# Frisco Foots Bill for Gov't Employee Transgender Ops--Thoughts? **URL:** \ **Category:** Great Debates\ **Created:** [May 2, 2001, 11:52pm UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149 "2001-05-02T23:52:38Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Pariah](https://avatars.discourse-cdn.com/v4/letter/p/41988e/32.png) [@Pariah](https://boards.straightdope.com/u/Pariah)\ **Post date:** [May 2, 2001, 11:52pm UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/1 "2001-05-02T23:52:38Z")
[Click Here For Article](http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2001/05/01/MN188596.DTL) I wanted to put this out on the ol’ floor and ask some questions. I understand gender reassignment is not simply a spur-of-the-moment process, and has deep psychological ramifications as well as roots. I also understand that the desire for gender reassignment surgery is far deeper, shall we say, than the homo/erotic satisfaction received by many representatives of TV/TS community. **In your opinion, what is the most productive means of presenting/justifying this decision to those who really have _no experience whatsoever_ with understanding the transgender ‘problem’ (and I say problem in that one needs ‘corrective’ surgery to remedy it) when they learn that the City of San Francisco is using taxpayer’s money to justify a $37,000 to $77,000 expenditure on the basis of a _seemingly_ rare psycho-sexual disorder?** (We can assume that most of the folks in S.F. understand the situation—they’d have to have some serious tunnel vision if they bore no knowledge that there was indeed a sizeable gay community around them, and not a few cross-dressers in the city limits.) S.F. is a benchmark city in this case, but it has no doubt opened the door for other cities to follow suit—Seattle comes to mind—and I am curious as to people’s thoughts on the ramifications of using taxpayer money for something very few people understand as being a ‘valid’ physical malady. I look forward to hearing your thoughts. ---
**Author:** ![Pariah](https://avatars.discourse-cdn.com/v4/letter/p/41988e/32.png) [@Pariah](https://boards.straightdope.com/u/Pariah)\ **Post date:** [May 2, 2001, 11:59pm UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/2 "2001-05-02T23:59:01Z")
Just to clarify: > [@](#): > > Premiums will increase up to $1.70 per active and retired employee to pay for the sex change coverage. However, because of prior labor agreements, the city helps pays those premiums – that will add an estimated $683,000 to the city’s labor costs. I am aware that the primary burden is **not** ‘taxpayer’ oriented, but those who participate in the City’s health program–but there is an overflow expenditure here, and that’s what people who do not understand the veracity of the scenario will most likely address. P. ---
**Author:** ![dixiechiq](https://avatars.discourse-cdn.com/v4/letter/d/57b2e6/32.png) [@dixiechiq](https://boards.straightdope.com/u/dixiechiq)\ **Post date:** [May 3, 2001, 12:20am UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/3 "2001-05-03T00:20:31Z")
though i disagree with it being a disorder, sex reassignment surgery is the official cure indicated by the apa for gender identity disorder. is there any good reason why a medically diagnosed disorder should not be cured and paid for by insurance?? ---
**Author:** ![Snooooopy](https://avatars.discourse-cdn.com/v4/letter/s/ee7513/32.png) [@Snooooopy](https://boards.straightdope.com/u/Snooooopy)\ **Post date:** [May 3, 2001, 12:43am UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/4 "2001-05-03T00:43:55Z")
This is just a fantastic development, because I’m a lesbian trapped in a man’s body. ---
**Author:** ![Sterra](https://avatars.discourse-cdn.com/v4/letter/s/8c91f0/32.png) [@Sterra](https://boards.straightdope.com/u/Sterra)\ **Post date:** [May 3, 2001, 12:45am UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/5 "2001-05-03T00:45:55Z")
Actually it says in the article that the expenditures cap at 50,000. And about it being seemingly rare, I don’t see why it would matter. The issue would not be an issue if it was rare. ---
**Author:** ![SuaSponte](https://avatars.discourse-cdn.com/v4/letter/s/67e7ee/32.png) [@SuaSponte](https://boards.straightdope.com/u/SuaSponte)\ **Post date:** [May 3, 2001, 1:04am UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/6 "2001-05-03T01:04:45Z")
> [@](#): > > \*Originally posted by dixiechiq \* > \*\*is there any good reason why a medically diagnosed disorder should not be cured and paid for by insurance?? \*\* Sure, lots of them. 1. Many, many medically diagnosed disorders are not covered by insurance. One example - dental problems, moles, dwarfism, LASIK for myopia, etc. 2. Insurance is not an infinite pot - every treatment paid for means that there is less money to pay for other treatments. 3. As a general rule, insurance shouldn’t pay for elective surgery, especially if such payments result in higher costs and/or the reduction in other coverage. 4. In the case of city-paid insurance, somewhere down the line, the city is going to have to make up that $683,000. It may be in smaller pay raises, a few less parks, one or two less fire engines, etc. Sua ---
