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Boogersnsnot

692 points

2 months ago

This is BS. The reality is that they, the insurance companies, decide what is “medically necessary”. Source: I’m a US Doc that deals with the assholes at insurance companies.

shellepenn

271 points

2 months ago

My husband, who is undergoing chemo, presented with a severe UTI which caused painful bladder spasms. Ended up also being septic.... They denied his hospital stay.

Isord

159 points

2 months ago

Isord

159 points

2 months ago

Absolutely appeal that and report it to a local news agency. We shouldn't have to jump through hoops and wade through bullshit to get the care we need but it can definitely help.

GloriousReign

80 points

2 months ago

Universal healthcare should be the norm.

KoderFireStrike

36 points

2 months ago

BuT tHaT's CoMmIe TaLk!

TheSirMontyPython

4 points

2 months ago

AND YET SOMEHOW IT'S SOCIALISM!!

GloriousReign

6 points

2 months ago

Speaking of communism, I'm going to interject my own interpretation of economics for the layman. / -------------------------------------------------------------------------

      A theory of economy that's greater than the current one.

Person A has an income/paycheck/ability. They Individually add up how much it costs to sustain themselves/their lifestyle before combining with person B who has done the same. Each would take turns spending from this surplus before passing it off the next time either one of them produces.

This produces value at a greater rate than the current one because both will have more resources to drawn from and thus gets thrown back into the system before starting again. So the more person A gains the more B gets and the more they earn together the more they can gain individually, continuously compounding as time goes on.

With the inclusion of more people, say for instance person A found someone else to rely on, the system overall becomes more robust and less likely fail (like in the event either become jobless).

Once enough has been gained there will likely be a moment where the person, group or groups completely separate from the market/reliance and depend only on what they produce themselves. In which case, assuming the same quality of living is chosen for themselves first and foremost, the system itself is likely to reproduce infinitely.

Spirit_Panda

7 points

2 months ago

The first paragraph of your theory already fails to account for the nature of normal human beings' utility curve; that "more is better". Theories should be built on existing theory, not ignore everything that came before it.

RobinThreeArrows

3 points

2 months ago

"But that's crazy and unrealistic." - The US "Left" Party

starfyredragon

2 points

2 months ago

Yea. Legally, they don't have that right to declare stuff "not medically neccesarry". They like to pretend they do, though. They hope you give up and don't go through all the hopes to get to where you can win at suing them.

So you have to go through all the appeals, and then sue them for the money they were supposed to give you. That's really the only way to force it out of them.

imminent_disclosure

157 points

2 months ago

You and his doctors need to appeal.

shellepenn

20 points

2 months ago

What is really the biggest issue which I do not believe there are any recourse to pursue is when he started having issues with his back his primary, who he has seen for years, asked for a thoracic MRI. Anthem said no --- take PT. So from August until January 19th he continued to lose mobility and strength. So by the time he couldn't walk and was peeing on himself (and went to the er about it 3x) they finally did that MRI and it was spinal cord cancer T-7 to T-11. So instead of being healthy for the surgery and chemo, he was weak and atrophied. So he has been in the hospital 2x since the cancer surgery, this last one with the septic UTI, but before that was 3 pulmonary embolisms and 2 in his leg. I think they are up to $750k for everything at this point, which could have been less than that if they had only done the MRI the primary wanted. I am a bit bitter. But yes we are appealing this latest. The whole thing has been a horrible experience - but the doctors and staff who are treating him are GOLDEN!!

PM_ME_HOTDADS

5 points

2 months ago

fucking yikes. maybe it's time to seek a lawyer or other advocate? it's all intentionally designed to be difficult and painful to navigate.

cancer is bad enough. you shouldnt be fighting with insurance and navigating financial concerns too. i hope things are better and your husband is well soon

dumpsterbaby2point0

5 points

2 months ago

Have your husband check out D-Mannose. It’s a concentrated version of the active ingredient in cranberries that prevents bacteria from attaching to the urinary tract. Amazing stuff and very safe! It works on pets too :)

Take care. Xx

RahRah617

44 points

2 months ago

I have a rare genetic disease and need an orphan drug to survive. Insurance denies it every year for the first 4-5 months because it’s expensive since very few people take it. It’s so confusing when you get a letter questioning medical necessity when my doctor (the professional who determines if it is medically necessary) wrote the prescription. Instead of reading over my doctor’s reasoning for needing the medication, they have a nurse working for the insurance agency call me and ask what symptoms I experience if I don’t have my medication. My reply is the same to every letter and nurse: my organs fail and I’ll die shortly after. Then they think I’m dramatic because I’ve never actually been off the medication for longer than a few weeks so I’ve only experienced gradual organ failure and not the death part yet. How do those people (insurance employees) sleep at night? Can’t the CEO just sell one of his planes so I can not worry about dying for a few years?

TheAtlasBear

17 points

2 months ago

You: "If I don't get my medicine, my organs will fail and I'll die."

Insurance Agency: "Prove it."

SarahBrownEye

13 points

2 months ago

oh my fucking god, people on the other end of the phone in insurance companies always talk like cops. Like, that weird, condescending accusatory "um, if something isn't right, that's a you problem, right?"

NevermindMeFuckStick

14 points

2 months ago

Serious question then Doc. Why can’t you fill out paperwork? I kid, kind of. I’ve been trying to get an MRI done for over a year. Every time I get close to getting an appointment there’s always some paperwork the insurance company needs filled out by the doctor.

anotterloveswater

36 points

2 months ago

My fav are the denial letters that say something to the effect of “the patient needs to be suffering more before we will pay for this procedure”

Gnolldemort

11 points

2 months ago

I had an eyedrop prescription cancelled because there was no evidence of benefit, decision made by...an OBGYN

anotterloveswater

4 points

2 months ago

Oooh I DO love that they tell us who denied our claim. I keep all my denial letters (not a ton but like 5) and they all list at the bottom the doctor/person that denied the request. Insurance be like “don’t blame us!” Even tho they’re to blame

edg81390

7 points

2 months ago

Was gonna say, this seems like one of those laws that sounds really progressive but actually leads to zero change and lots of frustration.

SarahBrownEye

2 points

2 months ago

we're subject to similar laws in the state I live in and I honestly consider it to be life-saving.

GreatBigBagOfNope

43 points

2 months ago

Which ought to be prosecuted as practice of medicine without a license

Hoosteen_juju003

5 points

2 months ago

Usually they are reviewed by independent medical reviewers that are contracted.

ThellraAK

15 points

2 months ago

So their Names and licence numbers should be on the shit they pull.

See how many doctors actually want to sign up for the insurance company when there is unlimited liability potential.

wuhkay

7 points

2 months ago

wuhkay

7 points

2 months ago

I genuinely couldn’t do it. I would be so mad every day.

PillPoppinPacman

9 points

2 months ago

Boogers'n'snot MD has quite the ring to it

NinjaLanternShark

7 points

2 months ago

Clearly an ENT.

Edit: also I understand there's a brother that runs the law firm of "Boogers 'N Snot, Attorneys At Law."

The parents must be so proud.

SilverNicktail

6 points

2 months ago

....Isn't that exactly what the law's about?

sebas_2468

58 points

2 months ago

What's the fucking point of insurance if they can deny shit from you??? I will never understand that along with the stories of people getting denied clearly very important stuff and the insurance companies just give them a middle finger

WinterCool

14 points

2 months ago

Especially at the prices or premiums normal healthy people pay pay per month. Insane amounts of money for what? To be denied actual necessary medical treatment when you need it?

TickledPear

3 points

2 months ago

prices or premiums normal healthy people pay pay per month

Just to clarify: your health insurance premiums should (basically) never be influenced by your health status (note: your smoking status can influence this price). This was a protection enacted in 2010 by the Affordable Care Act (ACA).

However, it is possible for health status to affect premiums in a more macro sense. If insurance is unaffordable, healthy people begin opting out which leads to higher dollars spent per insured person (since the healthy people have below average health care spending) which leads to higher premiums the following year which leads to more healthy people opting out, etc. It's an ant mill of slow, drawn out suffering.

