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      Health Insurance Coverage of Recommended Gender-Affirming Health Care Services for Transgender Youth: Shopping Online for Coverage Information

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          Abstract

          We assessed online health insurance plan indication of coverage and accessibility of information for recommended services for transgender youth (TY). Content analysis was performed for plans used at a pediatric Gender Clinic by reviewing information about coverage of puberty blockers, hormones, masculinizing chest surgery, and counseling. Transgender-specific exclusions and the time required for the research assistant to review each plan's online information were noted. No plan (0%; n=36) indicated coverage of all four categories of recommended services online. Forty-nine percent indicated ≥1 transgender-specific exclusion. The median time required for a research assistant to review online coverage information for each insurance plan was 50 min. Efforts are needed to ensure that online insurance information is accessible and updated in accordance with policy and coverage recommendations for TY.

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          Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline.

          Wylie Hembree, Peggy Cohen-Kettenis, Henriette Delemarre-van de Waal … (2009)
          The aim was to formulate practice guidelines for endocrine treatment of transsexual persons. This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence, which was low or very low. Committees and members of The Endocrine Society, European Society of Endocrinology, European Society for Paediatric Endocrinology, Lawson Wilkins Pediatric Endocrine Society, and World Professional Association for Transgender Health commented on preliminary drafts of these guidelines. Transsexual persons seeking to develop the physical characteristics of the desired gender require a safe, effective hormone regimen that will 1) suppress endogenous hormone secretion determined by the person's genetic/biologic sex and 2) maintain sex hormone levels within the normal range for the person's desired gender. A mental health professional (MHP) must recommend endocrine treatment and participate in ongoing care throughout the endocrine transition and decision for surgical sex reassignment. The endocrinologist must confirm the diagnostic criteria the MHP used to make these recommendations. Because a diagnosis of transsexualism in a prepubertal child cannot be made with certainty, we do not recommend endocrine treatment of prepubertal children. We recommend treating transsexual adolescents (Tanner stage 2) by suppressing puberty with GnRH analogues until age 16 years old, after which cross-sex hormones may be given. We suggest suppressing endogenous sex hormones, maintaining physiologic levels of gender-appropriate sex hormones and monitoring for known risks in adult transsexual persons.
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            Mental health of transgender youth in care at an adolescent urban community health center: a matched retrospective cohort study.

            Sari Reisner, Ralph Vetters, M. Leclerc … (2015)
            Transgender youth represent a vulnerable population at risk for negative mental health outcomes including depression, anxiety, self-harm, and suicidality. Limited data exist to compare the mental health of transgender adolescents and emerging adults to cisgender youth accessing community-based clinical services; the present study aimed to fill this gap.
            Article 0 comments Cited 163 times – based on 0 reviews     Review now
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              Youth and Caregiver Perspectives on Barriers to Gender-Affirming Health Care for Transgender Youth

              Samantha Gridley, David Breland, Kym Ahrens … (2016)
              Few transgender youth eligible for gender-affirming treatments actually receive them. Multidisciplinary gender clinics improve access and care coordination but are rare. Although experts support use of pubertal blockers and cross-sex hormones for youth who meet criteria, these are uncommonly offered. This study's aim was to understand barriers that transgender youth and their caregivers face in accessing gender-affirming health care.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Transgend Health
                Journal ID (iso-abbrev): Transgend Health
                Journal ID (publisher-id): trgh
                Title: Transgender Health
                Publisher: Mary Ann Liebert, Inc., publishers (140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA )
                ISSN (Electronic): 2380-193X
                Publication date (Electronic): 11 April 2019
                Publication date Collection: 2019
                Publication date PMC-release: 11 April 2019
                Volume: 4
                Issue: 1
                Pages: 131-135
                Affiliations
                [ 1 ]Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
                [ 2 ]Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
                Author notes
                [*] [ * ]Address correspondence to: Nadia L. Dowshen, MD, MSHP, Department of Pediatrics, Children's Hospital of Philadelphia, 2716 South Street, Philadelphia, PA 19146, dowshenn@ 123456email.chop.edu
                Article
                Publisher ID: 10.1089/trgh.2018.0055
                DOI: 10.1089/trgh.2018.0055
                PMC ID: 6608682
                PubMed ID: 31289750
                SO-VID: f218ac24-3264-4c97-a755-70b0382a4bf4
                Copyright © © Nadia L. Dowshen et al. 2019; Published by Mary Ann Liebert, Inc.
                License:

                This Open Access article is distributed under the terms of the Creative Commons License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Tables: 2, References: 24, Pages: 5
                Categories
                Subject: Short Reports

                Keywords: health policy,insurance coverage,transgender health,transgender youth
                Data availability:
                Keywords: health policy, insurance coverage, transgender health, transgender youth

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