Another brilliant post. It does not matter how frequent detransitioning might be. The individual cases must be addressed and these people need care. The system is clearly biased against them. As a physician, I believe that our society is harmed by malpractice attorneys and juries but suing the physician and surgeon perpetrators of the kind of poor care documented in this post would be a wake-up call. Another reason not to live on the west coast.
Coastal Elite: everything you write here is absolutely horrifying. I have read some already to Josie, and will be bookmarking this information for future use, as I can. As you note, it’s an uphill climb to figure out how to deal with politicians right now. In bright blue Manhattan, NYC, similar to what you are facing (though our laws here, while bad and trending in the wrong direction, are not (yet) as terrible as Oregon’s), the outcome is foreordained, no matter how I vote (or don’t vote). I am trying to figure out how to make a meaningful, visible protest vote. That suffragette party option would sure be helpful here, or, absent that option on the ballot, mounting a write-in campaign.
Speaking of that suffragette party, I was thinking of you yesterday while watching the Let Women Speak event in Belfast, for, as you may know, KJK is forming a Party of Women, which, in typical KJK fashion, she intends to make go worldwide. I am glad to report that, thanks to the Belfast Police, the gathering was not disrupted. I was able to hear many of the speakers, including a high school girl who had written and recited from memory a poem she wrote for the occasion. Here she is, reciting: https://twitter.com/StandingforXX/status/1647587318683914241 and here is the text: https://twitter.com/veroniquella/status/1647679303147048963
A friend and I, he even older than I am, separately associated to this song: https://youtu.be/ZrVLL7soS1U proving once again he and I are both dinosaurs, even if not T-Rex.
Coastal, as I learn more, from you, about what happened and is happening in Oregon, I have to say, with apologies, that my timing was off. Right now, what is needed much more than a little light-hearted pick me up is a tourniquet to stanch the bleeding.
I can add another reason why numbers for regret, detransition, and desistance are not accurately counted
My minor daughter is a desister. She was diagnosed by multiple psychiatrists with “gender dysphoria” and by one as a “transsexual.” These diagnoses were submitted to our insurance company. She was heavily encouraged to obtain hormones as soon as she could get away from us. If you read the Reuters article in which Reuters commissioned a review of private insurance records during a specified time frame to get the number of minors with a gender dysphoria diagnosis (which they reported in that article) my daughter’s diagnosis was in that number.
But now she does not identify as trans or have gender dysphoria. She said she doesn’t want that diagnosis on her insurance records. But there’s no ICD code for desistance or detransition. There’s no way to record or document that in her - or anyone else’s - records. Reuters can’t commission an insurance review and report those numbers.
Both she and I have informed individual medical professionals. How is it documented? For most, we don’t know because they refused to respond. She was no longer their patient, so it’s not their problem. One provider defended their diagnosis and refused to acknowledge the harm caused afterward. Another just changed her pronouns in their charts and went along like nothing happened.
So how is anyone going to collect and count data that isn’t coded or recorded anywhere even when it is reported
Privacy Rule gives you, with few exceptions, the right to inspect, review, and receive a copy of your medical records and billing records that are held by health plans and health care providers covered by the Privacy Rule.
If you think the information in your medical or billing record is incorrect, you can request a change, or amendment, to your record. The health care provider or health plan must respond to your request. If it created the information, it must amend inaccurate or incomplete information.
If the provider or plan does not agree to your request, you have the right to submit a statement of disagreement that the provider or plan must add to your record.
Really good points, thank you for noting them. The importance of accurate--including accurately categorized--data collection is woefully undersung in all of this. And within that, inaccurate or missing information in medical records can do continuing harm. It’s been a long time since I looked at this, but at least in NYS, there is, or at least was, a regulatory procedure by which any patient can formally record a correction to the medical record (if that is desired).
What a disturbing irony it is that "trans activists" seek to invalidate the "lived experience" of detransitioners in part by claiming "there aren't any/very many," given the solid data suggesting that trans people are about 0.6% of the population — and that they insist their own "lived experience" be adopted as gospel truth by everyone, in order for them to feel validated.
Question: if a child or young adult starts taking hormones that they obtain from a place like Planned Parenthood, then stops on their own, are they also considered Detransitioners? I’m sure PP and the like keep no record for people who get the prescriptions then just cease and never report back.
There are different definitions of detransitioners, for some it means not identifying as trans anymore, whether or not you take the drugs.
