The legal and political landscape regarding young people`s access to gender-sensitive care is changing across the country, with more and more states trying to restrict such access and impose sanctions. Such measures can have a significant negative impact on the health of young people. At the same time, these states disagree with federal law and policy, and in two recent cases, the courts have temporarily blocked the application of these restrictions. In the future, it will be important to observe how the state bills still under consideration unfold and the final outcome of cases in Alabama, Arkansas and Texas. Decisions in these cases could determine how these policies intersect with existing federal policies — including the prohibition of sex discrimination in health care in Section 1557, disability discrimination protections and HIPAA`s protection of patient privacy — as well as provider professional ethics standards. In June 2008, the American Medical Association (AMA) House of Delegates declared that the denial of patients with gender dysphoria or other covered benefits constitutes discrimination and that the AMA “supports public and private health insurance coverage for the treatment of gender dysphoria as recommended by the patient`s physician.” [56] Other organizations have made similar statements, including WPATH,[13] the American Psychological Association,[52] and the National Association of Social Workers. [53] However, if passed, the barriers to accessing health care for transgender children could be devastating. Nigeria: Medical procedures such as hormone replacement and sex change are not illegal, but resources are limited. In addition, it is not possible to change the name or gender marking in the country of Nigeria, and trans people in Nigeria are not protected by law for gender expression.
[85] [86] In 2017, the U.S. Defense Health Agency approved for the first time payment for sex reassignment surgery for a serving member of the U.S. military service. The patient, an infantry drug who is a transgender woman, had previously begun sex reassignment treatment. The procedure, which the attending physician deemed medically necessary, was performed on September 14. It was performed in November in a private hospital because U.S. military hospitals do not have the necessary surgical expertise. [57] After sex reassignment surgery, transsexuals (people who have undergone transsexual hormone therapy and gender reassignment surgery) tend to be less gender-dysphoric. They also generally function well socially and psychologically. Anxiety, depression and hostility were lower after sex reassignment surgery.
[64] They also tend to perform well in self-rated mental health, which is independent of sexual satisfaction. [65] Many studies have been conducted to examine patient satisfaction after sex reassignment surgery. In these studies, most patients reported that they were very satisfied with the results, and very few patients expressed regret for having undergone sex reassignment surgery. [66] Gender reassignment surgery can be difficult to obtain due to financial barriers, insurance coverage, and a lack of providers. More and more surgeons are being trained to perform such operations. In many areas, the pursuit of the SNS by an individual is often governed or at least guided by documents called the Standards of Health Care for Transsexual, Transgender and Gender Non-Conforming (SOC). The most widely used SOC in this field is published by the World Professional Association for Transgender Health (WPATH, formerly Harry Benjamin International Gender Dysphoria Association or HBIGDA) and frequently revised. Many jurisdictions and medical boards in the United States and other countries recognize the WPATH Standards of Care for the treatment of transgender people. Some treatments may require a minimum amount of psychological and life assessment as a full-time target sex member, sometimes called real-life experience (RLE) (sometimes mistakenly called real-life testing (RLT)) before sex reassignment surgery is covered by insurance.
[ref. needed] No State has generally prohibited the sex reassignment treatment of transgender minors. But the sheer volume of proposals in this legislature is worrying, he said. South Africa: Trans and gender people are protected and recognized by South African law, where sterilization or other coercive procedures are not required to legally recognize a person`s gender identity. Sex reassignment surgery is legal and accessible, but is not covered by medical assistance. [87] In May, the government decided to end discrimination protection for transgender patients. The proposal was rejected, but the U.S. Department of Health and Human Services has since proposed ending protection. TransChance HealthHelps transgender people navigate health care and insurance to receive respectful, high-quality transitional care and transitional care. Sex reassignment surgery is generally not performed on children under the age of 18, although in rare cases it may be performed on adolescents if health care providers agree that it is an unusual benefit or there is a risk of not performing them.
[40] Preferred treatments for children include puberty blockers, which are said to have reversible physical changes,[41] and sex hormones, which reduce the need for future surgeries. Medical protocols typically require long-term psychological counseling to check for persistent and actual gender dysphoria before any intervention, and the consent of a parent or guardian or a court order is required by law in most jurisdictions. [ref. needed] The Health Insurance Portability and Accountability Act (HIPAA) requires that most health care providers and health insurance companies protect your privacy when it comes to certain information about your health or medical history. Information about your transgender status, including your diagnosis, medical history, sex assigned at birth, or anatomy, can be protected health information. This information should not be shared with anyone, including family, friends and other patients, without your consent. Such information should also not be disclosed to medical staff unless there is a relevant medical reason to do so. Sharing this information for gossip or harassment purposes is a violation of HIPAA. Spain: Despite a 1989 European Parliament resolution proposing extended rights for all EU citizens, Andalusia`s public health system has only covered gender reassignment surgery since 2002.
[105] [best source needed] Uruguay: The Ley Integral para Personas Trans Law, passed on October 19, 2018, improves access to practices for transgender people, stating that the state will pay for them. For people under the age of 18 who wish to undergo surgery, an application for a change of legal name and gender must be attached to their registration. For minors who do not have the consent of the guardian, court approval can be obtained instead. [140] Feminization surgeries are surgeries that result in a typically female anatomy, such as vaginoplasty and breast augmentation, while masculinization surgeries are those that give rise to a typically male anatomy, such as phalloplasty and breast reduction. For many years, Medicare did not cover transition-related surgery due to a decades-old policy that classified such a treatment as “experimental.” This exclusion was lifted in May 2014, and there is now no national exclusion for transitional health care under Medicare. Some local Medicare entrepreneurs have specific policies that define their coverage for transitional care, as do some private Medicare Advantage plans. Many health professionals and professional associations have stated that surgical procedures should not be required for transgender people to change the gender designation on identity documents. [13] [52] [53] However, according to the legal requirements of many jurisdictions, transgender and transgender people are often unable to change their gender entry in public records unless they can provide a medical letter certifying that sex reassignment surgery has been performed.