Issue:  Vol. 48 / No. 7 / 15 February 2018

Health panel OKs
trans access to care


Health Commissioner Cecilia Chung (Photo: Jane Philomen Cleland)
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Seeking to correct a policy that had been viewed as discriminatory, San Francisco's seven-member Health Commission voted unanimously Tuesday, November 6 to improve access to health care for transgender people.

Healthy SF is the city's locally designed and funded universal health care program that was launched in 2007. It currently provides hormone treatment and mental health services to transgender participants, but administratively excludes sex reassignment surgery and denies coverage for certain surgical procedures to transgender people when the same procedures are provided to non-transgender participants

The panel resolved Tuesday to develop a program separate from Healthy San Francisco to provide sexual reassignment and gender-affirming surgeries to the city's uninsured transgender residents.

Before the vote Tuesday, Theresa Sparks, the transgender executive director of the city's Human Rights Commission, told commissioners that for her community, "This is one of the most significant advances ever." She expressed optimism that their action would be felt nationally and around the world.

Along with developing a separate program, health commissioners also voted Tuesday to amend the regulations implanting Healthy SF and medical reimbursement account provisions of the city's health care security ordinance to remove sexual reassignment surgery and gender-affirming surgeries from the list of excluded services. Their resolution also modifies Healthy SF program materials to reflect the change.

The actions of the panel, which serves as the governing and policy-making body of the Department of Public Health, follow a resolution recommending changes passed by the Board of Supervisors in July. Gay Supervisor Scott Wiener introduced that resolution, which called on the health department to provide medically necessary transition-related care for transgender people and to remove exclusions under the city's health care security ordinance.

Wiener told commissioners Tuesday that the city has "helped lead the way" in ensuring access to health care for transgender people, and "We have an opportunity to continue San Francisco on the cutting edge."

The health department's Tangerine Brigham said that the separate program would start in the fall of 2013 to contract with community providers to do the procedures with people who are uninsured. Officials will also look at expanding the health department's ability to do the procedures so that by the 2014-15 fiscal year the work is not contracted out for the full range of surgeries.

Transgender Commissioner Cecilia Chung suggested the "gender-affirming" language to the resolution, saying, "Not everybody needs to do corrective surgery on their genitals." For example, she said, some people "just need chest reconstruction surgery."

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