But yes, if you stop taking the drugs, that is something that should be tracked and correct, no one is keeping track.
That is, this huge body-modifying dangerous intervention is being made freely available and there is no record of the long term outcomes (8-10 years for surgical regrets on average/median in the past, and that was with a more careful vetting process).
To all: reading all the comments, and particularly Coastal Elite’s comments on Oregon, can we come up with a tick list of strategies of things we each can do from where we are? If folks add replies below, I will compile them into a list and find some way to feed them back to everyone in a comment. And of course, if this is been there/done that, I do get it, so just ignore this!
Here are some to start off (none new to folks here, and, of course, also, the first priority for those directly affected is to protect their families. So it’s to be recognized that each of these things, no matter how small, takes time and psychic energy, and the thought is only that a tick list may be helpful for those times when weighing is possible):
1) Whenever a bad gender-related piece of legislation comes up, write the appropriate representatives to weigh in. (The more people write to the same rep, the more s/he is likely to note it.)
2) if you decide not to vote for a politician you’ve supported in the past because of his/her stance on these issues, let him/her know why.
3) if any charitable organizations to which you give funds take a bad gender-related stance, give them one chance to correct, and if they do not, withdraw further contributions and advise why.
4) if any newspaper or magazine to which you subscribe takes a bad gender-related stance, write to the article author, cc to their editor, and try to educate.
Haha! As it happens, I only drink decaf. Otherwise, I am told on good authority, I am entirely too wired. How about we each write Lisa and let her know we’d like to share emails--she has mine, too, and I would be delighted for you to have it!
Watching this Rep. Goodwin respond to the inconvenient facts of how the system abused a young mentally-vulnerable man reminds me of the story about philosopher Cremonini, who clung to the perfection of his dogma so desperately he refused to even look through Galileo's telescope at any evidence that might disprove it.
Why is the answer to everything a bill to make insurance companies pay? Where do insurance companies get their money? From people who pay for health insurance. So you’re basically asking your neighbor to pay for transitioning and then when it doesn’t work out, asking them to pay for de transition.
The answer should be to make the doctors who advised and performed the transition pay for de transitioning. They should be held responsible. Only then will they be more careful with their diagnosis and treatment of such a serious endeavor.
Right now, they have only incentives to transition. And take no responsibility when things don’t work out.
Well, this is a good question. My guess, though I don’t know, is that, once Medicaid and insurers began to cover so-called gender affirming care without proper guardrails, the train left the station and is rolling downhill with no brakes. Proper medical standards, including a stringent definition of medical necessity, committed enforcement, and severe penalties for malpractice, including criminal penalties, should have helped here, but that so far doesn’t seem to be in the offing, either, though pending lawsuits might help. In this context, as so often is the case, the patient who now wants to undo the transition is left with no remedy unless that care is covered, too. It’s pretty easy to see, in this context, why so many states are banning pediatric care.
It looks like the Affordable Care Act is the vehicle that regulates transgender care for all states.
Maybe some states have their own bills but the ACA governs insurance companies Medicare and Medicaid. You can file a complaint using the link in the attached document.
Thank you Lisa for this thoughtful article and assessment of the situation. Frank Smith was the inspiration for the bill we drafted and Representative Jeff Leach is carrying in Texas. As we worked with Frank over the last several years on a possible lawsuit and just getting to know each other, it became clear that insurance companies (and Medicaid) need to be in for the long haul. If the upfront treatment has been deemed "medically necessary" as documented in a Blue Cross Blue Shield policy, then the long term implications, whether detrainsitioned or not, must be covered. Thanks again for your persistence in following gender.
Thank you for writing this! There must be better medical and mental healthcare for detransitioners (and may I add better mental health and social supports for desisters).
How can they continue to deny detransition care if they are going to claim it’s just a “natural” and “healthy” part of the gender journey? They can’t have it both ways.
“Yet in the trenches of trans health care, there is a growing idea that pushes back against the “one true gender for each individual” framing altogether—one that could allow us to resolve the bitterly divisive culture war over the psychological and medical care of transgender children. What if, instead of viewing gender as a fixed trait, we started to think of it as something that could evolve over the course of a lifetime? Or if detransitioning wasn’t considered a sign of failure and was instead regarded as a natural and healthy part of the gender development process?”
