Why is it so difficult to get gender affirmation surgeries?

Photo Courtesy of huffingtonpost.com ||  Gender affirmation surgeries are far more critical and inexpensive than any other surgery. So why is it so hard to get one, Cas Sweeney ’19 asks.

Photo Courtesy of huffingtonpost.com || Gender affirmation surgeries are far more critical and inexpensive than any other surgery. So why is it so hard to get one, Cas Sweeney ’19 asks.

Cas Sweeney '19
Associate Editor

One common worry when transgender people decide to medically transition is that they will regret the decision. To minimize this, there is a long and invasive process to be able to have any gender affirmation surgeries.

Until very recently, all trans people who wanted to take hormones had to be diagnosed by a doctor. Even now, though some people can be prescribed hormones on an informed consent basis, many insurance companies require therapy before they are willing to cover the hormones.

Usually to get a referral for any gender affirmation surgery, a trans person must be taking hormones for a certain amount of time and build up a rapport with one therapist who will vouch for their identity to a doctor.

All of this is done to keep the rate of regret as low as possible. The question we should be asking, however, is “Is it worth it?”

Many studies have been done on rate of regret after medically transitioning. All of them find that at least 96 percent of people are satisfied with their transition, with the average satisfaction being at 98 percent.

In 2016, 3,250 people had gender affirmation surgeries. Therefore of those 3,250, only approximately 65 people were dissatisfied.

That number is much lower than most other surgeries. The average rate of regret for cosmetic surgery which uses many similar techniques as gender affirmation surgery is much higher, at 65 percent.

Another very common surgery, knee replacement surgeries have a dissatisfaction rate between 15 and 30 percent.

Only an average of two percent of people who have gender affirmation surgeries regret it, much lower than either of these other surgeries, and yet there are so many restrictions in place specifically to keep that regret rate low. Why?

Is it because gender affirmation surgeries are less necessary than other surgeries? No. Studies have looked into the importance of gender affirmation surgeries for trans people and found them to be not only medically necessary, but also life saving, more so than cosmetic surgery or knee replacement surgery.

Is it because the surgery is expensive? No. It is an immense burden to have to pay out of pocket but it does not fall high on the scale of surgeries that insurance would usually cover. Gender affirmation surgeries can cost between $7,000 and $25,000 depending on the surgery, while knee replacement surgery can cost more than $35,000.

Is it because it’s dangerous? Again, not more so than cosmetic surgery. Things can and do go wrong, but that is true for all surgeries.

Reversing gender affirmation surgery is a long and difficult process for the few people that decide to do so. However, not having access to such surgeries is immensely dangerous to transgender people’s health and ability to live.

The cost of keeping the regret rate so low outweighs the benefits by leaps and bounds, so why continue to do so?

There are already so many barriers to getting gender affirmation surgery: cost, transphobia amongst family and friends, limited availability of trained doctors, lack of support before and after the surgery. Let’s not add more artificially.

Instead, we should lower the restrictions on getting gender affirmation surgery, making it available on an informed consent basis. More people will regret the surgery but many more will have access to it, which will save lives.