Gender Reassignment Surgery Purpose
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Why Allowing Sex-Reassignment Surgery for Transgender Life Prisoners Facilitates Rehabilitation and Reconciliation
THE CAGED BIRD SINGS OF FREEDOM: WHY ALLOWING SEX-REASSIGNMENT SURGERY FOR TRANSGENDER LIFE PRISONERS FACILITATES REHABILITATION AND RECONCILIATION BY: ALEXANDER KIRKPATRICK* ABSTRACT In October 2015, California became the first state in U.S. history to implement guidelines for transgender state prisoners to petition for gender- affirming and sex-reassignment surgeries. These guidelines raise the question why California would authorize gender-affirming surgeries for prisoners serving life-sentences, yet struggle to implement laws to make the same surgeries more accessible to law-abiding citizens. While the California Department of Corrections and Rehabilitation ("CDCR") likely implemented the radical SRS policy to abide by Eighth Amendment protections for transgender inmates suffering from severe gender dysphoria-inmates to whom SRS coverage is medically necessary and constitutionally required-this Note outlines four alternative justifications * Class of 2017, University of Southern California Gould School of Law, B.A. Political Science, University of Colorado at Boulder. This Note is dedicated to my client, Amelia, who shared her vulnerable and inspiring story of incarceration, transition, and hope. Amelia is fighting for freedom every day in a California male institution. Thank you to my mentor and Note supervisor, Heidi Rummel, whom champions juvenile justice at the Post-Conviction Justice Project. She has exemplified the values of a lawyer I hope to become. Dear thanks to my partner, Mifa, who continues to challenge me to approach the world with empathy and fight for social justice. Thank you to my parents, brother, and aunt who have supported me every step of the way and showed me the value of storytelling. -
Controversies and Complications in Pelvic Reconstructive Surgery (Didactic)
Controversies and Complications in Pelvic Reconstructive Surgery (Didactic) PROGRAM CHAIR Andrew I. Sokol, MD Cheryl B. Iglesia, MD Charles R. Rardin, MD Sponsored by AAGL Advancing Minimally Invasive Gynecology Worldwide Professional Education Information Target Audience Educational activities are developed to meet the needs of surgical gynecologists in practice and in training, as well as, other allied healthcare professionals in the field of gynecology. Accreditation AAGL is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AAGL designates this live activity for a maximum of 3.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. DISCLOSURE OF RELEVANT FINANCIAL RELATIONSHIPS As a provider accredited by the Accreditation Council for Continuing Medical Education, AAGL must ensure balance, independence, and objectivity in all CME activities to promote improvements in health care and not proprietary interests of a commercial interest. The provider controls all decisions related to identification of CME needs, determination of educational objectives, selection and presentation of content, selection of all persons and organizations that will be in a position to control the content, selection of educational methods, and evaluation of the activity. Course chairs, planning committee members, presenters, authors, moderators, panel members, and others in a position to control the content of this activity are required to disclose relevant financial relationships with commercial interests related to the subject matter of this educational activity. Learners are able to assess the potential for commercial bias in information when complete disclosure, resolution of conflicts of interest, and acknowledgment of commercial support are provided prior to the activity. -
Gender Reassignment Surgery Policy Number: PG0311 ADVANTAGE | ELITE | HMO Last Review: 07/01/2021
Gender Reassignment Surgery Policy Number: PG0311 ADVANTAGE | ELITE | HMO Last Review: 07/01/2021 INDIVIDUAL MARKETPLACE | PROMEDICA MEDICARE PLAN | PPO GUIDELINES This policy does not certify benefits or authorization of benefits, which is designated by each individual policyholder terms, conditions, exclusions and limitations contract. It does not constitute a contract or guarantee regarding coverage or reimbursement/payment. Self-Insured group specific policy will supersede this general policy when group supplementary plan document or individual plan decision directs otherwise. Paramount applies coding edits to all medical claims through coding logic software to evaluate the accuracy and adherence to accepted national standards. This medical policy is solely for guiding medical necessity and explaining correct procedure reporting used to assist in making coverage decisions and administering benefits. SCOPE X Professional X Facility DESCRIPTION Transgender is a broad term that can be used to describe people whose gender identity is different from the gender they were thought to be when they were born. Gender dysphoria (GD) or gender identity disorder is defined as evidence of a strong and persistent cross-gender identification, which is the desire to be, or the insistence that one is of the other gender. Persons with this disorder experience a sense of discomfort and inappropriateness regarding their anatomic or genetic sexual characteristics. Individuals with GD have persistent feelings of gender discomfort and inappropriateness of their anatomical sex, strong and ongoing cross-gender identification, and a desire to live and be accepted as a member of the opposite sex. Gender Dysphoria (GD) is defined by the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition, DSM-5™ as a condition characterized by the "distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender" also known as “natal gender”, which is the individual’s sex determined at birth. -
Oophorectomy Or Salpingectomy— Which Makes More Sense?
