Sex-Reassignment Surgeries Can Now Be Covered by Medicare, Following HHS Decision

People seeking sex-reassignment surgeries may now be able to have the procedure covered by Medicare, following a groundbreaking decision by the U.S. Department of Health and Human Services review board on Friday.

The ruling in question came in favor of 74-year-old Army veteran Denee Mallon, of Albuquerque, New Mexico, who was born as a man but now identifies as a woman, The Associated Press reported. The vet applied for genital reconstruction surgery two years ago through Medicare, the national social insurance program, but was denied because the program automatically excludes such surgeries.

"Sometimes I am asked aren't I too old to have surgery. My answer is how old is too old?" Mallon stated in an email before Friday's decision. "When people ask if I am too old, it feels like they are implying that it's a 'waste of money' to operate at my age. But I could have an active life ahead of me for another 20 years. And I want to spend those years in congruence and not distress."

The three decade-old directive that banned such coverage categorized sex-change surgery for transsexuals as controversial.

"Because of the lack of well controlled, long-term studies of the safety and effectiveness of the surgical procedures and attendant therapies for transsexualism, the treatment is considered experimental," it stated.

Jennifer Levi, a lawyer who directs the Transgender Rights Project of Gay & Lesbian Advocates and Defenders in Boston, clarified that the decision does not mean that sex-reassignment surgeries will automatically be paid by the government, but simply that the ban has been lifted. Patients will still need to submit documentation from a doctor and mental health professionals stating that the surgery they are seeking is medically indicated.

The AP article clarified that the ruling does not apply to the Medicaid program, which provides health coverage for individuals and families with low-incomes and is regulated on state-level. While some states exclude sex-change surgeries and sex hormones used by transgender people in the Medicaid coverage, others review claims on a case-by-case basis.

While specific statistics on transgender people are difficult to come by, an October 2012 Gallup poll of over 120,000 U.S. adults found that 3.4 percent of respondents personally identify as lesbian, gay, bisexual or transgender. Another 92.2 percent said that they do not, while 4.4 percent refused to answer.

The poll stated with 95 percent confidence that the maximum margin of sampling error is smaller than plus or minus one percentage point.

Family Research Council, which often speaks on family, marriage and human sexuality issues, did not immediately respond to a request for comment.

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