Pushed Face Down in the Snow
Accessing Medical Care When Trans & on Medicaid
I have VEDS. For most of my life now, the weight of my breasts has contributed to my shoulders subluxing. You can see from the image how the weight affects the attachments of the tendons and ligaments, twisting the scapula forward, forcing a hunched posture, the head to come forward, the shoulders to drop out of socket with relative ease, the ribs to twist into subluxion.
My neck is constantly tense, my back spasms from the constant strain of trying to hold my shoulders, neck, head, in place, to use my hands and arms against various pressures against them.
I finally, after over 20 years, got on a waiting list for top surgery. I had asked for various means of reduction over the years, but there was always a reason to say, “No.” I was too young. I’d want more kids. My spouse wouldn’t like it. I’d regret losing a 32G bust. A reduction wouldn’t work, it would all grow back, and I couldn’t get top surgery…
Since 2010 it was, “Yes, you need it, but Medicaid considers it ‘trans-affirming’. You can’t get on the wait list for plastic surgery.”
Last year Medicaid in my state changed that. Trans people could get care, as long as there was also a valid medical reason. I got on the wait list. I’ve been on it almost a year. I’ve asked three times about my status with the only plastic surgeon in Maine who takes Medicaid. The last time I asked, I was told, “cancer patients always are first.”
I got a bit snarky, but I had to know. I sent an email that said in part:
Do I understand this correctly?
Are cancer patients slotted in above anyone who is transgender, no matter the reason for needing surgery?
Is cisgender dysphoria rated as more painful than subluxations? Is waiting 2–8 weeks more worse than over 20 years (unless they get the front of the line every time, is that the case)?
I got a confusing reply. Again, this is about a plastic surgeon. All of her documentation highlights her reconstructive and top surgeries. She does not advertise ‘immediate reconstruction’ anywhere. She works two days a month for Medicaid in Maine.
I am sorry about the pain that you are in. I cannot stress enough to please see your Primary Care MD so they may help you with this.
Yes, cancer patients do and will always come first. Though breast cancer is not painful in the beginning stages, it is certainly deadly. There will be no way a cancer patient does not come first. It is a matter of life and death.
…
Again, I am very sorry to learn about the pain you are in, however that is extreme and you should be followed up with your PCP for this sooner rather than later.
They don’t consider that this is the last resort, the last treatment that I have come to. There are no pain meds that will be prescribed. My doctors know about and do not care about treating my pain. This is what they have done.
There you have it. Cis-gender dysphoria is apparently a life/death matter. Trans patients with extreme need and pain, in their own words, and no insurance but Medicaid, will be sent back to their doctors.
How many trans patients are getting necessary care with this policy in place, do you think?
