Medicaid coverage is now allowed for anyone, not just those over 18 years old, as previous regulations allowed, who seeks certain gender dysphoria treatments and meets a number of criteria. This includes gender reassignment surgery.
“I honestly think that’s great!” said Matt Pasini, 19. The young trans man started on hormone blockers, four years ago at age 15, following a difficult period in which his parents tried to “cure” him through reparative therapy. The native Venezuelan moved to the U.S. with his family when he was less than 2 and is now a U.S. citizen. He’s still living with his parents, who have come full circle in terms of acceptance.
“My parents were unaccepting to the point they put me in therapy,” Pasini told LGBTQNation. It backfired, in his favor. “The therapist they found me turned out to be a gender therapist, who helped my parents become more accepting.”
New York lawmakers needed a little of the same kind of help, according to Matthew Hamilton, blogger for the Times Union newspaper. He wrote that the NYS Department of Health received comments regarding the rule that “objected generally to medical intervention for a ‘delusion’” and others contending that gender dysphoria does not meet criteria for Medicaid coverage under state Social Services Law.
Hamilton wrote that the department addressed the response in its publishing of the rule Wednesday.
“In this rulemaking, and in prior rulemakings, the Department has established standards intended to ensure Medicaid pays for high-quality care that is not medically contraindicated, is medically necessary to treat an individual’s gender dysphoria, and is undertaken with the informed consent of the individual,” reads the department’s response.
Some health insurance plans that cover treatments for transgender patients do not cover procedures such as facial feminizing surgery for transgender women, and other operations to change a trans patient’s physical appearance to more closely conform to secondary sex characteristics of the gender with which that person identifies. The new Medicaid rule, it is covered if deemed medically necessary to treat gender dysphoria and prior approval is given.
The new rule also makes clear that gender reassignment surgery shall be covered by Medicaid for adults in New York.
According to the new rule, those under 16 can receive payment for the treatment in specific cases if deemed medically necessary and prior approval is granted. It was in Pasini’s case.
“The traumatizing thing of going through the wrong puberty, for me, when I first started developing at 11, I began having so much self hatred for myself,” Pasini told LGBTQNation, who has already legally changed his name, undergone top surgery and is living full-time as the male he’s known he was since he was 3 years old. The dysphoria he has felt since that time he stumbled into a bathroom and saw a male relative peeing standing up, realizing for the first time his body wasn’t the same as a grown man, only got worse when he reached puberty. “When the menstrual cycle started it caused so much anxiety,” he said.
It didn’t get much easier, he said, after he came out and started using the men’s bathroom and had to deal with his period in a stall. “It caused me so much anxiety and dysphoria, a constant kick in the face, like, ‘Hey! You were born in the wrong body.'”
All that Pasini lacks right now, he says, is a hysterectomy, which is difficult to obtain for anyone under 25. He’s working with transgender-friendly doctors at Mount Sinai in New York City in hopes of achieving that final transition goal. And he’s about to take the first step, to see a trans-supportive gynecologist:
“I have an appointment next week, wow!”