Thinking about spending the next 2 - 3 years diligently saving while living with this sternum fat (disclaimer: not in reference to "breasts" overall, but how I feel about mine) is a really discouraging, daunting thought.
Prior to coming out and starting my transition, I didn't anticipate that it would amplify a lot and actually become more difficult in many ways than it had been.
Since change and hope have become a reality for me in regards to this part of my being, I've admittedly grown impatient. I waited until I just couldn't take it anymore before I snapped and made an appointment with a therapist for the first time in my life, which instantly led to coming out and starting testosterone.
After spending 14 or so years repressing, ignoring, and letting it gnaw up my insides, my mind, my self-esteem... the lid just blew off the steaming kettle. I just want to finally.connect. I'm tired of it.
I'm tired of stressing out. I'm tired of being unable to look in a mirror, tired of fearing intimacy, tired of feeling so awkward and foreign in my own skin.
So I can spend the next 2 to 3 years saving. This may be my only option. If so, I'll just have to deal with the gnawing a tad bit longer and learn to adapt to the new forms of social repercussions that will stem from being a dapper young man with unwanted breasts.
Hopefully not, though. I've heard of cases where insurance has covered top surgery. Some have been able to get it covered as a preventative measure in regards to breast cancer, for example, or because their insurance policy doesn't specifically state that they exclude it for trans people. My ma's mom unfortunately died of breast cancer, so there's a history... but I'm hoping that my insurance might cover the cost of surgery, or at least some of it, irrelevant to the reason.
My preferred surgeon's office told me that they do not work with insurance companies, but provided me the procedural codes to inquire if they will cover a portion, if not all of the surgical expenses.
Still. I'm not sure exactly how to go about doing this. I'm afraid that if I do contact my insurance company that I'll mess it up, seeing as their #1 priority is to hold on to money, make more money, and to NOT spend it on helping people. It's the United States, after all, with our stellar health care system. So I want to think it out. See what my rights actually are and what they're obligated to provide.
When trying to look into the specifics of my policy on their site, I was able to find some overview information, but when I tried to find details it told me "At this time your coverage documents are not available to view."
I'm considering writing to my H.R. department to ask if maybe they could provide me with detailed information about what, specifically, my insurance is willing to cover and, more importantly, specifically do NOT cover.
I'm also thinking about taking my minuscule savings thus far to have a lawyer (through my work I can get one at discount!) potentially take a look and see if there's fine print or something I'd miss, hoping that this could help me figure out a battle plan of sorts and justify the economic expenditure.
I also have an appointment with my doctor this Friday. I'll need to scribble out a little list of things to talk to her about, such as the potential option of taking progesterone to induce periods, having my blood work done and other tests to see how my cholesterol, blood pressure, hormone levels, etc., are doing, and also to discuss this. To see if there's a way that she or a nurse there could potentially contact my insurance to inquire about those procedural codes my preferred surgeon's office gave me, or to at least get her feedback on it.
I'm also going to explain to her exactly how I intend to transition, with my plan to stop hormones approximately 4-5 years into it, then to resort to diet and exercise. Gadz I'm hoping that my body's genetics combined with the help of T do some fierce, irreparable male secondary sex characteristics damage. As much as can possibly be mustered!
I was nervous to explain it to her until she wrote me a prescription, fearing that if I didn't come across as transitioning in the way that's most familiar to her and presumably the most legitimate (i.e. get a hysterectomy, take T for life...), she wouldn't have given it to me. Now that I'm feeling more confident, I know that it's absolutely important that I explain the unique details of my particular mode of transitioning to her, since this will be the most likely way to make sure my body is doing well given the circumstances (i.e. not wanting my female reproductive organs to atrophy, for example, unlike another trans guy who may not care since they're being removed surgically down the road).
Oh stuff n' things to think about.
This has also been the most prominent road block to having my gender or name changed legally. I don't want to decrease my odds of insurance helping with top surgery by having my gender legally "male", which would potentially instantly out me to them as trans.
I'll figure this out.
Prior to coming out and starting my transition, I didn't anticipate that it would amplify a lot and actually become more difficult in many ways than it had been.