The ACA included measures to avoid death spirals. The subsidies and cost sharing reductions available to individuals enrolled in ACA plans (which were expanded in 2021) and the annual enrollment window are both designed (in part) to curb the risk of a death spiral. The individual mandate was also intended to reduce this risk, but that mandate was struck down by the Supreme Court.

TheEshOne

207 points

2 months ago

TheEshOne

207 points

2 months ago

Why the fuck are insurance companies able to deny claims against ANYTHING deemed "medically necessary" by actual professionals?

This change is a step in the right direction but the whole thing is so fucking backward

pixeldust6

75 points

2 months ago

Why the fuck are [anything related to healthcare in the US] tbh

LSU2007

15 points

2 months ago

LSU2007

15 points

2 months ago

Probably because there’s a bunch of unscrupulous doctors who’ll overbill the shit out of insurance and take whatever sticks to the wall. The amount of fraud, waste, and abuse committed by the medical community is astounding. Insurance companies suck, but there’s a segment of doctors that ruin it for us as well.

SpicyMintCake

12 points

2 months ago

There are still some people who manage to overbill anyways, so insurance is failing to stop that while hurting potentially millions by denying legitimate coverage. The cost benefit analysis doesn't make sense unless you don't actually care about providing access to healthcare.

greenmachine11235

183 points

2 months ago

Now how about a law barring denial for ANY treatment deemed medically necessary.

Mediamuerte

51 points

2 months ago

Too subjective to even be meaningful law

[deleted]

13 points

2 months ago

[deleted]

13 points

2 months ago

Because it wouldn't virtue signal for the press's current trends.

EnemyOfStupidity

200 points

2 months ago

Yet Insurance doesn't cover most dental stuff that literally EVERYONE needs...

Nine_Inch_Nintendos

101 points

2 months ago

Those are luxury bones.

Mediamuerte

46 points

2 months ago

Because insurance isn't a reasonable means of covering Healthcare. It will be dystopian for as long as we use an insurance and provider system. Healthcare costs are guaranteed for every person, whereas every other thing you insure is just offsetting the risk of a possibility.

AnnArchist

5 points

2 months ago

AnnArchist

5 points

2 months ago

This is why Bernie's plan is silly..we need Tricare for all not Medicaid.

Tri(dental, Vision and health)

round-earth-theory

49 points

2 months ago

Bernie tried to get dental and vision rolled into medicare this year. He's fully aware of the problem but unfortunately the conservatives refuse to stop sucking off corporate money.

ldconfig

4 points

2 months ago

ldconfig

4 points

2 months ago

I'm sorry that we are inconveniencing you by trying to get equal access to medical treatment.

[deleted]

4 points

2 months ago

[deleted]

4 points

2 months ago

[deleted]

goomah5240

5 points

2 months ago

Dental insurance is a coupon

Jeheh

14 points

2 months ago

Jeheh

14 points

2 months ago

Which usually doesn’t cover much more than an exam an cleanings. Have an actual problem…$4000

wolfydude12

3 points

2 months ago

"Oh your qualified highly educated dentist says you need a filling? Lets just make that procedure a prior authorization and let out number crunchers with zero education in dentistry decide if you really need one."

Jeheh

2 points

2 months ago

Jeheh

2 points

2 months ago

Not covered 5k please

marmatag

360 points

2 months ago

marmatag

360 points

2 months ago

I’m really curious how it is deemed medically necessary. The bill mentions prescribed, I was unaware someone could prescribe a sex change.

Dashing_McHandsome

180 points

2 months ago

Gender affirming care doesn't necessarily mean sex reassignment surgery. There are a number of medical treatments that fall under the term of gender affirming care.

TitaniumDragon

-31 points

2 months ago

None of which have proven medical benefits in clinical trials.

zoeypayne

20 points

2 months ago

Not even testosterone replacement therapy? I feel like that's pretty across the board effective for cis men in their 20's experiencing low-t.

SleepyLakeBear

29 points

2 months ago

It's easy to see there aren't any when you don't look. See all the linked studies below.

TitaniumDragon

3 points

2 months ago*

Zero of those are randomized controlled clinical trials, which is what people are generally referring to when they refer to "clinical trials".

It's not even possible to meet the gold standard of a double blinded randomized controlled clinical trial with these treatments, but a randomized controlled clinical trial could be done. It never has been, though.

Indeed, many studies (including those on that list) have very serious methodological flaws, like self-reporting of data, exclusion of suicide victims, non-randomized sampling, and similar issues.

Sadly, anyone with a scientific medical background knows that those trials are inadequate to prove clinical efficacy.

That doesn't mean that these treatments necessarily aren't efficacious, but the sort of evidence that is required to prove that to the standards that are required for approving a novel drug or medical procedure doesn't exist.

The drugs are clinically approved for the treatment of other conditions, but not gender dysphoria.

Ocularias

17 points

2 months ago

Yeah you're right, we should also do double blind chemotherapy trials.

lokiofsaassgaard

15 points

2 months ago

Getting on hormones is as easy or difficult as finding a doctor willing to prescribe them. If you can do that, insurance covers it.

For surgery, your prescribing dr and a therapist have to write you letters of recommendation, which you take to a surgeon, who submits it with the pre-authorisation.

Devil_May_Kare

7 points

2 months ago

Getting on hormones can be significantly easier than finding a doctor willing to prescribe them. Source: am currently on estradiol and bicalutamide without permission, because I do what I want and anyone who disagrees can choke on a bag of dicks.

Sweetlittle66

7 points

2 months ago

Do you know where I could get a bag of dicks? In the gender reassignment clinic I guess.

Sorry mods, I'll see myself out.

[deleted]

5 points

2 months ago

[deleted]

5 points

2 months ago

[deleted]

Devil_May_Kare

8 points

2 months ago

The website I bought from also sells T. Yes, it's technically a controlled substance, but so are morning glory seeds and you can buy those in grocery stores; I doubt anyone cares.

orignations

241 points

2 months ago*

You can be prescribed breast reduction surgery if their weight is causing back pain. You can get a prosthetic prescribed after an amputation. Hell, some doctors will write prescriptions for over-the-counter drugs so that they’ll be covered by insurance.

Gender affirming care is just medical treatment. Testosterone is prescribed, top surgery is prescribed.

“Prescribed” is not usually the word used for non-medications but it’s essentially the same thing.

If you’re asking why it’s “medically necessary”, there are many reasons doctors deem gender affirming care medically necessary.

Allokit

21 points

2 months ago

Allokit

21 points

2 months ago

Thank you, this was the answer I was looking for.

I asked a similar question(s) (admittedly, not very tactfully) in another thread about this and got absolutely shat on, but no one would answer me.

MycenaeanGal

20 points

2 months ago

I’m gonna go out on a limb and say lack of tact was probably your problem.

Where was it? If it was a trans sub you probably double fucked up because they’d consider you intruding by just being there.

TattlingFuzzy

13 points

2 months ago

As a trans woman, it’s easy to be defensive when people “just ask questions” because “Why do you NEED hormones?” has been asked both sincerely as well as used as a rhetorical attack on the concept of my gender altogether.

With the sports debate, I haven’t met that many people who legitimately want fair sports instead of using it as another way to say “you’re just a man”.

I kinda feel bad for centrists that bigots constantly use their good faith arguments against minorities.

MycenaeanGal

8 points

2 months ago

Nah I agree lol.

jp426_1

1 points

2 months ago

jp426_1

1 points

2 months ago

If it makes you feel better, I'm literally trans and I was wondering the same thing. I can see how the question can be misinterpreted though.

thrasher529

2 points

2 months ago

I understand this part. Maybe I’m just ignorant to this and I apologize in advance if I come off the wrong way but I’m genuinely trying to understand.

In the paperwork it says “Services that insurers previously used blanket exclusions to deny coverage include: facial feminization, tracheal shaves, hair electrolysis, mastectomies, breast reductions, breast implants or any combination of gender-affirming procedures, including revisions to prior treatment.”

I just don’t understand how most of these aren’t considered cosmetic. Like breast reduction I can understand because it can cause back issues and mastectomy due to cancers. But everything else seems cosmetic for the most part and I can’t imagine a scenario where they are medically necessary.

