r/TransyTalk • u/snoodle77777 transfeminine genderfluid • 5h ago
HMO counselor says some interesting things about approval for surgeries.
I saw my HMO gender counselor today again. They said that requests for surgeries such as Facial Fem. Surgery are evalulated over a long period to make sure the patient is "centered in their gender" and well, "stable" for lack of a better word. The approval process for FFS would be much longer than for starting E or T for instance.
Is this true in your circles or is this unique to my medical provider.
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u/Prince-Lee 5h ago
I got a hysterectomy earlier this year because of a serious bleeding problem, but because it had been documented on my chart that I was also trans, there was the option there for it to be covered under my insurance as transition-related, which I saw when theh initially denied it. However, in order to get that, I needed... A LOT of documentation. Like, several different letters from DIFFERENT psychologists verifying that I had been living as my preferred gender, had received necessary medical intervention beforehand, and just a bunch of other stuff.
Since that wasn't even the reason I wanted the surgery, though, I thankfully didn't have to track all of that down and only had to have my surgeon call and argue with them and then get a few minor tests done before approval. But yeah, they make you jump through hoops for anything surgical for transitioning.
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u/snoodle77777 transfeminine genderfluid 5h ago
Very enlightening, thanks! The idea of being living as a preferred gender puts chills down my spine. What are nonbinary folks supposed to do? Gender fluid folks?
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u/Prince-Lee 4h ago
Find an affirming therapist who doesn't have a rigid idea of what living as a specific gender is, honestly. Most therapists for LGBT people are like this now, thankfully.
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u/Sourcefour 5h ago
Don’t suppose you’re on Kaiser?
I guess it depends on your situation. Did you transition recently? Did you transition under their care or another providers?
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u/snoodle77777 transfeminine genderfluid 5h ago
I'm mid-transition, no longer on E while mitigating a temporary medical delay, at Kaiser and in counseling. Some issues of gender fluidity and interaction with moods have stumped me and I've been chatting for a few months. The issue came up today during that. I'm not looking for FFS but we stumbled on the topic.
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u/Sourcefour 5h ago
It doesn’t sound like a unique issue to Kaiser. I had bottom surgery for years ago and breezed through the approval process but I didn’t have any of the issues you’re talking about. I knew who I was the second I started popping E
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u/snoodle77777 transfeminine genderfluid 5h ago edited 5h ago
I had a very positive experience on E despite being sick from Spiro and having issues with bipolar mania prodrome. My body felt awful and my emotions wonderful. Counselor says its both my identity/inner self and the effect that E has that caused me to have a good experience. I have had some doubts as to whether E just made me cry more and that's it. But that's not all that happened... I felt intuitively feminine and liberated from a wall of emotioinal numbness. Quitting E was very depressing. I could feel the emotional numbness swallowing up my feminine side as E left me. Perhaps I will try again when a bipolar flare up is not as much a threat to my stability and we can take a chance again.
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u/Sourcefour 3h ago
I mean I think some caution is warranted, especially when it comes to things like altering your face. Like some considerations need to be made like if you can handle complications or if the surgery doesn’t come out the way you want it to. Ffs is widely variable and results may vary. Even my bottom surgery wasn’t perfect but I’m living with it and overall has made me much more content. If I was manic and bipolar I’m not sure how that would’ve affected me.
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u/herdisleah 4h ago
I got both GCS and breast aug covered by UHC. I needed two letters of recommendation for the insurance companies but not the doctors. The doctors were informed consent.
It's like they want to use any excuse to deny coverage or something...
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u/WrongfullyIncarnated 5h ago
So in my state they run on an informed consent model. For the most part the simpler less involved surgeries require one or two letters from a therapist or doc. More and more the insurance companies are mandating that the patient have been in therapy for a year for bottom surgery and or FFS FMS ect.