Outdated thinking of gender-positive care and mental health in CT
A little over a month ago, in August 2022, a statewide multidisciplinary group of mental health professionals with expertise in gender-affirming care sent a press release addressing the challenge to the Husky Department of Social Services. did. We recently updated our policy on gender-affirming healthcare. .
We were surprised and disappointed to see some of the September 8th content that the Connecticut Health Investigation Team or C-HIT.org reported in the Mirror article. “
While this article explores some of the barriers to gender-affirming care in Connecticut, an Aug. 17 press release detailing additional barriers enacted by DSS for Husky clients You do your readers a disservice by omitting the concerns raised by this group of providers. Review requirements for gender-affirming care, i.e. letters from mental health providers in support of care requests.
Our concern begins with the experts cited in the article. The quotes are all reportedly from white, cisgender experts on transcare. The reporter did not consult a well-known transgender provider of gender-affirming care in this state.
Few providers have attended Fenway’s Transecho (National LGBTQIA+ Health Education Center) or sought external training in transgender care, so our clinician group has concerns about training that is considered professional. There is. A cited expert had the opportunity to encourage reporters to seek out comments from gender-affirming transgender health care providers about these policies, but did not.Recently Connecticut None of us were contacted as a group of LGBTQIA+ providers of gender-affirming health care who spread sharp criticism of DSS/Husky policies in all media outlets.
Furthermore, while the article supports DSS actions, it does not address the recent increase in gatekeeping due to policy changes, creating barriers for those seeking gender-affirming care on Medicaid. , does not mention the insurmountable barriers for Medicaid users, who cannot afford to pay thousands of dollars out of their own pocket for care, which Connecticut health care providers do not provide or provide. Paying out-of-pocket for care you don’t do is also not allowed. Accept Husky payments.
A group of us have met over the past few days to review and discuss this article, but we also took issue with the article’s ignorance of the issue of body autonomy.Gender at Anchor Health It’s harmful and has been outdated for years, according to AJ Eckert, M.D., medical director of the & Life-Affirming Medicine Program. In fact, Laura Saunders, a psychologist quoted in your article, mentioned the mental health letter, but ignored the gatekeeper’s nature because she “provides guidance in a very murky area.” .
Bodily autonomy is not a vague theme. Desiring bodily autonomy is not a mental health pathology. Individuals should not be required to receive treatment. Identity verification is an internal process. Letters are invasive, costly, time consuming and completely unnecessary. The only “approval” required is the patient’s informed consent and baseline medical ability to perform the intended procedure in exactly the same process as a patient being screened for other types of surgery. must be based on
The article states that “Medicare, Husky, and many insurers follow the widely accepted guidelines of the World Association of Transgender Health Professionals (WPATH),” but Connecticut’s DSS: Implementing conventions that are unproven or not supported by best practices and guidelines.
There is growing evidence that gender reassignment surgery reduces mental health concerns. Exacerbating mental health conditions is the added barrier to surgery. To tell the full story about access to health care for transgender and nonbinary people, Mirror needs to uncover the issues we detailed.
Allison D. Pratt, LPC/LMHC, on behalf of: Alexandra Solomon, LCSW; Molly Conley, PsyD; Lauren Millard, LCSW; Kayti Protos, DSW, LCSW; Rebecca Toner, LCPC; Sarah A. Gilbert, LCSW.
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