I’m curious about this as well. I’m not so sure that it’s elective, at least not in the same sense that something like breast augmentation or a face lift is, because of the specific reasons why transgendered people undergo these operations. Although I came down against paying for prisoners to undergo sex reassignment I don’t feel comfortable referring to it as an elective procedure. There’s a world of difference between a face lift and sex reassignment.
Marc
You need to read your policy, again. Anthem has exclusion clauses specifically disallowing any illness or injury.
By refering to anti-depressives as “happy pills” you come across as both insensitive and ignorant - are you aware of that?
In other words, condemn prisoners to death because they’re prisoners, regardless of length of sentence. The guy was sentenced to 14 years, not to death.
Fact is, an available heart can only be used by a very limited number of people on the waiting list. You shouldn’t assume that this heart could have gone to someone else, it is quite likely the prisoner was the only match for it and if he hadn’t received it, it would have not been used at all.
By going in after the battle’s over and bayonetting the wounded you come across as someone who didn’t read posts 74 and 75 - are you aware of that?
Transsexualism is neither an illness nor an injury, though it does get medical treatment. The policy included a paragraph specific to transgender, not “any illness,” that’s what I mentioned. Logically, I don’t see how a blanket statement covering “any X” can be read as specific. Rather, it’s general.
I read this, nodded, and moved on. Then it kept popping back into my head.
Maybe that’s why I’m having such difficulty with this topic. Medical treatment, to me, is for illness, injury or is elective. That’s just how I think about it. If you haven’t been injured, and you don’t need to be cured, then it must not be necessary. I was raised that medical attention including any form of medication, falls into one of those 3.
I need to ponder creating a new catagory, but I’m not coming up with a nice neat definition. How do I define “Needs correction, but isn’t broken to start with”?
I do appologize, Johanna, if I’m somewhat bitter.
Thanks. It’s OK.
Ain’t we all…
Speaking of antidepressants, I started one last month and it’s really helping. I didn’t even bother going through Anthem, the plan I have is nearly worthless at paying for anything but wellness checkups. It seems like medical insurance benefits in general have been eroding away to practically nothing and makes me wonder what my employer and I are paying for anyway. I’m lucky I have an alternative to insurance: I got my antidepressant prescription filled at low cost from the pharmacy at the Whitman-Walker Clinic, a privately-funded charitable institution for LGBT people. They’ve recently taken on the patients from the defunct Free Clinic in DC, so now they also care for low-income straights.
It’s a sort of birth defect, a category that already exists. But classification seems beside the point when a person is suffering too much to live, and a treatment exists that brings relief. Ethically, relieve the pain and get the person out of danger before anything else. Buddha said “As if a man had been wounded by a poisoned arrow and when attended to by a physician were to say, ‘I will not allow you to remove this arrow until I have learned the caste, the age, the occupation, the birthplace, and the motivation of the person who wounded me.’”
This debate has made it clear that the larger paradox is how prisoners get medical treatment for anything while law-abiding but uninsured citizens on the outside can’t afford anything. The real debate ought to keep the focus on why doesn’t the system provide medical care to those who need it outside prison. I’m not arguing for special rights for prisoners, but equal rights for all.
My only concern as a trans person here was the equating of gender dysphoria treatment with elective procedures like a nose job, which is a distortion. Whether or not SRS is imperative for the relatively few severe cases where it’s medically indicated has neither been established nor ruled out given the lack of research, now why sufficient research hasn’t been done is another question.
There was a news story last year, in Wisconsin I think, a transsexual prisoner in a county jail was requesting HRT during incarceration. Many of the comments on that from citizens at the local news web site were extremely hateful toward all trans people in general, even saying we should all be put to death. I don’t understand–why all this hatred just because we exist?
I await your demonstration that SRS brings relief and gets the person out of danger.
Regards,
Shodan
I agree.
And it makes me wonder, theoretically, if a person with a cleft palate or club foot had, for some reason, gone untreated before making it into prison, would the state pay for surgery to correct it?
It would frankly be decided on a case by case basis, weighing the risks and benefits of treatment vs. non-treatment. Always with the underlying idea of doing the medically necessary things at the appropriate time.
