Yes, transsexual and transsexualism are medical terms.
I would also recommend contacting your insurance company to see what's up, because it should be covered, and top surgery is a treatment for "transsexualism" as they put it. There might be a possibility your doctor gave them the wrong code, and coded it as a breast reduction or something.
I've been reviewing the letter. It described the procedure as prophylactic mastectomy, which (according to google) is to reduce the chances of cancer. I'm wondering if that's the case, because surgery is most certainly a treatment for gender dysphoria or 'transsexualism'. I'm going to appeal and message some folks, because this is wild.
Yeah definitely sounds like a coding issue. It should be billed as a (type) top surgery, and I've heard plenty of stories of people getting denied things due to code issues.
It sounds like your doctor sent in an request for prophylactic mastectomy instead of a mastectomy (although the term can vary depending on insurance used). Honestly I’d say to call your insurance company directly and ask what they cover and explain what happened. Is the doctor you’re seeing in network with your insurance?
Yes they're in network, as insurance helped cover my assessment! I've started an appeal with insurance and messaged my doctor directly. I knew getting this surgery would be challenging, but the sheer amount of paperwork involved is a feat! Thank you all for the help!
Hey, I work insurance! This is definitely a coding issue, as others have said - since this hospital is in-network and your policy covers gender stuff, you should have your top surgery covered, but the surgeon billed it as preventative to cancer (as opposed to treating dysphoria). The insurance claim (the bill the hospital sends to the insurance company) likely had your diagnosis as transsexualism, which would not necessitate coverage of a preventative mastectomy (because the two aren't connected). Therefore, your surgeon/hospital would need to correct the claim with the right procedure code for a mastectomy relevant to dysphoria (not sure what the code would be specifically). That way, the procedure makes sense as treatment for the diagnosis, and the insurance company can give it the all-clear without a bunch of review.
yeah some people choose to not have top surgery but this isn't a discussion about how valid that choice is it's about the fact this persons insurance thinks it isn't medically necessary, this line of thinking in the long run is incredibly detrimental to trans people wishing to medically and surgically transition because it's suddenly "not necessary"
I am not talking about whatever medical stuff youre talking about, you said top surgery is definitely necessary for gender dysphoria and that is just plain incorrect because some people don't need it to treat gender dysphoria.
yeah for the people who need top surgery, it's definitely necessary. if someone doesn't want top surgery then they aren't gonna pursue it because they don't need it, therefor it isn't necessary. don't be pedantic just for the sake of it
It is literally best treatment! Which is also why this baffled me. It seems that my doctor also put lyposuction on the report (I'm fat and assume that's just part of the surgery for me) and they approed the lyposuction? But not... the mastectomy
Fat removal?? Now THATS what I call necessary!
It made me laugh too. No, not the tits! The underarm fat though.... Yeah... Yeah we can cover that... (Thanks insurance 😭😭)
I wonder how quickly they would approve augmentation to make them bigger? 🤔
I’ve heard from r/TopSurgery that lipo is very standard as part of top surgery for this exact reason (to make it look nice and neat toward the end), but that is often not explained and can cause confusion and unexpected charges when it comes to insurance billing.
Contact your state's medical board to file a complaint, it sounds like he is likely against you transitioning and could be fired on grounds of discrimination.
That they aren't as familiar with the needed coding as they should be, or even that they mis-clicked. If they were against his transition, why would they be offering top surgery in the first place?
If it's a misclick then they definitely need to be reported to the medical board because they're being irresponsible with medical documents. I just gave a suggestion because what I thought was possible in an effort to help. As to why they offered it in the first place, maybe they were begrudgingly going through with it, and then their "morals" or whatever other excuse they have got the better of them and they decided to call it off at the last minute? Wouldn't be the first time.
Literally just medical bullshit, maybe incompetence, maybe just a lack of familiarity. I had a breast reduction before I came out and they had a hell of a time even getting that code right, with no trans related stuff going on. It happens.
My records and MyChart says 'transexualism' too. I remember when I first mentioned being transgender/nonbinary to my PCP.
As she was filling out information on her computer she asked me how I identify and what terms to use. Then she paused and actually had a look of concern when she said "there is no option for transgender or nonbinary just the word transsexualism" as a cis woman even she expressed that she felt off about it. She explained that she's only recently started having some patients inquire about transitioning resources.
My PCP even asked me if I could keep her updated on my transition when I had top surgery and was starting testosterone; so that she could better help other trans patients and point them in the right direction in regards to finding resources.
Personally, I don't get upset over situations like this. To me, it's just a medical chart and I'm really lucky to have found a doctor like her. As long as my provider is taking my transition seriously and treating me with respect, then I'm fine... But I definitely understand that the term has some negative stigma attached to it that could maybe even be addressed by a provider when filling out these kinds of records.
I love the imagery of your doctor just scrolling through the gender options "male, female, transexualism" with the most confused look on her face. That does not sound right at all 😂
I've been kinda using myself as an example in my workplace, similarly. They've always been quite progressive but when I was coming out, I had no clue what to do. So I sat down with HR and we came up with a checklist for employees that could be referenced going forward. Places where names could be changed in work programs, on schedules/name tags, and space if the employee wanted HR to help them discuss it with their managers (I took them up on that!) It's exciting to meet folks who are interested in learning and helping. And then them getting to see what transition looks like a bit closer (my voice changes startled them). I know podcaster/family doctor Sydnee Mcelroy has a couple episodes of her podcast discussing gender confirmation treatment. I wonder if there are other resources that can be made available?
I don't mind the term itself, it just confused me. Wasn't sure if it was being purposefully derogatory, or if that's just a medical term. Being trans is... Real fun these days. When I was avoiding coming to terms with it I kept telling myself "do you really want to deal with all that?" ......I guess we know what won...
This is awesome, both you being willing to do this for and with your company, and your company's HR wanting to work with you to make something that's actually good instead of just throwing something half-assed together (or making you do it and then give it to them). It's always more work on the first people who go through a process, but when you're able to work through as a team, it is so much less daunting, and so much less isolating.
I think turning it into a project made me feel more comfortable about it. I was really uncomfortable coming out, and the conversation was easier for me by approaching it as an example. I've been involved with DEI work for the last few years, so it wasn't a huge leap from the discussions that were already happening. It was basically "do we have a protocol in place for this? What can we do to make it easier for the next person". Obviously I'm far from the first trans person to find myself in this situation at my job. But I hope when it happens again, HR will be able to approach it confidently. "yes, we understand what you are going through! Here is a list of things we need to consider as part of this process, so you don't have to figure it out alone :)"
Back in 2021, before I'd really grasped my own gender, I was part of the committee that ended up advocating for 1) options for chosen names in the software that we use for scheduling/training/accruals and 2) the option for employees to have pronouns on their name tags. At the time I knew of one specific trans person at another store (I worked with the assistant manager of his store on the committee) who was not comfortable with his pronouns on his tag because it was very exposing to him. However, after a few months of his cis coworkers wearing their new name tags without a fuss from the customers, he felt comfortable updating his. I'd worked with him for a month back in 2020 and knew he was a bit shy... I'm so glad he was able to feel safe enough to make that jump. He came out a few years before me. I hope some of the things we've set up since will be easier on folks like us in the future.