In her opening listing of the reasons Frank Smith gives for his medical transition, Lisa highlights his pornography addiction. Heretofore, in contrast to conservative critics, sexual liberal critics of legal and medical sex change have been generally avoiding any discussion of pornography as a causal factor. Why are these liberal critics protecting pornography? Also, it’s important to remember that children have access to the same pornography that adults do. Pornography like tobacco must be openly criticized as a social ill in terms of the consequences of its use. Thank you, Lisa, for this breakthrough.
Lisa, once again you shine a light on a woefully under covered aspect of these issues, with, as always, thorough research to guide your way, and therefore ours.
Relatedly, if folks haven’t seen this, Lisa has an excellent tweet thread in response to yet another lazy piece of reporting in the New York Times. As part of that, Lisa writes: “The Left has to stop blaming the Right for the gender culture war. Whether or not you like what they're doing with it, conservatives understand the science. They've listened to people who got hurt, to young women who lost to men they competed against. The Left didn't.” What we see in Lisa’s post are examples of that, in which not only does the R rep have the science right, but also is the one to come up with a compassionate approach, which the D side shoots down.
I’m interested, BTW, what Lisa or anyone here thinks about the MO AG’s Emergency Resolution on gender medicinal interventions. It appears to me he has got the science right, and may also, at least insofar as pediatric interventions are concerned, have a reasonable approach. Yet the New York Times, in a recent article, characterizes this as a “partial ban.” https://www.nytimes.com/2023/04/15/upshot/bans-transgender-teenagers.html Recently, when I tried to engage a friend in a discussion about this and started to describe the AG MO’s approach, she cut me short and said, “Josh Hawley. You sure are making strange bedfellows with this.”
Thanks, Susan, for pointing us to Lisa's tweets about the NYT piece. I've written (again) to the NYT to ask them to correct their mis-reporting of this as only right/left issue. The here-we-go-again feeling of this is kind of crazy making.
As Jamie Reed, the St. Louis whistle blower said in her recent Triggernometry interview, the language is cult-like. In "gender" clinics, "assigned female at birth" and "assigned male at birth" (AFAB and AMAB) are used instead of boy or girl, for pre-adolescents and adolescents. It is now believed in the field that, because Black females often go through puberty earlier than whites, they should get puberty blockers as early as age 9. Required is accurate, sex-based terms, such as cross-sex ideation, genital plastic surgeries, mastectomies, penile and testicle removal. The harsh realities of these treatments, completely unsupported by peer-reviewed or quality research, will surface. Dr. Ray Blanchard's "true life test" cited in my divorce papers by my former husband and his diagnosing psychologist, is not in any way reflecting an approximation of "true life." My ex was allowed to present to our sons as their father, did not explain why he dressed differently, and only told them after the surgeries. His journals recording this, which he took dutifully to his "therapy' with an uncertified practitioner, went on in gay bars in Greenwich Village, where he flirted with gay men. The entire diagnosis, as per expert witness testimony of Dr. Stephen B. Levine, is unstable and unpredictable. The Triggernometry interview with Jamie Reed is a must view for all of you here.
Would that it was just the coastal elites. The same thing is happening in Minnesota, which recently became a sanctuary state both for women seeking abortions and for those with gender dysphoria who want "gender affirming" care. Of course, the radical right's obsessive focus on this also doesn't help get us to a place where we can have real, civil, honest discussions about the issues related to this phenomenon.
I have been going back to KathyD’s excellent question, and how, as pediatric medical gender interventions are permitted and insured, it puts us in what I would call a doom loop, as I think Lisa is right, it then requires insurers to cover correction of bad outcomes experienced by detransitioners.
This brings me back to the concept of medical necessity, and I pose this question to all here for your thoughts. “Gender identity” is an idea, not a physical fact, condition, or disease. Under what circumstances is it medically necessary to medically “treat” a person for that idea, and what treatments should be considered medically necessary?
Another brilliant post. It does not matter how frequent detransitioning might be. The individual cases must be addressed and these people need care. The system is clearly biased against them. As a physician, I believe that our society is harmed by malpractice attorneys and juries but suing the physician and surgeon perpetrators of the kind of poor care documented in this post would be a wake-up call. Another reason not to live on the west coast.
