- The researchers of the study, which was published in JAMA Surgery and the first of its kind, found that the number of sex-reassignment surgeries increased four times from the years 2000 to 2014.
- The study, conducted by Brandyn Lau and other researchers from Johns Hopkins Medicine and Harvard University, was a result of analysis of 15 years worth of data of the National Inpatient Sample.
- Arguably all medical groups in the United States considered gender-affirming surgeries as medically necessary for the physical and mental health of transgender patients.
A study investigating gender-affirming surgeries among transgender individuals revealed an increase of such procedures as members of LGBT community find growing acceptance and expanded insurance coverage.
According to the transgender news stories posted by the Washington Post on February 28, the researchers of the study, which was considered as first of its kind and published in JAMA Surgery, found that the number of sex-reassignment surgeries increased four times from the years 2000 to 2014.
Transgender healthcare
Brandyn Lau, an assistant professor of surgery and health sciences informatics at the Johns Hopkins University School of Medicine, said that the research was focused on evaluating disparity of care among LGBT individuals.
“Early on we recognized there’s been a lot of work on health disparities having to do with age, race and so on that get collected in health-care settings,” Lau said. “One of the things we need to know is whether [lesbian, gay and transgender] patients are getting the same care.”
The study, conducted by Lau and other researchers from Johns Hopkins Medicine and Harvard University, was a result of analysis of 15 years worth of data of the National Inpatient Sample, a database of information from hospital inpatient department across the United States of America.
The research revealed that there were 4,118 of gender-affirming surgeries performed, majority of which were attributed by the researchers to the growing acceptance of LGBT people, particularly the younger generations.
Insurance coverage
In the past, patients had to pay out of pocket for the surgeries. But, over the years, there has been an increase in terms of number and types of insurance coverage for surgeries in Medicare, state-sponsored private plans, and employment insurance coverage.
For instance, half of the patients from 2000 to 2005 paid the procedures, a number that rose to 65 percent from the years 2006 until 2011.
From 2012 to 2014, the number fell to 39 percent, a decrease that researchers attributed to Medicare and Medicaid. Specifically, Medicare terminated its ban on transgender surgeries in 2014.
“I would say 85 to 90 percent of [my] procedures are covered now by insurance,” Loren Schechter said. He performs 300 procedures annually and accepts Medicare. Furthermore, he claimed that he did only 50 of such procedures back in 2000.
Arguably all medical groups in the country considered gender-affirming surgeries as medically necessary for the physical and mental health of transgender patients and recommended that they should be covered by health insurance.
Kellan Baker of the Johns Hopkins Bloomberg School of Public Health wrote in the New England Journal of Medicine last year explaining that such growth were prompted by many changes.
“These changes are driven by a growing expert consensus on the medical necessity of gender transition, new legal interpretations prohibiting insurance discrimination against transgender people, and mounting evidence that transgender-inclusive coverage is cost-effective,” Baker said.
While there are fewer studies looking into the outcomes of surgeries done in the United States, a 2014 research published in German Medical Association’s official bilingual science journal, Deutsches Arzteblatt, revealed that 90.2 percent of 119 transgender women reported that after their operations, their expectations to live as a woman were fulfilled.
However, advocates were concerned that the current administration of President Donald Trump would not enforce the policy as stated in Section 1557 of the Affordable Care Act, which prohibited discrimination on the basis of gender identity. The said provision was instrumental in helping transgender men and women in getting coverage for surgical procedures such as genital reconstruction.
“There’s going to be rough sailing ahead,” Schechter said. “There is concern in the community and among providers that many of the gains already made are in jeopardy.”
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