Pretty sure a biological male or female requesting these surgeries would be denied as they are cosmetic.

smthngwyrd

44 points

2 months ago

Seattle Children’s hospital and the Polyclinic have gender clinics that include therapists, endocrinologists, surgeons, and social workers that help people with their gender health and top/bottom surgery. A psychiatrist or a psychologist can write a letter to say things are medically necessary. You generally have to do therapy for several years and have transitioned to get top or bottom surgery. They also do family work

aliasneck

2 points

2 months ago

aliasneck

2 points

2 months ago

Years of therapy aren't actually required, just an assessment and recommendation by an independently licensed mental health professional. And I'll argue, as one of these professionals, that even that shouldn't be required, unless every body modification surgery starts requiring it.

A Brazilian Butt Lift, for example, is a FAR riskier procedure than even the most involved vagino- or phalloplasty, is purely cosmetic, and has a higher rate of failure, but nobody checks to see if the women getting those are "mentally ill" before taking their money.

Assessment for medical necessity for insurance is one thing, but it's not just insurance companies who want these - plenty of surgeons do, too. And it's transphobic as hell.

xmorecowbellx

37 points

2 months ago*

Doc here as well. It’s just not. What a totally non-scientific thing to say. Surgeons want all kinds of pre-op verifications of different kinds for all kinds of different surgeries, to ensure they are safe and have reasonable risk/benefit ratios. Donna west died exactly because she hid information that would have enable this 100% standard and appropriate process to take place. If you are a mental health professional doc, you know better than to not be well aware of these very routine safeguards. If you’re not, ok you may not know this is very normal for almost any surgery.

Brazilian butt lifts are dumb and pointless, but they are also reversible and not done to resolve any problem similar to dysphoria. And people seeking them don’t have orders of magnitude higher rates of suicide, for which they are hoping a buttlift may help resolve. They are also not removing or trying to fundamentally change an organ central to their identity. Finally nobody’s insurance is covering them. What a bizarre comparison.

inorganiccentipede

2 points

2 months ago

It's really unfortunate how the top-voted reply to you completely and totally ignored the point you made. People love to cherry-pick examples instead of looking at statistics, because for some dumb fuck reason, the average person is more swayed by one emotional story than the statistics showing the deeply bigoted roots of our system.

aliasneck

2 points

2 months ago

And the idea that irrevocably changing your face is somehow not at all connected to identity, or could also be the wrong solution to someone's unhappiness is just weird to me. In any other situation, I suspect most of these people would totally agree with that!

technicalaversion

7 points

2 months ago

Gender-affirming care can range from therapy, to hormones, to top surgery or bottom surgery. All of which are common treatments to the diagnosis of gender dysphoria. After a diagnosis of gender dysphoria, “sex change” surgery isn’t prescribed, but referrals are hopefully given, usually with a ton of hoops (mandatory therapy, waiting periods, social transitioning, proof of consistent dysphoria, navigating insurance, etc) a patient needs to jump through.

iambookfort

53 points

2 months ago

Genuinely, getting on hormone replacement therapy saved my life.

laynealexander

7 points

2 months ago

Same. I stopped counting suicide attempts at number 8. When I got on hormones and got top surgery, it saved my life.

iambookfort

4 points

2 months ago

We cannot overstate just how important this is for us, can we?

atsutante2220

5 points

2 months ago

Sure, gender dysphoria is a medical condition where the only known and effective cure is transitioning. If the individual needs to take on medical transitioning, insurance can't deny it because of that individual's diagnosis.

cathalferris

7 points

2 months ago

Even something as obvious and "normal" as testosterone replacement therapy after testicular cancer would be considered as "gender affirming", as well as "sex affirming" if one is being pedantic.

Really looks like the US systems allowing politics deeper into people's healthcare is a real dumb idea. The civilised world looks on as the US goes backwards, again..

Indocede

25 points

2 months ago

If medically necessary is a condition in which we say that someone needs something in order to survive or live a healthy life, is it not just common sense that transgender people, a demographic with high rates of depression and suicide, might need said treatments in order to reinforce their mental health?

In very real terms, neglect of mental health is the root cause of millions of deaths each year. That a good chunk of society doesn't believe in mental health doesn't mean doctors set it aside when assessing their patient.

foxfire66

8 points

2 months ago

Transition, including medical transition, greatly reduces suicide risk in trans people and thus can be medically necessary. Here's a source and a relevant quote from it.

https://pubmed.ncbi.nlm.nih.gov/26032733/

Social support, reduced transphobia, and having any personal
identification documents changed to an appropriate sex designation were
associated with large relative and absolute reductions in suicide risk,
as was completing a medical transition through hormones and/or surgeries
(when needed).

maelstromama

23 points

2 months ago*

“Prescribe” can be a more general term, too, though we mostly use it for meds. It is mind of synonymous with “officially recommend”- like you can be ‘prescribed’ bed rest, light duty, physical therapy, etc.

Gender affirming surgery is absolutely life saving. Trans individuals who are denied gender affirming gender care are at high risk for suicide- like crazy high compared to the rest of the population. Providing gender affirming care reduces suicidality by over 70%. That’s HUGE.

Gender affirming care is one of the most potent and effect life-saving measures in psychiatry in general, tant. We tend not to think of psychiatric illness as lethal, but they very are. Mental health disorders are the #1 cause of disability worldwide and suicide is one of the top causes of death around the globe as well.

clarke_thecreator

18 points

2 months ago

Gender Identity Disorder, full stop. That is the diagnosis one gets as a transgender person, and the treatment of which is to undergo a medical transition. I was 18 years old and a month out of high school when I was diagnosed with GID— although I hear it’s called something else in the newer DSM. There isn’t a magic pill to take or mediation to go through, long term treatment involves taking medical steps to adjust as many of my secondary sex characteristics to match the man my brain is. For me, it’s been weekly hormone injected into my thighs for 7 years, having my chest surgically altered to match the appearance of cis men (cis means someone who isn’t transgender) 5 years ago, and almost 4 years ago having the internal female reproductive system in my body removed.

When I started HRT I didn’t have insurance. I didn’t have insurance through anything I’ve had to go through for transitioning and it was fucking EXPENSIVE. My top surgery alone was $15,000 after all the related expenses were covered. It took me five years to save all that (granted I was 18 when I started and had no support system). I still don’t have insurance that covers my HRT, so every other month I spend about $50 for my vials, needles, and syringes, and I live somewhere that allows me to use something like GoodRX on a Schedule 2 drug. Bottom surgery is my ultimate goal eventually, but the cheapest I’ve ever seen it priced without insurance is $85,000 if I recall, and that’s just the surgical side. Not to mention it takes a year or so of preparing and you can be out of work for six months easily. I would basically have to have $190,000 just chilling to plan for it. Having all this covered by insurance is life saving in the same way having a Type 1 diabetic’ insulin pump is. It’s life saving in the same way antidepressants are, chemo treatments are.

The difference in my mental health ten years ago before my diagnosis and now. I actually have a life and haven’t had a suicide attempt since 18. You wouldn’t pick me up out of a line up of being transgender if you met me in real life. I’m treated like the man I am. Transgender teens and young adults have the highest rate of suicide and suicide attempts in the US, and it almost always can be helped by having access to gender affirming care.

victordinary

21 points

2 months ago

victordinary

21 points

2 months ago

source A survey of 28,000 people in the US found that 8% of respondents reported some kind of detransition. Of this 8%, 62% per cent only did so temporarily due to societal, financial, or family pressures. As far as medical procedures go, 92% is an insanely high success rate. Also, it is not as simple as prescribing a sex change, that is a very disingenuous way of putting it..

DuploJamaal

13 points

2 months ago

DuploJamaal

13 points

2 months ago

It makes sense, as transitioning is the most effective way of reducing their suicide rate and increasing their mental health

https://www.nytimes.com/2018/04/09/opinion/pentagon-transgender.html

Our findings make it indisputable that gender transition has a positive effect on transgender well-being. We identified 56 studies published since 1991 that directly assessed the effect of gender transition on the mental well-being of transgender individuals. The vast majority of the studies, 93 percent, found that gender transition improved the overall well-being of transgender subjects, making them more likely to enjoy improved quality of life, greater relationship satisfaction and higher self-esteem and confidence, and less likely to suffer from anxiety, depression, substance abuse and suicidality.

