Saturday, January 24, 2015

#045 - Part 2 - Persuasive letter to my health insurance.

 So this is part two of my previous blog post. I've been disputing with my health insurance for almost a year now and although I've convinced my HR representative that it would be foolish to deny coverage and she asked me to put my argument in the form of a letter. That way she can present the points to the policy makers that are also employed in the same company.

Below is a copy/paste of the letter I wrote. If you'd like to borrow the whole or part of the letter, feel free to do so. I am the original author of this, and I hold nobody to plagiarism charges if someone were to use any part of the letter or the whole thing. In short, feel free to use if you need to. Just remember to proof read what you plan on presenting first to check for spelling and grammar errors.

Anyways, here's the letter:
 ____________________________________________________________

Hello. This is Kris, you asked me to send you an email regarding the confusion with [company name] healthcare policies. I'm going to try to refrain from using inflammatory language if possible. This whole year long ordeal has left me quite upset with [company name] healthcare policies and those who write said policies.

So to start, I am transgender (male to female) and I'm having difficulty with receiving equal coverage under [company name] health plan. I understand that not all companies have experience or knowledge in working with transgender employees, but I think we can reach an acceptable solution.

Transgender definition, information, and terminology clarification can be found here:
http://en.wikipedia.org/wiki/Transgender

There is another term that needs to be clarified at that is Intersex (or Klinefelter syndrome for a more accurate name). People who are intersex are born with physical and/or mental characteristics that aren't exclusively male nor female, but somewhere in between and to varying degrees.

Intersex definition, information, and terminology clarification can be found here:
http://en.wikipedia.org/wiki/Intersex

Though it is still unknown at this time if the intersex condition is what causes the transgender condition, there is strong correlation between the two. Many intersex people go through gender transition, but not all who go through gender transition are intersex to any measurable degree. The field of medical science is still actively working on these issues.

The current issue I'm having with [company name] health plan is that it fails to include policies that address specific healthcare needs of transgender and intersex clients. I attribute that to two causes.

The first is that the population of transgender and intersex people is rather small. Not many people have encountered us nor understand our situations and issues. It's just not common knowledge to hear about or even meet someone who does not fit into the standard male/female gender binary.

The second is that persistent misinformation and social bias surround the issue. It is a common myth that LGBT (lesbian, gay, bisexual, transgender) people are the way they are because it is their "lifestyle" or choice. It's repeated so often in media that it almost sounds to be true. However, doctors and psychologists agree that it is in fact not a lifestyle nor a choice. To claim that is a lifestyle choice is demonstrably false based on all the evidence at hand.

The issue we ran into today is one of sex discrimination. What I mean by that is some medically necessary preventative treatments are exclusively for either males or females, and crossover is denied. This is especially problematic when a patient has the physical anatomy of both sexes.

What is a transgender or intersex person supposed to do with a healthcare policy that discriminates away half of their body? It doesn't make a lot of sense to only cover half of a human being and leave the other half of that same person to fend for themselves.

Currently, I am legally classified as male, but by tomorrow that should be changing to female. Sometime in the future, I will need prostate exams, mammograms, and once I can afford the surgery I will need gynecological exams.  I will need preventative treatment for all aspects of my body, not just the ones that [company name] healthcare policy feels like covering.

If I ever receive an illness or injury to the half of my body that's not covered, it won't be an isolated thing. That illness or injury affects my whole body and that preventative treatment that would have saved the company money would end up costing the company far more in general health treatment. An ounce of prevention is worth a pound of cure, and by denying parts of my body preventative treatment, the company runs the risk of having to pay for expensive illnesses or injuries down the road.

To put it in metaphor, it doesn't make sense to maintain the wheels on the left side of a car and neglect the wheels on the right side of the same car. Any catastrophe the neglected wheels suffer, the entire car suffers the catastrophe and the cost to repair the car is dramatically higher than if both sets of wheels were maintained.

By denying me coverage because half of me is one gender and the other half is another gender, [company name] opens itself to potentially paying for much higher medical expenses than it would have cost if preventative treatments were not sex exclusionary.

I would even argue that all the time, energy, lost man/hours, effort, and resources that have gone into this dispute have ended up costing [company name] more than what the bill would have cost on its own.

Having the main issue addressed, I would like to shed some light on other issues, specifically transgender exclusionary language in the healthcare policy and related care.

SRS (otherwise known as Sex Reassignment Surgery) is widely considered to be, in the field of medical science, a medical necessity. Few doctors and psychologists would disagree with the necessity of the procedure:

http://jurist.org/paperchase/2012/09/federal-judge-rules-sex-reassignment-medically-necessary-for-inmate.php

http://www.wpath.org/site_page.cfm?pk_association_webpage_menu=1352&pk_association_webpage=3947

http://www.lambdalegal.org/know-your-rights/transgender/transition-related-care-faq

http://www.aetna.com/cpb/medical/data/600_699/0615.html

Anthem BC/BS even agrees that it is medically necessary in other states where they offer their services:

http://www.anthem.com/medicalpolicies/guidelines/gl_pw_a051166.htm

There are also many instances of healthcare coverage denying medically necessary treatment and being taken to court over it:

http://transgenderlawcenter.org/archives/11285

http://lexiecannes.com/2013/01/30/lawsuit-prompts-state-of-oregon-to-provide-sex-reassignment-surgery-insurance-coverage-for-state-employees/

http://www.washingtonpost.com/national/health-science/ban-lifted-on-medicare-coverage-for-sex-change-surgery/2014/05/30/28bcd122-e818-11e3-a86b-362fd5443d19_story.html

http://kaiserhealthnews.org/news/transgender-lgbt-health-care-michelle-andrews-090412/

