Health insurance and the DIY dilemma

Hi everyone, So there something that has come up a lot lately and I thought it was worth writing a post about. I'm going to combine two topics briefly because the second gives justification for the first. The first issue that I will touch on only briefly is that of covering medications through healthcare. As we in the military prepare for open trans service many people have expressed concerns over the military covering transgender related care rough insurance. Now I have many arguments for trans care in the military but that could be and probably will be a post all its own. For the purposes of this I will touch on it briefly and then move on. In an overview, I will point out that as of right now transgender service members are the only people whom the federal government provides insurance too that don't receive trans care. The affordable care act provides transgender care to those who have income low enough to qualify. New federal mandate provides transgender care to civilian federal employees and even those incarcerated in the federal prison system receive transgender care. My second point on the issue is the relative affordability and quick healing times associated. The medications which transgender people use are readily available at any pharmacy or military treatment facility. Hormones are relatively cheap by comparison to many of the medications prescribed. As we look at healing times for genital reassignment surgery, the standard times are similar to most any surgery such as an appendectomy.

There are many other points that can be made and entire papers have been written on the topic, but for now I want to move onto my second topic. I want to talk about DIY or do it yourself hormone treatments. This is a common practice among transgender people. Often doctors appointments, lab tests and even the hormones people use for transition are not covered by insurance. Doctors appointments may be $150 or more. Labs are often $200-$300 and hormones are typically between $100-200 per month from a pharmacy. When you consider these costs and the difficulty of finding employment for trans people it's no surprise that folks would choose online options for ordering medications. There are places a person can go to order medications without a prescription. There are some obvious and really concerning issues with the DIY method of medication. All of the websites are located in other countries. There are definite concerns about the safety of these sites. The quality or even legitimacy of the medications cannot been verified. Additionally, because a person self medicates a doctor doesn't get to evaluate possible drug interactions. And if the person has a medical emergency there will be no record of what they are taking. The other issue with DIY medication is dosage amounts and schedules. I know many many trans women and the dosages of our various medications are as arrayed as we are. The levels of our medications are determined by many things including our lab results. DIY users often go on the information of a friend or that which they find on the web to determine their own dosage. They also don't often get labs to test their levels. Improper dosage can damage the liver and kidneys and cause blood clots. Transition is not an option for most transgender people. It's a medical necessity. Not providing transgender care is dangerous and can potentially cause medical issues which are much more costly to insurance companies. As I said these are incredibly complex issues but what is most important to remember is that at the end of the day these are people. I look forward to a day when this is no longer an issue.



"Nothing is too girly and nothing is too masculine. But I do love color, and maybe that's a little girly - especially pink." Stacy London

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