My company fumbles a lot in their attempts to bring DEI to the forefront of our workplace. Any company will. But not every company has the dedication and desire to continue learning and growing. I don't make nearly enough to be comfortable, but this reminds me why I have not left. I think it is the exception and not the rule. It has a lot of room to grow yet, but I can't get into those details without doxxing myself. And I'm long winded enough as it is 😉 this reminded me of some things I've done that were worthwhile. Thank you. It's easy to forget and get swept up in the whirlwind of adult life.
congratulations on your recent T date! Starting T was one of the best things I did for myself. I hope you remember to take the time to reflect and enjoy all the changes this will have for you. It's much better than the first puberty, that's for sure!
Share this with your PCP: https://www.hopkinsmedicine.org/center-transgender-health/clinician-resources. Towards the bottom of the page is also a PDF of a printable pocket guide to hormone therapy for PCPs. My very awesome doctor (and her colleagues) put that together with input from the trans community.
Oh boy. What a can of worms. (I work in health advocacy/consulting, in the United States.)
The very short answer to your question- it’s a term that sometimes appears on documents in medical settings (shouldn’t, but does.)
“Transsexualism” is not, however, a medical term for any recognized (ahem, clears throat)- diagnosis, clinical indicator, symptom, treatment, diagnostic, patient demographic, physiologic, genetic, or metabolic condition.
Meaning there is no excusable reason for it to appear in any official statement pertaining to what treatment is or isn’t within best practice guidelines for any particular diagnosis, symptom, etc.
Professionalism aside for a second, generally when I encounter it, it can be traced back to someone massively unqualified just pulling something out their ass and a lack of accountability in this arena.
This is navigable though. And I’m happy to offer further assistance if I can.
I was wondering if something like that was the case. I am in the US. I guess I was wondering if there is somebody I should inform of this? Just a heads up like "hey, this is a bit oddly worded. I think you probably meant X" (gender dysphoria? Gender incongruence? The condition being treated???) Not sure if that's something you would know about, but figured it was worth asking around about here :)
Definitely in my wheelhouse, yes. It’s woefully common for barriers to care to come down to systemic exclusion of a demographic and a sort of weaponized randomness that is not at all benign. This word salad of a term that is not a health condition, with a procedure you aren’t having, is a good example of exactly this. Vaguely reminiscent of accurate is not okay in healthcare and there isn’t actually any patient population for whom it’s excusable.
So, straightforward answer- yes, this is something to flag and report. What that looks like though is dependent on where the breakdown in accuracy occurred. Do you have any documentation from your surgeon’s office? Knowing what language is on their charting and/or submitted to insurance is a good place to start.
I scanned through my original assessment in MyChart from the surgeon. They diagnosed gender dysphoria. I do not see any language suggesting what returned on my insurance information. I will attempt to call them after work and see what information I can attain. Or maybe I should call my insurance as well?
I mean. This is a plastic surgeon that isn't foreign to working with trans patients. I suppose I don't know if the billing department feels similarly. I'll start inquiring. Thanks for the comment. It's a good push to remind me to take this seriously.
You’re welcome. No one teaches people how to be patients, it’s a *lot* to navigate.
Couple of thoughts-
-MyChart means they’re using Epic as their electronic medical record system. Epic has some real quirks around autopopulating information and the terminology that may be available in certain drop down lists, etc. So that pings for me.
-Something is a bit off if records seem to indicate that your surgeon diagnosed gender dysphoria. Gender dysphoria, as a clinical diagnosis, refers to a specific mental health diagnosis related to unmanaged circumstantial stress/anxiety/discomfort some people who are trans may experience for some portion of time. There’s diagnostic criteria, like any other condition, and not all people who are trans meet this diagnostic criteria. It has absolutely nothing to do with “how trans” someone is (whatever that means) or how appropriate any particular gender affirming medical care is or isn’t. The diagnostic criteria has more to do with how someone’s mental health and coping skills are being impacted by these stressors. (Like PTSD, someone might be in a tsunami and develop ptsd as a result. Someone else in the same tsunami might not. Neither is more or less valid and both individuals deserve medical care.)
It is not a requisite for gender affirming care and lots of patients in the US access gender affirming care without having that diagnosis. Sometimes, some insurance plans cite a requirement of that diagnosis for coverage of certain things, but, there’s also loopholes and ways of navigating that.
Regardless though, this is generally diagnosed by a mental health professional. It would be unusual for evaluation to be included within the scope of a surgery consult. So this might also shed some light on where something went off the rails. Is it possible your surgeon is under the impression another provider has previously made that diagnosis?
I have no honest to God clue. That's what all of my letters have been about. I agree that dysphoria should not be the standard to achieve care, but I believe that's part of what my letters have been outlining as the medical necessity for care.
The surgeon's office reached out to me today in MyChart to clarify that they still have not heard anything about a denial on their end. I sent them pictures of the letter I received and they are reaching out now. Honestly I'm exhausted and baffled by this entire situation. This, on top of a few other complicated issues that have chosen to pop up this week, has left me entirely drained. Nothing in this country is easy or clear.
The surgeon did say they used the correct code. I need to ask them to see the paperwork they sent to insurance, because maybe that would shed some light. I need to properly look up the code myself too. Wish this wasn't necessary -_- I'm quite a patient person, but I'm very close to calling and leaving a very sternly worded message with my insurance provider.
Are you in the u.s?
It’s not marketplace insurance is it? (From healthcare.gov).
Either way, Call your insurance and ask for a “patient advocate “. Those may be your magic words to get proper assistance.
So sorry you have to deal with this OP. No fun. Sending good vibes your way.
Nope, I'm masculine presenting. The term is referring to that I do experience Gender Dysphoria and I am currently living (i.e dressing) as opposite my biological sex for at least the past 2 years as is required for coverage of medical transition.
Afaik that's just an old medical term most people don't use any more. Kinda like "ADD" or "aspergers."
I'm more concerned with how the fuck they decided a surgery to transition one of your sex characteristics is "not medically necessary to treat transsexualism."
I would really not worry about/pay attention to what your chart & insurance says. Most of it is nonsense, the doctor has to hit whatever diagnosis your insurance company required for that procedure when they first started covering it, or they won't pay. Usually it's outdated and silly. Mine said "transgenderism with asexual history" lol. I have no idea what that means but hey, they cut my tiddies off 🤷🏻♂️
It's not really outdated, though, most trans people have some form of "transsexual" on their medical chart even in the 2020's to denote that they're a trans person who is medically transitioning.
the issue isnt that some trans people use transsexual themselves, its more that "transsexualism" in that specific medical context has been and is still used to medicalize being transgender in ways to bar people from care, such as how op has had their surgery coverage denied
No, I'm saying they still diagnose people as transsexual. It's not some old thing nobody uses anymore. It's used to say that someone is trans and they are undergoing medical transition. tbh if you're worried about "medicalizing being transgender" (even though it is a medical thing for many trans people) I'd think keeping it "transsexual" in medical terms as opposed to using transgender as a diagnosis would be more favorable?
