I recently connected with Nic and Cat, a duo based in Philadelphia, who have been working super hard for about a year, creating an app for anyone who is LGBTQ+ and is looking for a health care provider. It will be simple, straightforward, user-based, and reliable. A beta version will be available soon, and Nic says, “the more the merrier, because once we’re beta testing we want to have as many reviews on there as possible–that’s what’s gonna make the app useful.”
I already signed up. You can too! At: https://qspacesapp.com/qreview/
I definitely will have a lot to add, from
The first primary care doctor who proscribed me T,
The terrible consultation I had for top surgery in my area,
and, yeah, there will be much more. I have thoughts on my current doctor. Thoughts about the surgeon who did do my top surgery. Thoughts about my sometimes therapist and my psychiatrist (refreshingly, those two are all positive.)
I asked Nic a few questions to get a better sense of who they are and what their project is all about…
K: I’m curious, do you and Cat have experience in web design? Or, what are your backgrounds?
K: Was there a specific moment or incident where you said, “We need an app to fill in this void of information.”
The title says it all, but here’s the details: Prior to surgery, I put a lot of effort into trying to figure out what I might be able to get reimbursed for. I was on the phone with customer service for a long time one day; I scoured my insurance’s webpage; I tried to figure out codes and what they mean; my therapist called multiple times on my behalf. I oscillated between feeling hopeful I might get partial coverage, and being convinced that there was no chance.
Ultimately it seemed like there was no chance. I found a promising document at one point called, “Gender Reassignment Surgery Medical Policy,” followed by criteria to prove it is medically necessary. Then I was told that that applies to some insurance policies with my insurance company, but my particular policy excludes this coverage, and that was the bottom line.
Still, people told me that it’s against the law to deny coverage, on a state by state basis, and my state should cover it. I paid out of pocket, first for the surgeon’s fees in advance, and then for the surgical center, the day of. After the fact, I asked my surgeon’s office to send me an itemized bill of what I’d paid for, and I submitted that to my insurance company, without much hope. I figured it’d get denied, then I’d appeal and take it as far as I could. Maybe I’d get some advice from my local gay alliance, etc.
About 2 weeks later, I got a piece of mail. I didn’t open it because I didn’t care to read the bad news. My spouse and I were leaving for vacation last Wednesday, and I figured I’d better open it before we left. In case there was some deadline for appealing it. I opened it up, and it was a check for $2,800.09!!!! I yelled at my partner about it, the excitement of it, which must have been jarring because I almost never yell. What an amazing way to start our trip!
That’s 47% of the surgeon’s fees (including 100% of the accommodations – staying at the surgeon’s guest room!) I really could not believe it – either the person on the receiving end wasn’t paying attention at all, or they knew exactly what it was and had some strong personal beliefs of what should get to be covered!!
Now I’m just deciding if I should also get an itemized bill from the surgical center and try to get more money back… Maybe I don’t want to push my luck…
It really paid off to just try, even though I didn’t believe anything would come of it!
Here’s a post I wrote earlier on this topic:
In February, I wrote GID: exclusion for top surgery coverage
I have been seeing a doctor that I don’t like for about a year, in order to access testosterone. I’ll be going to his office tomorrow actually, hopefully for the last time. For a few weeks now, I’ve been actively trying to find a doctor that I would want to go to. My therapist thought she had a good lead on someone who works with trans* patients, but it turns out this person works with adolescents and young adults. Whoa, when did I stop being a young adult?!!!! According to this doctor, it’s when I turned 27.
I really wasn’t sure where to start. As far as I was aware, I had exhausted my resources for trans* specific health care. Ideally, what I’d have done next was turn to all my local trans* friends, and ask them who they see and who they’d recommend. But, I’ve been out of the loop for a while now, and it felt daunting to drop in on a social group or support group just to ask about this. So I turned to my local gay alliance’s resource webpage and wrote down the names of a couple of “LGBT friendly” doctors. I narrowed it down somewhat arbitrarily because, hey, I gotta start somewhere.
I called the first number and left a message. Then called again 2 days later. And again the beginning of the following week. And a 4th time the next day. My faith was waning; it hit me it was probably a really bad sign I couldn’t get through to anyone. I finally got a message back from them, but I’d started to lose interest and was already moving on to the next doctor.
I got through immediately and asked if this doctor was taking new patients? I was told that if I’m a friend or family member of a current patient, then yes. Or if I was being referred to her by a doctor of any sort, then yes. Wait, you need a referral for a primary care physician?!! I asked, “In what form should this referral take? Like a note from a doctor or an email?” “No, you just tell us their name.” I said OK thanks and hung up.
So basically, I can see this doctor through the powers of nepotism and name dropping. (Warning, I’m still highly suspicious of doctors. Doctors, please, prove me wrong!) I felt more determined than ever to see this doctor, just on principal, because I think this policy is fucked-up. She should either be taking new patients or not taking new patients. Period.
I called my therapist (technically, she’s a doctor) and asked her if she would refer me to this doctor. She said sure, she’d do whatever, and that she’s never heard of needing a referral for a PCP. She suggested that maybe I just misunderstood, and they just want to know how I heard about / was referred to this doctor. So when I called back, I gave them the benefit of the doubt, but it was reinforced that yes, I need a verbal referral.
I then said that I have a therapist who will vouch for me. (The term “vouch” was never actually used, but that’s what seems to be going on?) I was then put on hold, and they seemed to be attempting a stalling tactic. She (receptionist) said she is short staffed and busy, could I call back Thurs. or Fri. of this week? I was assured that I’d be able to make an appt. at that time, and I was directed to name-drop whoever at that time.
So I followed these directions and finally got an appointment! (For 3 months from now.) A few days later, a packet of paperwork arrived in the mail, and I immediately opened it and started to peruse. Their pamphlet states, right on the cover, “Designed by Women / Delivered by Women / For Women Like You.”
Whaaaaa? Apparently, I got myself a doctor through a women’s health group without even knowing it! I just have to take a giant step away from this situation and laugh. And laugh and laugh some more.
Is this going to be a good fit? I thought it through quite a bit, and decided that I’m going to try it. And I’m going to make my decision based on the doctor, and not the Women thing. Because really, although I am definitely not a woman, I am closer to a woman in some ways, and closer to a man in other ways. And being at this health center is not going to mess with my identity or psyche or ego.
As long as they can understand what I am saying to them, as long as they can use my preferred name and male pronouns, and as long as I’m getting good treatment, I will be proud to go here.
(And if it doesn’t work out, then it doesn’t work out.)