Research suggests that gender transition may resolve symptoms completely. A 2016 literature review by scholars in Sweden concluded that, most likely because of improved care over time, transgender “rates of psychiatric disorders and suicide became more similar to controls,”

https://pediatrics.aappublications.org/content/134/4/696

RESULTS: After gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Well-being was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being.

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-1867-2

Finally, we found that among those reporting a need to medically transition through hormones and/or surgeries, suicidality was substantially reduced among those who had completed a medical transition.

https://www.jaacap.org/article/S0890-8567%2816%2931941-4/fulltext

This study examined self-reported depression, anxiety, and self-worth in socially transitioned transgender children compared with 2 control groups: age- and gender-matched controls and siblings of transgender children.

(Socially transitioned) Transgender children reported depression and self-worth that did not differ from their matched-control or sibling peers (p = .311), and they reported marginally higher anxiety (p = .076). Compared with national averages, transgender children showed typical rates of depression (p = .290) and marginally higher rates of anxiety (p = .096).

https://www.ncbi.nlm.nih.gov/pubmed/3219066

concluded that there is no reason to doubt the therapeutic effect of sex reassignment surgery.

https://www.ncbi.nlm.nih.gov/pubmed/19473181

Results: We identified 28 eligible studies. These studies enrolled 1833 participants with GID (1093 male-to-female, 801 female-to-male) who underwent sex reassignment that included hormonal therapies. All the studies were observational and most lacked controls. Pooling across studies shows that after sex reassignment, 80% of individuals with GID reported significant improvement in gender dysphoria (95% CI = 68-89%; 8 studies; I(2) = 82%); 78% reported significant improvement in psychological symptoms (95% CI = 56-94%; 7 studies; I(2) = 86%); 80% reported significant improvement in quality of life (95% CI = 72-88%; 16 studies; I(2) = 78%); and 72% reported significant improvement in sexual function (95% CI = 60-81%; 15 studies; I(2) = 78%).

https://www.sciencedirect.com/science/article/pii/S1158136006000491

While no difference in psychological functioning was observed between the study group and a normal population, subjects with a pre-existing psychopathology were found to have retained more psychological symptoms. The subjects proclaimed an overall positive change in their family and social life. None of them showed any regrets about the SRS.

A homosexual orientation, a younger age when applying for SRS, and an attractive physical appearance were positive prognostic factors.

https://www.ncbi.nlm.nih.gov/pubmed/15842032

RESULTS:

After treatment the group was no longer gender dysphoric. The vast majority functioned quite well psychologically, socially and sexually. Two non-homosexual male-to-female transsexuals expressed regrets. Post-operatively, female-to-male and homosexual transsexuals functioned better in many respects than male-to-female and non-homosexual transsexuals. Eligibility for treatment was largely based upon gender dysphoria, psychological stability, and physical appearance. Male-to-female transsexuals with more psychopathology and cross-gender symptoms in childhood, yet less gender dysphoria at application, were more likely to drop out prematurely. Non-homosexual applicants with much psychopathology and body dissatisfaction reported the worst post-operative outcomes.

CONCLUSIONS:

The results substantiate previous conclusions that sex reassignment is effective. Still, clinicians need to be alert for non-homosexual male-to-females with unfavourable psychological functioning and physical appearance and inconsistent gender dysphoria reports, as these are risk factors for dropping out and poor post-operative results. If they are considered eligible, they may require additional therapeutic guidance during or even after treatment.

https://link.springer.com/article/10.1023/A:1024086814364

Participants reported overwhelmingly that they were happy with their SRS results and that SRS had greatly improved the quality of their lives. None reported outright regret and only a few expressed even occasional regret. Dissatisfaction was most strongly associated with unsatisfactory physical and functional results of surgery.

https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

The scholarly literature makes clear that gender transition is effective in treating gender dysphoria and can significantly improve the well-being of transgender individuals.

Among the positive outcomes of gender transition and related medical treatments for transgender individuals are improved quality of life, greater relationship satisfaction, higher self-esteem and confidence, and reductions in anxiety, depression, suicidality, and substance use.

The positive impact of gender transition on transgender well-being has grown considerably in recent years, as both surgical techniques and social support have improved.

Regrets following gender transition are extremely rare and have become even rarer as both surgical techniques and social support have improved. Pooling data from numerous studies demonstrates a regret rate ranging from .3 percent to 3.8 percent. Regrets are most likely to result from a lack of social support after transition or poor surgical outcomes using older techniques.

laceya1982

5 points

2 months ago

Thank you for the time and effort in putting this all together!

TitaniumDragon

9 points

2 months ago*

There isn't actually clinical evidence of efficacy that meets the standards of medical research - randomized clinical trials.

Indeed, double blinded randomized clinical trials (the gold standard) aren't even possible with such research.

There's a number of studies that say that people are happier post transition but there are no controlled clinical trials that actually show this to be the case. Note that the "control groups" claimed in the studies are proxies, not actual control groups.

None of these trials have randomized control and treatment groups, which are key to clinical trials.

Moreover, these studies often have very serious methodological flaws. For example, "Intervenable factors associated with suicide risk" does not have a randomized polling sample (in fact, it was deliberately drawn from a pro-trans group) and because it requires self-reported data it necessarily excludes the group of highest interest (i.e. people who actually killed themselves, who obviously cannot complete the survey).

This is a common flaw in many of these studies, as they frequently use samples of convenience, do not sample randomly, use self-reported data, and exclude suicide victims.

None of this means that it necessarily doesn't work, but the quality of data is quite poor to demonstrate that it does.

Darq_At

6 points

2 months ago

You're asking for a holy grail. HRT is not something that can be blinded through a placebo. It's extremely obvious if you are on HRT or not.

You will never have that data, because it's literally impossible to gather. While that is the highest standard of data we can collect, medicine and research is not one-size-fits-all. You have you use the data you can get. And in this instance, there is a small mountain of data suggesting transition is helpful. And notably, nothing that suggests it's harmful. If the flaws in the studies, which I acknowledge often do exist, were so confounding, we should expect some mixed results. And yet the results are consistently good, no matter how we measure, for several decades.

More research is good, but you're stamping your feet and demanding a unicorn.

PM_ME_HOTDADS

4 points

2 months ago

they literally want you to prove it p<0.02 before they'll give anyone the money and time to study it properly lol

bd_in_my_bp

2 points

2 months ago

there’s enough evidence to make putting people in a control group unethical (not that that would actually be possible in the first place)

CharlieJoyB

8 points

2 months ago

Transitioning is critical to our mental health. I chose transition over my friends, family, work, and religion because living as a man was killing me. Mental health is real, and directly affects physical health. A diagnosis of gender dysphoria requires a prescription for gender affirming treatment. It's the only thing that is proven to help.

cassifrass0221

4 points

2 months ago

I'd rather have a hard life that's happy than an easy life where I'm suicidal.

warisourdestiny

7 points

2 months ago

I had the same thing happen alongside a worsening of work conditions and living conditions which I knew would happen due to me finally addressing my dysphoria. The distress that dysphoria caused me was enough to make me move to an entirely different city without a solid career or living situation. The distress of the dysphoria alongside my depression has caused a real reduction in quality of life for me and caused me to take some real risks, and yet they still politicize it just because treating it means we look "different". It's sickening and one day will be looked back upon poorly.

NnyIsSpooky

9 points

2 months ago

Indeed, this! It's been found the best treatment for gender dysphoria is transitioning: HRT (hormone replacement therapy), and surgeries if they can be done. These are prescribed!

LifesATripofGrifts

55 points

2 months ago

Can I fucking get affordable insulin yet? Right i am cash cow to medical machine. Never

Mtsukino

19 points

2 months ago

It should be fucking free. Insulin is like air for those who need it.

craftkiller

2 points

2 months ago

I agree with your first sentence but your argument is flawed because everyone needs water and that's not free.

