Some exclusions may apply

By , January 13, 2012 12:52 pm

Exclusions. Covered expenses of the Plan shall not include … procedures, treatments, equipment, transplants, or implants, any of which are … for, or resulting from, a gender transformation operation. – 215 Illinois Compiled Statutes 105 – Comprehensive Health Insurance Plan Act

It’s unclear whether the State of Illinois has defined – through statute or the courts – what specifically “gender transformation operation” means. But it seems pretty safe to assume that the surgery I’m currently considering would fall under its purview. Surgery in which the “spongiform erectile tissue of the penis is removed, and the skin, with its nerves and vascular system (blood supply) still attached, is used to create a vestibule area and labia minora, which then are inverted into the neovaginal cavity created in the pelvic tissue.” That seems pretty gender transformative to me.

What’s interesting about the Illinois Comprehensive Health Insurance Plan Act (or the ICHIP Act) is what other injuries, procedures, and categories of coverage are excluded.  Gender transformation operations (item 14.iv on the list of exclusions) is lumped in with cosmetic surgery (item 1), anything which exceeds “reasonable or customary” cost (item 4), injury due to war (item 9) , services that are “not provided in accord with generally accepted standards of current medical practice” (item 14), contraceptives (item 19), weight loss programs (item 21), acupuncture (22). Interestingly enough, the act itself does not, as best as I could find, mention abortion or early termination of a pregnancy, but the ICHIP website stil says such services are excluded.

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