Since change and hope have become a reality for me in regards to this part of my being, I've admittedly grown impatient. I waited until I just couldn't take it anymore before I snapped and made an appointment with a therapist for the first time in my life, which instantly led to coming out and starting testosterone.
After spending 14 or so years repressing, ignoring, and letting it gnaw up my insides, my mind, my self-esteem... the lid just blew off the steaming kettle. I just want to finally.connect. I'm tired of it.
I'm tired of stressing out. I'm tired of being unable to look in a mirror, tired of fearing intimacy, tired of feeling so awkward and foreign in my own skin.
So I can spend the next 2 to 3 years saving. This may be my only option. If so, I'll just have to deal with the gnawing a tad bit longer and learn to adapt to the new forms of social repercussions that will stem from being a dapper young man with unwanted breasts.
Hopefully not, though. I've heard of cases where insurance has covered top surgery. Some have been able to get it covered as a preventative measure in regards to breast cancer, for example, or because their insurance policy doesn't specifically state that they exclude it for trans people. My ma's mom unfortunately died of breast cancer, so there's a history... but I'm hoping that my insurance might cover the cost of surgery, or at least some of it, irrelevant to the reason.
My preferred surgeon's office told me that they do not work with insurance companies, but provided me the procedural codes to inquire if they will cover a portion, if not all of the surgical expenses.
Still. I'm not sure exactly how to go about doing this. I'm afraid that if I do contact my insurance company that I'll mess it up, seeing as their #1 priority is to hold on to money, make more money, and to NOT spend it on helping people. It's the United States, after all, with our stellar health care system. So I want to think it out. See what my rights actually are and what they're obligated to provide.When trying to look into the specifics of my policy on their site, I was able to find some overview information, but when I tried to find details it told me "At this time your coverage documents are not available to view."
I'm considering writing to my H.R. department to ask if maybe they could provide me with detailed information about what, specifically, my insurance is willing to cover and, more importantly, specifically do NOT cover.
I'm also thinking about taking my minuscule savings thus far to have a lawyer (through my work I can get one at discount!) potentially take a look and see if there's fine print or something I'd miss, hoping that this could help me figure out a battle plan of sorts and justify the economic expenditure.
I also have an appointment with my doctor this Friday. I'll need to scribble out a little list of things to talk to her about, such as the potential option of taking progesterone to induce periods, having my blood work done and other tests to see how my cholesterol, blood pressure, hormone levels, etc., are doing, and also to discuss this. To see if there's a way that she or a nurse there could potentially contact my insurance to inquire about those procedural codes my preferred surgeon's office gave me, or to at least get her feedback on it.
I'm also going to explain to her exactly how I intend to transition, with my plan to stop hormones approximately 4-5 years into it, then to resort to diet and exercise. Gadz I'm hoping that my body's genetics combined with the help of T do some fierce, irreparable male secondary sex characteristics damage. As much as can possibly be mustered!
I was nervous to explain it to her until she wrote me a prescription, fearing that if I didn't come across as transitioning in the way that's most familiar to her and presumably the most legitimate (i.e. get a hysterectomy, take T for life...), she wouldn't have given it to me. Now that I'm feeling more confident, I know that it's absolutely important that I explain the unique details of my particular mode of transitioning to her, since this will be the most likely way to make sure my body is doing well given the circumstances (i.e. not wanting my female reproductive organs to atrophy, for example, unlike another trans guy who may not care since they're being removed surgically down the road).
Oh stuff n' things to think about.
This has also been the most prominent road block to having my gender or name changed legally. I don't want to decrease my odds of insurance helping with top surgery by having my gender legally "male", which would potentially instantly out me to them as trans.
I'll figure this out.
Good luck, it's a lot of tiring work, just trying to figure this stuff out, I'm sure.. It's hard to know which doctors you can and can not talk to about this type of things.
ReplyDeleteHeck, its hard to know who to talk to in terms of friends and family as well.
Again, good luck, and in time, you'll figure it out.
Holy CRAP this is complicated.