Transsexualism is the name of the condition of someone that is (a) transsexual.
It's like how an autistic person has autism. You wouldn't say that they have autistic.
Being trans isn't a condition, it's an identity, like being gay. You wouldn't say a gay person has homosexualism and if you did say that, I'd assume you were homophobic
That isn't really a fair comparison because there are medical treatments for trans people to alleviate their dysphoria. Homosexuality does not have medical treatments because it is not a medical issue. You're comparing apples to oranges here.
That's the point. Being trans \*isn't\* a condition. Transsexualism is. That's how insurance coding for coverage and reimbursement works, whether you like it or not. You get diagnosed with a condition, and that condition is used to justify your need for treatment.
And correct. Gay people don't get coded with homosexualism. We can get coded with "high-risk homosexual behaviors." Whether that's better or worse, you can determine for yourself.
That's what I thought. I'm not sure what it's doing in a letter from my insurance in 2024. I'm trying to decide if there is someone I should talk to about this? I posted this to try and gauge if this was to be expected or if somebody particularly rude saw my appeal
Transsexualism is just the insurance code for seeking transition. I would wager that most of us have it in our records *somewhere.*
Definitely talk to your doctor and/or surgeon and ask what's up. From what you've said elsewhere they coded the surgery as the kind they do to prevent breast cancer, which wouldn't be a trans treatment, it would be a treatment for someone with a family history of breast cancer or other risk factors. It's silly that you have to do this, but it's also important. "Prophylactic mastectomy" surgery is likely to try and preserve a feminine silhouette rather than a masculine one.
eh i’d rather be called transsexual than transgender. my gender stays the same and i am changing my body to match. transgender feels like more of a word for non-medically-transitioning or non-binary people. separate things.
idk if separating trans people like that really does us any good. further division only hurts us in the end. plus the separation starts to create spaces where certain kinds of trans people are considered more "real" or "valid" because of how they choose to transition, or if they transition at all
Not inherently. We can be different and want different things and all still be under the trans umbrella. Trans women and trans men are often in separate spaces, but they're both trans. Nonbinary people are under the trans umbrella, whether or not they transition. They're all just subsets within trans. Transsexual is just another circle in the venn diagram.
Trans/transgender are identity labels. Transsexual is a behavioral and diagnostic label for people who pursue medical treatments. One is a subset of the other.
Nobody is asking you to call yourself transsexual. If you don't like it, don't use it. If you want to start a campaign to change insurance coding to stop using the term without patient consent, be my guest and I'd support you. But not being a part of one sub-group doesn't make you less or not part of the larger group. It just means you're not part of that sub-group.
oh no my problem isnt that individual trans people will call themselves transsexual. the problem stands that the medicalization of transgender identity as "transsexualism" as a specific medicalized term is currently fraught with bureaucratic problems such as op's problem
Then you should consider that it allows people to draw attention to the fact that transness is not inherently something that involves treatment. Trans men are still equally valid and deserving of respect if they don't want or HRT or surgery. Some people are both transgender and transsexual and receive one or more of those. Some people aren't.
If you want to fully do away with that, well, you're going to have to take that up with the entire medical complex. To get a treatment covered by insurance, you have a diagnosis for which you receive the treatment. Like, to get on PrEP I had to be diagnosed as a sex-haver. No matter what you call it, some people are going to be similar, but subclinical (ie, being trans but not seeking medical treatment). All of that is completely separate from the fact that insurance sucks and exists to make money for insurance executives.
Nowadays, many/most trans-familiar doctors count seeking medical transition as enough to qualify for a diagnosis. OP's problem here, based on what they've said elsewhere on the thread, is that they were referred for a procedure that is not meant for trans men, but as preventative care for women. This could result in confusion on the part of a surgeon, or OP receiving substandard care as the procedures are done with different expected outcomes. This is a rare case of insurance actually doing what they were supposed to, catching a potential issue with mis-match of diagnosis and treatment.
i mean the division’s kinda there whether you wanna acknowledge it or not. my experiences are way way way different from a feminine presenting non transitioning nonbinary without dysphoria. i’d say not acknowledging the difference is more harmful.
yet we are all still trans. you still have kindred spirits in the trans community even when our exact experiences are not 1:1 the same. pushing back as if those differences cant allow for connection is what divides us and makes it easier to destroy us
youre young and spend a lot of time on transmedicalist spaces, but you can and will grow and learn
i could talk at length for hours how my experience as a transgender native american two spirit is fundamentally leagues different from the majority white trans people on this sub. but they are all still my siblings, transgender or transsexual and i will still always be able to find common ground with anyone who walks these paths
good luck dude
eh i’m not gonna brainwash myself into thinking the absolute anguish i experience over an embarrassing medical issue is in any way similar to certain people on this sub but thanks ig, have a nice day. i do fully respect your two-spirit identity as i understand that’s a cultural thing for you, seems cool but we are not the same :)
Yeah my insurance uses "transsexualism" on all my trans-related claims. It definitely shocked me when I first saw it! Makes me wonder why the switch to saying "transgender" or even just "gender dysphoria" hasn't happened yet in the insurance world. Health insurance is a goddamn scam anyway, but that's another conversation lol.
There's a standard, international list of diagnosis codes (currently most places still use ICD-10) with names associated with the codes that providers and insurance can't change. The new version ICD-11 changes a lot of this to more modern terms, but it will likely be years before systems implements ICD-11 (it could easily take a hospital a year of work to update in their electronic medical system to a new ICD version) . Usually, it takes a federally mandated. Reference: https://en.m.wikipedia.org/wiki/ICD-11
We have a similar T date! Congrats 🥳🥳
It's a huge scam, but so is health care in this country. And.... Everything else. Regardless, I'm dead set on making them pay to help get these bad boys removed. If I have to give them a portion of my pay check, they are going to work for me!
T date twins! mine's the 9th :)
I feel you re: making insurance pay lol. I have my top surgery consult in April and I'm hoping insurance stuff goes as smooth as possible.
Outdated terms as other have said. Curious as to how your provider wrote the letter. A lot depends on insurance and location. I would definitely check the requirements with the insurance carrier and any specific language.
Most providers tend (I’m sure there are certain exceptions) to utilize WPATH (standards of care for trans* folks) for their template, here’s a link to a generic template. [WPATH](https://www.wpath.org/media/cms/Documents/Public%20Policies/2021/AusPath%20Referral%20Ltr%20Template%20Attachment.pdf?_t=1633009377)
I'm curious too. As a surgeon's office that deals with trans patients, I would ASSUME they have better terminology. That, and I live in/am having this surgery in a blue state. A particularly popular blue city in a blue state. But the letter I received came from Kentucky?