Oophorectomy or salpingectomy— which makes more sense? During hysterectomy for benign indications, many surgeons routinely remove the ovaries to prevent cancer. Here’s what we know about this practice. William H. Parker, MD CASE Patient opts for hysterectomy, asks than age 45 to prevent the subsequent devel- about oophorectomy opment of ovarian cancer (FIGURES 1 and 2). Your 46-year-old patient reports increasingly The 2002 Women’s Health Initiative re- severe dysmenorrhea at her annual visit, and a port suggested that exogenous hormone use pelvic examination reveals an enlarged uterus. was associated with a slight increase in the You order pelvic magnetic resonance imaging, risk of breast cancer.2 After its publication, which shows extensive adenomyosis. the rate of oophorectomy at the time of hys- After you counsel the patient about terectomy declined slightly, likely reflect- IN THIS her options, she elects to undergo lapa- ARTICLE ing women’s desire to preserve their own roscopic supracervical hysterectomy and source of estrogen.3 For women younger Algorithm: Should asks whether she should have her ovaries than age 50, further slight declines in the rate the ovaries removed at the time of surgery. She has no of oophorectomy were seen from 2002 to be removed? family history of ovarian or breast cancer. 2010. However, in the United States, almost page 54 What would you recommend for this 300,000 women still undergo “prophylactic” woman, based on her situation and current bilateral salpingo-oophorectomy every year.4 medical research? The lifetime risk of ovarian cancer Ovarian cancer does among women with a BRCA 1 mutation not come from the prophylactic procedure should be is 36% to 46%, and it is 10% to 27% among ovary considered only if 1) there is a rea- women with a BRCA 2 mutation. -
Salpingectomy for Ovarian Cancer Prevention Approved 11/9/2017
Health Evidence Review Commission (HERC) Coverage Guidance: Opportunistic Salpingectomy for Ovarian Cancer Prevention Approved 11/9/2017 HERC Coverage Guidance Opportunistic salpingectomy during gynecological procedures is recommended for coverage, without an increased payment (i.e., using a form of reference-based pricing) (weak recommendation). Note: Definitions for strength of recommendation are in Appendix A. GRADE Informed Framework Element Description. Table of Contents HERC Coverage Guidance ............................................................................................................................. 1 Rationale for development of coverage guidances and multisector intervention reports .......................... 3 GRADE-Informed Framework ....................................................................................................................... 4 Should opportunistic salpingectomy be recommended for coverage for ovarian cancer risk reduction? .................................................................................................................................................................. 4 Clinical Background ....................................................................................................................................... 7 Indications ................................................................................................................................................. 7 Technology Description ........................................................................................................................... -
Trans People, Transitioning, Mental Health, Life and Job Satisfaction
DISCUSSION PAPER SERIES IZA DP No. 12695 Trans People, Transitioning, Mental Health, Life and Job Satisfaction Nick Drydakis OCTOBER 2019 DISCUSSION PAPER SERIES IZA DP No. 12695 Trans People, Transitioning, Mental Health, Life and Job Satisfaction Nick Drydakis Anglia Ruskin University, University of Cambridge and IZA OCTOBER 2019 Any opinions expressed in this paper are those of the author(s) and not those of IZA. Research published in this series may include views on policy, but IZA takes no institutional policy positions. The IZA research network is committed to the IZA Guiding Principles of Research Integrity. The IZA Institute of Labor Economics is an independent economic research institute that conducts research in labor economics and offers evidence-based policy advice on labor market issues. Supported by the Deutsche Post Foundation, IZA runs the world’s largest network of economists, whose research aims to provide answers to the global labor market challenges of our time. Our key objective is to build bridges between academic research, policymakers and society. IZA Discussion Papers often represent preliminary work and are circulated to encourage discussion. Citation of such a paper should account for its provisional character. A revised version may be available directly from the author. ISSN: 2365-9793 IZA – Institute of Labor Economics Schaumburg-Lippe-Straße 5–9 Phone: +49-228-3894-0 53113 Bonn, Germany Email: [email protected] www.iza.org IZA DP No. 12695 OCTOBER 2019 ABSTRACT Trans People, Transitioning, Mental Health, Life and Job Satisfaction For trans people (i.e. people whose gender is not the same as the sex they were assigned at birth) evidence suggests that transitioning (i.e. -
(8Th Edition) Procedure Code ACHI (8
