Comments on: Sex Reassignment Surgery Is Tax Deductible

By: Bridget Crawford

Bridget Crawford — Thu, 04 Feb 2010 20:05:33 +0000

Profriend:

Could you say a little more about the desire on the part of some transgender people to characterize gender identity disorder as a “birth defect”?

I can see that “mental illness” is a stigmatizing label, and I understand the argument that characterizing the same as a physical “illness” might be less stigmatizing.

I do wonder about labeling as “defective” someone whose physical body doesn’t match her or his gender identity. Would it be possible to describe that condition as something other than physically or mentally defective? Perhaps the existing medical/mental health models are too prejudicial for this to ever occur?

Further thoughts?

By: Profriend

Profriend — Thu, 04 Feb 2010 13:25:34 +0000

Many transgender people I work with would prefer the condition be considered as a true birth defect rather than as a “mental illness.”

I tend to agree – how else would you characterise being born with the body of one sex, and the physical brain gender of the other? WPATH’s Standard Of Care supports this view by promoting corrective physical treatments following a vetting process, accompanied by supportive counselling when needed.

The mental health industry tends to support a “mental defect” approach (no surprise there) which, in addtion to creating unneccesary stigma, is a pretty much useless approach to helping transgender people live “normal” lives.

The difference in approach probably stems from the reluctance of some mental health professionals to accept solid evidence that many so-called mental disorders are caused by physical and chemical differences in the brain and cannot be effectively ameliorated through any form of psychotherapy.

By: Tony Infanti

Tony Infanti — Wed, 03 Feb 2010 15:46:44 +0000

Thanks so much for these comments. They are very helpful and insightful. Why am I not surprised that insurance companies refuse to cover GID-related costs? Anything to make a buck. Also, in case anyone is interested, there is significant discussion in the various opinions of the treatment of GRS/SRS in other areas of the law.

By: TransWoman

TransWoman — Wed, 03 Feb 2010 14:15:22 +0000

I am not a lawyer, but I have been following this case because I know Ms. O’Donnabhain and because of the effect this ruling will have upon the trans-community.
I feel that this case is another brick that has been removed from the wall of discrimination. My insurance policy from my employer has a transsexual exemption and none of my medical expenses related to my Gender Identity Disorder (GID) has been covered. The major barrier to insurance coverage has been ERISA, because they are self-insured they fall under ERISA regulations and since there is no federal protection against gender identity discrimination they are free to discriminate. One of the arguments by companies is that the Gender Reconstruction Surgery (GRS, sometimes know as SRS) is not a medical necessity, the ruling yesterday is one more step to refute that argument.
Other tools in the argument to bring about insurance coverage are the AMA, APA and the World Professional Association for Transgender Health (WPATH) policies supporting the medical necessity treatment for GID and requiring insurance coverage.
In addition, federal courts have been ruling that gender identity and expression is covered under Title VII. The most recent case was U. S. District Court for the District of Columbia ruling that the Library of Congress discriminated against Diane Schroer.
I hope that eventually the right to gender self-determination will be seen as a Human Right as called for in the UN Declaration on Human Rights and the General Comment 20, which the United States signed and also in the Yogyakarta Principles.

AMA Policy: http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/glbt-advisory-committee/ama-policy-regarding-sexual-orientation.shtml

APA Policy: http://www.apa.org/about/governance/council/policy/transgender.aspx

WPATH Policy: http://www.wpath.org/documents/Med%20Nec%20on%202008%20Letterhead.pdf

Schroer v Billington,: http://www.aclu-nca.org/pdf/SchroerDecisionLiability.pdf

By: rapid_butterfly

rapid_butterfly — Wed, 03 Feb 2010 13:20:32 +0000

I am a transwoman and a public interest (poverty law) attorney. My brief take is a pragmatic one. I do lament the pathologization of my condition, but the fact is that I can use all the help I can get if I am ever to be able to afford SRS; and so can most of my sisters and brothers. The deduction may be helpful in its own right and the case *may* have an impact on the view of insurers regarding the medical necessity of SRS in appropriate cases.

I guess I don’t see this case really making the pathologization of gender nonconformity any worse than it ever was. To many folks we will be seen as “ill” no matter what the case law says or whether we’re taken out of the DSM, for example. So again – I’ll view it as a positive and a possible help to my transition, and likely, that of many others.

~mina