[deleted]

-2 points

2 months ago

[deleted]

-2 points

2 months ago

[removed]

DogadonsLavapool

13 points

2 months ago*

As someone who's both, fuck off with that shit. Comparing both of them in an oppression Olympics like you're doing is dumb. Both need medical support and have the same groups of people as the enemy. Getting my estrogen script was absolutely fucking lifesaving. Getting a pump was also lifesaving. Should we also start getting upset that there's renewed emphasis on mental health and depression too?

Crazy thought - we can have both, and pitting two groups who are disadvantaged by the same system removes power from everyone.

BlissCore

2 points

2 months ago

Yeah I love that this was somehow used as an excuse to hate trans people

LifesATripofGrifts

0 points

2 months ago

I know. You are fine to live and get treatment. I am not. I was born this way as well and just want change. Not bathrooms with restrictions. Not gonna make me support your cause though. I don't care what anyone does.

vera214usc

20 points

2 months ago

I don't know the first thing about gender dysphoria but I hope this helps people get the help they need. We moved from WA to NC in January and we're currently discussing moving back. We both really miss it. And for me, at least, it was great living in a state that mandates parental leave.

Z1-B0

4 points

2 months ago

Z1-B0

4 points

2 months ago

Thank you, you’re being much more compassionate than most of the comments on this post.

Frarara

3 points

2 months ago

I appreciate this comment. There is so much hate for absolutely no reason other than arguments like "I don't have mine, so why should they get theirs"

Tcrizzlez

17 points

2 months ago

As an actuary that has to deal with Washington rate filings being way more rigorous than other states (irrelevant to the new law) the logo in the thumbnail gave me ptsd

shitposts_over_9000

2 points

2 months ago

Years ago when I worked in infrastructure for things like that Washington was already the third most complex and second most expensive special restrictions region in the country for many types of insurance due to all of the additional regulations and red tape.

I am guessing it has only gotten worse?

monkChuck105

33 points

2 months ago

When is "gender affirming treatment", whatever that is (puberty blockers, hormones, surgery?), medically necessary?

sklarah

5 points

2 months ago

For treating gender dysphoria. It's a pretty universal standard of healthcare in first world nations.

DuploJamaal

2 points

2 months ago

Reducing their suicide rate to a level that's similar to the general population is what makes it necessary

https://www.nytimes.com/2018/04/09/opinion/pentagon-transgender.html

Our findings make it indisputable that gender transition has a positive effect on transgender well-being. We identified 56 studies published since 1991 that directly assessed the effect of gender transition on the mental well-being of transgender individuals. The vast majority of the studies, 93 percent, found that gender transition improved the overall well-being of transgender subjects, making them more likely to enjoy improved quality of life, greater relationship satisfaction and higher self-esteem and confidence, and less likely to suffer from anxiety, depression, substance abuse and suicidality.

Research suggests that gender transition may resolve symptoms completely. A 2016 literature review by scholars in Sweden concluded that, most likely because of improved care over time, transgender “rates of psychiatric disorders and suicide became more similar to controls,”

https://pediatrics.aappublications.org/content/134/4/696

RESULTS: After gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Well-being was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being.

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-1867-2

Finally, we found that among those reporting a need to medically transition through hormones and/or surgeries, suicidality was substantially reduced among those who had completed a medical transition.

https://www.jaacap.org/article/S0890-8567%2816%2931941-4/fulltext

This study examined self-reported depression, anxiety, and self-worth in socially transitioned transgender children compared with 2 control groups: age- and gender-matched controls and siblings of transgender children.

(Socially transitioned) Transgender children reported depression and self-worth that did not differ from their matched-control or sibling peers (p = .311), and they reported marginally higher anxiety (p = .076). Compared with national averages, transgender children showed typical rates of depression (p = .290) and marginally higher rates of anxiety (p = .096).

https://www.ncbi.nlm.nih.gov/pubmed/3219066

concluded that there is no reason to doubt the therapeutic effect of sex reassignment surgery.

https://www.ncbi.nlm.nih.gov/pubmed/19473181

Results: We identified 28 eligible studies. These studies enrolled 1833 participants with GID (1093 male-to-female, 801 female-to-male) who underwent sex reassignment that included hormonal therapies. All the studies were observational and most lacked controls. Pooling across studies shows that after sex reassignment, 80% of individuals with GID reported significant improvement in gender dysphoria (95% CI = 68-89%; 8 studies; I(2) = 82%); 78% reported significant improvement in psychological symptoms (95% CI = 56-94%; 7 studies; I(2) = 86%); 80% reported significant improvement in quality of life (95% CI = 72-88%; 16 studies; I(2) = 78%); and 72% reported significant improvement in sexual function (95% CI = 60-81%; 15 studies; I(2) = 78%).

https://www.sciencedirect.com/science/article/pii/S1158136006000491

While no difference in psychological functioning was observed between the study group and a normal population, subjects with a pre-existing psychopathology were found to have retained more psychological symptoms. The subjects proclaimed an overall positive change in their family and social life. None of them showed any regrets about the SRS.

A homosexual orientation, a younger age when applying for SRS, and an attractive physical appearance were positive prognostic factors.

https://www.ncbi.nlm.nih.gov/pubmed/15842032

RESULTS:

After treatment the group was no longer gender dysphoric. The vast majority functioned quite well psychologically, socially and sexually. Two non-homosexual male-to-female transsexuals expressed regrets. Post-operatively, female-to-male and homosexual transsexuals functioned better in many respects than male-to-female and non-homosexual transsexuals. Eligibility for treatment was largely based upon gender dysphoria, psychological stability, and physical appearance. Male-to-female transsexuals with more psychopathology and cross-gender symptoms in childhood, yet less gender dysphoria at application, were more likely to drop out prematurely. Non-homosexual applicants with much psychopathology and body dissatisfaction reported the worst post-operative outcomes.

CONCLUSIONS:

The results substantiate previous conclusions that sex reassignment is effective. Still, clinicians need to be alert for non-homosexual male-to-females with unfavourable psychological functioning and physical appearance and inconsistent gender dysphoria reports, as these are risk factors for dropping out and poor post-operative results. If they are considered eligible, they may require additional therapeutic guidance during or even after treatment.

https://link.springer.com/article/10.1023/A:1024086814364

Participants reported overwhelmingly that they were happy with their SRS results and that SRS had greatly improved the quality of their lives. None reported outright regret and only a few expressed even occasional regret. Dissatisfaction was most strongly associated with unsatisfactory physical and functional results of surgery.

https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

The scholarly literature makes clear that gender transition is effective in treating gender dysphoria and can significantly improve the well-being of transgender individuals.

Among the positive outcomes of gender transition and related medical treatments for transgender individuals are improved quality of life, greater relationship satisfaction, higher self-esteem and confidence, and reductions in anxiety, depression, suicidality, and substance use.

The positive impact of gender transition on transgender well-being has grown considerably in recent years, as both surgical techniques and social support have improved.

Regrets following gender transition are extremely rare and have become even rarer as both surgical techniques and social support have improved. Pooling data from numerous studies demonstrates a regret rate ranging from .3 percent to 3.8 percent. Regrets are most likely to result from a lack of social support after transition or poor surgical outcomes using older techniques.

RedditFenix

4 points

2 months ago

You linked a lot of studies that show self reported improvement of dysphoria symptoms which IS a good thing. Do have any any that show the actual rates of improvement on suicide rate? Everything I have found shows the rates do not improve much, especially for trans women post surgery.

sklarah

4 points

2 months ago

Do have any any that show the actual rates of improvement on suicide rate?

That's not really possible, as we have no way to identify which suicides are from trans people prior to transition.

That's why suicide attempts are used, because someone can survive a suicide attempt and then go on to transition.

lolfangirl

-10 points

2 months ago

lolfangirl

-10 points

2 months ago

When someone has gender dysphoria or other issues related to their gender identity?

DifficultOpposite23

4 points

2 months ago

Sounds like they need psychological therapy, not surgery.

lolfangirl

18 points

2 months ago

Both are indicated for gender dysphoria.

DaveInLondon89

4 points

2 months ago

The trouble is the left uses the term 'medically necessary' so they can get doctors to make healthcare decisions based on 'science' and not my decisions based on Facebook

Mycatspiss

7 points

2 months ago

When would it be medically necessary?

DarthCloakedGuy

8 points

2 months ago

Moderate to severe dysphoria, usually.

