|By Askini, Danielle|
Transgender Americans have won major victories in the past year as bans on coverage for gender-confirming surgeries were overturned in five states, in
But the opposition is fierce-and sometimes vicious.
I recently attended an administrative hearing on removing transgender health-care exclusions in state insurance plans. A dentist sitting on a panel of health-care policy makers who will determine covered benefits asked me how gender dysphoria wasn't like "giving people who want to amputate their limbs access to amputation." I explained that gender-confirmation surgery is "reconstructive, as the end results are functional and healthy." He was not sold, although he later admitted, "The idea of it-just the idea-scares me."
He's hardly alone.
Despite what that dentist or Perkins may think, these interventions help save lives and tax dollars.
According to a study from
Those are better rates than many other mental-health interventions. For example, 20 percent of people with untreated major depressive disorder will attempt suicide, and that drops to only roughly 8 percent even with therapy and antidepressants.
These aren't just abstract statistics for me. During my own transition as a 15-year-old in
After coming out as transgender and finally beginning to see myself in the mirror, I felt a huge sense of relief and happiness. I felt free to make close friends, as I was finally living an authentic life. I had nothing to hide. Since the late 1990s, I have worked with thousands of other transgender people as a therapist, activist, and social worker. I have seen my story repeated by countless people.
Beyond being effective, these types of interventions are also incredibly inexpensive when considering the alternatives (suicide attempts, ER visits, lifelong therapy, and antidepressants that won't get at the root problem). Every analysis of the cost, from a
One big reason transgender health-care exclusions continue to exist is a lack of public understanding, accompanied by a heavy dose of prejudice against transgender individuals.
While we have made huge gains, naysayers continue to ignore the irrefutable evidence provided by the medical and mental-health communities. For some individuals, just hormonereplacement therapy is enough, while others will need surgery to align their bodies with who they know themselves to be-but without a doubt, gender-affirming transition care is life saving.
So how do we end this debate now that the evidence is in?
Hormonal and surgical options must be made available to transgender people, just as they are to everyone else. Policy makers from the
45 percent of transgender people in this state will attempt suicide at some point. After transgender people receive medical assistance, suicide rates drop dramatically.
DANIELLE ASKINI is a social worker, writer, and activist. She is one of the founders of
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