**Author:** ![Pariah](https://avatars.discourse-cdn.com/v4/letter/p/41988e/32.png) [@Pariah](https://boards.straightdope.com/u/Pariah)\ **Post date:** [May 3, 2001, 1:15am UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/7 "2001-05-03T01:15:34Z")
**dixiechiq** said: > [@](#): > > is there any good reason why a medically diagnosed disorder should not be cured and paid for by insurance?? I’m not in argument with you, **dixiechiq**. There’s no good reason why insurance should not subsidize treatment for medical disorders. My question is not ‘Is this right?’ but ‘How shall it be justified/presented to those who do NOT understand it?’ Cancer, easy to justify. Open heart surgery, ditto. Severed limb, quite the norm. Mr. Jorgenson wants his sexual organ replaced with a reasonable facsimile of the organs belonging to the opposite sex–perhaps more difficult to explain to the single worker with 3 kids who suddenly has to pay more for insurance. See what I mean? I am not posing an argument “for/against”–I am wondering as to people’s opinions on how best to explain it to the _layman_–because San Francisco will only be the beginning. This will most likely set the course for other cities, reaching areas which do not boast such an overwhelmingly ‘liberal’ community, and affect their pocketbooks as well. They will require justification as to why they need to pay more out of their pocket because ‘some chick wants to be a dude,’–and there will be not a few who might use more colorful colloquialisms than I have. **Asmodean** > [@](#): > > Actually it says in the article that the expenditures cap at 50,000. The expenditures cap at 50,000, yes–per incident. This has no bearing on the City employees who will still pay more for their premiums regardless of their involvement or not. But that is really here nor there in my OP question. > [@](#): > > And about it being seemingly rare, I don’t see why it would matter. The issue would not be an issue if it was rare. I submit that it isn’t rare to _you_, because you are directly involved with the scenario–as are many of the citizens of San Francisco, which is a self-proclaimed mecca for freedom in sexual orientation. SeaTac, Washington, however, may not be so intimately aware of the facts as you are–but they’re less than 20 minutes from Seattle, which also boasts a large gay/lesbian community. The predominant method of transportation there are pickup trucks and '70s Camaros. See where I’m going? Where is the proper median for broaching this ‘progression’ without coming to loggerheads? Thanks for your thoughts! ---
**Author:** ![dixiechiq](https://avatars.discourse-cdn.com/v4/letter/d/57b2e6/32.png) [@dixiechiq](https://boards.straightdope.com/u/dixiechiq)\ **Post date:** [May 3, 2001, 2:35am UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/8 "2001-05-03T02:35:33Z")
\*Originally posted by SuaSponte \* \*\* > [@](#): > > 1. As a general rule, insurance shouldn’t pay for elective surgery, especially if such payments result in higher costs and/or the reduction in other coverage. > \*\* the number one medical procedure is elective, and guess what?? it is generally covered by insurance. childbirth. that said, i’m not particularly for or against insurance covering srs. but as the system exists, i tend to be for it. how can it be justified to those who do not understand it?? only one way i can think of, education. education about the issues that tg’s face in everyday life. ---
**Author:** ![Milossarian](https://avatars.discourse-cdn.com/v4/letter/m/3ec8ea/32.png) [@Milossarian](https://boards.straightdope.com/u/Milossarian)\ **Post date:** [May 3, 2001, 2:40am UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/9 "2001-05-03T02:40:52Z")
I have the same questions about it in a general sense as Sua has outlined. However, I do see this as local democracy in action. If people feel strongly opposed to the city council’s actions, they can vote them off the board. Or, if enough of them complain about this decision, it’s very likely to be changed. I don’t, uh, think it’s going to start a national trend. ---
**Author:** ![ITR\_champion](https://avatars.discourse-cdn.com/v4/letter/i/c67d28/32.png) [@ITR\_champion](https://boards.straightdope.com/u/ITR_champion)\ **Post date:** [May 3, 2001, 5:39am UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/10 "2001-05-03T05:39:09Z")
The article mentions that the insurance plan will now cover Viagra as well. I think that pretty much explains it. I mean, if you’ll pay for a 60-year-old guy to get horny, how can you not pay for somebody to get the sexual identity that they feel they should have? ---
