Hey! Where was my mandated, “ObamaCare” sex-change operation?

Genital reconstruction surgery (GRS). Sex reassignment surgery (SRS). Gender affirmation surgery (GAS). Vaginoplasty. Bilateral orchiectomy (orchi). These are all terms associated with genital surgeries on transsexual people.

Image: Autumn Sandeen, about 30-minutes after completion of her bilateral orchiectomy ('orchi'), performed by Dr. Tuan Nguyen at the Lake Oswego Plastic Surgery CenterFor those who don’t know, I’m a male-to-female transsexual.

The term transsexual is a term referring to a medical condition where the shape of one’s genitalia at birth doesn’t match the gender between one’s ears. (I also identify as transgender — a umbrella term for sociopolitical community that doesn’t conform to societal sex and gender norms — but that’s an essay for another day.)

Emoticon: Changing leafFor those who are new to Pam’s House Blend here at the new Firedoglake digs, in two recent essays (entitled What Genital Reconstruction Surgery, And When and “Ow,” But “Yay!”) I talked about having a bilateral orchiectomy. I had the “orchi” on August 17, 2011 as gender affirmation surgery (surgery that is done to affirm the gender between one’s ears that doesn’t match the shape of one’s genitalia at birth). The surgery marked a further change of seasons to Autumn for me, so to speak, to affirm my female gender identity.

Male-to-female trans women also can have vaginoplasties as gender affirmation surgery, and that surgery is that one that’s usually associated with the term sex reassignment surgery. Quite a number of transsexual women believe vaginoplasties are a requirement to fully transition from man to woman. I believe instead that I was female before my orchiectomy, female afterwards, and female still should I ever have a vaginoplasty. Genital surgery is used by many transsexuals to affirm gender, but it doesn’t create male or female gender in the first place.

By the way, there are genital reconstruction surgeries for female-to-male transsexuals too — those are Metoidioplasties, Centurions, and Phalloplasties.

But back to my “orchi”: On Tuesday, August 30th, I went to my primary care physician at the Veteran Administration (VA) San Diego Healthcare System for follow-up care relating to the surgery. Essentially, I have no infection in the area of surgery, and the area of surgery appears to be healing well.

[More below the fold.]


Thumbnail Link to Veterans Heathcare Administration (VHA) Directive 2011-024: Providing Health Care For Transgender And Intersex VeteransHaving follow-up care to surgeries related to transsexual people’s transitions is specifically allowed under the relatively new, Veterans Healthcare Administration (VHA) Directive 2011-24 (dated June 9, 2011), entitled Providing Health Care For Transgender And Intersex Veterans. From paragraph 4.b. of the directive, :

(1)Transgender patients and intersex individuals are provided all care included in VA’s medical benefits package, including, but not limited to: hormonal therapy, mental health care, preoperative evaluation, and medically necessary post-operative and long-term care following sex reassignment surgery to the extent that the appropriate health care professional determines that the care is needed to promote, preserve, or restore the health of the individual and is in accord with generally-accepted standards of medical practice:

(a) Patients will be addressed and referred to based on their self-identified gender. Room assignments and access to any facilities for which gender is normally a consideration (e.g., restrooms) will give preference to the self-identified gender, irrespective of appearance and/or surgical history, in a manner that respects the privacy needs of transgender and non-transgender patients alike. Where there are questions or concerns related to room assignments, an ethics consultation may be requested.

(b) The documented sex in the Computerized Patient Record System (CPRS) should be consistent with the patient’s self-identified gender. In order to modify administrative data (e.g., name and sex) in CPRS, patients must provide official documentation as per current VHA policies on Identity Authentication for Health Care Services and Data Quality Requirements for Identity Management and Master Patient Index Functions.

(c) Sex reassignment surgery, as defined in subparagraph 2b(4), will not be provided or funded.

(d) Non-surgical, supportive care for complications of sex-reassignment surgery will be provided.

So, I received post operative care on August 30th, consistent with the VA’s relatively new healthcare policy document.

And, of course, I didn’t receive a “tax-payer funded,” “mandated,” “sex change operation” that Matt Barber of the Liberty Counsel, Bryan Fischer of the American Family Association, and Peter LaBarbera of Americans For Truth About Homosexuality stated that the Healthcare Reform Act (or as these folk call it, “ObamaCare”) said was going to be provided to we trans people. In fact, according to Fischer and LaBarbera, it appears that I specifically was supposed to receive one of those tax-payer funded, mandated, ObamaCare sex-change operations.

Emoticon: Thinking, scratching chinSo, since it wasn’t tax-payers in accordance with an “ObamaCare” mandate paying for my bilateral orchiectomy, I’ll give you one guess who did end up paying for it out of pocket.

I probably won’t be discussing my bilateral orchiectomy much in the future unless 1.) there are complications that arise from that surgery, or 2.) unless I have a very specific reason to in the telling of a narrative. But, I did want to let those who’ve been following my essays on my orchiectomy that post surgery, everything physically specific to the orchiectomy is going well. And, if you were curious, I feel absolutely wonderful about having the surgery.

Emoticon: Female SmileySo when y’all refer to me, the correct pronoun is she — I didn’t have that gender affirmation surgery for nothing, y’know?