The Pain of Rejection - The Road to Jenny - Transgender Universe - Everything finally looked like I may be able to live in peace until I decided to pursue getting gender confirmation surgery.

The past few months have been looking up in my personal life. My family and I bought a house and finally got settled in. We had a wonderful over the top Christmas season full of family activities, baking cookies, spending time with friends that we dearly love, and taking stock of the blessings that life had to offer. My writing took a back seat for a while after I started antidepressants. They worked wonders for my anxiety, but they completely destroyed my ability to get my thoughts in writing. Writing was always cathartic for me. It gave me an outlet to release some of the ghosts that set up house in my head. Everything finally looked like I may be able to live in peace until I decided to pursue getting gender confirmation surgery.

“With everything falling into place it just made sense that the timing was right to take the next huge step in my transition.”

With everything falling into place it just made sense that the timing was right to take the next huge step in my transition. My idea was to do a video journal and share all the steps of the process with you. I wanted to show the struggles of losing weight and the processes of getting the required letters. Taking you guys and gals with me was important to me and it was somewhat comforting being able to share the experience. So I started the process of contacting the clinic. Their welcome packet came with all the required materials and duties they needed. I ripped open the packet like a five-year-old opening Christmas presents. I was so excited we must have read through it six times that night. The first thing I had to do was get a letter from my general practitioner. She could see the excitement in my face as I showed he the list of requirements the letter needed. She was more than willing to write the letter and get it to the clinic. Next was the mental health letters from two therapists. My regular therapist sat with me and drafted the required letter. Boom! Another checked off box! I started getting the downstairs drapes removed. With laser taking multiple treatments I figured that by the time surgery came around that it would be taken care of. I had my first appointment with the urologist. He was informative and compassionate. He made Mandy and I feel comfortable with everything and answered every question we had for him. I was told that I needed to lose 40 lbs. to be approved for surgery. This was completely doable! We started a diet plan in our house and were off to a wonderful start.

Then the mail started coming in. It started with a claim for blood work from my general practitioner. Denied! A few days later another claim for my therapist. Denied! Then the others rolled in one after another. After the fifth claim came in I called my healthcare provider. They just told me the diagnosis code was wrong that I should have them resubmitted. I am not fluid in healthcare lingo so I thought it was a formality. I started calling the billing departments of the different clinics. They would either respond with “Okay we will send it through again” or “I will ask the doctor.” Then I started getting letters from them again saying that the claims were denied. I called the healthcare provider a few more times before I finally spoke with someone in the civil rights department. They informed me that my insurance does not cover gender identity or gender transition in any way. They were happy to include a letter that explained this followed with a memo attached saying how they do not discriminate “gender identity” was listed. It was a punch to the chest.

The Pain of Rejection-The Road to Jenny-Transgender Universe - Everything finally looked like I may be able to live in peace until I decided to pursue getting gender confirmation surgery.

I emailed my benefits department to see if this was true. Their response was:

“I’m sorry that Highmark was not able to answer your questions regarding the availability for coverage for various types of services under our plans.  I will address that with our Client Services Rep at Highmark.

Highmark is a third-party administrator for your company’s medical plan as it is a self-funded plan (not insurance). As such, the plan is only required to comply with federal mandates and it is exempt from all state insurance mandates.  Our plan does not cover gender transition/reassignment services. Hopefully, this clarifies the issues that you are having with Highmark and why they have not paid various claims.”

I responded asking if there was a way to increase the coverage and if not when could this be addressed. Their response was swift:

Jen,

Not at this time.

There has been no further information provided to me.

I can’t explain to anyone the devastation I feel. Mandy is upset but she is upset that it bothers me so much and she just wants me to be happy. She knows how unfair it is and why it upsets me but I still can’t explain how much this hurts me. Everyone says things like “It will be Okay. It will just take longer than expected” or “Maybe you should change jobs to get insurance that covers it”. I don’t need to explain to y’all that quitting a stable job that pays well while being transgender is not the best idea. It is more than just waiting. I allowed myself to get excited. I dropped that wall and allowed myself to be vulnerable and open. Now I feel violated on such an internal level that I do not know if I can approach this subject again and if I do, I don’t think I can allow myself to be excited about the process.

  • Josi Alexa

    i at least partly understand what you’re going through. i had a great job, with inusrance that covered everything. As i got the ball rolling, i became more and more sure that it was something i needed to feel whole. i got my letters, had a consultation with the surgeon, filled in the paperwork, and finally, with a non-refundable deposit, i secured my day for surgery. i had to wait 22 months.

    Flash ahead 20 months. i had been making plans, and counting days. Right up to the day that i lost my job, and the insurance that went with it. Your comment about trying to get another job after transitioning is on the mark. i have had terrible luck finding another job. Finally, a couple weeks ago, i called the surgeon’s office to cancel my appoinment for surgery. It was devastating.

    i cried on and off as i told stunned friends and loved ones i had cancelled my surgery date. It’s taken a lot out of me to pick things up from there. i’m still looking for a job, and just hoping on hope that it will cover my surgery, and that i can keep it long enough to at least get it done.

    • Jenny Simmons

      I am so sorry to hear that you went through a similar situation. I truly wish that I was the only one handling these situations but unfortunately I am not.

      • Josi Alexa

        Thank you. i really appreciate that. At least we have a community in which to share our stories and commiserate with each other. It can help us realize that we aren’t alone in our individual miseries, and sharing helps us not only vent our feelings, but also cope with them.

        • Jenny Simmons

          I am happy I have a platform to be a bigger part of our community. Thank you for reading.

    • SF Garcia

      This is awful… I’m so sorry this happened to you.

  • SharonAnne McC

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    Jennifer:

    I hope alternative plans are not too late for you to try.

    Sometimes, healthcare providers can modify their diagnoses and procedures to codes and terms that do conform with your carrier’s acceptance.

    At least that was how it worked for me when I began transition at age 18 in 1974.

    I managed to achieve legal identification to female. With that, all treatments followed for me as female rather than as male. My employer and my insurance could no longer placed me inside their exclusions for transsexual procedures.

    I also got a lucky break. My doctors examined me and determined that I am female by inter-sex. At that point it made me legally, medically, biologically, socially, psychologically female; there was no way that my insurance could deny any coverage since my ‘Team Sharon’ filed me as female for corrective procedures.

    Life was not all a bed of roses. There I was female post-op but still encumbered to present as male at work when my employer, the federal government, began action to fire me in 1983. I pursued my appeal process through 1985 until I took advantage of a personal opportunity to complete my transition to female full-time. I eventually won my job issue through the un-employment process who declared that my federal agency conducted a long-term campaign of a hostile work environment.

    That was the ‘old days’, Sadly, these same obstructions continue to hinder today’s trans persons. We can’t expect much during the current political climate in the USA unless enough people join us to create that change.

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