Waymon Hudson

Good News from the AMA

Filed By Waymon Hudson | June 18, 2008 3:00 PM | comments

Filed in: Living, Living, Transgender & Intersex
Tags: AMA, American Medical Association, gender identity, GID, transgender

Good news from the American Medical Association regarding the care and treatment of transgender people.

Resolution 122, called "Removing Financial Barriers to Care for Transgender Patients," was approved by the Reference Committee and subsequently by the entire House of Delegates. The resolution and statement of support will essentially change the argument in many legal cases against public coverage for the treatment of transgender patients. This is especially relevant, for example, in that it means Medicaid cannot discriminate with regard to diagnosis, since many of their denials of coverage have been because they view treatment as either "not medically necessary" or as being "experimental".

Read the entire resolution after the jump...

RESOLUTION 122

Subject: Removing Financial Barriers to Care for Transgender Patients

Whereas, Our American Medical Association opposes discrimination on the basis of gender identity; and

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

Whereas, GID, if left untreated, can result in clinically significant psychological distress, dysfunction, debilitating depression and, for some people without access to appropriate medical care and treatment,
suicidality and death; and

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

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

Whereas, Health experts in GID, including WPATH, have rejected the myth that such treatments are "cosmetic" or "experimental" and have recognized that these treatments can provide safe and effective
treatment for a serious health condition; and

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

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

Whereas, Many health insurance plans categorically exclude coverage of mental health, medical, and surgical treatments for GID, even though many of these same treatments, such as psychotherapy, hormone therapy, breast augmentation or removal, hysterectomy, oophorectomy, orchiectomy, and salpingectomy, are often covered for other medical conditions; and

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

Whereas, Delaying treatment for GID can cause and/or aggravate additional serious and expensive health problems, such as stress-related physical illnesses, depression, and substance abuse problems,
which further endanger patients' health and strain the health care system; therefore be it

RESOLVED, That our American Medical Association support public and private health insurance coverage for treatment of gender identity disorder as recommended by the patient's physician. (New HOD Policy).

Hopefully this resolution will open the door to coverage and financial assistance for transgender people in the US.


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This is really great news. Let's hope that insurance companies do the right thing and start covering health coverage for transgender patients. I know . . . I'm a hippie to believe that insurance companies are going to do the right thing.

Brynn Craffey Brynn Craffey | June 18, 2008 5:55 PM

Wow.

The AMA actually passed this?!

I never thought I'd see the day!

This and marriage-equality in California in the same week. Could an Obama presidency be far off?

(And Serena, you hippie, you took the words right out of my mouth!!!)

This sounds good but I am not holding my breath to see any thing transgender related covered by insurance.

Fantastic! I included a tidbit with more good AMA news in my roundup.

I'm with Cathy. Breath-Holding is contra-indicated. But even if it takes 20 years, as it may, to get this implemented widely (I doubt it will ever be implemented universally), it's a start. We should neither play down the great significance of this step, nor pretend that it is more than just a necessary step, and no solution.

We'll see how O'Donnabhain vs IRS plays out. An adverse ruling in the face of the AMA's position would send us back to square 1. Again.

Robert Ganshorn Robert Ganshorn | June 19, 2008 4:07 AM

Maybe with national health care it won't just be a dream, but a reality. Gender change can hardly be called an unnecessary procedure considering all the unnecessary tests doctors currently perform on the insured just to protect themselves from liability.

I was startled to read of the AMA's decision. but, of course, very happy. I wonder who was behind the proposal in the first place? I would like to thank them.

Persuading Medicaid to cover treatment will probably be tough. States seem to be pinching pennies as is, limiting care. They will be averse to adding expanded coverage. Getting coverage will require savvy politics and perhaps some court cases.

I sent this information to my Benefits person at the company I work for because the insurance company denied a medically-necessary procedure. My company can tell the insurance company to pay for the procedure, but they aren't. So, don't expect bigoted companies to embrace this new reality.

At some point someone will probably have to take this to court with Resolution 122 in hand to force the insurance companies to cover expenses associated with hormones, therapy, and GRS. I would hope that if we have national health insurance in a couple of years that these expenses are included there as well.

shakay is right, this is only one step, with court cases being the next. Right now, it is the only obvious way to push insurance companies for coverage.

An alternative would be if more companies demanded it for their employees' benefit plans, but that's not on the horizon, and the money to be gained from offering it is still far less than the potential money lost by a religious reich boycott.

On the other hand, coverage by a new body, oh, say a national program, might be easier to obtain, now that the AMA is batting for it. Don't hold your breath, of course, but it's not unthinkable. That's how we obtained it in several provinces in Canada: it was simply asserted at the time to be medically necessary.

As far as who to thank, I've heard the name Dr Becky Allison. I don't know if she was the only one.