**Author:** ![Badtz\_Maru](https://avatars.discourse-cdn.com/v4/letter/b/e36b37/32.png) [@Badtz\_Maru](https://boards.straightdope.com/u/Badtz_Maru)\ **Post date:** [May 3, 2001, 6:41am UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/11 "2001-05-03T06:41:12Z")
Shit, and my insurance doesn’t even cover birth control or certain weight loss drugs. ---
**Author:** ![SuaSponte](https://avatars.discourse-cdn.com/v4/letter/s/67e7ee/32.png) [@SuaSponte](https://boards.straightdope.com/u/SuaSponte)\ **Post date:** [May 3, 2001, 12:19pm UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/12 "2001-05-03T12:19:20Z")
> [@](#): > > \*Originally posted by dixiechiq \* > \*\*\*Originally posted by SuaSponte \* > \*\* > > > [@](#): > > > > 1. As a general rule, insurance shouldn’t pay for elective surgery, especially if such payments result in higher costs and/or the reduction in other coverage. > > \*\* > > the number one medical procedure is elective, and guess what?? it is generally covered by insurance. > > childbirth. 'Taint elective at all. Under _Roe_, the state has an interest in the health and well-being of a third-trimester fetus. As either the mother or the fetus could be at risk, childbirth is not “elective”. BTW, come up with a citation that childbirth is the most commonly performed medical procedure. I would think an eye exam or dental exam is more common, as close to 100% of the population gets them and on an annual or semi-annual basis at that, as compared to childbirth, which occurs in less than half the population approximately 2 times in a lifetime. And, of course, dental and optical exams are usually not covered by insurance. Try again, and try not to be so trite next time. Sua ---
**Author:** ![lee](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lee/32/7455_2.png) [@lee](https://boards.straightdope.com/u/lee)\ **Post date:** [May 3, 2001, 1:52pm UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/13 "2001-05-03T13:52:18Z")
The suicide rate of Transsexuals who are denied access to reassignment is about 25%. The chance for a positive outcome of Male to Female TS that undergo SRS is 90%-98%. I see no difference in insurance paying for basic reassignment and insurance paying for treatment for depression. Afterall, one reason depression is treated is the potential for fatality due to suicide. If it were not for a major reseach scientist that lied about his findings, this would probably be covered by most insurance today. I think it is sad that insurance companies stand by a discredited study in order to defend their choice not to fund SRS. That said, there are much more costs to transition than just surgery. If a transexual is ready to undergo surgery in the United states at least, you can bet that they have spent a lot of their own dollars getting ready. This is not elective surger done on a whim. Why shouldn’t insurance help to pay for it? ---
**Author:** ![lee](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lee/32/7455_2.png) [@lee](https://boards.straightdope.com/u/lee)\ **Post date:** [May 3, 2001, 1:54pm UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/14 "2001-05-03T13:54:03Z")
> [@](#): > > \*Originally posted by Milossarian \* > \*\*I have the same questions about it in a general sense as Sua has outlined. > > However, I do see this as local democracy in action. If people feel strongly opposed to the city council’s actions, they can vote them off the board. Or, if enough of them complain about this decision, it’s very likely to be changed. > > I don’t, uh, think it’s going to start a national trend. \*\* I hope so. I really hope so. ---
**Author:** ![lee](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lee/32/7455_2.png) [@lee](https://boards.straightdope.com/u/lee)\ **Post date:** [May 3, 2001, 1:56pm UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/15 "2001-05-03T13:56:10Z")
I meant to say I hope it does start a national trend. There is every evidence that it could. SF pioneered domestic partner benefits, now they are not uncommon. They were unheard of at the time. If a deputy in Texas can transition from male to female on the job, then there is hope. ---
