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Gender reassignment now covered by insurance

A Campus Memo sent out on Tuesday, Oct. 28 announced that Grinnell has conditionally included coverage for gender reassignment surgery in the Grinnell College Student Accident and Sickness Insurance plan for the 2014-2015 school year.

After a controversial period last year after the passage of the Affordable Care Act when it was not known whether gender reassignment surgery, hormone replacement therapy or other treatments associated with the transition process would be included, the decision was made to incorporate these benefits into the student health care plan.

Director of Compensation and Assistant Treasurer Jim Mulholland wrote in an email to The S&B that the decision was made as part of the College’s commitment to social justice and the plan’s overall affordability.

“The decision to include gender reassignment surgery in the student health plan was decided just prior to renewing our policy with Student Assurance Services in May,” he wrote. “These services were included in the plan based on Grinnell’s history of supporting social justice.”

Mulholland stated that hormone replacement therapy will also be included in the plan, as it is a requirement of the process of changing one’s gender. He also noted that the cost of the plan was very reasonable for the range of benefits that will be included.

“The additional cost for transgender coverage is less than $40 per student participant for the year,” Mulholland wrote. “The plan provides extremely good coverage for the premium and would be hard to replace with a comparable plan in the Healthcare Marketplace. It has an unlimited general benefit maximum and a $2,000 out-of-pocket maximum (participant costs) for medical services with low prescription copays and coinsurance for in-network service providers.”

Covered students interested in pursuing gender reassignment surgery must satisfy all of the eligibility criteria and should have a good understanding of the maximum dollar amounts for this benefit. According to a document linked in the memo, those insured under this plan must “submit information regarding the treatment they have received or are currently receiving to the Plan Administrator for review and authorization of services under this benefit” as developed across industry standards, but may be subject to change.

Further, the document specified that insured persons must be at least 18 years of age or older and pass the diagnosis of “true” transsexualism, in addition to having completed a recognized program of gender identity treatment. According to the plan, to qualify for the prescription of “true” transsexualism, the insured must have the desire to “make his or her body as congruent as possible with the preferred sex through surgery and hormone treatment” and have a “stable transsexual orientation evidenced by a desire to be rid of one’s genitals and to live in society as a member of the other sex for at least 2 years, that is, not limited to periods of stress.” There are significantly more criteria that must be met in addition to those listed above, which the document noted are “based on industry standards developed from peer-reviewed treatment protocols and may be subject to change.”

Amanda Magyar ’17, a co-leader of Grinnell’s Trans Action Group (TAG), explained in an email to The S&B that TAG members were initially very excited when they discovered that the College had decided to include gender reassignment surgery, which was achieved after a large amount of time spent tabling and gathering signatures in the JRC.

“[When] we first found out that the College had agreed to find a more trans-inclusive insurance provider, everyone was pretty excited. A few of us put pretty significant effort into postering and gathering signatures to convince them to do so—we got over 800 signatures, which was incredible,” Magyar wrote. “We had someone meet with President [Raynard] Kington personally after we’d gotten the signatures and he was very receptive to the idea.”

The new policy had an immediate impact on those who have often faced financial difficulties in their pursuit of various gender treatments, Magyar noted. However, there were issues with the wording and guidelines of the new healthcare policy which a number of TAG members pointed out as being offensive.

“I know of several students who’re starting HRT (hormone replacement therapy) now when they wouldn’t have been able to afford it before,” Magyar wrote. “In spite of its flaws, [the plan] is very useful to a lot of trans Grinnellians who can finally afford hormones or surgery that were prohibitively expensive. I’m glad we accomplished this … [However] the language [the document] uses throughout has this sort of uncomfortable 80s pathologizing vibe to it, with all the talk of ‘true transsexualism’ and ‘gender identity disorder’ which is a sort of language that has really fallen out of favor in the trans community and comes off as a little uncomfortable.”

Magyar noted additional problems TAG members identified from the policy, such as the exclusion of any intersex condition and the mention of “associated psychiatric disorders” as limiting factors. Specifically, Magyar mentioned that this “could make it difficult for mentally ill trans students to get coverage, even though mental illness does not make someone’s gender identity any less valid.”

Additionally, Magyar added that the policy is discriminatory against transfeminine students covered under the plan and is thereby transmisogynistic, including concerns with the long periods of time required to qualify for many of the treatments.

“For trans masculine individuals, the policy covers top surgery, bottom surgery and HRT. The policy specifically excludes, however, many procedures important for trans feminine people,” Magyar wrote. “I have also been told that breast enhancement surgery is not covered, because it is considered ‘cosmetic,’ even though breast removal for transmasculine people is covered. This prejudice on the part of the policy is frankly ridiculous, and speaks of a long societal legacy of transmisogyny.”

Those who are interested in reading more about the plan and the specific criteria associated with qualifying for the program can do so at or through the Campus Memo.

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    LynnNov 7, 2014 at 7:44 am

    Gender reassignment???? Impossbile unless brain surgeons are able to change gender. I think it is an excellent that this condition addresses a ‘true’ transsexual rather use the overbearing transgender construct.
    There are just too many ‘mimic’s that make claim there is but a small difference between a person in NEED of corrective surgery and one who suffers from a gender identity disorder that oft times seems to raise its head at the time of puberty.
    A true transsexual in my mind is one who was well aware of their feelings of being not the right sex long before they reached puberty and into their teens. In that regard, and only that regard, would it be acceptable to take the stance that transsexual’s make the argument it is not basically about sex although in the final analysis it really is: to meld ones sex with their inborn brain sex (gender). A true transsexual is born; he or she does not ‘become’ or ‘grow’ into that condition although the transgender might well disagree seeing as their company have no attachment with what is a ‘true transsexual’.