[MaggieL]

Oh, dear....yet another can of worms.

Do I think insurance "should" cover reassignment? Well....given that I consider it an effective treatment for a medically-recognized condition: yes.

Do I *expect* it? Absolutely not...I've worked for insurance companies, and given how few people this affects, what happens is they specifically exclude it in the plan language, and not enough people care about it to make them change it, so the current situation is likely to continue.

I *do* know people who have had insurance that was good enough that it was covered. As it happened, my company mereged with another just before my surgery, and we of course got the lowest-common-denominator coverage. The company we mereged with had just had an employee whose surgery was covered. Mine wasn't. C'est la vie, like I said.

Those who have or are about to hold forth on "cosmetic surgery" I remind that not all plastic surgery is "cosmetic" surgery...reconstruction after an accident, for example. There's plenty of women who have gotten breast augmentation--or reduction, for that matter--covered as "medically necessary".

As for "birth defect", there's enough controversy about that, too. Until the etiology of transsexualism is *much* better established than it is today--today there are only theories, with sketchy experimental evidence--I don't think universal acceptance of it as a "birth defect" is within realistic reach.

Typically, (and the well-moneyed folk who appeared in the Discovery channel show are *not* typical) TS folks are not in a position to engage in a long legal battle with their insurance companies to establish that reassignment surgery is "medically necessary"...especially when the insurance company is perfectly willing to invest in expert witnesses (mostly from Johns Hopkins, originally a center for treatment for gender dysphoria but now the mecca for the anti-SRS crew) who are happy to testify that it isn't.

The insurance companies will spend a *whole* lot more than the $20K or so they'd be out for covering one case to keep this one off the books. So an individual could spend *all* the money that would pay for their surgery, plus quite a bit more, and then still end up with nothing to show for it.

Personally, I thought my SRS was "medically necessary", and so-voted with $13K of my own money. I also think it should have been covered, but I do know that most people--who really have no idea what gender dysphoria is--would disagree.

Of course, I don't think I "should" have to pay for lung cancer treatment for smokers either--but have accepted that I have to, because the incidence of that is so much higher: just about everybody knows someone who killed themselves with cigarettes.

It's really a political issue--a matter of how many people something like this affects.