Michigan Blue Cross Blue Shield No Longer Covering Gender Reassignment

This story was forwarded to me by some friends at the Rainbow Law Center in Michigan. It seems that one of the largest HMOs in the country, Blue Cross Blue Shield, will no longer be covering patients who have gender reassignment surgery. BCBS has often been seen as one of the more progressive HMOs, choosing to cover homeopathic remedies, massage therapy and acupuncture, and other non-western or non-traditional treatments as well as cover gender and sexuality specific therapy when other HMOs refused. Many feminist non-profits in my area specifically chose BCBS as their provider for these reasons and I distinctly remember being encouraged to take this option when I worked outside of academe for these reasons as well. So it comes as some shock that this once “progressive” HMO has now taken what appears to be such a transphobic stance.

Both the Michigan Coalition for Gender Equality, which includes Rainbow Law Center, and the ACLU have issued statements condemning BCBS Michigan and asking them to re-establish coverage:

Michigan Coalition for Gender Equality Statement

We are concerned that BCBSM underestimates the profound impact of these medically necessary procedures,” said Andre Wilson of MCGE. “Gender reassignment surgeries can be a critical part of the transition process and these new exclusions will place many transgender individuals and their families at real risk.

The American Medical Association, American Psychological Association, National Association of Social Workers, and World Professional Association for Transgender Health (WPATH) have called for coverage by public and private insurers of all medically necessary procedures for the treatment of gender dysphoria or transsexualism, including gender reassignment surgeries. Treatment delays or denials for such services often lead to more serious and expensive health problems, states the AMA, which has also called exclusions of transgender-related services discriminatory. WPATH affirms that gender reassignment surgeries are “cost-effective, not cost-prohibitive” and can be “essential to achieving well-being for the transsexual patient.”

Many people are unaware of the distress accompanying gender dysphoria and of the damage caused by insurance exclusions,” said Maxine Thome Executive Director of NASW Michigan. “Research shows the effectiveness of treatment, and Social Workers see the difference firsthand.  Access to services brings dramatic improvements in health status, as well as increased employability and social acceptance.

ACLU Statement

Excluding medically necessary gender reassignment surgeries endangers patients’ health which strains the entire health care system, driving costs up for everyone. We urge both BCBSM and the Michigan Office of Financial and Insurance Regulation to reconsider this benefit change.

If you belong to a feminist organization that uses BCBS as one or your only HMO coverage option, please alert your agency to the decision of BCBSM and ask them to write a letter condemning those actions as well as to consider alternative coverage that is more in keeping with the rights of all women. One thing that I think most feminists agree on is that health care is not a privilege it is a right and that women and children bear the largest burden when that right is compromised by oppression based politics.

If you live in Michigan, as many of my readers do, please consider calling in to BCBSM and letting them know that it is not ok to cancel coverage of needed services nor to render something elective that is essential to some transpeople’s sense of wholeness.

Obviously, while addressing the transphobic outcome of the BCBSM decision we must also recognize that many transwomen have no health care whatsoever.The Obama administration has claimed to understand that health care is a right and be working on ensuring that we are all covered. He has not shown the same understanding of transwomen’s or queer people in general’s rights. So we have to keep on top of his health care plan and make sure that all women are also represented in whatever he offers up b/c ultimately, most marginalized women will be depending on his plan to cover gender reassignment surgery and other medical needs specific to women.

As I’ve said in other posts, it seems this economic crisis is being used as the excuse to attack the most marginalized among us, whether it is universities doing away with Women and Gender Studies and Ethnic Studies or HMOs calling gender reassignment elective surgery it is all part of the same vein that says those on the margin must shoulder the blame for the actions of those in the center. And though we so often use very little, we are always the ones asked to pay so very much . . .

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