San Francisco has responded to transgender advocates who have said that the hormones and counseling now offered under the city's universal health care plan are not sufficient for transsexual people (those for whom the disparity between their bodies and their gender identities is a torment). The city has plans to have a comprehensive transgender health care program in operation by 2014 which will include sex reassignment surgeries (mastectomies, genital reconstructions and other surgeries) which are currently specifically excluded from the city's Healthy San Francisco coverage.
The vote of the city's Health Care Commission was announced on Thursday. The move also had the backing of the San Francisco Board of Supervisors.
The Healthy San Francisco Plan, which is in its 5th year, covers uninsured residents of the city.
The community felt the exclusion on Healthy San Francisco was discriminatory and we wanted to change that as the first step.
--Public Health Director Barbara Garcia
Garcia acknowledged that for now the move is "a symbolic process" since the city does not currently have expertise, capacity or protocols to offer the surgeries through its clinics or public hospitals.
The Health Commission approved the establishment of a separate program covering all aspects of transgender health, including gender transition. Garcia hopes the program will begin running by late next year. However, she also stated her department needs to first study how many people it would serve, how much it would cost, who would perform the surgeries and where they would be performed.
Sex reassignment surgery is not the end all. It’s one service that some transgender people want and some don’t. We can’t manage this over the next three years without much of a budget increase because we already have these (other) services covered.San Francisco and Portland, OR already cover sex reassignment surgeries for city employees, San Francisco since 2001 and Portland since 2011.
I am filled with hope and gratitude that we are achieving this level of support for the well-being of the transgender community.The number of major US corporations also cover the surgeries doubled over the past year. The Human Rights Campaign Foundations white paper on transgender inclusive health care coverage is available here (pdf).
--Kathryn Steuerman, local transgender health advocate
In May Argentina became the first country to offer the surgeries as part of both public and private health care plans as part of its gender rights law.
The National Review Online, as expected, used the announcement to attack the city for its intolerance of of people with traditional values and as evidence that "Obamacare" needs to be dismantled, lest public funding of sex change surgeries become universally available. But we knew that would happen. To such people, we are less than human and hence deserve less in the way of any public service.