Appendix 1. Procedure and Diagnostic Codes Used to Identify Prior Procedures Procedure ACHI (8th ACHI (8th edition) procedure names ICD-10- ICD-10-AM edition) AM diagnosis name procedure diagnosis code code Gynecological laparoscopy 35638-00 Laparoscopic wedge resection of ovary 35638-01 Laparoscopic partial oophorectomy 35638-02 Laparoscopic oophorectomy, unilateral 35638-03 Laparoscopic oophorectomy,bilateral 35638-04 Laparoscopic ovarian cystectomy, unilateral 35638-05 Laparoscopic ovarian cystectomy, bilateral 35638-06 Laparoscopic salpingotomy 35638-07 Laparoscopic partial salpingectomy, unilateral 35638-08 Laparoscopic partial salpingectomy, bilateral 35638-09 Laparoscopic salpingectomy, unilateral 35638-10 Laparoscopic salpingectomy, bilateral 35638-11 Laparoscopic salpingo-oophorectomy, unilateral 35638-12 Laparoscopic salpingo-oophorectomy, bilateral 35638-14 Laparoscopic uterosacral nerve ablation 35637-02 Laparoscopic diathermy of lesion of pelvic cavity 35637-04 Laparoscopic ventrosuspension 35637-07 Laparoscopic rupture of ovarian cyst or abscess 35637-08 Laparoscopic ovarian drilling 35637-10 Laparoscopic excision of lesion of pelvic cavity 35729-00 Laparoscopic transposition of ovary 90430-00 Laparoscopic repair of ovary 90433-00 Other laparoscopic repair of fallopian tube 35694-00 Laparoscopic salpingoplasty 35694-01 Laparoscopic anastomosis of fallopian tube 35694-02 Laparoscopic salpingolysis 35694-03 Laparoscopic salpingostomy 35694-06 Laparoscopic salpingotomy 35649-01* Myomectomy of uterus via laparoscopy Hysteroscopy, including operative hysteroscopy 35630-00 Diagnostic hysteroscopy 35649-00 Hysterotomy 35633-00 Division of uterine adhesions 35634-00 Division of uterine septum via hysteroscopy 35649-02 Division of uterine septum via hysterotomy 35633-01 Polypectomy of uterus via hysteroscopy 35623-00 Myomectomy of uterus via hysteroscopy Baldwin HJ, Patterson JA, Nippita TA, Torvaldsen S, Ibiebele I, Simpson JM, et al. Antecedents of abnormally invasive placenta in primiparous women: the risk from gynecologic procedures. -
Sex Reassignment Surgery Page 1 of 14
Sex Reassignment Surgery Page 1 of 14 Medical Policy An Independent licensee of the Blue Cross Blue Shield Association Title: Sex Reassignment Surgery PRE-DETERMINATION of services is not required, but is highly recommended. http://www.bcbsks.com/CustomerService/Forms/pdf/15-17_predeterm_request_frm.pdf Professional Institutional Original Effective Date: January 1, 2017 Original Effective Date: January 1, 2017 Revision Date(s): January 1, 2017; Revision Date(s): January 1, 2017; January 27, 2021; March 18, 2021 January 27, 2021; March 18, 2021 Current Effective Date: January 1, 2017 Current Effective Date: January 1, 2017 State and Federal mandates and health plan member contract language, including specific provisions/exclusions, take precedence over Medical Policy and must be considered first in determining eligibility for coverage. To verify a member's benefits, contact Blue Cross and Blue Shield of Kansas Customer Service. The BCBSKS Medical Policies contained herein are for informational purposes and apply only to members who have health insurance through BCBSKS or who are covered by a self-insured group plan administered by BCBSKS. Medical Policy for FEP members is subject to FEP medical policy which may differ from BCBSKS Medical Policy. The medical policies do not constitute medical advice or medical care. Treating health care providers are independent contractors and are neither employees nor agents of Blue Cross and Blue Shield of Kansas and are solely responsible for diagnosis, treatment and medical advice. If your patient is covered under a different Blue Cross and Blue Shield plan, please refer to the Medical Policies of that plan. DESCRIPTION Gender dysphoria involves a conflict between a person's physical or assigned gender and the gender with which he/she/they identify. -
The Costs and Benefits of Moving to the ICD-10 Code Sets
CHILDREN AND ADOLESCENTS This PDF document was made available from www.rand.org as a public CIVIL JUSTICE service of the RAND Corporation. EDUCATION ENERGY AND ENVIRONMENT Jump down to document HEALTH AND HEALTH CARE 6 INTERNATIONAL AFFAIRS POPULATION AND AGING The RAND Corporation is a nonprofit research PUBLIC SAFETY SCIENCE AND TECHNOLOGY organization providing objective analysis and effective SUBSTANCE ABUSE solutions that address the challenges facing the public TERRORISM AND HOMELAND SECURITY and private sectors around the world. TRANSPORTATION AND INFRASTRUCTURE U.S. NATIONAL SECURITY Support RAND Purchase this document Browse Books & Publications Make a charitable contribution For More Information Visit RAND at www.rand.org Explore RAND Science and Technology View document details Limited Electronic Distribution Rights This document and trademark(s) contained herein are protected by law as indicated in a notice appearing later in this work. This electronic representation of RAND intellectual property is provided for non-commercial use only. Permission is required from RAND to reproduce, or reuse in another form, any of our research documents for commercial use. This product is part of the RAND Corporation technical report series. Reports may include research findings on a specific topic that is limited in scope; present discus- sions of the methodology employed in research; provide literature reviews, survey instruments, modeling exercises, guidelines for practitioners and research profes- sionals, and supporting documentation; -
