Tag Archives: transgender

Being Trans and Navigating the Healthcare Marketplace

So, this new Healthcare Marketplace is going to take some work. Not only to implement, but also to navigate.  If you ask 10,000 trans-identified people to tell you about their experience, you’re going to get 10,000 different individual experiences – and this is what the Healthcare Marketplace is going to be.

According to NCTE, “Transgender people are less likely to have health insurance than non-transgender people, and 48% of transgender people have avoided going to the doctor when they were sick because they could not afford it.”  How many people do you know who avoid going to the doctor because they can’t afford it, or are worried about being discriminated against because of their gender identity? I know many people.

The Affordable Care Act (ACA) will prohibit discrimination on the basis of gender identity in the regulations implementing the law, will expand coverage for HIV/AIDS treatments, will provide free preventive care and clearly states that individuals cannot be denied health insurance because of pre-existing conditions.

All plans in the Marketplace are required to cover the same essential health benefits which include at least the following items and services:

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  • Emergency services
  • Hospitalization (such as surgery)
  • Maternity and newborn care (care before and after your baby is born)
  • Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services

Essential health benefits are minimum requirements for all plans in the Marketplace. Plans may offer additional coverage. You will see exactly what each plan offers when you compare them side-by-side in the Marketplace.

The ACA and its laws protect you in the following ways:

Medicaid and Ohio (Applies only to Ohio residents)
Ohio is one of the states that has chosen NOT to expand its Medicaid program at this time.

Here are some good resources to read about how Ohio’s lack of Medicaid expansion affects you:

You can find out whether you qualify for Medicaid under Ohio’s current rules 2 ways:

If you reside outside of Ohio, you can find out how your state is managing Medicaid online at (https://www.healthcare.gov/).

While there are some common steps for people to take to get signed up, people’s individual plan choices will make each person’s experience unique.

Male or Female?
When I created my online account, one of the questions was, of course, the infamous binary question: Male or Female.  I chose how I identify and wondered if I selected correctly, thinking that if I need additional preventative care for my body, did I make the right choice?  I connected with Andrew Cray who is a Policy Analyst at the Center for American Progress and asked him about what do Trans people select – Male or Female?

According to Andrew Cray, “When Trans people are applying for coverage through the Marketplace, they should use the sex on their social security card. It’s intended for matching against tax records. No physician will see the sex indicated on that application, and it shouldn’t be relevant to insurance companies regardless, because insurance companies can’t charge more based on gender, and because discrimination in coverage based on gender identity and sex are prohibited by federal regulations. Because of those protections, we’re fairly certain that gender no-matches for preventive screenings shouldn’t be an issue with plans sold through the marketplace. But if people are denied coverage, we’re happy to help folks with basic info about appeals, and the Marketplace will have that information as well.”

Here are the steps you need to follow in order to create your online Marketplace account:

If you are living in Ohio, you’ll use the Heatlhcare.gov website (https://www.healthcare.gov/).

Keep in mind that Plan information and costs will be available on October 1, 2013. So, you can at the very least, create an online account and be set to go when the Marketplace opens!  (If you reside outside of Ohio, you can check how your state is going to manage its own Marketplace also at https://www.healthcare.gov/)

  1. Create an account
    You’ll need to provide some basic info and select a username, password, and security questions.

  2. Apply for Marketplace coverage
    Of course, you’ll need to provide info about you and your family, including your income, household size, etc. (There is a generic checklist available to help you gather the info you’ll need).

  3. Pick a plan
    Next, you should get a list of all the health insurance plans and programs you’re eligible for. Make sure you take a look at all the plans and compare them to one another! Depending on your income, you’ll also find out if you are eligible for lower costs on Marketplace coverage — again, it’s all based upon income and household size.

    (**Note: there is a Subsidy Calculator available online at http://kff.org/interactive/subsidy-calculator/  — The Kaiser Family Foundation is solely responsible for the tool. The Kaiser Family Foundation has no connection with Kaiser Permanente or any health care provider.)

  4. Enroll
    Select an insurance plan that meets your needs and enroll! (Looks like actual enrollment will open in November.)

Simple, right?  Seems like it, but, it’s going to take some time and research on our own part, as individuals (or as a household) to find a plan that works best for each of us.

That said, NCTE adds that the “ACA reforms will eliminate many barriers to coverage access for trans people and will provide avenues for people to file discrimination complaints. No longer will plans be able to refuse to sell you insurance, charge you more, or deny coverage for routine preventive or emergency care because you are trans.”

A new campaign called Out2Enroll (http://out2enroll.org/) is in its final days before launching on October 1, 2013.  Out2Enroll will be available for every state and is a collaborative project between the Sellers Dorsey Foundation, the Center for American Progress (CAP), and the Federal Agencies Project to educate the lesbian, gay, bisexual, and transgender community about their options under the Affordable Care Act.

I recommend visiting their website and signing up for an email.  When Out2Enroll launches, you’ll be able to receive updated information as it pertains to the ACA and being Trans (or bisexual, lesbian or gay).

Personally, I think that this is going to be pretty complex system to implement and I think it’s going to work.