Coastal Elite: everything you write here is absolutely horrifying. I have read some already to Josie, and will be bookmarking this information for future use, as I can. As you note, it’s an uphill climb to figure out how to deal with politicians right now. In bright blue Manhattan, NYC, similar to what you are facing (though our laws here, while bad and trending in the wrong direction, are not (yet) as terrible as Oregon’s), the outcome is foreordained, no matter how I vote (or don’t vote). I am trying to figure out how to make a meaningful, visible protest vote. That suffragette party option would sure be helpful here, or, absent that option on the ballot, mounting a write-in campaign.
Speaking of that suffragette party, I was thinking of you yesterday while watching the Let Women Speak event in Belfast, for, as you may know, KJK is forming a Party of Women, which, in typical KJK fashion, she intends to make go worldwide. I am glad to report that, thanks to the Belfast Police, the gathering was not disrupted. I was able to hear many of the speakers, including a high school girl who had written and recited from memory a poem she wrote for the occasion. Here she is, reciting: https://twitter.com/StandingforXX/status/1647587318683914241 and here is the text: https://twitter.com/veroniquella/status/1647679303147048963
A friend and I, he even older than I am, separately associated to this song: https://youtu.be/ZrVLL7soS1U proving once again he and I are both dinosaurs, even if not T-Rex.
Coastal, as I learn more, from you, about what happened and is happening in Oregon, I have to say, with apologies, that my timing was off. Right now, what is needed much more than a little light-hearted pick me up is a tourniquet to stanch the bleeding.
Yes, pulling up stakes is not an option for most, which makes this all the more terrifying.
I can add another reason why numbers for regret, detransition, and desistance are not accurately counted
My minor daughter is a desister. She was diagnosed by multiple psychiatrists with “gender dysphoria” and by one as a “transsexual.” These diagnoses were submitted to our insurance company. She was heavily encouraged to obtain hormones as soon as she could get away from us. If you read the Reuters article in which Reuters commissioned a review of private insurance records during a specified time frame to get the number of minors with a gender dysphoria diagnosis (which they reported in that article) my daughter’s diagnosis was in that number.
But now she does not identify as trans or have gender dysphoria. She said she doesn’t want that diagnosis on her insurance records. But there’s no ICD code for desistance or detransition. There’s no way to record or document that in her - or anyone else’s - records. Reuters can’t commission an insurance review and report those numbers.
Both she and I have informed individual medical professionals. How is it documented? For most, we don’t know because they refused to respond. She was no longer their patient, so it’s not their problem. One provider defended their diagnosis and refused to acknowledge the harm caused afterward. Another just changed her pronouns in their charts and went along like nothing happened.
So how is anyone going to collect and count data that isn’t coded or recorded anywhere even when it is reported
Actually, I am reminded, looking at this, that there are federal requirements on this, pursuant to HIPAA: https://www.hhs.gov/hipaa/for-individuals/medical-records/index.html
A couple pertinent provisions from the link:
Privacy Rule gives you, with few exceptions, the right to inspect, review, and receive a copy of your medical records and billing records that are held by health plans and health care providers covered by the Privacy Rule.
If you think the information in your medical or billing record is incorrect, you can request a change, or amendment, to your record. The health care provider or health plan must respond to your request. If it created the information, it must amend inaccurate or incomplete information.
If the provider or plan does not agree to your request, you have the right to submit a statement of disagreement that the provider or plan must add to your record.
Really good points, thank you for noting them. The importance of accurate--including accurately categorized--data collection is woefully undersung in all of this. And within that, inaccurate or missing information in medical records can do continuing harm. It’s been a long time since I looked at this, but at least in NYS, there is, or at least was, a regulatory procedure by which any patient can formally record a correction to the medical record (if that is desired).
I just sent this to my governor. thank you!!!!!
What a disturbing irony it is that "trans activists" seek to invalidate the "lived experience" of detransitioners in part by claiming "there aren't any/very many," given the solid data suggesting that trans people are about 0.6% of the population — and that they insist their own "lived experience" be adopted as gospel truth by everyone, in order for them to feel validated.
Question: if a child or young adult starts taking hormones that they obtain from a place like Planned Parenthood, then stops on their own, are they also considered Detransitioners? I’m sure PP and the like keep no record for people who get the prescriptions then just cease and never report back.
There are different definitions of detransitioners, for some it means not identifying as trans anymore, whether or not you take the drugs.
But yes, if you stop taking the drugs, that is something that should be tracked and correct, no one is keeping track.
