With the Centers for Medicare & Medicaid Services and other payers providing coverage for transition surgeries for transgender patients, more hospitals now offer such procedures.
Genital surgeries are often out of reach for transgender patients, according to an article in The Wall Street Journal, as they’re expensive and rarely covered. However, in 2014, CMS began to allow coverage of such surgeries--which has thus far spread to 12 states and the District of Columbia--and private insurers are also offering coverage.
Major hospitals and health systems like the Cleveland Clinic and Johns Hopkins have established or are re-establishing transgender surgical program to offer complex procedures like vaginoplasty and phalloplasty, according to the article. These procedures are in high demand from prospective patients--at Boston Medical Center, for instance, more than 200 patients are on the waiting list for a vaginoplasty.
“There’s much greater buy-in [for transgender surgeries] in the conventional medical community than there ever was before,” Joshua Safer, M.D., director of Boston Medical Center’s transgender center, told the WSJ.
Most of these transgender healthcare programs follow guidelines from the World Professional Association for Transgender Health, according to the article. Before patients are scheduled for a genital surgery, the patient must have two letters from two different medical professionals confirming a diagnosis of gender dysphoria and must have been on hormone treatments and living in their affirmed gender for at least a year.
Cecile Unger, M.D., director of Cleveland Clinic’s transgender surgery and medicine program, told the WSJ that such checks just ensure patients are “are happy and comfortable living as themselves full-time” before an irreversible surgery is completed.
Physicians who want to expand there services to include transgender surgical care will be able to this fall at Weiss Memorial Hospital in Chicago, too, according to the article. The hospital will begin offering one of the first fellowships specializing in transgender medicine.