Do I believe that it’s a perfect system for Trans-identified persons?

  • No, I don’t think so.

Will it cover surgery for people?

  • Most likely, definitely not. And never say never. Maybe someday.

Will it provide mental health and physical health medical coverage for Trans-identified persons?

  • Yes, definitely.

Will Trans-identified people be able to access preventative health care?

  • Yes, I definitely believe so.

Will Trans-identified people be able to access mental health professionals?

  • Yes, I believe they will.

Do I believe that Trans-identified people who want access to hormones be able to get access to them safely?

  • Yes, I believe they will.

If you ask me if I believe if there will still be discrimination facing individuals in our Trans community…Yes, I unfortunately believe that there will be and there will be a way to report and address it.  While the ACA addresses some basic needs and access to health care for our community, we still have a way to go in making sure that more than just our basic healthcare needs are met.

To compare your health insurance options and enroll in a plan, visit healthcare.gov or call the 24/7 Consumer Call Center at 1-800-318-2596 starting Oct. 1, 2013.  You can also visit out2enroll.org to get more trans-specific information about the new marketplaces.

Here are some resources that are available online for reference, research or if you have a general interest in how this is going to work at a larger scale:

Trans Film Series Hosted by TransOhio & Gateway Film Center: She’s A Boy I Knew

Monday, February 21 · 8:00pm – 10:00pm

Gateway Film Center
1550 North High Street
Columbus, Ohio
$6—Benefits TransOhio

They say that when someone comes out of the closet, they can’t stop talking about it. Vancouver filmmaker Gwen Haworth not only talked she made a movie. Using archival family footage, interviews, phone messages, and hand-drawn animation, Haworth’s documentary SHE’S A BOY I KNEW begins in 2000 with Steven Haworth’s decision to come out to his family about his life-long female gender identity. The resulting auto-ethnography is not only an exploration into the filmmaker’s process of transition from biological male to female, from Steven to Gwen, but also an emotionally charged account of the individual experiences, struggles, and stakes that her two sisters, mother, father, best friend and wife brought to Gwen’s transition.

Under Haworth’s sensitive eye, each stepping stone in the process of transitioning becomes an opportunity to explore her community’s and our own underlying assumptions about gender and sexuality. When Steven starts to wear his wife Malgosia’s clothing, she struggles with whether Steve “wants to be with me or to be me;” when Steven changes her name to Gwen, her father comments, that’s “when I realized I lost my son;” Haworth’s gender reassignment surgery, or vaginoplasty, forces her sister Kim to grapple with her own experiences in the medical establishment and raises questions about the implications of the medicalization of gender.

In these tender and difficult moments, SHE’S A BOY I KNEW forces us to question our own assumptions about the role that names, clothing, and anatomy play in our constructions of gender identity. As her transition progresses, Gwen is forced to reckon with the end of her marriage and the loss of her status as son and brother. But in doing so, she also discovers that while the nature of personal relationships may change, the love and support present within those relationships can remain just as powerful and sometimes even more so.

At turns painful, funny, and awkward, SHE’S A BOY I KNEW explores the frustrations, fears, questions, and hopes experienced by Gwen and her family as they struggle to understand and embrace her newly revealed identity.

You’re Invited: Final Full-Dress Rehearsal of I AM MY OWN WIFE Presented by CATCO & TransOhio

You’re Invited…

Join TransOhio & CATCO for the final full dress rehearsal of the Tony Award winning play:

I Am My Own Wife

Charlotte von Mahlsdorf was a transgender person, who lived through the horrors of pre- and post-World War II Germany. How did she survive the harsh regimes of both Nazi Germany and the post-war East German Communists? How did she create a respected museum that also served as a safe haven for Berlin’s homosexual community? This Pulitzer Prize and Tony Award winning play illuminates the sacrifices and betrayals of Charlotte von Mahlsdorf through the artistry of a single actor playing more than 30 characters.

Date: Tuesday, February 1, 2011
Time: 7:00pm
Doors open at 6:30pm
RSVP’S Required!

Riffe Center Studio Two Theatre
77 S High Street
Columbus, Ohio

RSVP’s ARE REQUIRED and suggested donation of $10 at the door.
(All Donations go DIRECTLY back to TransOhio).

For more information about CATCO and I Am My Own Wife, visit
http://www.catco.org/seasons/2010-2011-season/i-am-my-own-wife

The Importance of the TransOhio Needs Assessments

AIDS Clinical Trials Research Site at Case Western Reserve/University Hospitals in Cleveland

Recently, an HIV vaccine trial in Cleveland has opened enrolling gay men and transgender women who have sex with men.  The AIDS Clinical Trials Research Site is located at Case Western Reserve/University Hospitals in Cleveland.

They are particularly interested in reaching out to the transgender community, both for the community’s understanding of the HIV vaccine trial, as well as for recruitment purposes.

Preliminary information on the trial is available at www.hopetakesaction.org.  Please feel free to contact Outreach Coordinator, Bob Bucklew, with any questions or comments you may have.

Bob Bucklew, Outreach Coordinator
CWRU/UH AIDS Clinical Trials Unit
office: 216-844-2247
fax: 216-844-3926