As of January 1, Oregon joined several other states that now cover transition-related health care expenses for transgender people.
The policy was carefully considered over more than a year through public meetings and deliberation. The law is, however, under scrutiny as it covers treatment for teenagers as young as 15 years old, according to Mashable.
Although coverage has painted a picture of minors swapping genders at a moment’s notice without parental consent at the expense of taxpayers, the facts of the new regulations are being explained.
The truth is that the new guidelines were put into place to help guide youth with gender dysphoria, a condition that some transgender people experience when their expressed gender does not match the gender assigned to them at birth. Therefore, there is now support for young people going through this that is covered by the state.
The rules were actually based off of safeguards to ensure that all patients had access to appropriate medical care, regardless of condition or age.
“It’s not like surgery on demand,” says Danni Askini, executive director of Gender Justice League, a Seattle-based nonprofit activist organization and who was closely involved in the process of developing the new policy.
Medical treatments available to all eligible transgender patients in Oregon, and many other states, do include surgery, but that does not mean it is the only or ultimate treatment. In contrast, treatments are meant to alleviate depression and emotional suffering related to gender dysphoria as well as offer education and support.
Research has shown through that gender dysphoria is tightly linked to a higher suicide risk which was a concern that played a key part in Oregon’s decision to cover transition-related healthcare.
The medical age of consent in Oregon is 15. The new rule not written specifically to include teenagers starting at the age of 15, but any medical rule written in Oregon automatically includes any patient 15 or over for services.
The surgery and other treatments under ridicule for being subsidized by taxpayers is because the insurance coverage, like coverage for many other treatments, is offered through Medicaid, a federal health insurance program. Medicaid is typically available to low-income people, and also children and teenagers may also be eligible for the coverage in Oregon.
Under Oregon’s Medicaid program, treatment includes hormone therapy, transition surgery as well as medication that delays puberty if deemed appropriate. Less than 200 people covered by Medicaid in the state has utilized the treatment. No minors have ever undergone any surgery.
Askini clarified that the process of transitioning is far from walking into a doctor’s office and asking for hormones surgery. That’s not the way it works.
“That’s not a realistic portrayal of how extraordinarily difficult it is for young people to transition.”
In Oregon, and many other states, a mental health provider as well as a physician must first agree to offer treatment to a patient such as cross sex-hormones like testosterone and estrogen. Transition surgery itself requires the consensus of up to four medical providers who will always prescribe therapies as part of the transition process to help the patient make sure it is the right approach for them.
Askini points out that transition surgery is not always the ultimate goal for patients, or for many transgender patients. A large amount of transgender patients find some relief and comfort in puberty suppression, sex hormones, psychiatric therapy and group support. In that case, surgery may be a last, but life-saving resort.
“For a young person, being told to wait five years is a lifetime, and that creates a huge amount of despair and hopelessness,” Askini says. “The reality is that denying people access to this care leads to a lot of negative long-term outcomes.”
