Facial Feminization Surgery: The Ethics of Gatekeeping in Transgender Health. Issue 12 (2nd December 2018)

• Record Type: Journal Article
• Authors: Dubov, Alex; Fraenkel, Liana
• Is Part Of: American journal of bioethics. Volume 18:Issue 12(2018)
• Page Start: 3
• Page End: 9
• Publication Date: 2018-12-02
• Subjects: gender/sexuality -- health care delivery -- insurance; Bioethics -- Periodicals; Medical ethics -- Periodicals; 174.957
• DOI: 10.1080/15265161.2018.1531159
• Languages: English
• ISSNs: 1526-5161

Abstract

Abstract : The lack of access to gender-affirming surgery represents a significant unmet health care need within the transgender community, frequently resulting in depression and self-destructive behavior. While some transgender people may have access to gender reassignment surgery (GRS), an overwhelming majority cannot afford facial feminization surgery (FFS). The former may be covered as a "medical necessity, " but FFS is considered "cosmetic" and excluded from insurance coverage. This demarcation between "necessity" and "cosmetic" in transgender health care based on specific body parts is in direct opposition to the scientific community's understanding of gender dysphoria and professional guidelines for transgender health. GRS affects one's ability to function in an intimate relationship, while FFS has the same impact on social interactions an, therefore may have a far greater implication for one's quality of life. FFS is a cost-effective intervention that needs to be covered by insurance policies. The benefits of such coverage far exceed the insignificant costs.