<p>Clearly, Brown is not alone.</p>
<p>[Transgender</a> Health - UCLGBTIA](<a href=“California Campus LGBTQ Centers: UCLGBTIA”>California Campus LGBTQ Centers: UCLGBTIA)</p>
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<p>Remarkably enough, I’ve heard no reports of ensuing financial disaster, or of legions of trans people having reassignment surgery at these places. (The annual cost of hormones is generally quite minimal.)</p>
<p>From what I’ve been able to determine through a quick Google search, the City of San Francisco has provided insurance coverage for all of this for its employees for the last decade or so. I imagine that San Francisco has more employees than Brown or any of the other listed schools has students. And that their average age is considerably older, so that any trans employees are far more likely to be at the point of having surgery. And yet, the total number of people taking advantage of the surgical coverage has been – again, from what I can tell – no more than one or two people a year. </p>
<p>It’s a rare thing, people – with rarity having nothing to do with medical necessity.</p>
<p>Nobody seemed outraged when a court ruled that breast reduction surgery for adolescent boys with gynecomastia was medically necessary and had to be covered by insurance. Breast reduction surgery for women is generally covered too, so long as one’s physician attests that it’s medically necessary, and not just for “cosmetic” purposes. There are lots of things deemed medically necessary and covered by insurance beyond strictly life-saving procedures. </p>
<p>The medical consensus (confirmed by a number of court rulings) is that transition-related genital surgery is, in fact, medically necessary, and does allow many trans people to function normally in society; the fact that some trans people don’t need it hardly means that nobody needs it. Everybody is an individual, and there’s no single, universally applicable course of treatment for gender dysphoria. The fact remains, however, that social, medical, and/or surgical transition are the only known “cure” for gender dysphoria – and believe me, people have been trying for a hundred years to treat it otherwise, without success! – and the idea that lots of people have surgery or go through hormone treatments and then regret it is a myth. Even if their lives aren’t ideal after transition – often because of continued discrimination against those who are “visibly” trans – most people with trans histories would do it all over again. It’s better than the alternative. </p>
<p>In any event, it really isn’t up to people, in my opinion, to argue that one class of medically necessary procedures should be excluded from coverage because some people personally go ewww and think it’s icky. I think worm therapy and fecal transplants are kind of icky, but I wouldn’t dream of saying that for that reason, they aren’t medically necessary. Medical necessity shouldn’t be up for popular vote based on longstanding societal prejudices.</p>