So, if the guy’s in for a year or three, and got by with his club foot for his whole life, tho it might be desireable to fix it at some point to save wear and tear on the hip, it may not get done while he’s locked up. Unless the hip issue is truly becoming critical.
Ditto for the cleft palate guy. If he’s coping, we might get dental make him a mouthpiece to wear. If that’s been tried, and he’s got chronic aspiration and bad sinuses, we may have to do more.
If they’re longtimers or lifers, and we know they’ll need the fix eventually but not urgently, it’ll get scheduled when it’s convenient for the system all around.
OK, so the same as I think treatment of transsexuals should go: on a case by case basis, doing the least expensive medically necessary treatment when it’s appropriate. I just wanted to be sure I was being internally consistent. Thank you for taking the time to answer fully.
Insensitivity has already been pointed out and apologized for.
Ignorant, however, is an incorrect perception. Cons WILL DO ANYTHING to get meds in a prison. Anti-depressants make prison MUCH more tolerable, and less like a prison. Separating out the truly clinically depressed from the drug seekers is very difficult. It is even harder for the psychiatrists in the prison to deny given that the warden is often happy to have a large percentage of the population stoned to some degree. I was using the vernacular that is bandied about in my home when my mental-health professional friends are visiting, some of them who have worked with or in the prisons.
As for our heart patient, according to this:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1172112
I think they could have found someone NOT in prison to give that heart to, who needed it just as much. Prisoners should be dropped to the bottom of the waiting list. If there are not enough hearts, then deal with that. With a limited supply, however, I have no problem giving the limited resource of organ donations to someone who is NOT doing 14 years in prison.
Most of my patients (inmates all) are clamoring for either opiates or benzodiazepines. Occasionally I find a few with a yen for thorazine, or butalbital, or cyclobenzaprine. A few are abusing clonidine or dextromethorphan. Ritalin is a favorite, as is dextroamphetamine.
Very few seem to want anti-depressants in quite the same way as they want the above. Not even close.
The modern anti-depressants are pretty far removed from happy pills. If one has a clinical depression, they may help abate it. If one isn’t depressed, they don’t tend to do very much in the way of making most folks feel better.
Convicts gets lots of care that law abiding poor people cannot have. Maybe rather than deny care to convicts, we could consider that the real injustice is to the poor people, and work to provide universal health care.
Heath care is not a zero sum game. It is not wrong that a convict should get gender reassignment surgery. It is wrong that **Johanna **cannot (for example, and I hope you don’t mind me using your name, Johanna). The fact that law abiding transpeople cannot get the surgery they need, along with many other people who are unable to get the medically necessary treatment they need for all kinds of other ailments is a very real problem, and this whole story is just a distraction from that. Denying care to convicts who need it does nothing to solve this problem.
Well, the prison doesn’t officially “do” tattoos, either, but plenty of people get them there. Same for lasik; you just need to ask around the exercise yard until you find the right guy. I imagine fellow in the OP could do the same for his GRS.
OK, one more time.
Organ transplants depend on tissue compatibility. That is a biological trait of the immune system. If the donor and and recipient have compatible immune systems a transplant can take place. If donor and recipient are incompatible attempting a transplant will rapidly result in death of the recipient.
There are occassions where an organ is available and no one on the waiting list is a match. So the organ isn’t used.
It’s not a matter of simply reassigning the organ to someone more “deserving” (however you define it).
I’ve read Johanna’s posts numerous times, and I keep coming back to this: When law-abiding, poverty-stricken citizens of the United States get decent health care for free, when honest but poor people get adequate psychological and psychiatric care, good life-coping counseling and free eyeglasses so they can see; when all high school graduates can actually read, write, compute, and reason at a high school level; when all of those problems are solved, then we can talk about public funding for “gender realignment surgery.” Until then – nope, it is just not even on the priority scale.
How does treating transexuals not fall under one of the first two items on your list?
Also, why the scare quotes around gender realignment surgery?
Maybe I could if I were Cuban, amiga. Cuba is planning to provide SRS for anyone who needs it, 100% paid by the government (like all other health care there).
Hey, maybe I could get on a leaky boat, escape from Miami to Havana, and claim political asylum. Practicing my Spanish already: ¡Tratamiento médico gratis sí! ¡Seguros particulares no! ¡Viva Fidel!
(solo bromeanda)