Researchers from Johns Hopkins Medicine and Harvard University analyzed 15 years of data and found a fourfold increase from 2000 to 2014.
They took their data from the National Inpatient Sample, finding a total of 4,118 gender-affirming surgeries, and believe better access to healthcare could be behind the major shift.
“Most transgender patients in this national sample undergoing inpatient gender-affirming surgery were classified as self-pay; however, an increasing number of transgender patients are being covered by private insurance, Medicare, or Medicaid. As coverage for these procedures increases, likely so will demand for qualified surgeons to perform them,” the researchers explain in the abstract of their report, published in JAMA Surgery.
Most surgeries occurring between 2000 and 2011 involved patients not covered by health insurance, but that trend reversed between 2012 and 2014, with the number dropping to 39 percent. Medicare ended a 33-year ban on transgender surgeries in 2014.
“Early on we recognized there’s been a lot of work on health disparities having to do with age, race and so on that get collected in health-care settings,” Brandyn Lau, an assistant professor of surgery and health sciences informatics at the Johns Hopkins University School of Medicine, told The Washington Post. “One of the things we need to know is whether [lesbian, gay and transgender] patients are getting the same care.”
As the Post notes, medical associations in the United States say gender confirmation surgery is “medically necessary” for the physical and mental health of the individuals seeking them, and contend that they should be covered just like any other surgery.
In addition to Medicare and Medicaid, over the past decade an increasing number of insurance plans have started to cover transgender healthcare costs, including state-sponsored plans and those gained through employers.
The cost of transgender healthcare was one of the issues President Trump has raised in defense of his ongoing attempts to keep transgender people out of the military, despite the expected costs being minimal.
Section 1557 of the Affordable Care Act, aka Obamacare, barred discrimination on the basis of gender identity, helping to grant more access to surgeries for transgender people, but there are fears the Trump administration will fail to defend that policy.
This is, after all, the same administration that is refusing to hear discrimination complaints from transgender students who are denied access to the facilities matching their gender identity.
“There’s going to be rough sailing ahead,” said Loren Schechter, who specializes in transgender surgeries. “There is concern in the community and among providers that many of the gains already made are in jeopardy.”