I bring these examples up because there is strong legal precedent for overturning these bans on medically necessary treatments. I don't mean to imply any sort of threat of any kind, that isn't my goal here. My intent on presenting this information is to highlight an opportunity.

There is an organization called Human Rights Campaign, I'm sure you've seen their bumper sticker on the road. It's the square blue background with a yellow equal sign. Here is their website:

http://www.hrc.org/

They have what's called Corporate Equality Index, where businesses and companies are given a score based on equal treatment and equally administered benefits for all employees.

http://www.hrc.org/campaigns/corporate-equality-index

Many of the corporations on the list are major fortune 500 companies, as well as others who wish to boast their CEI score to customers and clients. [company name] could easily make the grade if it weren't for its arbitrary and exclusionary healthcare policies.

Healthcare equality is starting to sweep across the country, often either voluntarily or through the judges gavel. It doesn't make any sense to have doctors and psychiatrists say a treatment is medically necessary, yet the health insurance claims it's not medically necessary. One has got to give, and the current legal trend is going in the right direction towards equality.

In conclusion, I hope that this email will help with future policy writing, and that hopefully [company name] will be able to one day claim they are an equal opportunity employer with equal benefits for all employees. Currently we're not there, but it would be nice to be there.

#045 - Need laser hair removal, official name change, business class, and persuasive letter to insurance. (HRT 1 year, 6 months)

Saturday, January 24, 2015

 A late post by about two months, but I finally have time to sit down and write this. So it's been just under a year and a half that I've been on HRT and I think the effects are starting to slow down. I don't want to say reverting, but I think a leveling out is more accurate. The shape I now have I think is the one I'm going to get through HRT and any further changes would require surgery. I definitely want to get breast augmentation, trachea shave, and SRS, but my biggest priority is laser hair removal.

I used to get electrolysis done every Friday, but my electrologist fired me. How a business fires a customer I don't know, but she claims I missed too many appointments. I missed three and they were all called in weeks in advance, so I'm not really sure why that's an issue for her, but whatever I guess. Now I'm looking for another permanent hair removal method. I'm looking into real laser hair removal, but it's insanely expensive. Ideal Image wants to charge me $8,400 for a package treatment. No way can I afford that. I'll have to keep looking and in the meantime I'm stuck using a standard razor.

Anyways, my legal name and gender has officially changed. Yay! I'm no longer Christopher Blair [last name]. I'm now Kristen Joanne [same last name]. I received the name change letter in the mail on December 24th, Christmas Eve, and I received the gender change sometime earlier this January.


Aside from that, both of my roommates moved away and I have the entire house to myself. My male roommate was an OK guy, but he never left the house. He went to work and came straight home to drink and watch wrestling. He was annoying at times, but it was the kind of annoying that's easily avoidable.

My other roommate was a 65 year old lady who was an absolutely horrid monster. Bitter, angry, and utterly spiteful. She stole things, she sabotaged parts of the house to break down, and every word that came out of her mouth was angry and nasty. When she moved out, she stole a LOT of stuff. She stole light bulbs, toilet paper, utensils, and all the lids on my coffee mugs.

I had to spend most of my savings replacing everything that she stole. There's really no point in filing a police report because the stuff she took is cheap insignificant stuff. It's really not worth the effort, but damn am I angry about it. I was trying to save up for laser and this knocked out my savings. But they're gone and that's all that really matters. I have the whole house to myself which is awesome. I can finally practice my voice lessons without being interrupted.

I also recently finished a major part of my bachelors degree and it's the business capstone. It's an accumulation of everything I've learned in the past year. The class was such a big deal that it broke my fear of going full time. The final project of this class is to draw up a new product, the business model behind it, and pitch it to a classroom full of venture capitalists. I had to go full time and dressed in a business suit. Here's the pictures:




I had to throw in a picture of my cute boots that I wore. They're a little muddy due to all the rain that day, but they look super cute and I absolutely love them. My bedroom mirror is also a little dirty, please excuse the mess :-P

But anyways, I'm still fighting with my health insurance which, it turns out, is owned and paid for by my employer. Anthem is simply the company my employer pays to run it, but the company pays for everything. They've been rejecting my medical claims and making all sorts of excuses. Their latest excuse is that some medical treatments are gender specific and aren't allowed to be used by the opposite gender. I seemed to have convinced my HR representative, but she asked me to write her a letter the argument I was making for her to present to the company policy writers. I'll include the letter in another post.

Aside from all of that, it's been fairly quiet, so that will do it for this blog post I guess.