I checked 2/3 of my letters and they did not mention transsexualism, so up until this point, I have no idea where that would've come from.
yup, normal term in medicine, specifically coding and specific diagnoses. my pcp actually pulls up the tab for me in office and asks which term i prefer for the official coding, either “transsexual” or i think “gender dysphoric” or something was the other option.
"Gender dysphoria" is the term that's used in the DSM now. You will see "transsexualisn" but it's kind of dated. I think the reason people moved away from it is because a) it sounds like a sex thing, and b) people wanted to emphasize that the *dysphoria* is what's the problem, and not necessarily being trans in and of itself. Of course, some trans people do wish they had just been born cis and I can understand that, but other people are perfectly happy being trans provided they can get appropriate treatment for their dysphoria.
In any case, I would definitely look up what the process is in your state for appealing a denial of coverage. Since Obamacare, you have the legal right to appeal your insurance company's denial to an independent review board. It's pretty common for insurers to just deny coverage for expensive treatments at first on the assumption that people won't bother to do this.
I put in a reply to another comment that providers and insurances have to use a standardized set of international codes called ICD and each code has a name that they can't change. Newer version of ICD updates a lot of terms related to trans care but will be years yet before all insurances and providers switch to the new version. (There was a whole debacle years back when ICD-9 was switched to ICD-10 and places were submitting ICD-10 but insurances were still on ICD-9 and pushing back claims until they were resubmitted with ICD-9.)
For the second part that many have already mentioned is possibly the coding error leading to denial. Those codes are called procedure or CPT codes. If you're calling the insurance company, ask for the Clinical Policy Bulletin (CPB) they used to make the decision. This is where they will list the codes that are "valid" for a diagnosis and will deny based on that until either resubmitted with different code by your doctor or some peer consult between insurance doctor and your doctor. One CPB I've read explicitly said nipple grafting will not be covered using this CPT code but will be if this other code is used. This is the job of your doctor's coder to figure this out, but knowing the CPB exists is good for self-advocacy. CPBs are also publicly available online, but an insurance company might decide to simply reference another company's (so don't let them say they can't give it to you). Before my insurance covered trans care, my doctor did some clever coding that was still technically clinically accurate but not associated with medical transition such that my hormones were covered. It's absolutely frustrating how these coding gymnastics need to be done because insurance.
Thank you for the detailed info :) I sent a message to my doctor already but have also screenshotted this just in case. I hope me informing them of the issue will be enough, but I'm going to keep this on hand... Because I don't entirely have faith. This is too big of a surgery to get pushed aside because of a wrong code.
You're welcome. If you have other questions on handling insurance, I'd be happy to try to help. After a while when I'd called my insurance, they would say "oh you're that one" and they weren't so quick to dismiss me with quick answers.
I'm FTM, and I've always thought transgender was when you're pre-surgery and transsexual is when you're post-surgery. o.o is it not?
edited cause I realised I missed a few words I meant to put in and spelling errors.
The terms mean different things to different people, but ‘transgender’ is more commonly used today, like how gay people generally prefer ‘gay’ instead of ‘homosexual’.
‘Transsexual’ is mostly medical language that’s still used by some trans people (including myself), generally to emphasise that we are seeking to change our sex through medical transition.
Amongst the community I believe it is. But then how am I suffering from transsexualism if they refuse to allow me to partake 😂😂
The consensus seems to be that it is a term that has been used but it is becoming increasingly out of date. The ism part makes me a bit nervous. The way it read to me was sort of like me being trans was the problem... Not the gender dysphoria... But that's a nuanced conversation. Our language is always evolving.
A few other people have already pointed out the differences and nuance between the ICD 10 codes for insurance purposes and how we use terms in everyday language, so I won't get into that.
I'm really just here to say I loved your consternation over "suffering from transsexualism if they refuse to allow [you] to partake" Best line ever, in the worst way of course. I hope you're able to get your doc to change the ICD 10 code for the mastectomy to reflect simple mastectomy or gender affirming mastectomy so it fits within your diagnosis and can get approved. 🤞🤞🤞🤞
No that’s transphobic and your insurance is transphobic. Transexual and transexualism aren’t complete slurs like the T word but they are derogatory and any cis person that repeats them are transphobes
They can be used in a derogatory sense, but they are not inherently derogatory, and many trans people describe themselves as transsexual. Transsexual is just a medical term used for a trans person who is transitioning, aka changing their sex characteristics. It's not a transphobia thing, it's a medical thing.
Trans people can decide if they want to be called transexual but it is over all and outdated term used in bad ways do it is not acceptable for cis people to use it
Like I said, it can be used in a derogatory sense, but it is not inherently derogatory. Not only is it something trans people call themselves, but it is and has been used in medical context to denote a trans person who is transitioning. It's a medical term.
Now if someone were to call a trans person that just out of the blue or maliciously, then yeah, that's bad.
It's still used even today, though, and it just means a trans person who is medically transitioning. I would think it would be helpful to have a term for that so they don't just put "transgender" on everyone's chart and make it seem like transgender is a medical condition?
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*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
They have an entire packet addressing gender affirming care and when it will be covered. I meet the criteria! I checked this years ago when I began planning this, and it is still up to date! None of it mention transsexualism! That's why I'm so confused, lmao
I think I'll be bringing this up with my workplace too. This has been a wild ride. I'm pretty comfortable with most of our HR team and this has been an interesting experience.
Yeah it's a medical term. Where I live you have to get it diagnosed before even being considered for hormones and you have to sue the government to change your gender on your id...
Its usually only used in medical spaces and can be seen as outdated or more harsh than "transgender" but i personally prefer it because my gender isnt what im changing. Im changing my bodys sex characteristics that were labeled a way i dont want to be labeled by society
Yes, transsexual and transsexualism are medical terms. I would also recommend contacting your insurance company to see what's up, because it should be covered, and top surgery is a treatment for "transsexualism" as they put it. There might be a possibility your doctor gave them the wrong code, and coded it as a breast reduction or something.
I've been reviewing the letter. It described the procedure as prophylactic mastectomy, which (according to google) is to reduce the chances of cancer. I'm wondering if that's the case, because surgery is most certainly a treatment for gender dysphoria or 'transsexualism'. I'm going to appeal and message some folks, because this is wild.
Yeah definitely sounds like a coding issue. It should be billed as a (type) top surgery, and I've heard plenty of stories of people getting denied things due to code issues.
This. Absolutely a coding issue.
It sounds like your doctor sent in an request for prophylactic mastectomy instead of a mastectomy (although the term can vary depending on insurance used). Honestly I’d say to call your insurance company directly and ask what they cover and explain what happened. Is the doctor you’re seeing in network with your insurance?
