Transgender

Why is gender affirming care so expensive?

I’ve written quite a bit about the costs that I have incurred along my journey of trying to inhabit a trans body. But even as I look forward to the upcoming revision surgery on my vulva, it is a harsh awakening to realize that I am going to have to spend yet another $6,000+ for housing simply because Seattle has no transgender vaginoplasty surgeons and most insurance refuses to pay for out of state surgery costs.

So how much have I paid out of pocket so far for gender affirming care?

  • $5,000+ for electrolysis and laser hair removal on my face and body (not considered “essential” by insurance)
  • $9,500 in travel costs for consults, surgical recovery housing, and post-op appointments
  • $6,000+ for housing for revision surgery recovery

All told, I can account for over $20,000 in costs that insurance refused to cover.

I am one of the lucky ones. I am privileged enough to have a good job with decent health insurance so my co-pays are minor and I can afford to save up for these procedures. And I have a large network of friends who have generously donated over $5,000 towards those costs.

But can we talk about why these costs exist in the first place? Why is it considered ok for transfeminine people to have to pay for face and body hair removal to deal with dysphoria? In a world that demands that we “pass” as women to use public facilities such as restrooms, that is incredibly classist and discriminatory. And why does insurance not have to pay for the costs of getting an out of town surgery when there are no local surgeons available? My insurance now pays for cancer patients to get out of town specialty care but despite my advocacy for the past several years, continues to deny trans people that same right.

Luckily, starting in 2022, insurers in Washington State are now going to be required to pay for all doctor-prescribed gender affirming treatments and will no longer be allowed to label them as “cosmetic”. This is thanks to the tireless work of many many advocates and organizations who fought for years against insurance denials. And I hear through the trans rumor grapevine that Seattle may FINALLY be getting a surgeon soon who can perform vaginoplasties locally. But while that helps people here in Seattle, that doesn’t change the fact that far too many trans people around the US aren’t given equal healthcare access. We need laws in place federally to mandate coverage of gender-affirming care.

So next time you think of asking someone if they have had “the surgery” or make any kinds of assumptions about what trans people should look like, think about how expensive it is to look like I do. How inaccessible it is to the vast majority of trans people in this country to achieve what Laverne Cox, Caitlyn Jenner, and Elliot Page have done. And if you have resources, I encourage you to donate generously to your local trans fundraisers and places like the Jim Collins Foundation to help more trans people get the care we so desperately need.

An open letter to OKCupid about the proposed “Real Name” policy

Here is a copy of what I wrote in the OKCupid feedback form in response to their proposed policy change that would require real first names instead of custom usernames by the end of 2017.

Dear OKC team,
I’ve been a user since 2004, I met my spouse here, and I’ve had many relationships ranging from casual to long term that started on your site. I love a lot about your site and I am usually a fan of your changes, especially those to reduce unwanted and harassing messages. I’m not the type to complain every time someone releases a new feature, even if I’m not a fan.

However, I sincerely hope that by “real name policy” you don’t mean to police that like Facebook has done to the detriment and harm of transgender people. For many people, the name that everyone knows them by is not the name on their government issued ID. And forcing someone to use a real name not only violates their privacy but can cause extreme emotional harm and potential violence towards them. It has driven many trans people off of Facebook and I truly hope that you won’t undo the great work you put in with your expanded gender options by forcing us to use our “birth names” which many of us call our dead names.

As a nonmonogamous person, I also know that many people are not “out” about their identity to family and coworkers because we have no workplace protections or laws to protect us from societal harm. Almost every polyamorous person I know is on OKC but a LOT of them will be leaving soon if you enforce this rule.

Then there’s the safety concern in general, especially for women, who are opening themselves up to stalkers by having a profile with their real name. Being on OKC and revealing the kinds of personal details we do already contains a huge amount of risk, especially for queer, feminine, transgender, nonbinary, nonmonogamous people like me. And having that data attached to our real name is not only going to drive a large portion of your loyal users away, but it will likely cause a lot of those who stay to be more cautious about what they share, harming their potential for building successful relationships.

People have a lot of options for dating sites these days and most of us are here because right now you are the best, particularly around nonmonogamy, gender, and sexuality. Please don’t ruin a good thing by forcing real names.

 

If you are an OKCupid user and you have opinions about the change, please take a moment to speak up on Twitter, use their feedback form, or comment on their blog post.

Update: They seem to have clarified on their Twitter:

We love our members. You do not need to use your government name or even your full first name. Use the name, nickname, or initials you’d like your date to call you on OkCupid.