That is, this huge body-modifying dangerous intervention is being made freely available and there is no record of the long term outcomes (8-10 years for surgical regrets on average/median in the past, and that was with a more careful vetting process).
It's criminal.
Thank you. I figured that there was no data on people like this but I wonder how high that number is.
To all: reading all the comments, and particularly Coastal Elite’s comments on Oregon, can we come up with a tick list of strategies of things we each can do from where we are? If folks add replies below, I will compile them into a list and find some way to feed them back to everyone in a comment. And of course, if this is been there/done that, I do get it, so just ignore this!
Here are some to start off (none new to folks here, and, of course, also, the first priority for those directly affected is to protect their families. So it’s to be recognized that each of these things, no matter how small, takes time and psychic energy, and the thought is only that a tick list may be helpful for those times when weighing is possible):
1) Whenever a bad gender-related piece of legislation comes up, write the appropriate representatives to weigh in. (The more people write to the same rep, the more s/he is likely to note it.)
2) if you decide not to vote for a politician you’ve supported in the past because of his/her stance on these issues, let him/her know why.
3) if any charitable organizations to which you give funds take a bad gender-related stance, give them one chance to correct, and if they do not, withdraw further contributions and advise why.
4) if any newspaper or magazine to which you subscribe takes a bad gender-related stance, write to the article author, cc to their editor, and try to educate.
Haha! As it happens, I only drink decaf. Otherwise, I am told on good authority, I am entirely too wired. How about we each write Lisa and let her know we’d like to share emails--she has mine, too, and I would be delighted for you to have it!
Watching this Rep. Goodwin respond to the inconvenient facts of how the system abused a young mentally-vulnerable man reminds me of the story about philosopher Cremonini, who clung to the perfection of his dogma so desperately he refused to even look through Galileo's telescope at any evidence that might disprove it.
Heather: Brilliant, and I a, saving this, as it is a perfect analogy applicable to so much of the discourse on these topics.
Why is the answer to everything a bill to make insurance companies pay? Where do insurance companies get their money? From people who pay for health insurance. So you’re basically asking your neighbor to pay for transitioning and then when it doesn’t work out, asking them to pay for de transition.
The answer should be to make the doctors who advised and performed the transition pay for de transitioning. They should be held responsible. Only then will they be more careful with their diagnosis and treatment of such a serious endeavor.
Right now, they have only incentives to transition. And take no responsibility when things don’t work out.
Well, this is a good question. My guess, though I don’t know, is that, once Medicaid and insurers began to cover so-called gender affirming care without proper guardrails, the train left the station and is rolling downhill with no brakes. Proper medical standards, including a stringent definition of medical necessity, committed enforcement, and severe penalties for malpractice, including criminal penalties, should have helped here, but that so far doesn’t seem to be in the offing, either, though pending lawsuits might help. In this context, as so often is the case, the patient who now wants to undo the transition is left with no remedy unless that care is covered, too. It’s pretty easy to see, in this context, why so many states are banning pediatric care.
It looks like the Affordable Care Act is the vehicle that regulates transgender care for all states.
Maybe some states have their own bills but the ACA governs insurance companies Medicare and Medicaid. You can file a complaint using the link in the attached document.
https://www.hhs.gov/civil-rights/for-individuals/section-1557/index.html
Thank you Lisa for this thoughtful article and assessment of the situation. Frank Smith was the inspiration for the bill we drafted and Representative Jeff Leach is carrying in Texas. As we worked with Frank over the last several years on a possible lawsuit and just getting to know each other, it became clear that insurance companies (and Medicaid) need to be in for the long haul. If the upfront treatment has been deemed "medically necessary" as documented in a Blue Cross Blue Shield policy, then the long term implications, whether detrainsitioned or not, must be covered. Thanks again for your persistence in following gender.
Thank you for writing this! There must be better medical and mental healthcare for detransitioners (and may I add better mental health and social supports for desisters).
How can they continue to deny detransition care if they are going to claim it’s just a “natural” and “healthy” part of the gender journey? They can’t have it both ways.