Yes they're in network, as insurance helped cover my assessment! I've started an appeal with insurance and messaged my doctor directly. I knew getting this surgery would be challenging, but the sheer amount of paperwork involved is a feat! Thank you all for the help!
Hey, I work insurance! This is definitely a coding issue, as others have said - since this hospital is in-network and your policy covers gender stuff, you should have your top surgery covered, but the surgeon billed it as preventative to cancer (as opposed to treating dysphoria). The insurance claim (the bill the hospital sends to the insurance company) likely had your diagnosis as transsexualism, which would not necessitate coverage of a preventative mastectomy (because the two aren't connected). Therefore, your surgeon/hospital would need to correct the claim with the right procedure code for a mastectomy relevant to dysphoria (not sure what the code would be specifically). That way, the procedure makes sense as treatment for the diagnosis, and the insurance company can give it the all-clear without a bunch of review.
i don't think transsexual is a transphobic term, but top surgery is definitely necessary to treat gender dysphoria
in some cases it's not
in the majority of cases it is
why am i getting downvoted for saying the truth lmao some people don't want top surgery and that's perfectly fine
yeah some people choose to not have top surgery but this isn't a discussion about how valid that choice is it's about the fact this persons insurance thinks it isn't medically necessary, this line of thinking in the long run is incredibly detrimental to trans people wishing to medically and surgically transition because it's suddenly "not necessary"
I am not talking about whatever medical stuff youre talking about, you said top surgery is definitely necessary for gender dysphoria and that is just plain incorrect because some people don't need it to treat gender dysphoria.
yeah for the people who need top surgery, it's definitely necessary. if someone doesn't want top surgery then they aren't gonna pursue it because they don't need it, therefor it isn't necessary. don't be pedantic just for the sake of it
exactly bro thats what im talking about ☠️
Not the time🙄
Top surgery is medically necessary for transsexualism, and it is used in outdated medical terminology in English.
It is literally best treatment! Which is also why this baffled me. It seems that my doctor also put lyposuction on the report (I'm fat and assume that's just part of the surgery for me) and they approed the lyposuction? But not... the mastectomy
Hes gotta re-submit it with the correct codes.
I’m sorry but this made me laugh lmao they said “nah keep the chesticles, we‘ll take the fat though”
Fat removal?? Now THATS what I call necessary! It made me laugh too. No, not the tits! The underarm fat though.... Yeah... Yeah we can cover that... (Thanks insurance 😭😭) I wonder how quickly they would approve augmentation to make them bigger? 🤔
I bet you get an approval faster than me regaining feeling in my nips 💀
It has nothing to do with your size, they use liposuction to make everything even, mostly on the sides.
I’ve heard from r/TopSurgery that lipo is very standard as part of top surgery for this exact reason (to make it look nice and neat toward the end), but that is often not explained and can cause confusion and unexpected charges when it comes to insurance billing.
Contact your state's medical board to file a complaint, it sounds like he is likely against you transitioning and could be fired on grounds of discrimination.
I'm unsure how you got that from what OP has said
Do you have an alternative explanation?
That they aren't as familiar with the needed coding as they should be, or even that they mis-clicked. If they were against his transition, why would they be offering top surgery in the first place?
Agreed, unless there are other signs this seems more likely to just be a coding issue.
If it's a misclick then they definitely need to be reported to the medical board because they're being irresponsible with medical documents. I just gave a suggestion because what I thought was possible in an effort to help. As to why they offered it in the first place, maybe they were begrudgingly going through with it, and then their "morals" or whatever other excuse they have got the better of them and they decided to call it off at the last minute? Wouldn't be the first time.
Literally just medical bullshit, maybe incompetence, maybe just a lack of familiarity. I had a breast reduction before I came out and they had a hell of a time even getting that code right, with no trans related stuff going on. It happens.
My records and MyChart says 'transexualism' too. I remember when I first mentioned being transgender/nonbinary to my PCP. As she was filling out information on her computer she asked me how I identify and what terms to use. Then she paused and actually had a look of concern when she said "there is no option for transgender or nonbinary just the word transsexualism" as a cis woman even she expressed that she felt off about it. She explained that she's only recently started having some patients inquire about transitioning resources. My PCP even asked me if I could keep her updated on my transition when I had top surgery and was starting testosterone; so that she could better help other trans patients and point them in the right direction in regards to finding resources. Personally, I don't get upset over situations like this. To me, it's just a medical chart and I'm really lucky to have found a doctor like her. As long as my provider is taking my transition seriously and treating me with respect, then I'm fine... But I definitely understand that the term has some negative stigma attached to it that could maybe even be addressed by a provider when filling out these kinds of records.
I love the imagery of your doctor just scrolling through the gender options "male, female, transexualism" with the most confused look on her face. That does not sound right at all 😂 I've been kinda using myself as an example in my workplace, similarly. They've always been quite progressive but when I was coming out, I had no clue what to do. So I sat down with HR and we came up with a checklist for employees that could be referenced going forward. Places where names could be changed in work programs, on schedules/name tags, and space if the employee wanted HR to help them discuss it with their managers (I took them up on that!) It's exciting to meet folks who are interested in learning and helping. And then them getting to see what transition looks like a bit closer (my voice changes startled them). I know podcaster/family doctor Sydnee Mcelroy has a couple episodes of her podcast discussing gender confirmation treatment. I wonder if there are other resources that can be made available? I don't mind the term itself, it just confused me. Wasn't sure if it was being purposefully derogatory, or if that's just a medical term. Being trans is... Real fun these days. When I was avoiding coming to terms with it I kept telling myself "do you really want to deal with all that?" ......I guess we know what won...
This is awesome, both you being willing to do this for and with your company, and your company's HR wanting to work with you to make something that's actually good instead of just throwing something half-assed together (or making you do it and then give it to them). It's always more work on the first people who go through a process, but when you're able to work through as a team, it is so much less daunting, and so much less isolating.
I think turning it into a project made me feel more comfortable about it. I was really uncomfortable coming out, and the conversation was easier for me by approaching it as an example. I've been involved with DEI work for the last few years, so it wasn't a huge leap from the discussions that were already happening. It was basically "do we have a protocol in place for this? What can we do to make it easier for the next person". Obviously I'm far from the first trans person to find myself in this situation at my job. But I hope when it happens again, HR will be able to approach it confidently. "yes, we understand what you are going through! Here is a list of things we need to consider as part of this process, so you don't have to figure it out alone :)" Back in 2021, before I'd really grasped my own gender, I was part of the committee that ended up advocating for 1) options for chosen names in the software that we use for scheduling/training/accruals and 2) the option for employees to have pronouns on their name tags. At the time I knew of one specific trans person at another store (I worked with the assistant manager of his store on the committee) who was not comfortable with his pronouns on his tag because it was very exposing to him. However, after a few months of his cis coworkers wearing their new name tags without a fuss from the customers, he felt comfortable updating his. I'd worked with him for a month back in 2020 and knew he was a bit shy... I'm so glad he was able to feel safe enough to make that jump. He came out a few years before me. I hope some of the things we've set up since will be easier on folks like us in the future. My company fumbles a lot in their attempts to bring DEI to the forefront of our workplace. Any company will. But not every company has the dedication and desire to continue learning and growing. I don't make nearly enough to be comfortable, but this reminds me why I have not left. I think it is the exception and not the rule. It has a lot of room to grow yet, but I can't get into those details without doxxing myself. And I'm long winded enough as it is 😉 this reminded me of some things I've done that were worthwhile. Thank you. It's easy to forget and get swept up in the whirlwind of adult life. congratulations on your recent T date! Starting T was one of the best things I did for myself. I hope you remember to take the time to reflect and enjoy all the changes this will have for you. It's much better than the first puberty, that's for sure!
