For everyone in the US here, there is currently a FDA petition to create a federal registry of all trans women taking HRT. The FDA is currently taking public comments supporting and opposing the petition. Here's a link on how to make your voice heard: https://transresilience.org/issues/fda-registry.

You can comment anonymously if you feel unsafe putting your name out there.

I've read some of the comments and most of them so far seem to be from transphobic ppl.

Montgomery County Planning Commission // Creative Commons

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On Sunday, a federal judge ruled that Aetna's categorical denial of facial feminization surgery for transgender women constitutes sex discrimination under the Affordable Care Act. The landmark ruling, handed down in the U.S. District Court for the District of Connecticut, is believed to be the first federal court order requiring a major private insurer to make individualized coverage determinations for gender-affirming facial surgery rather than automatically rejecting every claim as "cosmetic." The case was brought by six transgender women who sought coverage for facial feminization surgery to treat severe gender dysphoria but were denied under Aetna's Clinical Policy Bulletin 0615, which categorically excludes all gender-affirming facial procedures from coverage. Though the preliminary injunction applies to only two of the six plaintiffs, the class action is pending, and the court's legal reasoning will serve as a powerful precedent for transgender women denied facial surgery coverage nationwide.

“To be clear, the issue is not whether Aetna’s policy exclusion prohibits this type of gender-affirming care, but rather that Aetna’s policy exclusion prohibits only transgender individuals, the only individuals who can experience gender dysphoria, from receiving this type of gender-affirming care. Thus, when Aetna decided that facial gender-affirming procedures “performed as a component of a gender transition [were] not medically necessary and cosmetic,” Aetna prohibited only transgender individuals from seeking this medical care, and thus discriminated on the basis of sex,” wrote Judge Bolden in his ruling.

The ruling was made on behalf of two patients, Dr. Jamie Homnick and Dr. Gennifer Herley, both transgender women seeking gender-affirming facial surgery. Both reported severe depression, suicidality, and intensifying gender dysphoria related to facial masculinization—the result of not having access to puberty blockers or hormone therapy early in life. Both were denied categorically under CPB 0615, which does not evaluate requests for gender-affirming facial surgery on the basis of medical necessity but instead denies them altogether, regardless of a patient's individual medical circumstances or whether their treating physicians have deemed the procedures medically necessary.

The court leaned on the Supreme Court's decision in Bostock v. Clayton County and Title IX, as incorporated into Section 1557 of the Affordable Care Act, to find that Aetna's exclusion constitutes sex discrimination. The court reasoned that to deny a facial surgery claim under CPB 0615, Aetna must first determine whether the patient is transgender—which necessarily requires considering their sex assigned at birth. If a person assigned male at birth seeks facial reconstruction to treat a congenital condition or traumatic injury, Aetna evaluates the claim for medical necessity. If that same person seeks the same procedures to treat gender dysphoria, Aetna denies it automatically. Change the reason for the surgery—which is inextricable from the patient's sex assigned at birth—and the coverage determination changes. That, the court held, is textbook sex discrimination. Notably, the court also addressed the Supreme Court's ruling in United States v. Skrmetti, which upheld state bans on gender-affirming care for minors under the Equal Protection Clause, finding that it did not disturb Bostock's application to insurance discrimination claims under the ACA.

Gender-affirming facial surgery can be a critical part of a transgender person's care. A UCLA study published in the Annals of Surgery found that transgender patients who received facial feminization surgery reported significantly better outcomes across several measures of psychosocial health, including reduced anxiety, depression, and social isolation. The World Professional Association for Transgender Health recognizes FFS as medically necessary for many transgender women. Some states, including Colorado, Washington, and Oregon, explicitly prohibit insurers from categorically excluding facial feminization surgery and require that claims be evaluated on a case-by-case basis for medical necessity. Most states, however, leave it up to individual insurers—and many, like Aetna, have maintained blanket exclusions. This ruling may change that calculus, giving transgender women denied coverage a legal framework to challenge categorical exclusions nationwide.

