Season 01 Ep 14: Medical Insurance–Opening Doors for Medical Intervention

Every step along the medical journey requires some level of interaction with an insurance company.

Prior to the Affordable Care Act, most, if not all, insurance companies did not cover any gender affirming care. They saw it purely as elective and not a medical necessity, but as you are experiencing firsthand, times they are a-changin’!

And with that, so has what is and is not covered under insurance benefits.

Some of the most comprehensive coverage plans I've seen will cover everything a person might need in order to feel affirmed: blockers, hormones, surgeries, voice therapy, the list goes on. Whereas other plans cover far less and/or have more hoops that they want people to jump through in order to approve an intervention.

That's why I've asked Rachel back to the podcast. Rachel is the mama bear of Archie, who is 16. We first heard from Rachel in Episode 7. Rachel is one of the fiercest parent advocates I've met doing this work. When her kid needs something, you better believe she's not going to rest until they get it.

For our conversation today, we're talking about insurance, top surgery and her experience in navigating both of those things at the same time and still managing to stay sane.

It's my hope that Rachel's story will provide you with the awareness and common humanity that it isn't just your kid. It isn't just you that has to wrestle with the bureaucracy to get what you and your family need.

Pushing back is a headache, but the payoff of seeing your child thrive, if medical intervention is something that they need, will be well worth it.

Find this episode for free on your favorite podcast player.

Check out the full episode to hear about:

  • Why shifting her mindset from being the container for her son’s transition to being the channel for it has made it easier for Rachel to advocate for medical support

  • Why Rachel advocated for top surgery as a mental health and social wellbeing issue when it came to getting insurance authorization

  • How working with experienced professionals writing letters in support of services can alleviate some of the insurance hurdles

  • Asking for help and seeking out resources to navigate insurance from your company and your community

Resources:

Find out more about Mackenzie Dunham:

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Season 01 Ep 15: Therapy and Assessment for Trans Youth - Forging a Supportive Path Forward with Laura Edwards-Leeper, Ph.D

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Season 01 Ep 13: Overcoming the Emotional Hurdles of Medical Intervention