThank you for sharing this with us, Grace! I have focused a lot of my attention on issues of LGBTQ healthcare, but even within that category I feel that struggles specific to transgender individuals are often pushed aside. Your post was incredibly helpful in making me realize just how much I didn't know about the transition process. I have thought before about costs for those who choose to undergo surgery, but I hadn't even considered how great of an expense monthly hormone treatments would be. It hurts knowing that healthcare discrimination prevents so many people from being who they feel they are. I completely agree with your stance, and I will definitely continue to follow our country's progress on this issue.
ReplyDelete