Just over a month ago, in August 2022, a statewide interdisciplinary group of mental health professionals with expertise in gender-affirming care sent out a press release addressing their challenges at the Department of Social Services. Husky recently updated gender-affirming healthcare policies. .
So we were surprised and dismayed to see some of the September 8 content reported by the Connecticut Health Investigation Team or C-HIT.org in the Mirror article, “Access, Assurance still barriers to gender-affirming surgery in CT. ”
While the article explores some of the barriers to gender-affirming care in Connecticut, it does readers a disservice by omitting the very concerns this group of providers raised in an August 17 press release that detailed additional barriers. issued by the DSS for Husky customers. see gender-affirming care, namely the requirements of letters from mental health providers to support the request for care.
Our concerns begin with the professionals cited in the article. The quotes are all from white cisgender experts on trans care; the reporter did not consult with well-known transgender providers of gender-affirming care in that state.
Our group of clinicians are concerned about training to be seen as experts, as few providers have participated in Fenway’s Trans Echo (National Center for LGBTQIA+ Health Education) or sought external training in transgender care. The quoted professionals had occasion to encourage the reporter to seek input from gender-affirming trans health-care providers about these policies, and did not. As a group of gender-affirming LGBTQIA+ healthcare providers, who recently aired a pointed critique of DSS/Husky policies to all Connecticut media, none of us have been contacted.
Further, the article supports the actions of the DSS without mentioning their recent increase in access control through policy change, creating barriers for people on Medicaid seeking gender-affirming care. Further, there is no mention of the insurmountable barrier for Medicaid clients who do not have thousands of dollars to pay out of pocket for care and are not allowed to pay out of pocket for care that Connecticut providers do not provide or who do not. accept Husky payment.
As our group has met over the past few days to review and discuss this article, we have also taken issue with the article’s neglect of the issue of bodily autonomy. According to Dr. AJ Eckert, Medical Director of Anchor Health’s Gender and Life-Affirming Medicine Program, “The story…deepens the narrative of a model of mental health care as a standard of care. for trans people – a model of care that has been severely harmful and outdated for many years.In fact, a psychologist quoted in your article, Laura Saunders, mentioned the mental health letters, but dismissed their controlling nature because “they provide advice in an area that can sometimes be very murky”.
Bodily autonomy is not a nebulous subject. The desire for bodily autonomy is not a mental health pathology. People should not be required to go to therapy, let alone contact a second psychiatric service provider, to verify who they are. Affirmation of identity is an internal process. Letters are invasive, expensive, time-consuming and totally unnecessary. The only “approval” needed should be based on the person’s informed consent and basic medical capacity to undergo the desired procedure, exactly the same process as a patient being screened for any other type of surgery.
The article states, “Medicare, Husky, and many insurance companies follow widely accepted World Professional Association for Transgender Health (WPATH) guidelines,” but the DSS in Connecticut has rules in place that are not supported or supported by the best recommendations or guidelines.
There is growing evidence that gender-affirming surgery alleviates mental health issues. It is the added barriers to surgery that exacerbate mental health issues. To tell the full story of healthcare access for transgender and non-binary people, the Mirror needs to expose the issues we’ve detailed.
Allyson D. Platt, LPC/LMHC on behalf of: Alexandra Solomon, LCSW; Molly Conley, Doctor of Psychology; Lauren Millerd, LCSW; Kayti Protos, DSW, LCSW; Laura S. Dodge, LCSW; Rebecca Toner, CLPC; and Sarah A. Gilbert, LCSW.