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Perspectives on coverage of trans surgery

With the addition next year of transgender surgery coverage to Cardinal Care, Stanford’s student health plan, some students say there are quality-of-life improvements on the horizon for transgender students here.

Some international students, who next year are required to buy into Cardinal Care, are expressing frustration with the plan, whose transgender coverage they say they won’t need.

By and large, however, many students have welcomed the change.

“It is fantastic that Stanford is leading the world in trans rights and equality by making sure that trans students at Stanford are well supported in the student health care plan,” said ASSU executives David Gobaud, a coterminal student, and Andy Parker ’11 in a statement.

The decision to cover transgender surgery aimed to provide adequate medical treatment for students with gender identity disorder, according to Ira Friedman, the director of Vaden Health Center at Stanford.

Friedman said he does not expect the coverage option to be widely used.

“We do not anticipate a large number of surgeries,” Friedman wrote in an e-mail to The Daily. “Having this benefit opens the plan to additional expenses, but for the plan as a whole we do not anticipate that the impact will be very costly.”

He said the decision to cover transgender surgical treatments was made after students and staff articulated the transgender community’s needs and concerns.

According to Juno Obedin-Maliver, a fifth-year medical student and co-founder of the Stanford LGBT Medical Education Research Group, the move is a statement toward tolerance and acceptance of the transgender community.

“By providing this surgery, they’re saying that they’re willing to think about and create a welcoming environment for transgender patients,” she said.

Obedin-Maliver said that transgender health care challenges can be many: doctors may refuse to treat a transgender person due to fear, transphobia or inexperience, and without proper insurance, health care costs for transgender people can skyrocket.

“Denying care to transgender individuals is inappropriate and disrespects their diagnosed condition,” Obedin-Maliver said.” By covering this care, we can make sure it’s done in a quality way that avoids complications in the future.”

Charles Syms ’11, an LGBT Community Resources Center student staff member, pointed out that the change allows transgender students to live more comfortably in general.

“There are still many ways in which transgender students face discrimination here,” he said. “For example, changing one’s registered name is an extremely cumbersome process, and students have reported different names appearing on the diploma and the Cardinal Careers recruiting Web site.”

For some international students, however, the addition of transgender surgery coverage raises cost concerns as it coincides with a new requirement that all foreign students buy into Cardinal Care next year.

“Most students in my community (Chinese community) find Cardinal Care super expensive and completely unnecessary as things that would never be helpful to most of us, such as transgender surgery, are now covered,” wrote Crystal Yin, a first-year graduate student in management science and engineering, in an e-mail to The Daily.

Across the bay, UC-Berkeley instated services for transgender members in their Student Health Insurance Plan in August 2009.

  • Lewis Marshall

    It’s nice that our medical care is now covering this surgery. And I’m sure that transgendered people do face discrimination here on campus.

    That having been said, I think it’s important to differentiate between discriminatory policies and policies that have unintended consequences for a minority like the transgendered community.

    Regarding this statement: ‘ “There are still many ways in which transgender students face discrimination here,” he said. “For example, changing one’s registered name is an extremely cumbersome process, and students have reported different names appearing on the diploma and the Cardinal Careers recruiting Web site.” ‘

    I doubt there’s an administrator somewhere who’s cackling, “Let those transgendered folks try to change their names now!” It’s probably just an extension of the bureaucracy that we all have to deal with. It just happens to disproportionately affect the transgendered in this case.

  • Aidan Dunn

    Quote from article: “For some international students, however, the addition of transgender surgery coverage raises cost concerns as it coincides with a new requirement that all foreign students buy into Cardinal Care next year.”

    Problem with that argument: The cost of Cardinal Care is actually *decreasing* next year. From http://vaden.stanford.edu/insurance/2010_message.html: “For next year, the annual premium for Cardinal Care will decrease by 4%.”

    More and more U.S. universities, city governments, and private corporations are offering this benefit to their employees. Thanks, Stanford, for offering this important coverage!

  • Cathy

    I am so happy that this policy is going into place! I think the additional cost per person will be negligible, and it will open doors for a lot of trans folk who feel they need surgery. Hopefully it will also reduce stigma and make our campus feel more welcoming to trans people.

  • Mike

    With all due respect to international students and those who are looking to save some money, the price of the premium for cardinal care is actually decreasing next year. And the argument that one group of people should not have to pay for the health care of another group is akin to me saying that I don’t want to pay for women’s reproductive healthcare because I am a guy and I will never need it. Also, I don’t want to have to pay for healthcare for folks with HIV because I plan to never contract it. It’s an argument that is selfish and somewhat bigoted.

  • Jamie Adams

    Glad to see that sex reassignment surgery is finally covered in Cardinal Care. This is an important step towards full support of the transgender community at Stanford.

  • Violet

    I’m thrilled to see Stanford among the frontrunners in covering procedures that can frequently be literally lifesaving for transgendered folks. And as far as the majority paying for coverage that is only needed by a minority, Mike (above) is absolutely correct. You could make the same argument about heart transplant surgery, or many types of cancer treatment, or just about any expensive medical procedure that affects only a small percentage people who are covered under an insurance plan. Assuming that he’s also correct that premium prices are actually decreasing next year, it’s also great to know that they are not using this as one more excuse to drive up costs — something insurance companies in general do regularly without any justification at all.

  • Cristopher Bautista

    As a transgender person this news has made me very, very happy.

  • http://vaden.stanford.edu/insurance/2010_message.html Aidan Dunn

    Quote from article: “For some international students, however, the addition of transgender surgery coverage raises cost concerns as it coincides with a new requirement that all foreign students buy into Cardinal Care next year.”

    Problem with that argument: The cost of Cardinal Care is actually *decreasing* next year. From the letter they sent out to students (see web link above): “For next year, the annual premium for Cardinal Care will decrease by 4%.”

    More and more U.S. universities, city governments, and private corporations are offering this benefit to their employees. Thanks, Stanford, for offering this important coverage!

  • Meh

    @Crystal Yin:
    You know, if you think it’s too expensive, then get your own healthcare plan from your home country. Or alternatively, don’t come to Stanford where we have these requirements. I figured foreign graduate students would be less selfish and self-centered, but I guess I was wrong. Also, do your research on the subject before being quoted. After all, grad school in MS&E teaches you how to do that, right?

  • Linda

    Why does Stanford deny our rights to proper dental care?! You would think that they would first think about covering regular dental visits for the majority of the student body before thinking about transgender surgery (which–don’t get me wrong–I have nothing against).