Transgender Youth, the Non-Medicaid Reimbursable Policy, and Why the New York City Foster Care System Needs to Change
Transgender Youth, the Non-Medicaid Reimbursable Policy, and Why the New York City Foster Care System Needs to Change * Julie Anne Howe CONTENTS I. INTRODUCTION ........................................................................................... 2 II. TRANSGENDER YOUTH IN FOSTER CARE ....................................................... 4 A. TERMINOLOGY ................................................................................. 4 B. A HISTORY OF DISCRIMINatION AGAINST TRANSGENDER ...... YOUTH........................................................................................ 5 C. THE IMPORtaNCE OF MEDICAL NECESSITY .............................8 III. MARIAH L. V. ADMINISTRATION FOR CHILdren’s SERVICES ................ 12 IV. THE NON-MEDICAID REIMBURSABLE POLICY ............................................. 14 V. A FACIAL DUE PROCESS CHALLENGE TO THE POLICY’s VETO ClAUSE ................................................................................................................... 16 A. THE State’s DuTY TO YOUTH IN FOSTER CARE ................... 17 B. THE RIGHT TO PRIVACY ......................................................... 17 i. The Right’s Scope ..........................................................................18 ii. The Undue Burden Test .......................................................... 22 VI. AN AS-APPLIED EQUAL PROTECTION CHALLENGE TO THE POLICY .... 25 A. THE SEX DISCRIMINatION FRAMEWORK ............................... 25 B. DISCRIMINatORY INTENT ..................................................... -
Detransition, Retransition: What Providers Need to Know
Detransition, Retransition: What Providers Need to Know julie graham, MS, MFT Director, Gender Health SF San Francisco Department of Public Health Continuing Medical Education Disclosure . Program Faculty: julie graham, MS, MFT . Current Positions: Director, Gender Health SF, San Francisco Department of Public Health . Disclosure: No relevant financial relationships. It is the policy of The National LGBT Health Education Center, Fenway Health that all CME planning committee/faculty/authors/editors/staff disclose relationships with commercial entities upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, they are resolved prior to confirmation of participation. Only participants who have no conflict of interest or who agree to an identified resolution process prior to their participation were involved in this CME activity. 2 Agenda . Introductory remarks . How I learned about this topic . Contextualizing detransition and regret . Definitions, language and frames . What people say they need . Q and A Complexity . Listen to this talk in its entirety— . Don’t cherry pick . Clinical talk . My interest is helping you do a better job than I did with my first detransitioning patient . We need to tolerate increasing complexity as people experience a new landscape—one where surgeries are paid for, where there is a little bit more openness to exploration . Lack data we will have in the future, learning as we go Harriet Controversial . It is a fact that some people will die or have a terrible quality of life if they do not access every possible medical procedure to decrease their gender dysphoria. They experience pain and suffering from lack of access and poorly educated provider care. -
Rights of Transgender Adolescents to Sex Reassignment Treatment
THE DOCTOR WON'T SEE YOU NOW: RIGHTS OF TRANSGENDER ADOLESCENTS TO SEX REASSIGNMENT TREATMENT SONJA SHIELD* I. INTRODUCTION .................................................................................................... 362 H . DEFINITIO NS ........................................................................................................ 365 III. THE HARMS SUFFERED BY TRANSGENDER ADOLESCENTS CREATE A NEED FOR EARLY TRANSITION .................................................... 367 A. DISCRIMINATION AND HARASSMENT FACED BY TRANSGENDER YOUTH .............. 367 1. School-based violence and harassment............................................................. 368 2. Discriminationby parents and thefoster care system ....................................... 372 3. Homelessness, poverty, and criminalization...................................................... 375 B. PHYSICAL AND MENTAL EFFECTS OF DELAYED TRANSITION ............................... 378 1. Puberty and physical changes ........................................................................... 378 2. M ental health issues ........................................................................................... 382 IV. MEDICAL AND PSYCHIATRIC RESPONSES TO TRANSGENDER PEOPLE ........................................................................................ 385 A. GENDER IDENTITY DISORDER TREATMENT ........................................................... 386 B. FEARS OF POST-TREATMENT REGRET ...................................................................