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Dr. Leis on TGs and The Affordable Care Act

The Editor | Sep 8, 2014

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(Philadelphia, PA) – The transgender community celebrated the groundbreaking U.S. Government’s recognition of gender dysphoria and its coverage of transgender surgery under the Affordable Care Act (ACA). However, as the law begins to be implemented and real transgender people attempt to use its coverage, they are starting to discover its acute limitations, even to the point where many believe that transgender surgery is little more available now than it was before the law.

Dr. Sherman Leis, a transgender surgeon of international renown and founder of The Philadelphia Center for Transgender Surgery, said, “although it is a wonderful step forward, that our government has legitimized transgender healthcare, the Affordable Care Act’s coverage, through Medicare, pays only a miniscule amount towards that coverage.” He noted, “Unfortunately, most experienced transgender surgeons cannot even begin to cover basic costs from this reimbursement, let alone earn a reasonable amount for time and experience.” As a result, Dr. Leis believes that few if any transgender surgeries will be scheduled in the foreseeable future that will be covered and paid for by the Affordable Care Act’s provisions.

In fact, Dr. Leis sees a potentially dangerous side to this situation.

“Because government coverage is far below the market, I’m afraid we may see unqualified people, who will accept the low reimbursement rate, performing transgender surgeries and achieving less than satisfactory results. These are people who may not be fully trained in transgender surgery itself or in the care and sensitivity to the patient throughout the process. Already, I perform a number of transgender surgery revisions and expect more as a result of these circumstances.”

That said, Dr. Leis recognizes that the law is an important first step. “At the moment, many private health insurance companies and state-run Medicaid programs do not cover transgender surgical procedures at all. These insurers tend to follow the federal government’s lead. Ultimately, this law will definitely be a catalyst for change for the better for the transgender community in the United States,” noted Dr. Leis.

Dr. Sherman Leis is Board Certified in General Surgery and Plastic and Reconstructive Surgery, and one of the world’s pre-eminent transgender surgeons, having performed thousands of transgender surgical procedures including facial feminization, chest surgery, vaginoplasty, phalloplasty, and others. He founded The Philadelphia Center For Transgender Surgery to be a complete resource for the transgender community worldwide.