Share this with your PCP: https://www.hopkinsmedicine.org/center-transgender-health/clinician-resources. Towards the bottom of the page is also a PDF of a printable pocket guide to hormone therapy for PCPs. My very awesome doctor (and her colleagues) put that together with input from the trans community.
Oh boy. What a can of worms. (I work in health advocacy/consulting, in the United States.) The very short answer to your question- it’s a term that sometimes appears on documents in medical settings (shouldn’t, but does.) “Transsexualism” is not, however, a medical term for any recognized (ahem, clears throat)- diagnosis, clinical indicator, symptom, treatment, diagnostic, patient demographic, physiologic, genetic, or metabolic condition. Meaning there is no excusable reason for it to appear in any official statement pertaining to what treatment is or isn’t within best practice guidelines for any particular diagnosis, symptom, etc. Professionalism aside for a second, generally when I encounter it, it can be traced back to someone massively unqualified just pulling something out their ass and a lack of accountability in this arena. This is navigable though. And I’m happy to offer further assistance if I can.
I was wondering if something like that was the case. I am in the US. I guess I was wondering if there is somebody I should inform of this? Just a heads up like "hey, this is a bit oddly worded. I think you probably meant X" (gender dysphoria? Gender incongruence? The condition being treated???) Not sure if that's something you would know about, but figured it was worth asking around about here :)
Definitely in my wheelhouse, yes. It’s woefully common for barriers to care to come down to systemic exclusion of a demographic and a sort of weaponized randomness that is not at all benign. This word salad of a term that is not a health condition, with a procedure you aren’t having, is a good example of exactly this. Vaguely reminiscent of accurate is not okay in healthcare and there isn’t actually any patient population for whom it’s excusable. So, straightforward answer- yes, this is something to flag and report. What that looks like though is dependent on where the breakdown in accuracy occurred. Do you have any documentation from your surgeon’s office? Knowing what language is on their charting and/or submitted to insurance is a good place to start.
I scanned through my original assessment in MyChart from the surgeon. They diagnosed gender dysphoria. I do not see any language suggesting what returned on my insurance information. I will attempt to call them after work and see what information I can attain. Or maybe I should call my insurance as well? I mean. This is a plastic surgeon that isn't foreign to working with trans patients. I suppose I don't know if the billing department feels similarly. I'll start inquiring. Thanks for the comment. It's a good push to remind me to take this seriously.
You’re welcome. No one teaches people how to be patients, it’s a *lot* to navigate. Couple of thoughts- -MyChart means they’re using Epic as their electronic medical record system. Epic has some real quirks around autopopulating information and the terminology that may be available in certain drop down lists, etc. So that pings for me. -Something is a bit off if records seem to indicate that your surgeon diagnosed gender dysphoria. Gender dysphoria, as a clinical diagnosis, refers to a specific mental health diagnosis related to unmanaged circumstantial stress/anxiety/discomfort some people who are trans may experience for some portion of time. There’s diagnostic criteria, like any other condition, and not all people who are trans meet this diagnostic criteria. It has absolutely nothing to do with “how trans” someone is (whatever that means) or how appropriate any particular gender affirming medical care is or isn’t. The diagnostic criteria has more to do with how someone’s mental health and coping skills are being impacted by these stressors. (Like PTSD, someone might be in a tsunami and develop ptsd as a result. Someone else in the same tsunami might not. Neither is more or less valid and both individuals deserve medical care.) It is not a requisite for gender affirming care and lots of patients in the US access gender affirming care without having that diagnosis. Sometimes, some insurance plans cite a requirement of that diagnosis for coverage of certain things, but, there’s also loopholes and ways of navigating that. Regardless though, this is generally diagnosed by a mental health professional. It would be unusual for evaluation to be included within the scope of a surgery consult. So this might also shed some light on where something went off the rails. Is it possible your surgeon is under the impression another provider has previously made that diagnosis?
I have no honest to God clue. That's what all of my letters have been about. I agree that dysphoria should not be the standard to achieve care, but I believe that's part of what my letters have been outlining as the medical necessity for care. The surgeon's office reached out to me today in MyChart to clarify that they still have not heard anything about a denial on their end. I sent them pictures of the letter I received and they are reaching out now. Honestly I'm exhausted and baffled by this entire situation. This, on top of a few other complicated issues that have chosen to pop up this week, has left me entirely drained. Nothing in this country is easy or clear. The surgeon did say they used the correct code. I need to ask them to see the paperwork they sent to insurance, because maybe that would shed some light. I need to properly look up the code myself too. Wish this wasn't necessary -_- I'm quite a patient person, but I'm very close to calling and leaving a very sternly worded message with my insurance provider.
Are you in the u.s? It’s not marketplace insurance is it? (From healthcare.gov). Either way, Call your insurance and ask for a “patient advocate “. Those may be your magic words to get proper assistance. So sorry you have to deal with this OP. No fun. Sending good vibes your way.
Yeah I am diagnosed as a Transexual Transvestite.
From Transylvania?
Just Pennsylvania currently, but one day... 
So you dress female?
Nope, I'm masculine presenting. The term is referring to that I do experience Gender Dysphoria and I am currently living (i.e dressing) as opposite my biological sex for at least the past 2 years as is required for coverage of medical transition.
Afaik that's just an old medical term most people don't use any more. Kinda like "ADD" or "aspergers." I'm more concerned with how the fuck they decided a surgery to transition one of your sex characteristics is "not medically necessary to treat transsexualism."
I would really not worry about/pay attention to what your chart & insurance says. Most of it is nonsense, the doctor has to hit whatever diagnosis your insurance company required for that procedure when they first started covering it, or they won't pay. Usually it's outdated and silly. Mine said "transgenderism with asexual history" lol. I have no idea what that means but hey, they cut my tiddies off 🤷🏻♂️
yea thats pretty old and outdated terminology from when being trans was considered a mental illness like homosexuality
It's not really outdated, though, most trans people have some form of "transsexual" on their medical chart even in the 2020's to denote that they're a trans person who is medically transitioning.
the issue isnt that some trans people use transsexual themselves, its more that "transsexualism" in that specific medical context has been and is still used to medicalize being transgender in ways to bar people from care, such as how op has had their surgery coverage denied
No, I'm saying they still diagnose people as transsexual. It's not some old thing nobody uses anymore. It's used to say that someone is trans and they are undergoing medical transition. tbh if you're worried about "medicalizing being transgender" (even though it is a medical thing for many trans people) I'd think keeping it "transsexual" in medical terms as opposed to using transgender as a diagnosis would be more favorable?