**Author:** ![Pariah](https://avatars.discourse-cdn.com/v4/letter/p/41988e/32.png) [@Pariah](https://boards.straightdope.com/u/Pariah)\ **Post date:** [May 3, 2001, 4:35pm UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/16 "2001-05-03T16:35:48Z")
**lee** said: > [@](#): > > If it were not for a major reseach scientist that lied about his findings, this would probably be covered by most insurance today. Could you clarify this statement? Also, could you provide a cite supporting the “25% suicide” figure? I hadn’t seen that figure before… **Milo** said: > [@](#): > > I don’t, uh, think it’s going to start a national trend. Heh, maybe not a _fad_–but the door has now been opened. Just as Vermont set a precedent which other states at least have a point of reference to, so has San Francisco. I’ll warrant that this establishment will be referred to quite often in the near future. **dixiechiq** said: > [@](#): > > how can it be justified to those who do not understand it?? only one way i can think of, education. education about the issues that tg’s face in everyday life Makes sense. But how? Should we expect to see TG commercials in the same vein as Viagra commercials? Viagra is an ongoing remedy for _physical_ erectile dysfunction, _possibly_ stemming from psychological basis in isolated situations. But ‘gender disorder,’ save for hermaphroditic situations (in which the child is born with two sets of genitalia) is psychological in nature–with no apparent physical ailment other than the effects of whatever psychological trauma the ‘victim’ suffers–depression, anxiety, self-deprecation, etc. There is no _apparent_ ‘danger’ or ‘ill effect’ of remaining male or female other than mental duress. Not to say mental duress is insufficient as a valid malady. The medical profession has conjured up medications to treat the most obscure of ailments–and if they don’t understand it, they have many drugs they can throw at it anyway. Why, it could be argued, is this expensive surgery _necessary_ when, by the standards of many other mental disorders it would seem gender dysfunction is _psychologically_ treatable? In short, has the City Council utilized their ‘authority’ prudently in sanctioning taxpayer and ‘unaffected’ employee monies to facilitate this, or is this a ‘championed cause’ borne of collective (the majority of the City Council)agenda? (Again, please keep in mind I am not offering a _moral_ argument here, as to whether the whole proceeding is ‘right’ or ‘wrong’) ---
**Author:** ![Sterra](https://avatars.discourse-cdn.com/v4/letter/s/8c91f0/32.png) [@Sterra](https://boards.straightdope.com/u/Sterra)\ **Post date:** [May 3, 2001, 4:48pm UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/17 "2001-05-03T16:48:40Z")
> [@](#): > > by the standards of many other mental disorders it would seem gender dysfunction is psychologically treatable? I guess thats why its not really a mental disorder. Most of the duress is caused by other people. Its a disorder the same way being gay was 30 years ago. It is really a physical disorder. One that is entirely in the mind but none the less a physical disorder. ---
**Author:** ![11811](https://avatars.discourse-cdn.com/v4/letter/1/9d8465/32.png) [@11811](https://boards.straightdope.com/u/11811)\ **Post date:** [May 3, 2001, 5:32pm UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/18 "2001-05-03T17:32:47Z")
Right to the bottom of the thread and post, without looking at the whole argument: I understood (or thought I did) that most transsexuals end up no less unhappy about themselves and their lives than before surgery. IF that is the case, it would be foolish to subsidize the surgery. ---
**Author:** ![Grim\_Beaker](https://avatars.discourse-cdn.com/v4/letter/g/46a35a/32.png) [@Grim\_Beaker](https://boards.straightdope.com/u/Grim_Beaker)\ **Post date:** [May 3, 2001, 6:55pm UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/19 "2001-05-03T18:55:16Z")
I’m not convinced that we should be spending tax dollars on SRS. I’d like the people who are in favor of SRS being paid for by the government to address the following: Let’s say we have a hypothetical man named Joe. Joe has a very high pitched feminine sounding voice. Because of this he has been ridiculed and tormented his entire life by insensitive peers of his and he has found his voice an impediment in his attempts to get a date. Joe attributes his ongoing battle with depression to the characteristics of his voice. Assuming there was an operation which could change the tone/pitch of his voice to be deeper and more masculine, would you support tax payer dollars being spent to subsidize Joe’s vocal chord surgery? Grim ---
**Author:** ![Sterra](https://avatars.discourse-cdn.com/v4/letter/s/8c91f0/32.png) [@Sterra](https://boards.straightdope.com/u/Sterra)\ **Post date:** [May 3, 2001, 9:07pm UTC](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149/20 "2001-05-03T21:07:27Z")
Chrome, that study was probably discredited a while ago. I think it was what lee was talking about earlier. Grim beaker, actually really the issue is almost nothing like that. Transgendered people do not change their sex because of other people or depression. Some people did, but they then realise that they cannot live as the opposite sex and eventually try to reverse the surgery. Which is why there is a 1 year minimum of living as a woman before SRS. Thats what I meant about it not being a mental disorder:) [Next page](https://boards.straightdope.com/t/frisco-foots-bill-for-govt-employee-transgender-ops-thoughts/64149.md?page=2)