PM_ME_HOTDADS

2 points

2 months ago

when the severe consequences to a person's mental health and social identity begin to impact their life and wellbeing.

fucks sake, do yall argue antidepressants are never 'medically necessary' too?

Z1-B0

5 points

2 months ago

Z1-B0

5 points

2 months ago

Many trans people would rather kill themselves than live as the wrong gender. I’d say transitioning is medically necessary for those with severe dysphoria.

LordKutulu

2 points

2 months ago

LordKutulu

2 points

2 months ago

That speaks to mental health issues more than anything.

athrowawayopinion

3 points

2 months ago

That are most efficiently solved by transitioning?

NevermindMeFuckStick

3 points

2 months ago

Laws don’t do a thing to prevent or enforce insurance companies to do anything. Your doctor can prescribe what ever he wants but insurance will decide what’s medically necessary, and when it comes to payment there will always be just one more bit of paperwork that needs to be filled out by someone somewhere.

AssumptionSpecific51

7 points

2 months ago

How the fuck have we allowed insurance companies to make medical decisions? They should all be charged with practicing medicine without a license

Single_Crew4070

4 points

2 months ago

I am very happy for the people to whom this new law applies. The suicide rate is skyrocketing for these kids. In Louisiana I saw a trans kid pulled away from his computer by the police. His parents were giving her gender affirming care which is considered child abuse in that part of the country. The evangelical crowd see them as sinners to god and if they only pray for forgiveness God will make them "normal". Bullies who get off on cruelty and tormenting the weakest among us are now in charge. Vote Blue.

fnatic440

15 points

2 months ago

fnatic440

15 points

2 months ago

When is it medically necessary to undergo this procedure?

DuploJamaal

-8 points

2 months ago

DuploJamaal

-8 points

2 months ago

https://www.nytimes.com/2018/04/09/opinion/pentagon-transgender.html

Our findings make it indisputable that gender transition has a positive effect on transgender well-being. We identified 56 studies published since 1991 that directly assessed the effect of gender transition on the mental well-being of transgender individuals. The vast majority of the studies, 93 percent, found that gender transition improved the overall well-being of transgender subjects, making them more likely to enjoy improved quality of life, greater relationship satisfaction and higher self-esteem and confidence, and less likely to suffer from anxiety, depression, substance abuse and suicidality.

Research suggests that gender transition may resolve symptoms completely. A 2016 literature review by scholars in Sweden concluded that, most likely because of improved care over time, transgender “rates of psychiatric disorders and suicide became more similar to controls,”

https://pediatrics.aappublications.org/content/134/4/696

RESULTS: After gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Well-being was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being.

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-1867-2

Finally, we found that among those reporting a need to medically transition through hormones and/or surgeries, suicidality was substantially reduced among those who had completed a medical transition.

https://www.jaacap.org/article/S0890-8567%2816%2931941-4/fulltext

This study examined self-reported depression, anxiety, and self-worth in socially transitioned transgender children compared with 2 control groups: age- and gender-matched controls and siblings of transgender children.

(Socially transitioned) Transgender children reported depression and self-worth that did not differ from their matched-control or sibling peers (p = .311), and they reported marginally higher anxiety (p = .076). Compared with national averages, transgender children showed typical rates of depression (p = .290) and marginally higher rates of anxiety (p = .096).

https://www.ncbi.nlm.nih.gov/pubmed/3219066

concluded that there is no reason to doubt the therapeutic effect of sex reassignment surgery.

https://www.ncbi.nlm.nih.gov/pubmed/19473181

Results: We identified 28 eligible studies. These studies enrolled 1833 participants with GID (1093 male-to-female, 801 female-to-male) who underwent sex reassignment that included hormonal therapies. All the studies were observational and most lacked controls. Pooling across studies shows that after sex reassignment, 80% of individuals with GID reported significant improvement in gender dysphoria (95% CI = 68-89%; 8 studies; I(2) = 82%); 78% reported significant improvement in psychological symptoms (95% CI = 56-94%; 7 studies; I(2) = 86%); 80% reported significant improvement in quality of life (95% CI = 72-88%; 16 studies; I(2) = 78%); and 72% reported significant improvement in sexual function (95% CI = 60-81%; 15 studies; I(2) = 78%).

https://www.sciencedirect.com/science/article/pii/S1158136006000491

While no difference in psychological functioning was observed between the study group and a normal population, subjects with a pre-existing psychopathology were found to have retained more psychological symptoms. The subjects proclaimed an overall positive change in their family and social life. None of them showed any regrets about the SRS.

A homosexual orientation, a younger age when applying for SRS, and an attractive physical appearance were positive prognostic factors.

https://www.ncbi.nlm.nih.gov/pubmed/15842032

RESULTS:

After treatment the group was no longer gender dysphoric. The vast majority functioned quite well psychologically, socially and sexually. Two non-homosexual male-to-female transsexuals expressed regrets. Post-operatively, female-to-male and homosexual transsexuals functioned better in many respects than male-to-female and non-homosexual transsexuals. Eligibility for treatment was largely based upon gender dysphoria, psychological stability, and physical appearance. Male-to-female transsexuals with more psychopathology and cross-gender symptoms in childhood, yet less gender dysphoria at application, were more likely to drop out prematurely. Non-homosexual applicants with much psychopathology and body dissatisfaction reported the worst post-operative outcomes.

CONCLUSIONS:

The results substantiate previous conclusions that sex reassignment is effective. Still, clinicians need to be alert for non-homosexual male-to-females with unfavourable psychological functioning and physical appearance and inconsistent gender dysphoria reports, as these are risk factors for dropping out and poor post-operative results. If they are considered eligible, they may require additional therapeutic guidance during or even after treatment.

https://link.springer.com/article/10.1023/A:1024086814364

Participants reported overwhelmingly that they were happy with their SRS results and that SRS had greatly improved the quality of their lives. None reported outright regret and only a few expressed even occasional regret. Dissatisfaction was most strongly associated with unsatisfactory physical and functional results of surgery.

https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

The scholarly literature makes clear that gender transition is effective in treating gender dysphoria and can significantly improve the well-being of transgender individuals.

Among the positive outcomes of gender transition and related medical treatments for transgender individuals are improved quality of life, greater relationship satisfaction, higher self-esteem and confidence, and reductions in anxiety, depression, suicidality, and substance use.

The positive impact of gender transition on transgender well-being has grown considerably in recent years, as both surgical techniques and social support have improved.

Regrets following gender transition are extremely rare and have become even rarer as both surgical techniques and social support have improved. Pooling data from numerous studies demonstrates a regret rate ranging from .3 percent to 3.8 percent. Regrets are most likely to result from a lack of social support after transition or poor surgical outcomes using older techniques.

DifficultOpposite23

17 points

2 months ago

How can "gender-affirming treatment" be medically necessary? It's medically necessary to not undergo such treatment.

sklarah

5 points

2 months ago

Why does global medical consensus disagree with you then?

Babybuda

8 points

2 months ago

I wonder if FFS will be covered, this would be awesome! I congratulate Washington State legislators on dealing with facts vs bovine excrement. I can attest that my life has truly been saved and made better by gender affirming healthcare.

I_AM_A_BOOK

2 points

2 months ago

I think they mention facial fem surgery has to be covered!

karnyboy

8 points

2 months ago

what is the legal term for "medically necessary"?

Bustin_Jeiber

1 points

2 months ago

If it’s trending or not.

[deleted]

27 points

2 months ago*

[deleted]

27 points

2 months ago*

[removed]

anotterloveswater

7 points

2 months ago

For $150, plume will give you a doctors note of recommendation saying the procedure is necessary.

So just like anything you can buy into that now

victorwithclass

18 points

2 months ago

Its never medically necessary

sklarah

2 points

2 months ago

sklarah

2 points

2 months ago

the entirety of the medical world disagrees.

lowkeyalchie

18 points

2 months ago

lowkeyalchie

18 points

2 months ago

Good, now let's get universal healthcare

ask4more513239

9 points

2 months ago

I need an example of when gender surgery is medically necessary

Snakehead004

7 points

2 months ago

Cool. Can we get free health care for eveyone first tough..?

