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View Public Comments for Gender Dysphoria and Gender Reassignment Surgery (CAG-00446N)

Careccia, Tera

I write in support of equal and fair treatment of all patients. In order to accomplish this, it is integral that patients who are transgender receive equal care to their cisgender counterparts. Therefore, Gender Dysphoria-related procedures and surgeries must be recognized as essential and life-saving facets of healthcare which are currently being denied. Human lives are the cost of this delay and denial, and this heavy cost has been paid daily by some of the most vulnerable people in our society.

Restriction of these procedures behind financial and social barriers has played a major part in the epidemics of suicide, self-harm, and other mortally dangerous behavioral and physical health problems faced by transgender people, ranging from "avoidable with timely treatment" to "mortally dangerous". Due to the current dearth of cultural competency in American medical facilities, many transgender people face severe mistreatment from physicians regarding even the most basic health issues.

Tragic instances like those which led to the avoidable death of [PHI Redacted] from ovarian cancer are far more common than can be adequately communicated. It is important to recognize that not all negative clinician interactions result in death; many transgender patients endure chronic disability, injury, and other negative outcomes as a result of lack of guidance provided to clinicians. Transgender people are abused and ignored within the privacy of their own health consultations by physicians they are unable to trust with faith equal to that enjoyed by their cisgender counterparts. Without the support of guidelines laid out in clear terms, transgender patients lack even the resources to fight mistreatment when it is experienced.

This disparity in quality of care is so extreme as to be explicitly documented and pinpointed for improvement in the Healthy People 2020 objectives released in December of 2010. The procedures included under the umbrella proposed for review are critical to help many transgender people achieve a healthy quality-of-life. Without definitive statements from reputable medical sources on the undeniable right of transgender citizens to these procedures as part of truly equal healthcare, there can be no advancing in the face of bigotry and hatred. It is our job as workers in the healthcare field to defend to our fullest the health and safety of the patients under our care. CMS stands to work in favor of the American public, to push toward a better future, to support those who have been ignored, hurt, killed; those who watched their cisgender counterparts enjoy healthcare while suffering silently in poverty, struggling alone with illnesses and disabilities.

The situation is grave and it is high time for a change. Please be a part of that change and bring the bright minds of American Medicine together to find a way to make unequal treatment of transgender patients a relic instead of the unspoken norm.