Freedom from Gender Affirmation Timelines

Freedom from Gender Affirmation Timelines

Author: Ewan Wolff, PhD, DVM, DACVIM
Review: Mia Cary, DVM

From the GIBOR

“The veterinary profession should accept and support the right of transgender, non binary, and gender non-conforming individuals to pursue or not pursue gender affirming medical and/or surgical treatment on their own timeline without interference from an employer, administrator, company, section head, or individual other than the transgender, non-binary, and/or gender non-conforming individual. Transition can look different for everyone, and the outward perception of such is not a starting or stopping point for resources and access to safe spaces.”

Importance

Gender affirmation as a process is highly individual as discussed earlier, and may be finite or a lifelong process. Gender affirming care, from a medical therapy standpoint is frequently lifelong and requires ongoing access to hormone replacement therapy. For individuals seeking surgical therapy, multiple procedures may be involved. Other affirming care may not be surgical but includes treatment like hair removal, speech therapy and other more cosmetic therapy that provides increased safety and wellbeing for many (see references below for tables concerning gender affirming care/transition milestones). Significant progress in gender affirmation care often takes years. Because gender affirming care frequently involves a second puberty and years of physical adjustment it does not and cannot fit a standardized framework.

Legal Precedence

Due to the current shifting landscape, please stay abreast of the latest information by engaging with organizations such as Transgender Law Center and independent journalists such as Erin Reed.

Impacts of Harm

Any limitation on transition is essentially rushing people’s process in their own personal development including decision making. Additionally this is actively preventing people from receiving care as wait lists can delay an initial appointment for medical therapy, surgical therapy, or other care by months to years – especially with the winnowing of specialists by state climates. Lastly, any compression of the time frame for transition limits the number of ways in which an individual can be helped during a coverage time period.

Individual Action

If you are directly impacted by the attempt to impose a timeline on your transition then you should reach out to your insurance provider regarding whether this is the actual policy. If this is an actual policy with your insurance provider then consider reaching out to your local Pride Center or state equality/LGBTQ+ organization for further guidance. 

If you are an ally and know someone who is affected, then with their permission you can question and intervene on their behalf. You can discuss this with your Human Resources department although they will be precluded from sharing any information with you. And importantly, you can express support for your colleague.

Implementation

Implementation of this freedom should be centered around education of Human Resources officers regarding what transition entails. Additionally, the negotiation of benefits should be done by those who are well informed about the needs of the gender diverse community.

Consequences of Violation

Consequences of violation of this freedom vary legally by jurisdiction. A timeline is an artificially created limitation on gender affirming care that is not based on fact. This differs from coverage limits that are related to insurance levels.

References

Deutsch, M. 2020. Information on Testosterone Hormone Therapy. UCSF. https://transcare.ucsf.edu/article/information-testosterone-hormone-therapy

Deutsch, M. 2020. Information on Estrogen Hormone Therapy. UCSF. https://transcare.ucsf.edu/article/information-estrogen-hormone-therapy

Ferguson, Sian 2023- What’s the Timeline for Trans Women and Transfeminine People Medically Transitioning? Healthline. https://www.healthline.com/health/mtf-transition-timeline

Kassel, Gabrielle, 2023. Testosterone Therapy for Transgender Men and Gender Diverse People. Healthline. https://www.healthline.com/health/testosterone-for-transgender#safety

Resources

1. HRC Gender Affirming Care: https://www.hrc.org/resources/get-the-facts-on-gender-affirming-care
2. How to Support Transitioning Employees – Indeed.com: https://www.indeed.com/lead/five-ways-to-support-transgender-employees-who-are-transitioning
3. Oregon State University has a great sheet for an example of how to get people directly to resources: https://hr.oregonstate.edu/sites/hr.oregonstate.edu/files/insurance_navigation_information_for_transgender_employees.pdf
4. Harvard Public Health Article on Gender Affirming Care: https://hr.oregonstate.edu/sites/hr.oregonstate.edu/files/insurance_navigation_information_for_transgender_employees.pdf