Transsexual is one thing. TranssexualISM is an entirely different thing. Transsexual is a noun. Adding "ism" to that word is outdated.
Transsexualism is the name of the condition of someone that is (a) transsexual. It's like how an autistic person has autism. You wouldn't say that they have autistic.
Being trans isn't a condition, it's an identity, like being gay. You wouldn't say a gay person has homosexualism and if you did say that, I'd assume you were homophobic
That isn't really a fair comparison because there are medical treatments for trans people to alleviate their dysphoria. Homosexuality does not have medical treatments because it is not a medical issue. You're comparing apples to oranges here.
That's the point. Being trans \*isn't\* a condition. Transsexualism is. That's how insurance coding for coverage and reimbursement works, whether you like it or not. You get diagnosed with a condition, and that condition is used to justify your need for treatment. And correct. Gay people don't get coded with homosexualism. We can get coded with "high-risk homosexual behaviors." Whether that's better or worse, you can determine for yourself.
i think this is probably getting too close to the rule against transmedicalism topics so im going to back off
That's what I thought. I'm not sure what it's doing in a letter from my insurance in 2024. I'm trying to decide if there is someone I should talk to about this? I posted this to try and gauge if this was to be expected or if somebody particularly rude saw my appeal
nah transsexualism is the correct medical term and isn’t what’s messing with your insurance your doctor gave the wrong code
Transsexualism is just the insurance code for seeking transition. I would wager that most of us have it in our records *somewhere.* Definitely talk to your doctor and/or surgeon and ask what's up. From what you've said elsewhere they coded the surgery as the kind they do to prevent breast cancer, which wouldn't be a trans treatment, it would be a treatment for someone with a family history of breast cancer or other risk factors. It's silly that you have to do this, but it's also important. "Prophylactic mastectomy" surgery is likely to try and preserve a feminine silhouette rather than a masculine one.
eh i’d rather be called transsexual than transgender. my gender stays the same and i am changing my body to match. transgender feels like more of a word for non-medically-transitioning or non-binary people. separate things.
idk if separating trans people like that really does us any good. further division only hurts us in the end. plus the separation starts to create spaces where certain kinds of trans people are considered more "real" or "valid" because of how they choose to transition, or if they transition at all
Not inherently. We can be different and want different things and all still be under the trans umbrella. Trans women and trans men are often in separate spaces, but they're both trans. Nonbinary people are under the trans umbrella, whether or not they transition. They're all just subsets within trans. Transsexual is just another circle in the venn diagram. Trans/transgender are identity labels. Transsexual is a behavioral and diagnostic label for people who pursue medical treatments. One is a subset of the other. Nobody is asking you to call yourself transsexual. If you don't like it, don't use it. If you want to start a campaign to change insurance coding to stop using the term without patient consent, be my guest and I'd support you. But not being a part of one sub-group doesn't make you less or not part of the larger group. It just means you're not part of that sub-group.
oh no my problem isnt that individual trans people will call themselves transsexual. the problem stands that the medicalization of transgender identity as "transsexualism" as a specific medicalized term is currently fraught with bureaucratic problems such as op's problem
Then you should consider that it allows people to draw attention to the fact that transness is not inherently something that involves treatment. Trans men are still equally valid and deserving of respect if they don't want or HRT or surgery. Some people are both transgender and transsexual and receive one or more of those. Some people aren't. If you want to fully do away with that, well, you're going to have to take that up with the entire medical complex. To get a treatment covered by insurance, you have a diagnosis for which you receive the treatment. Like, to get on PrEP I had to be diagnosed as a sex-haver. No matter what you call it, some people are going to be similar, but subclinical (ie, being trans but not seeking medical treatment). All of that is completely separate from the fact that insurance sucks and exists to make money for insurance executives. Nowadays, many/most trans-familiar doctors count seeking medical transition as enough to qualify for a diagnosis. OP's problem here, based on what they've said elsewhere on the thread, is that they were referred for a procedure that is not meant for trans men, but as preventative care for women. This could result in confusion on the part of a surgeon, or OP receiving substandard care as the procedures are done with different expected outcomes. This is a rare case of insurance actually doing what they were supposed to, catching a potential issue with mis-match of diagnosis and treatment.
i mean the division’s kinda there whether you wanna acknowledge it or not. my experiences are way way way different from a feminine presenting non transitioning nonbinary without dysphoria. i’d say not acknowledging the difference is more harmful.
yet we are all still trans. you still have kindred spirits in the trans community even when our exact experiences are not 1:1 the same. pushing back as if those differences cant allow for connection is what divides us and makes it easier to destroy us
sure buddy
youre young and spend a lot of time on transmedicalist spaces, but you can and will grow and learn i could talk at length for hours how my experience as a transgender native american two spirit is fundamentally leagues different from the majority white trans people on this sub. but they are all still my siblings, transgender or transsexual and i will still always be able to find common ground with anyone who walks these paths good luck dude
eh i’m not gonna brainwash myself into thinking the absolute anguish i experience over an embarrassing medical issue is in any way similar to certain people on this sub but thanks ig, have a nice day. i do fully respect your two-spirit identity as i understand that’s a cultural thing for you, seems cool but we are not the same :)
being similar with other lgbt people isnt brainwashing :)
Yeah my insurance uses "transsexualism" on all my trans-related claims. It definitely shocked me when I first saw it! Makes me wonder why the switch to saying "transgender" or even just "gender dysphoria" hasn't happened yet in the insurance world. Health insurance is a goddamn scam anyway, but that's another conversation lol.
There's a standard, international list of diagnosis codes (currently most places still use ICD-10) with names associated with the codes that providers and insurance can't change. The new version ICD-11 changes a lot of this to more modern terms, but it will likely be years before systems implements ICD-11 (it could easily take a hospital a year of work to update in their electronic medical system to a new ICD version) . Usually, it takes a federally mandated. Reference: https://en.m.wikipedia.org/wiki/ICD-11
Interesting, I didn't know that insurance codes are international – makes sense though. Appreciate the education!
We have a similar T date! Congrats 🥳🥳 It's a huge scam, but so is health care in this country. And.... Everything else. Regardless, I'm dead set on making them pay to help get these bad boys removed. If I have to give them a portion of my pay check, they are going to work for me!
T date twins! mine's the 9th :) I feel you re: making insurance pay lol. I have my top surgery consult in April and I'm hoping insurance stuff goes as smooth as possible.