“Yet in the trenches of trans health care, there is a growing idea that pushes back against the “one true gender for each individual” framing altogether—one that could allow us to resolve the bitterly divisive culture war over the psychological and medical care of transgender children. What if, instead of viewing gender as a fixed trait, we started to think of it as something that could evolve over the course of a lifetime? Or if detransitioning wasn’t considered a sign of failure and was instead regarded as a natural and healthy part of the gender development process?”
https://thewalrus.ca/new-gender-paradigm/
In her opening listing of the reasons Frank Smith gives for his medical transition, Lisa highlights his pornography addiction. Heretofore, in contrast to conservative critics, sexual liberal critics of legal and medical sex change have been generally avoiding any discussion of pornography as a causal factor. Why are these liberal critics protecting pornography? Also, it’s important to remember that children have access to the same pornography that adults do. Pornography like tobacco must be openly criticized as a social ill in terms of the consequences of its use. Thank you, Lisa, for this breakthrough.
Lisa, once again you shine a light on a woefully under covered aspect of these issues, with, as always, thorough research to guide your way, and therefore ours.
Relatedly, if folks haven’t seen this, Lisa has an excellent tweet thread in response to yet another lazy piece of reporting in the New York Times. As part of that, Lisa writes: “The Left has to stop blaming the Right for the gender culture war. Whether or not you like what they're doing with it, conservatives understand the science. They've listened to people who got hurt, to young women who lost to men they competed against. The Left didn't.” What we see in Lisa’s post are examples of that, in which not only does the R rep have the science right, but also is the one to come up with a compassionate approach, which the D side shoots down.
I’m interested, BTW, what Lisa or anyone here thinks about the MO AG’s Emergency Resolution on gender medicinal interventions. It appears to me he has got the science right, and may also, at least insofar as pediatric interventions are concerned, have a reasonable approach. Yet the New York Times, in a recent article, characterizes this as a “partial ban.” https://www.nytimes.com/2023/04/15/upshot/bans-transgender-teenagers.html Recently, when I tried to engage a friend in a discussion about this and started to describe the AG MO’s approach, she cut me short and said, “Josh Hawley. You sure are making strange bedfellows with this.”
Thanks, Susan, for pointing us to Lisa's tweets about the NYT piece. I've written (again) to the NYT to ask them to correct their mis-reporting of this as only right/left issue. The here-we-go-again feeling of this is kind of crazy making.
Suzanne: I’m glad you reminded us about the option of writing to the Times. To whom did you write in this instance?
I write to letters@nytimes.com and include the authors' names in the subject line. In this case, For Adam Nagourney and Jeremy Peters.
Done, thanks.
As Jamie Reed, the St. Louis whistle blower said in her recent Triggernometry interview, the language is cult-like. In "gender" clinics, "assigned female at birth" and "assigned male at birth" (AFAB and AMAB) are used instead of boy or girl, for pre-adolescents and adolescents. It is now believed in the field that, because Black females often go through puberty earlier than whites, they should get puberty blockers as early as age 9. Required is accurate, sex-based terms, such as cross-sex ideation, genital plastic surgeries, mastectomies, penile and testicle removal. The harsh realities of these treatments, completely unsupported by peer-reviewed or quality research, will surface. Dr. Ray Blanchard's "true life test" cited in my divorce papers by my former husband and his diagnosing psychologist, is not in any way reflecting an approximation of "true life." My ex was allowed to present to our sons as their father, did not explain why he dressed differently, and only told them after the surgeries. His journals recording this, which he took dutifully to his "therapy' with an uncertified practitioner, went on in gay bars in Greenwich Village, where he flirted with gay men. The entire diagnosis, as per expert witness testimony of Dr. Stephen B. Levine, is unstable and unpredictable. The Triggernometry interview with Jamie Reed is a must view for all of you here.
This piece is powerful and focused on a critical issue. Thank you, Lisa!
Would that it was just the coastal elites. The same thing is happening in Minnesota, which recently became a sanctuary state both for women seeking abortions and for those with gender dysphoria who want "gender affirming" care. Of course, the radical right's obsessive focus on this also doesn't help get us to a place where we can have real, civil, honest discussions about the issues related to this phenomenon.
I have been going back to KathyD’s excellent question, and how, as pediatric medical gender interventions are permitted and insured, it puts us in what I would call a doom loop, as I think Lisa is right, it then requires insurers to cover correction of bad outcomes experienced by detransitioners.
This brings me back to the concept of medical necessity, and I pose this question to all here for your thoughts. “Gender identity” is an idea, not a physical fact, condition, or disease. Under what circumstances is it medically necessary to medically “treat” a person for that idea, and what treatments should be considered medically necessary?
Good read thx u