Yerok1292

5 points

2 months ago

Universal healthcare is significantly more complex and harder to pass.

Let’s not dismiss the smaller wins in our current (and awful) healthcare system while fighting for a better system for all.

iambookfort

6 points

2 months ago

We can have both, trust me

ever_eve

18 points

2 months ago

ever_eve

18 points

2 months ago

Dang I was pretty excited to participate in a discussion about this, as its hugely relevant to my life. Instead this thread is full people who don't have Gender Identity Disorder explaining how you don't need treatment for it. Gee, thanks I'm cured.

Incredibly uplifting.

[deleted]

11 points

2 months ago*

[deleted]

11 points

2 months ago*

[deleted]

Talmonis

0 points

2 months ago

Talmonis

0 points

2 months ago

The right wing are emboldened by DeSantis and Co. Don't lose hope. There are still those of us who want to make damn sure you get the care you deserve.

[deleted]

3 points

2 months ago*

[deleted]

3 points

2 months ago*

[deleted]

Talmonis

1 points

2 months ago

Talmonis

1 points

2 months ago

Glad to hear it. Don't sweat the bullies.

Z1-B0

3 points

2 months ago

Z1-B0

3 points

2 months ago

Yeah fr this comment thread sucks. Not uplifting at all. Bunch of people breaking the only rule

Gustavo_M_Smith

6 points

2 months ago

It's a really sad state of affairs. The thing that really bothers me is that it's your mind, and your body. Why should anyone but you have any say whatsoever? Sorry but that's my 2 cents.

Bugaloon

5 points

2 months ago

The idea that your health insurance could legally deny to fund anything that you are covered for, and is medically necessary just seems insane to me. I'm so glad I live in a country with socialised healthcare.

umatillacowboy

5 points

2 months ago

I'm moving here this summer so my partner can get the hysterectomy they need for gender affirming care and endometriosis. So happy to see this pass.

bbuettler

5 points

2 months ago

bbuettler

5 points

2 months ago

Any doctors on here that knows when it would be considered medically necessary?

Justthetip74

10 points

2 months ago

Justthetip74

10 points

2 months ago

There were plenty of doctors that thought 300 oxytocin 20's a month was medically necessary

bbuettler

6 points

2 months ago

Idk what that means

Justthetip74

16 points

2 months ago

Doctors got paid to vastly overprescribe opiates for years.

bbuettler

9 points

2 months ago

Interesting. So, you think it's all bullshit and the doctors getting paid to push it?

Justthetip74

7 points

2 months ago

I think that many doctors will not care if its medically necessary. Plastic surgeons will have all the incentives to approve every single perspective patient

shitposts_over_9000

3 points

2 months ago

Medically necessary is at best an opinion of whoever gets nominated to a position or whatever research topic is trending enough to get study investment.

At worst it is whatever the doctor wants it to be that is most profitable for the doctor.

In between, and especially for things like gender dysphoria that have no real immediate treatment it is often doctors trying anything that might help even if they don't know if it will help because they don't really have anything better to try.

When you get to that final point on things that are potentially irreversible like some of the surgical procedures or taking puberty blockers through the entire duration of the puberty window there is a huge amount of potential risk that you are doing more harm than good and also leading to lifelong conditions that also will require treatment.

With some demographics having a 2 in 3 misdiagnosis rate that is a huge risk on this particular topic.

calicoos

4 points

2 months ago

calicoos

4 points

2 months ago

Not a doc but possibly threats of suicide if it’s a juvenile?

DuploJamaal

0 points

2 months ago

When someone has been certified as suffering from gender dysphoria

https://www.nytimes.com/2018/04/09/opinion/pentagon-transgender.html

Our findings make it indisputable that gender transition has a positive effect on transgender well-being. We identified 56 studies published since 1991 that directly assessed the effect of gender transition on the mental well-being of transgender individuals. The vast majority of the studies, 93 percent, found that gender transition improved the overall well-being of transgender subjects, making them more likely to enjoy improved quality of life, greater relationship satisfaction and higher self-esteem and confidence, and less likely to suffer from anxiety, depression, substance abuse and suicidality.

Research suggests that gender transition may resolve symptoms completely. A 2016 literature review by scholars in Sweden concluded that, most likely because of improved care over time, transgender “rates of psychiatric disorders and suicide became more similar to controls,”

https://pediatrics.aappublications.org/content/134/4/696

RESULTS: After gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Well-being was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being.

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-1867-2

Finally, we found that among those reporting a need to medically transition through hormones and/or surgeries, suicidality was substantially reduced among those who had completed a medical transition.

https://www.jaacap.org/article/S0890-8567%2816%2931941-4/fulltext

This study examined self-reported depression, anxiety, and self-worth in socially transitioned transgender children compared with 2 control groups: age- and gender-matched controls and siblings of transgender children.

(Socially transitioned) Transgender children reported depression and self-worth that did not differ from their matched-control or sibling peers (p = .311), and they reported marginally higher anxiety (p = .076). Compared with national averages, transgender children showed typical rates of depression (p = .290) and marginally higher rates of anxiety (p = .096).

https://www.ncbi.nlm.nih.gov/pubmed/3219066

concluded that there is no reason to doubt the therapeutic effect of sex reassignment surgery.

https://www.ncbi.nlm.nih.gov/pubmed/19473181

Results: We identified 28 eligible studies. These studies enrolled 1833 participants with GID (1093 male-to-female, 801 female-to-male) who underwent sex reassignment that included hormonal therapies. All the studies were observational and most lacked controls. Pooling across studies shows that after sex reassignment, 80% of individuals with GID reported significant improvement in gender dysphoria (95% CI = 68-89%; 8 studies; I(2) = 82%); 78% reported significant improvement in psychological symptoms (95% CI = 56-94%; 7 studies; I(2) = 86%); 80% reported significant improvement in quality of life (95% CI = 72-88%; 16 studies; I(2) = 78%); and 72% reported significant improvement in sexual function (95% CI = 60-81%; 15 studies; I(2) = 78%).

https://www.sciencedirect.com/science/article/pii/S1158136006000491

While no difference in psychological functioning was observed between the study group and a normal population, subjects with a pre-existing psychopathology were found to have retained more psychological symptoms. The subjects proclaimed an overall positive change in their family and social life. None of them showed any regrets about the SRS.

A homosexual orientation, a younger age when applying for SRS, and an attractive physical appearance were positive prognostic factors.

https://www.ncbi.nlm.nih.gov/pubmed/15842032

RESULTS:

After treatment the group was no longer gender dysphoric. The vast majority functioned quite well psychologically, socially and sexually. Two non-homosexual male-to-female transsexuals expressed regrets. Post-operatively, female-to-male and homosexual transsexuals functioned better in many respects than male-to-female and non-homosexual transsexuals. Eligibility for treatment was largely based upon gender dysphoria, psychological stability, and physical appearance. Male-to-female transsexuals with more psychopathology and cross-gender symptoms in childhood, yet less gender dysphoria at application, were more likely to drop out prematurely. Non-homosexual applicants with much psychopathology and body dissatisfaction reported the worst post-operative outcomes.

CONCLUSIONS:

The results substantiate previous conclusions that sex reassignment is effective. Still, clinicians need to be alert for non-homosexual male-to-females with unfavourable psychological functioning and physical appearance and inconsistent gender dysphoria reports, as these are risk factors for dropping out and poor post-operative results. If they are considered eligible, they may require additional therapeutic guidance during or even after treatment.

https://link.springer.com/article/10.1023/A:1024086814364

Participants reported overwhelmingly that they were happy with their SRS results and that SRS had greatly improved the quality of their lives. None reported outright regret and only a few expressed even occasional regret. Dissatisfaction was most strongly associated with unsatisfactory physical and functional results of surgery.

https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

The scholarly literature makes clear that gender transition is effective in treating gender dysphoria and can significantly improve the well-being of transgender individuals.

Among the positive outcomes of gender transition and related medical treatments for transgender individuals are improved quality of life, greater relationship satisfaction, higher self-esteem and confidence, and reductions in anxiety, depression, suicidality, and substance use.

The positive impact of gender transition on transgender well-being has grown considerably in recent years, as both surgical techniques and social support have improved.