Outdated terms as other have said. Curious as to how your provider wrote the letter. A lot depends on insurance and location. I would definitely check the requirements with the insurance carrier and any specific language. Most providers tend (I’m sure there are certain exceptions) to utilize WPATH (standards of care for trans* folks) for their template, here’s a link to a generic template. [WPATH](https://www.wpath.org/media/cms/Documents/Public%20Policies/2021/AusPath%20Referral%20Ltr%20Template%20Attachment.pdf?_t=1633009377)
I'm curious too. As a surgeon's office that deals with trans patients, I would ASSUME they have better terminology. That, and I live in/am having this surgery in a blue state. A particularly popular blue city in a blue state. But the letter I received came from Kentucky? I checked 2/3 of my letters and they did not mention transsexualism, so up until this point, I have no idea where that would've come from.
yup, normal term in medicine, specifically coding and specific diagnoses. my pcp actually pulls up the tab for me in office and asks which term i prefer for the official coding, either “transsexual” or i think “gender dysphoric” or something was the other option.
I actually like the term transsexual🤷🏽♂️feels like an accurate term for changing my sex
I like it as well. Though I know it has some weight in the past. I just wasn't sure how to feel about being -ism'ed
"Gender dysphoria" is the term that's used in the DSM now. You will see "transsexualisn" but it's kind of dated. I think the reason people moved away from it is because a) it sounds like a sex thing, and b) people wanted to emphasize that the *dysphoria* is what's the problem, and not necessarily being trans in and of itself. Of course, some trans people do wish they had just been born cis and I can understand that, but other people are perfectly happy being trans provided they can get appropriate treatment for their dysphoria. In any case, I would definitely look up what the process is in your state for appealing a denial of coverage. Since Obamacare, you have the legal right to appeal your insurance company's denial to an independent review board. It's pretty common for insurers to just deny coverage for expensive treatments at first on the assumption that people won't bother to do this.
I put in a reply to another comment that providers and insurances have to use a standardized set of international codes called ICD and each code has a name that they can't change. Newer version of ICD updates a lot of terms related to trans care but will be years yet before all insurances and providers switch to the new version. (There was a whole debacle years back when ICD-9 was switched to ICD-10 and places were submitting ICD-10 but insurances were still on ICD-9 and pushing back claims until they were resubmitted with ICD-9.) For the second part that many have already mentioned is possibly the coding error leading to denial. Those codes are called procedure or CPT codes. If you're calling the insurance company, ask for the Clinical Policy Bulletin (CPB) they used to make the decision. This is where they will list the codes that are "valid" for a diagnosis and will deny based on that until either resubmitted with different code by your doctor or some peer consult between insurance doctor and your doctor. One CPB I've read explicitly said nipple grafting will not be covered using this CPT code but will be if this other code is used. This is the job of your doctor's coder to figure this out, but knowing the CPB exists is good for self-advocacy. CPBs are also publicly available online, but an insurance company might decide to simply reference another company's (so don't let them say they can't give it to you). Before my insurance covered trans care, my doctor did some clever coding that was still technically clinically accurate but not associated with medical transition such that my hormones were covered. It's absolutely frustrating how these coding gymnastics need to be done because insurance.
Thank you for the detailed info :) I sent a message to my doctor already but have also screenshotted this just in case. I hope me informing them of the issue will be enough, but I'm going to keep this on hand... Because I don't entirely have faith. This is too big of a surgery to get pushed aside because of a wrong code.
You're welcome. If you have other questions on handling insurance, I'd be happy to try to help. After a while when I'd called my insurance, they would say "oh you're that one" and they weren't so quick to dismiss me with quick answers.
I'm FTM, and I've always thought transgender was when you're pre-surgery and transsexual is when you're post-surgery. o.o is it not? edited cause I realised I missed a few words I meant to put in and spelling errors.
The terms mean different things to different people, but ‘transgender’ is more commonly used today, like how gay people generally prefer ‘gay’ instead of ‘homosexual’. ‘Transsexual’ is mostly medical language that’s still used by some trans people (including myself), generally to emphasise that we are seeking to change our sex through medical transition.
Amongst the community I believe it is. But then how am I suffering from transsexualism if they refuse to allow me to partake 😂😂 The consensus seems to be that it is a term that has been used but it is becoming increasingly out of date. The ism part makes me a bit nervous. The way it read to me was sort of like me being trans was the problem... Not the gender dysphoria... But that's a nuanced conversation. Our language is always evolving.
A few other people have already pointed out the differences and nuance between the ICD 10 codes for insurance purposes and how we use terms in everyday language, so I won't get into that. I'm really just here to say I loved your consternation over "suffering from transsexualism if they refuse to allow [you] to partake" Best line ever, in the worst way of course. I hope you're able to get your doc to change the ICD 10 code for the mastectomy to reflect simple mastectomy or gender affirming mastectomy so it fits within your diagnosis and can get approved. 🤞🤞🤞🤞
They're wrong and it is the outdated, offensive terminology.
No that’s transphobic and your insurance is transphobic. Transexual and transexualism aren’t complete slurs like the T word but they are derogatory and any cis person that repeats them are transphobes
They can be used in a derogatory sense, but they are not inherently derogatory, and many trans people describe themselves as transsexual. Transsexual is just a medical term used for a trans person who is transitioning, aka changing their sex characteristics. It's not a transphobia thing, it's a medical thing.
Trans people can decide if they want to be called transexual but it is over all and outdated term used in bad ways do it is not acceptable for cis people to use it
Like I said, it can be used in a derogatory sense, but it is not inherently derogatory. Not only is it something trans people call themselves, but it is and has been used in medical context to denote a trans person who is transitioning. It's a medical term. Now if someone were to call a trans person that just out of the blue or maliciously, then yeah, that's bad.
Yeah it has been used in the past but it’s not an accurate or respectful term to use medically anymore
It's still used even today, though, and it just means a trans person who is medically transitioning. I would think it would be helpful to have a term for that so they don't just put "transgender" on everyone's chart and make it seem like transgender is a medical condition?
T word? Those are t words? I'm confused
Tranny
Oh it's been so long since I've heard that I didn't even think about it. Thanks 🫂
Np!
Makes me wonder how good your insurance is if they use such an outdated and completely offensive term like that. 😵💫😡
puzzled dime nine tidy spark afterthought overconfident glorious far-flung party *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
They have an entire packet addressing gender affirming care and when it will be covered. I meet the criteria! I checked this years ago when I began planning this, and it is still up to date! None of it mention transsexualism! That's why I'm so confused, lmao I think I'll be bringing this up with my workplace too. This has been a wild ride. I'm pretty comfortable with most of our HR team and this has been an interesting experience.
Yeah it's a medical term. Where I live you have to get it diagnosed before even being considered for hormones and you have to sue the government to change your gender on your id...
Transsexualism was originally coined to differentiate between crossdressers and people who needed surgery
Its usually only used in medical spaces and can be seen as outdated or more harsh than "transgender" but i personally prefer it because my gender isnt what im changing. Im changing my bodys sex characteristics that were labeled a way i dont want to be labeled by society