Health

Half of transgender patients leave home state for surgery

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About half of all transgender patients in the United States who undergo genital mutilation surgery travel outside their home state to receive this care, and those who travel pay about 50% of the cost of treatment in pocket, according to a new study published by researchers from the University of Oregon Health and Science, published in JAMA Surgery.

The OHSU-led study provides an initial national estimate of the average cost of confirming the operation of a penis. The results of the study could help patients and insurance companies better plan to receive or close this much-needed medical care, says lead researcher Jae Downing, Ph.D., assistant professor of health policy at the University of Nursing Oregon-Portland Health and Science. University School of Public Health.

“Going a long way for a highway like a gender-based surgical procedure puts a lot of weight on patients,” Downing said. “We already know that travel for health care requires patients to take a break from work and pay for travel and accommodation on their own, and this can lead to getting care from experienced providers who are accustomed to it. “

Different sexes and sexes are sexually active at birth which is different from their actual gender. Most transgender patients seek medical attention from health professionals to confirm their gender. Every transgender cares for special needs; some patients seek hormone replacement therapy and others seek surgery for their chest, face or genitals. The management of conventional surgery is complicated, led by specialists surgeons and may require several steps, next.

To understand the cost of gender-based surgery, Downing and colleagues from OHSU and the University of Washington analyzed research data that included data on U.S. business insurance claims for 129 million people between 2007 and 2019. In this data set , 771 patients received women. genital surgery, also known as vaginoplasty, or men’s and women’s surgery, also known as phalloplasty.

For all forms of genital mutilation combined, 49% of patients travel outside their home state for surgical care. At the same time, whether the surgery was performed inside or outside the nursing home, there was no significant difference in the total cost of each procedure.

To calculate external medical costs, investigators included co-pays, payments and deductions to be deducted from insurance claims. They found that patients who left their state for surgery paid almost 50% more out-of-pocket expenses than those who did not. The average non-state patient paid $ 2,645, compared to $ 1,781 for the average in-state patient.

The study also showed that patients living in the South travel from their home state more often to undergo genital mutilation surgery. For example, patients living in the West were 36% less likely to leave their home state for surgery than those living in the South.

As a result, many of my patients may need to leave their state to undergo gender-based surgery because there are not enough doctors to provide this care to begin with, and travel needs may be higher in the South because gender inequality. -serving the gynecologists are greater in this area, Downing and colleagues noted. They point to a 2020 study that found that there were 11 surgeons who provided this special care in the South, with four working in Florida.

Geolani Dy, MD, author and co-author of the study said “Migrants and patients face a major barrier to access to gender-based surgery, with one barrier being homelessness, surgeons and dedicated support groups to help patients do this care, ”said Geolani Dy, MD, study author and assistant. professor of urology, plastic surgery and reconstruction surgery at OHSU School of Medicine, which also offers vaginal surgery and other sex-enhancing techniques through the OHSU Transgender Health Program.

Dy goes on to say that “patients and surgeons already know this very well, and now this study is helping to determine how much we need more doctors to confirm gender.”

The researchers also found that only 1 in 100,000 patients underwent genital mutilation surgery paid for by their commercial health insurance company in 2019, which is equivalent to nearly 1,800 such surgeries nationwide. that year. Drawing from a separate 2021 study on bariatric surgery — which is not often covered by insurance — the authors of this study found that in 2019, bariatric surgery is 20 times more likely to be insured than genetically modified surgery. .

While an estimated 0.6% to 3% of the U.S. population may appear as transgender, 1 in 100,000 patients equates to approximately 0.001% of patients undergoing gender-based surgery whose business is insured closed. Although not all transgender patients seeking masturbation surgery, commercial insurance appears to be hiding those doing it, Downing said.

The researchers agree that their research does not count all out-of-pocket expenses; only traces out-of-pocket expenses paid by patients to their patient insurer, without a Medicare or Medicaid claim. They also noted that research is needed to understand the extent to which travel from the state affects the outcome of surgery and to study why patients leave the state. Downing and Dy are looking for additional research support to study some of the key questions.

Downing and colleagues followed this study as a result of their work with Transgender and the Non-Binary Allied Research Collective, or TRANS-ARC. The 2021 TRANS-ARC Summit of Researchers, Healthcare Providers and Patients highlights a number of research topics related to gender-specific surgical care, including inshora inshora and out-of-pocket expenses affect the outcome of surgery.


After female genital mutilation, transgender people report better mental health


Learn more:
Jae Downing et al, Expenditures and Pocket Funds to Ensure First Blood in the United States, JAMA Surgery (2022). DOI: 10.1001 / jamasurg.2022.2606

hintHalf of transgender patients leave home state for surgery (2022, July 6) and recovered 6 July 2022 from https://medicalxpress.com/news/2022-07-transgender-patients-home-state-surgery.html

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