San Francisco to Become First U.S. City to Cover Cost of Transgender Surgeries

San Francisco is on its way to becoming the first U.S. city to provide and cover the cost of sex reassignment surgeries for uninsured transgender residents.

The city’s Health Commission voted Tuesday to create a program for treating transgender people experiencing mental distress because of the mismatch between their bodies and their gender identities. San Francisco already provides transgender residents with hormones, counseling and routine health services. However, Public Health Director Barbara Garcia said Thursday it has stopped short of offering surgical interventions.

The idea of offering a new program featuring surgeries came out of conversations between public health officials and transgender rights advocates who wanted mastectomies, genital reconstructions and other surgeries that are recommended for some transgender people covered under San Francisco’s 5-year-old universal health care plan.

Once the San Francisco Board of Supervisors and the San Francisco-based Transgender Law Center urged for changed, the commission agreed to drop this week sex reassignment surgery from the list of procedures specifically excluded from the Healthy San Francisco Plan.

Garcia describes the move as “a symbolic process” because the city does not have the expertise, capacity or protocols in place to provide the surgeries through its clinics and public hospital.

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“The community felt the exclusion on Healthy San Francisco was discriminatory and we wanted to change that as the first step,” said Garcia.

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,” said Garcia. “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.”

In 2001, San Francisco became the first city in the U.S. to cover sex reassignment surgeries for government employees. Portland, Ore. did the same in 2011. The number of major U.S. companies covering the cost of gender reassignment surgery for workers doubled last year, reflecting a push by activists to get insurance companies to treat such surgeries as medically necessary.

Kathryn Steuerman, a member of a transgender health advocacy group in San Francisco, stated the city’s latest move would help residents avoid going into debt to finance operations, as she did.

“I am filled with hope and gratitude that we are achieving this level of support for the well-being of the transgender community,” said Steuerman.

Based on reporting by The Associated Press.

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