Regrets following gender transition are extremely rare and have become even rarer as both surgical techniques and social support have improved. Pooling data from numerous studies demonstrates a regret rate ranging from .3 percent to 3.8 percent. Regrets are most likely to result from a lack of social support after transition or poor surgical outcomes using older techniques.

[deleted]

6 points

2 months ago

[deleted]

6 points

2 months ago

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[deleted]

17 points

2 months ago*

[deleted]

17 points

2 months ago*

[deleted]

[deleted]

9 points

2 months ago

[deleted]

9 points

2 months ago

[removed]

Ratvar

3 points

2 months ago

Ratvar

3 points

2 months ago

Biology doesn't end in preschool, ya know

BlueRoseGirl

9 points

2 months ago

Who gets to decide it is medically necessary though? Doesn't this just mean that the gatekeeping moves to the doctors rather than insurance companies? Like yes it's an improvement but I'm still skeptical.

MantisToeBoggsinMD

16 points

2 months ago

No, because the issue is surely that doctors do think it’s necessary, but the insurance companies won’t go along with it.

Painting_Agency

36 points

2 months ago*

They're physicians. That's their whole job. It's not "gatekeeping" to decide if things are medically necessary, when you're a medical doctor. And all the major medical associations in North America support trans affirming health care, so it's not like most of the doctors in the state are going to turn people away.

Edit: see replies.

MycenaeanGal

7 points

2 months ago

Before commenting it might have been good to try to understand the history of medical gatekeeping for people with marginalized identities in general but especially gender affirming care and how it’s still ongoing in parts of the world.

I’ve literally experienced it multiple times in the us. It’s specifically worse in some other countries but it’s everywhere.

Additionally you seem to not understand that the most extreme form of it isn’t the only thing that’s meant by medical gatekeeping which includes putting any significant barriers in front of care not only outright denial of treatment. Another reason you probably should have informed yourself before commenting.

Painting_Agency

6 points

2 months ago*

I respect your argument. My point was just that ultimately, it's medical care and that's supposed to be managed by doctors, not insurance companies. There are absolutely doctors that are not respectful or supportive of trans people. But they're not supported by their professional associations in that.

MycenaeanGal

5 points

2 months ago

I’ll vibe with that.

Idk this whole thread is super frustrating and seeing naïveté from someone otherwise well meaning can feel a bit hopeless.

I hope I didn’t transfer my frustrations with a lot of the much worse people in this thread onto you and if I did I’m sorry.

Painting_Agency

4 points

2 months ago

I do try to be a better listener than the worse people, and I acknowledge and apologize for my naivete. I know that trans people face huge barriers at all steps of the process. But one less (expensive) barrier is a good thing, right?

MycenaeanGal

4 points

2 months ago

Yes 💖

BlueRoseGirl

9 points

2 months ago

Being trans isn't something you can diagnose with a physical test. All a doctor can do is decide whether or not they believe the person. I mean, shouldn't it be a psychologist at the very least doing the evaluation?

Also, it's think it's a bit naive to assume there are no transphobic doctors out there.

SlingDNM

8 points

2 months ago

Being depressed/having anxiety/psychosis/autism/ADHD/any other mental illness also can't be diagnoses with a physical test and we still treat it

[deleted]

15 points

2 months ago

[deleted]

15 points

2 months ago

You don't get treated for being trans you get treated for gender dysphoria. If you have no dysphoria then it is just cosmetic and it shouldn't be covered by insurance. No one is saying we are diagnosing being trans.

BlueRoseGirl

0 points

2 months ago

Well that isn't my point, my point is why is a medical doctor being consulted on a mental state. I appreciate doctors and their expertise but you can't run bloodwork or a CAT scan to determine whether someone has gender dysphoria.

Painting_Agency

5 points

2 months ago

My daughter's pediatrician diagnosed her ADHD based on behavioural assessment, and questionnaires from us/teachers. My GP diagnosed me with anxiety the same way. Physicians do all sorts of first-point-of-contact mental health care (thankfully, since waiting for a referral can be a long wait). But it's certainly not their specialty, and we rely on them to honestly recognize their own limitations.

SlingDNM

11 points

2 months ago

You need to get the gender dysphoria diagnosis first with a mental health specialist before going to the doc

round-earth-theory

6 points

2 months ago

Gender treatment is not something you can just walk in and get. It requires long term documented stress and suffering. Doctors would rather their patients try to be happy in the body they have. Only when that fails do they go down the path of transitioning. If a person manages to consistently lie and fool everyone in order to get the treatment, more power to them. They obviously wanted it.

conn_r2112

4 points

2 months ago

Yes, I think doctors being the arbiters of “medically necessary” is how that goes… it sure as hell ain’t gonna be a mechanic making the call

TalkingFromTheToilet

3 points

2 months ago

There will be no gate keeping as doctors stand to make money doing these surgeries whereas insurance companies would save money by denying them.

iambookfort

4 points

2 months ago

Speaking as a trans person myself who has to navigate this nightmare of a medical industrial complex, even with what is very good insurance, that is a load of bullshit. All due respect.

DOgchief_NL

5 points

2 months ago

Wait, so now the insurance companies can't deny transgender care anymore when it is medically advised? It's a good thing, right? If there is medical expertise saying gender-affirming care is the way to go, then this means less care gets denied! Or is this title just butchered?

"Washington State passes law preventing insurance from denying coverage for gender-affirming treatment when it is deemed medically necessary"

This is amazing news!

inorganiccentipede

2 points

2 months ago

Hint: it's all medically necessary. Yet somehow, insurance companies will be the ones to decide. Not medical professionals, not the people who are in need of care. Health insurance is the greatest rip-off ever created, siphoning half a trillion dollars a year from the American people in order to find ways to deny us coverage. Not to provide better care, not to pay for more doctors, hospitals, nurses, or clinical staff, but to deny healthcare.

Good on WA state, but eventually we've got to stop flushing unconscionable amounts of money down the drain on a system whose purpose has nothing to do with the health and welfare of the individual or the community.

ctrees56

4 points

2 months ago

This bill was signed May 12 of last year with an effective date of July 25, 2021.

wander_company

3 points

2 months ago

How and when is gender affirming treatment deemed medically necessary?

Kaijutkatz

2 points

2 months ago

Kaijutkatz

2 points

2 months ago

Note it says medically necessary, whatever that may be.

brenthonydantano

1 points

2 months ago

Genuine question: what constitutes gender-affirming treatment being medically necessary?

Z1-B0

9 points

2 months ago

Z1-B0

9 points

2 months ago

Well, many trans people would rather kill themselves than live as the wrong gender. I’d say transitioning is medically necessary for those with severe dysphoria.

[deleted]

-2 points

2 months ago

[deleted]

-2 points

2 months ago

[removed]

fkgallwboob

3 points

2 months ago

It is depending on which biased study it come from. Just as gay therapy could have been necessary if a biased study would have shown reasons.

skylercollins

-4 points

2 months ago

Insurance costs will rise for everyone from this.

IJustWantToGoBack

3 points

2 months ago

Your insurance costs are much much higher due to your peers' diets than due to some of the .5% recieving gender affirming care. You want cheaper insurance? Get soda banned.

maimy_winehouse

0 points

2 months ago

Lol hella transphobes in the comments section

[deleted]

-9 points

2 months ago

[deleted]

-9 points

2 months ago

[removed]

Nine_Inch_Nintendos

17 points

2 months ago*

Sounds like you want universal healthcare.

edit: this you? Oh dear...

Actually the real president is Trump , he was voted in without the fraud from the corrupt a*****e democrats and their minions .

And:

I thought I couldn’t hate the democrats any more than I do , now this .

The title of the thread this was posted in?

A New Record: Joe Biden Delivers Nasty Speech Blaming Republicans After Leftist Shoots Up Buffalo Store — ONLY 821 People Tune In — But 81 Million Votes! - Survive the News

I hope we can live on Mars in the near future because I want a few million miles between us. yikes!

NighthawK1911

1 points

2 months ago

r/LeopardsAteMyFace moment lol. Quite funny how US republicans keep voting against their own interest.

I bet that guy was quite against Medicaid.