ReplyDeleteYou should look into whether or not your insurance will cover top surgery as treatment for gynecomastia if you are listed as legally male. Theoretically this should make no sense, but some insurance companies have done such wonderful things as pay for viagra and not birthcontrol, so hey male breast development might be higher on their priority list than one would expect.
I think the lawyer might be a good idea, if you can find one who is familiar with these sorts of things. Even something as seemingly obvious as my jaw surgery was a nightmare (thank god my mom was taking care of the insurance end, or I still wouldn't be able to open my mouth). Because the surgeon went in from outside my mouth (medical!) and the bite splint/adjustment guy dealt with my teeth (dental!) everything was a constant fight. I think the lesson here is that even if it seems obvious or clear, it isn't, and there are probably 80 billion loopholes that could be used in your favor, OR to screw you over with a huge bill after a "pre-authorized" proceedure is already finished.
The important thing to remember is that there is no singular medical 'truth.' If you can't get 'reconstructive' surgery as a trans guy, maybe you can get 'corrective' surgery for gynecomastica as a guy, or 'prophylactic' surgery as a woman with a history of breast cancer in the family. Hell, maybe you can go at it as a 'reduction' because you've had back problems. Getting it covered may end up being as simple as getting the right kind of reccomendation from the right kind of doctor, but you'll probably need help figuring out what the magical combination is.
In the meantime, I would try to dig up some legal precidents to see if other people have already fought the battle for you. :)
That's a great idea about the gynecomastia. I've been wanting to tell you about a local surgeon, and this is a great time to maybe investigate him as a potential source.
ReplyDeleteI had a breast reduction surgery by Dr. Charles Pledger when I was 19. He's local, and at the time he worked with my insurance company. They covered 80% of my surgery. His website shows an example of gynecomastia surgery he's performed and it looks pretty good, imo. It would be worth a call, anyhow, since he's local. I'm not sure how trans friendly he is, but he's a damn fine surgeon. If you could get a little coverage, that would help a lot. It might even be worth financing if it would help your state of mind.
Technicly your DR should be helping you figure out this insurance stuff.
ReplyDeleteYou need to find a Dr that does work with insurance companies. You may have to go out of the remls of your already safe Dr. and find a Dr who can do the surgery and knows how to code things. That is what it will ultimatly come down to.
You may have better luck if you are not going to a trans specific Dr, who is willing to work with you and not Flaged per say by the insurance co as a tranny Dr. Know what I mean?
Who is your insurance co? As shitty as they are some of them are actually starting to encompase GLBT issues and cover more things.
I swear I did a spell check on that and fixed all the errors...DAMN COPY AND PAST :)
ReplyDeleteLost: Thanks. Hopefully insurance will cover it, which they should dag nabbit.
ReplyDeleteraedances: Woo, thanks for the thoughtful comment and good advice, as always!
ReplyDeleteThe fact that there isn't any "singular medical truth" is almost precisely why it's so difficult to find a precedence in regards to this. What worked for one person may not work for another, depending on our individual insurance plans, states, yada yada.
But yeah, good points. There has to be a loop hole or two. Not that it should have to be a loop hole - and it may not be. I may be able to just have chest reconstruction surgery covered, as is. But that's just hopeful thinking. We'll see. ;]
dscokween: Thanks for the input about a local surgeon.
ReplyDeleteThe surgeon I chose is in California, and I picked him since he's been doing chest reconstruction surgery for some time, he's for sure 100% trans-friendly, and is really, really good at what he does. I figure it's worth the extra headache (i.e. him being an obviously trans-friendly surgeon to insurance companies) to make sure it's done right and as well and safely as possible.
Kegg: My insurance is "United Healthcare", and I'm hoping that my doctor can help in regards to figuring this out!
ReplyDeleteIf you got genetic testing that proved you have BACA 1 or 2 in your genes, that's the specific gene where they actually *recommend* double-mastectomy. Then it'd be easy- but I do believe that most people with BACA 1 or 2 are of Jewish descent. Something to look into, though.
ReplyDeleteDouchebaguette: I would've never gone thunk a'that. Definitely worth looking into. Thank you!
ReplyDelete