Obtaining appropriate health care – including adequate medical insurance coverage – has often proved challenging for patients who may identify with one gender, yet still have body parts of another gender. A trans man who still has breasts may not get coverage for a mammogram, for example.
But that may now change: The Department of Health and Human Services has confirmed that the Affordable Care Act prohibits federally funded health-care programs from discriminating against transgender people. ABC News reports on this today and highlights the case of Jay Kallio, who faced discrimination when he sought treatment for breast cancer:
At the age of 50, Kallio transitioned from female to male, but never had gender reassignment surgery, only hormone treatment. ‘I accept my body as I was born,’ he said. But when a suspicious lump was found in his breast and tested positive for cancer, the surgeon was so shocked that Kallio’s body didn’t match his gender identification — not knowing whether to address him as ‘he’ or ‘she’ — that he couldn’t bring himself to tell his patient the grim biopsy results.
Due to the doctor’s mistake, Kallio was late in receiving treatment.
In a story on transgender health care for the recent issue of Stanford Medicine, I highlight the barriers facing the patients and the importance of doctors providing prejudice-free care. A Stanford physician also emphasizes the unique needs of transgender patients:
Physicians should be cognizant that sex-change surgery patients often still carry reproductive organs from before, and these may need continuing medical attention. That’s something that can be easily missed, says Nelson Teng, MD, associate professor of obstetrics and gynecology at Stanford, who has treated several female-to-male transsexuals for endometrial cancer — cancer of the lining of the uterus. “Many male transgender patients still have a uterus and still should see gynecologists.”