My insurance company denied my top surgery consultation because my doctor’s office did not submit the letters with the referral. Now I have to vent about why this is so frustrating. 

In order to get gender-affirming top surgery, or any gender-affirming surgery, you have to have two letters–one from your medical doctor and one from a mental health professional. Both letters must state that you have been living as your preferred gender for at least one year, and that you have been receiving mental health counseling for at least six months. 

Furthermore, the letters must detail what actions you’ve been taking to live as the gender you have chosen (dressing, binding, etc.), what your goals are after the surgery (gaining self-esteem, living comfortably in your own skin, etc.), and that you’ve been fully informed of the risks involved (no duh!). 

You must have a diagnosis of gender dysphoria, and that the surgery is the only option for you to live without the depression you’ve been dealing with, despite several interventions to the contrary by your doctors (because people need to talk you out of it first!), yet, you can’t be so depressed to the point of being unstable. It’s gotta confirm you’re stable enough to make this life-changing decision.  

Then the letters have to mention the disclaimer about your rights under the World Professional Association for Transgender Health, which promotes the highest standards of health care. They are the experts that have come to this consensus in the mental health community worldwide so you can get such a procedure. If they didn’t exist, it would be like the olden days where people would have an even tougher time getting these surgeries.

In having to go through all this, you’d think people would stop asking me, “Are you absolutely sure you want to do this? Have you really thought about it?” I mean, who would go through this shit if they didn’t really want to do it?

Anyway, with all this being said, I have these two letters. They are supposed to be submitted with the doctor’s referral to the insurance company so I can get a consultation with a surgeon. But despite me sending the doctors’ office the letters multiple times and calling them to make sure they send those letters with the referral–and talking to the doctor himself, they did not submit the letters to the insurance. Now, the people in the doctors’ office say they were not aware of any letters and that I was denied, and oh well. WTF!

So, I had to yell. I don’t like being an asshole. Who wants to be an asshole? “We can resubmit another referral if you want.” I told them if they don’t do it with the letters, I’m going to keep getting denied. I’ve told at least three people on the staff this fact. 

They said they’d resubmit it again, and they haven’t. Not yet anyway. I wrote my doctor a note telling him I was frustrated. What good is that? What good is venting here on my blog? 

All I know is that I’m getting my hair cut tomorrow! My dreads are gone. I’ve combed them all out and cut off the dead ends. Now I want short hair, and this is the cut I’m thinking about: 

It won’t look as good on me as it does on this person, but maybe by the time I lose weight, it will look pretty cool. As of today, I’ve lost 27 pounds from my heaviest weight. That’s half-way before I can get my surgery. I mean, technically, I could get it now, but I’d like to get my BMI down to be safer. I’m shooting for the first of the year. 

2 thoughts on “Incompetence

  1. cindyschnackel August 26, 2020 / 3:11 pm

    What a freaking hassle! I’m so sorry you have to go thru this. We (patients) shouldn’t have to do their jobs for them, nor even explain it to them. Unforgivable ignorance. Sadly, it is common in many professions anymore, and it’s always the customer’s fault that they didn’t do their job right. UGH! That’s a cute haircut, too, BTW.

  2. Carol Es August 28, 2020 / 11:37 am

    Thanks for commiserating Cindy. I needed that. Look on today’s blog post and you’ll see a better update. 🙂

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