Q&A: Why Do People Separate Mental and Physical Health Though They Are Sensitively Dependent on Each Other?

Question by Renny: Why do people separate mental and physical health though they are sensitively dependent on each other?
I get at this because, in part, of the treatment of transgendered/transsexual individuals.

In this community your left out in the cold in a lot of cases to take care of your condition alone. Most of us don’t even have the option to see a therapist to get the okay for hormone therapy much less anything else. This results in suicides, attempts, and self-medicating which can be equally dangerous. But fundamentally what I see is this… Doctors can refuse to give you hormones on the premise that they could have negative impacts on your health and that it’s psychological, and insurance companies won’t cover them because they say “It’s not like your going to die without them”.

Is there is disconnect for the providers in which “Yes, this patient could die without hormones, but not from medical complications, but psychological side effects” just slips their mind? On another approach, if a woman is suicidally depressed about her breast size they’ll okay breast augmentation, but if a transwoman has the same issue she can’t even get insurance to cover a consult. In spite of the lobbying in the AMA and APA there still seems to be a serious issue of coverage, not just for surgeries, and hormones, but for generally accepted forms of transgender care and feminine preventative care like (mammograms, pap smear (post SRS), hair loss treatment, et cetera). Not only do I feel we deserve to be treated like women in the sense of medical care, (where applicable) but I think we should be able to get the same standards of care and coverage.

I know that for some, there is still the disconnect in the belief that trangenderism is an idea that involves the lifestyle of one living as the opposite gender in spite of the medical evidence supporting the contrary. But the basic problem still exists, why do they separate the mental and physical aspect when in a condition like Gender Identity Disorder (DSM-IV~TR) are sensitively dependent. I just don’t think that one should be separate from the other. The mind can’t live without the body, and like-wise the counter is true as well (the body can’t live without the mind). I’d like to know my doctors would save my life if I suffered a condition that may cause me to commit suicide eventually. They treat bipolar, and clinical depression as such, why not GID?

Best answer:

Answer by Erica
You are just about spot on with all your observations. The answer is simple. Transsexual people represent a ridiculously small minority amongst the insured, and insurance companies are not going to provide for anything not currently covered unless forced to by legislation or government pressure. Even though the financial impact on the system would be negligible (it’s been estimated at a couple of cents per person), they just won’t do it unless forced.

The legal decision that forced the IRS to allow Transition expenses as deductions came primarily as a result of one Trans-woman’s costly legal battle, which took years, and could be easily overturned in the future at a judges whim. That is how little representation the Transsexual community has in the legislative processes in our country.

One bright spot is the recent declaration by the HRC (human rights commission) that in order for corporations to receive a score of 10 from the HRC, they must offer at least one insurance option that provides for Gender Transition coverage. This will encourage providers to at least add such coverage to *some* of their corporately targeted policies, though they probably won’t include such coverage in plans for individuals or small businesses. It is a start though.

Certain cities are also providing coverage for city employees, which sets another good precedent.

What is so incredibly frustrating is the hypocrisy that fuels the insurance industry. A single organ transplant can cost $ 500,000, and there’s no guarantee it will take, or that the patient will survive. That amount would pay for 20 SRS surgeries, which we know statistically have a better than 95% success rate. It would seem like a no-brainer, but because there are no reliable statistics on mortality rates due to Transsexualism, we have little ammunition to pressure the insurance industry with. The blurring of social “gender variance” with genuine Transsexualism doesn’t help. The average person has no idea what the difference is between “transgendered” and “transsexual.” Hell, many transsexual PEOPLE don’t know. Too many Transsexual people get themselves involved in subcultures such as drag, cross-dressing, fetishes, porn, prostitution, etc, which depict gender variance as a choice, or a lifestyle. Street hormones, self-medication, backdoor surgeries, illegal procedures like silicone injections, not to mention the huge business of “shemale porn” that has proliferated on the internet has solidified in many people’s minds that Transgendered = deviant behavior, or mental illness, which in some cases may be true, but certainly is not the case for the majority of Transsexual people.

Another huge obstacle is the inclusion of Transsexualism in the DSM under the idiotic nomenclature “Gender Identity Disorder.” This is a completely inaccurate representation of what Transsexualism is, and at this point even the psychiatric community concedes that Transsexual people are not suffering from mental illness. Transsexualism needs to be REMOVED from the DSM in totem. It is not a mental disorder. Transsexual people KNOW what their gender identity is. They simply want their bodies to match their minds. Transsexualism is a physical condition. It is ONLY the dysphoria that Transsexualism produces that causes temporary psychiatric conditions such as depression or thoughts of suicide. These are symptomatic of the underlying condition. The incongruous feelings that Transsexual people experience originate entirely because of the body/brain mismatch, not because there is mental illness present.

The trouble is, the DSM is used internationally, and in many countries with socialized medicine it endorses a legitimate medical condition, which must then be covered by the health-care system. For Transsexual people in places like Canada and the UK, G.I.D. is what allows them to Transition and get surgery through their nationalized health-care. In American, the DSM works against us. Worse still is that morons like Blanchard and Zucker are on the panel that is responsible for the next revision of the DSM (version V) and they are doing everything they can to keep their idiotic theories of Autogynephilia and Repairative Therapy relevant. The latest I’ve heard is that they now want to call Transsexualism “Gender Incongruity”, which is better, but still not accurate, and they are still pushing to keep a “fetishistic version” of gender identity disorder in the book.

We have a growing body of health-care providers, therapists, psychiatrists, surgeons, legal professionals and of course Transsexual people who are becoming incensed at the dismissive attitude insurance companies in America have taken towards a serious, physical birth condition that has been incontrovertibly proven to be deadly if left untreated, and which needs to be corrected in order for people to live healthy, functional lives. Our insurance premiums continue to rise, while deductibles go up, coverage decreases, and red-tape increases. The only way change is going to happen is when enough people organize and pressure legislators to pass legislation that forces insurance companies to acknowledge Transsexualism for what it is… a serious physical birth condition that when left untreated can result in death.

Know better? Leave your own answer in the comments!