Medicare ban on sex reassignment surgery lifted

Saturday, May 31, 2014
Medicare ban on sex reassignment surgery lifted
Medicare can no longer automatically deny coverage requests for sex reassignment surgeries, a federal board ruled Friday.

SANTA ANA, Calif. (KABC) -- The ruling by a U.S. Department of Health and Human Services review board has lifted a plan in place for more than 30 years. Now, transgender people may be able to have Medicare cover their sex change operation.

"This federal ruling that was just passed is very important for a transgender such as me, to be able to be how we want to be or who we want to be, authentically within ourselves," said Karina Samala of the West Hollywood Transgender Advisory Board.

Two years ago, 74-year-old U.S. Army veteran Denee Mallon had her request denied when she tried to have Medicare cover the cost of genital reconstruction.

On Friday, the Appeals Board sided in her favor, ruling it was not justified to exclude these surgeries from those covered by the National Health Program for disabled or elderly people.

Now, officials say that the ruling does not mean that Medicare recipients are automatically entitled to have the surgery paid for by the government. What it means is the coverage ban has been lifted, and that means transgender people can now try to get approval by submitting documents from their doctor to show the surgery is medically necessary.

The importance of gender identity is gaining more attention.

This week, a San Diego family posted a video on YouTube, highlighting their child, Ryland, born a girl, but whose brain identified with that of a boy. The 7-minute video ends with the child's family allowing her to make the transition to become a boy.

"I'm the happiest I've ever been in my whole life, thank you to my parents," he says.

"When we're talking about gender and gender identity, it's very important for all of us as humans to have our outsides match our inside," Tony Viramontes, Director of Prevention Services at The Center Orange County said.

But some people say they consider sex reassignment surgery to be cosmetic, which should not be covered by Medicare.

"As far as the sex change and the hormones and all that, they should cover it themselves," Marissa Trujillo of Orange said.

"I don't think necessarily the government or taxpayers should be paying for something like that, buy maybe private insurance should pay for something like that," Kersten Tedesco of Huntington Beach said.

Members of the LGBT community say Friday's ruling could pave the way for such surgeries to be routinely covered, since private insurance companies often look to the federal government for guidance on what treatments to include.

"We're really ecstatic and this is a step in the right direction for the trans community," said Viramontes.