Costs and Benefits of Transgender Surgery
Despite the discussion of transgender individuals and issues in society these days, there’s a good-sized group of people who are still behind the curve in terms of openness to learning and accepting new realities. Some of the blowback is quite disheartening, such as when politicians claim (falsely) that boys and girls are being forced to shower together. Even worse is the rising rate of hate crimes against transgender people.
That’s why it’s always refreshing to read good news like some we found recently. Two new interesting studies have been published: they point to benefits of medical treatments for a group of transgender people and evidence that the cost to society of providing surgical options is minimal.
Health Benefits for Transgender Women
As reported last month in Medical News Today, new research presented at the conference of the American Physiological Society suggests that transgender women who receive both hormone therapy and removal of the testicles (surgery called orchiectomy) are healthier than patients who receive hormones only.
The study, though small, found that transgender women who receive hormone therapy alone tended to experience fat build up in the liver. Patients who elect orchiectomy lower their testosterone levels, thereby reducing the risk of liver problems. Specifically, the researchers discovered that in the study group, “transgender women who had the highest levels of testosterone were found to have the poorest metabolic health.”
Covering Health Care Makes Sense
On another positive note, researchers at Johns Hopkins School of Medicine in Baltimore just published a study showing that covering transgender surgery makes economic sense for insurers. The study’s leader, William Padula, explained that insurance companies feel treatment is cost effective if a “per year per quality of life” measure is below $100,000. Padula discovered that for the first five years, the per year per quality of life price of transgender surgery and hormone treatment ranges between $34,000 and $43,000. After ten years, the cost drops to between $7,000 and $10,000.
Not only is it clear to Padula that covering transgender procedures is good for insurance companies, he noted that when transgender individuals want surgery and are unable to afford it, they tend to suffer in other ways. Depression, substance abuse and HIV/AIDS are common to this group, and the cost of treating those conditions is not much less than the cost of transitioning, the researcher maintains. He stated, “This is a small population of people, and we can do them a great service without a huge financial impact on society.”
Seeing the Whole Picture
Although society is making progress in understanding and supporting transgender people, there’s still a long way to go. Those who take anti-transgender positions continue to twist numbers and trends to support their stance that transgender people are mentally ill and that surgery can lead to suicide. Despite evidence that other factors contribute heavily to psychological challenges for transgender individuals—such as rejection, harassment, violence and adverse life circumstances—we can expect people to go on insisting that gender reassignment treatment is not a valid choice.
One thing the rest of us are realizing is that the word “individual” is key when it comes to understanding transgender individuals. Each person takes a unique path to living an authentic life. Some opt for no treatment at all; for others, hormone treatment is sufficient. Many elect to undergo transgender “top surgery”—breast augmentation or breast reduction as the case may be. Some want to have genital surgery and perhaps facial plastic surgery as well.
In our practice in New York, transgender individuals are very welcome. As experts in breast surgery for men and women for more than 30 years, we offer top surgery for both male to female and female to male patients. We perform a variety of complementary treatments as well, from forehead surgery to liposuction to fillers and Botox. Call us at 212-570-6080 or contact us online if you would like to talk.
