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San Francisco is known to be a progressive idea lab, especially when it comes to LGBT issues. However, San Francisco now is in a position to breed another great idea, that is, covering sexual reassignment surgery for uninsured residents.

From CBS News:

San Francisco is preparing to become the first U.S. city to provide and cover the cost of sex reassignment surgeries for uninsured transgender residents.

The city’s Health Commission voted Tuesday to create a comprehensive program for treating transgender people experiencing mental distress because of the mismatch between their bodies and their gender identities. The vote was announced Thursday.

The idea came out of conversations between public health officials and transgender rights advocates who wanted mastectomies, genital reconstructions and other surgeries covered under San Francisco’s universal health care program.

Public Health Director Barbara Garcia says the new transgender health initiative probably won’t be running until late next year.

Her department needs to study how many people it would serve, how much it would cost and who would perform the surgeries.

Note that the program will be geared towards the uninsured. Those who are on Medicaid may use their medical assistance to receive surgery; California is the only state to allow such.


This means that if any city in any other state decided to do such a program, they would have to include low-income people as well.  I would LOVE to see the city of Philadelphia to cover, for income eligible individuals, sexual reassignment surgery, as well as laser hair removal. This city has stood up and passed numerous LGBT friendly policies when the state of Pennsylvania has constantly said no.

Yes, I may admit that Philadelphia, with its many budget woes, would be a challenge. However, the city should, in order to get public support behind this issue, do what San Francisco has done in terms of healthcare a few years ago.

San Franciscans, [mayor Gavin Newsom] announced this week, are poised to become the first  recipients of universal health care.  This means uninsured city dwellers will  gain access to basic medical services  they otherwise couldn’t afford. While not  free, the care will come at sharply  reduced costs. Enrollment fees will range  from $3 to $201, depending on participants’ incomes. Most, however, will pay $35  a month—far less than what HMOs  typically charge.

It’s part of an unprecedented program called “San Francisco Health Access  Plan,” which Newsom hammered out with labor, business, and city leaders. More  than  82,000 San Franciscans who lack health insurance and do not qualify for  Medicare or Medicaid stand to benefit. The  majority  are employed adults  (children already have access to subsidized care); others are unemployed,  self-employed, homeless, or have  pre-existing conditions like diabetes, AIDS or  cancer; some are even  undocumented (yes: illegal) workers. Starting in early  2007, every uninsured  San Franciscan can seek comprehensive primary care at the  city’s public and  private clinics and hospitals, including top research  facilities like the University of California at San Francisco.  Coverage  includes lab work, prescriptions, X rays, hospitalization and surgery.  Annual  funding for the $203 million program will come from re-routed city funds  (including $104 million that now goes toward uninsured care via emergency rooms  and  clinics), business contributions and individual enrollment fees, which will  be income-adjusted.

If, in addition to providing health coverage for those not already covered by other sources, a city universal healthcare program for Philadelphia could ”augment” Medicare/Medicaid coverage (ie: Pennsylvania’s medical assistance could cover a transgender person’s hormones, but the city plan would cover the surgery) , we could see a city universal healthcare plan that benefits all people, regardless of gender identity, and allows for the trans* community to have their FULL health needs met, and implements it in a manner that does not cause controversy or resentment.

I believe that a universal healthcare plan that covers those not covered and augments the underinsured (which all low income trans people in Pennsylvania are, by design) is a great policy idea for my city. However, lasting change must be done at a higher level.

-Jordan Gwendolyn Davis