Faces of Trans-Inclusive Health Care

In my mid-twenties, I started to get the idea
that I was going to need to transition from female. At the time, there wasn’t a lot
of information. So I went looking around, I knew I had options. Some people decide to
pursue medical options, some people don’t. I work at a place where I’m covered by health
insurance, but actually accessing the specific medically necessary health care that I need
isn’t available because of the explicit exclusions within the insurance policies. My experiences trying to access healthcare
have been kind of up and down, tumultuous. There’s the threat of losing my health insurance,
or all of a sudden not getting the kind of care that I need. I worked for 30 years as a machinist, I made
a good salary. I happily, happily paid into Medicare all my life, and now it was being
denied to me. It’s just unimaginable to not be able to
get the benefits that you paid for all your life. I found a lot of employment discrimination,
I found it was very difficult to get a job or even an interview. My education and my
work history was under my female name and as a woman, and then at some point I had to
start building a work history as male. It was very difficult to find steady employment
or full-time employment. And when I did get my first full-time job, an office job it happened
to be, I had medical insurance, which was great. And they mailed the policy, and it’s
an inch thick, and no one ever reads those things, and I remember looking through every
page trying to see if they covered trans or gender-related medical expenses. I remember
there was one paragraph that explicitly said we won’t cover anything for transgender
patients. Reading that felt like being punched in the stomach. It felt like being singled
out, it felt like them saying “we would provide this for anyone else, but not for
you.” I was in practice for 36 years and I guess
for about the last 15 years of the practice I was taking care of transgender patients. It was really very offensive to me to not
be able to provide care for what is recognized as a medical condition. The AMA has said this
is a recognized medical condition that’s in all the diagnostic code books and yet if
I would list the code for gender dysphoria, which is the code for being transgender, when
a patient would come in for an office visit almost every insurance company would specifically
deny payment for that. I think it is really outrageous that insurance
companies will pay for other recognized medical conditions but they specifically exclude this
one. As a preventative measure in care, it would
have saved me a lot of costs, a lot of health costs, it would have saved society in general
a lot of costs. My personal experience with the cost of healthcare
can’t speak for everybody, but in the six years that I was wearing my chest binder it
ended up shifting and moving my ribs around and I did end up going to the emergency room
two or three times. And when you go to the emergency room with
chest pain and you can’t breathe very well, you’re pretty much fast-tracked. Even at
27, they think that you could be having some kind of heart problems, and so they do all
these tests and it really racks the money up a lot. It just doesn’t make any sense
to me to cover something two or three times going to the emergency room as opposed to
covering something once, which is the surgery. Multnomah County was the first jurisdiction
in the state of Oregon to provide transgender health benefits. When we started looking at this, a lot of
people who were pushing back on this were concerned about the cost — how much was
this going to cost the taxpayers, how much would this cost the County. The reality is
it cost virtually nothing extra. It had almost no impact whatsoever on the
cost of our health care delivery system at Multnomah County. We all know that when your employees are physically
healthy and their mental health needs are taken care of, they’re going to be more
productive, engaged employees, and so it’s good for the bottom line. Many people have difficulties accessing the
care that they need. But as someone who’s transgender, being able to access health care
and being denied because of that Gender Identity Disorder is a huge piece. I can’t imagine
not having that as a concern how that would help me, that would be such a load off my
mind as far as being able to just be more present and just be more in my body, which
is something I that think a lot of people take for granted. You just can’t get past that, walking out
the door every day, feeling uncomfortable every single day, having to put a binder on
every day. It hurts you. It’s not something that anybody should have to go through. It’s
something that people go through because there is no other option. But when you have the
option to get it taken care of, it’s life changing. It’s really something that you
can never describe what it feels like. It’s just something that, people are finally themselves,
they’re finally whole. It’s indescribable really. There are people in our community who have
very specific physical health and mental health needs, and we should address those needs along
with the other physical and mental health needs of the community, so there’s the social
justice issue: it’s the right thing to do. Everybody at one point or another is going
to meet someone who is transgender, whether they can recognize them as transgender, whether
the person is already “passable”, or whether they’re fighting to become who they want
to be. We want the same things. We want to have a
family, we love our families. Not having healthcare access impacts how you
can get a job. It impacts – your job then leads towards housing discrimination. It just
becomes this huge snowball effect in that you’re wanting to just be able to access
medical care but then it just impacts your life, everything about your life is impacted
by not being able to access healthcare. I’ve had my struggles, I’ve made mistakes,
I’ve had my joys and my successes. Just like you. And I think that everybody, including
myself, deserves the chance to be happy, and to be healthy, and to be successful. Just
like you. If I didn’t have to go through the hoops,
if they actually covered everything I needed as a transsexual woman, that would be like
freedom, it’s like the cage door opening and finally being able to fly out and just
totally live as who I am. [Music]

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