Though the ruling applies to only two patients for now, the plaintiffs are seeking class certification, which could broadly impact every transgender woman on an Aetna plan who has been denied coverage for facial surgery. Members of the same legal team—Advocates for Trans Equality, Wardenski PC, and Cohen Milstein—successfully challenged Aetna's categorical exclusion of breast augmentation for transgender women in 2021, resulting in a settlement that changed the insurer's general policy. If this case follows the same trajectory, it could force Aetna to add facial feminization surgery to its list of potentially covered gender-affirming procedures. More broadly, the court's holding that categorical exclusions of gender-affirming facial surgery constitute sex discrimination under the Affordable Care Act gives transgender women across the country a legal framework to challenge similar denials from other insurers.

You can see the full decision here:

Gordon Order Granting Pi Denying Mtd

419KB ∙ PDF file

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Bored and feeling too nauseous to do much atm while recovering from surgery. So i wanted to hear about some of your experiences. I think mine was quite uncommon because i never identified my personal discomfort as dysphoria and rather found out through lying about my identity online (for anonymity purposes) that being seen and addressed as male felt incredibly euphoric and just right. Through that the discomfort in my day to day life becoming more apparent till i eventually had to consider the possibility of being trans and everything else kinda started from there. I was 15-16 during that time. The dysphoria i felt in younger years for me back then was just something i assumed is normal if youre a teenage girl

For the past few years I've been keeping my hair short but recently I decided to start growing it out. I haven't had actually long hair in years and I completely forgot how much of a pain in the ass growing your hair out is, especially when it's just long enough to get in your way but not long enough to do anything with. All of this isn't even getting into the dysphoria aspect. I just want to have an androgynous hairstyle that's long but I really don't know what to aim for and how to avoid it being too fem/too masc. Does anyone have any tips? Any suggestions for what to tell/show to my friend who's a stylist and cuts my hair? My hair is very straight and kind of a mullet currently. Just at my eyes in the front and down to the base of my neck in the back, the sides go a little past my jaw. I also have an undercut. My goal is to be androgynous and at least try to avoid the constant misgendering I get from trans and cis people alike.

I finally got top surgery today and i have never felt happier, i still cant fully believe it and havent seen my new chest but this felt impossible for so long. I was really worried about it before the surgery and scared i would experience depression but none of that happened. With this i consider my transition done for the near future, i feel like i can finally breathe again and quit chasing the next appointment

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Important to note: I have OCD, and I seem to have this obsession with the idea of me being transphobic. I am a member of the LGBTQ+ community, I have known this for years, and I try my best to support everyone. I have a lot of trans friends, I love them a lot, and treat them and see them as I would anyone else.

So, I feel like I’m transphobic. Is there any evidence of this? No. I’ve been a vocal supporter about LGBTQ+ rights for years (online), including trans rights, but I’ve recently become increasingly anxious at the thought of me being transphobic.

This likely stems from my questioning of my own gender, often times I feel that I am not quite male, maybe that I’m nonbinary or genderfluid. I mentioned this to my nonbinary friend, and they said “you don’t seem nonbinary”. This sent me spiraling, questioning my own gender and identity, and questioning if I was transphobic for believing that I was nonbinary (or possibly genderfluid, as at times I feel very comfortable being male, but at others I feel a lot more feminine).

At some point, I have to accept the fact that this is delusion, but I still really feel like I need guidance/assurance. I do not really know what to do about this.

(ANOTHER WORRY I HAVE is acting so paranoid and making it seem like I think trans people are going to cancel me and ruin my life if I say anything wrong, like a lot of transphobic people claim and act like. This is NOT AT ALL my intention, but I know I probably come off that way.)

Anyone in the UK on HRT and getting blood tests? I am going through the onboarding process for GAHT via Imago.tg.

Imago provide the full list of tests I need to take, but I can only contact my GP via their online intake forms. They do provide a space to ask for a nurse appointment for a blood test, but I'm a little cagey about outing myself to them if they will not actually help me. They don't have a way for me to just ask "can i see my GP" so i can talk to them in person.

As for private options, i only seem to see the off-the-shelf stuff at superdrug and the like, and none of their off-the-shelf offerings have the range of tests I need in them.

I'd love some advice from someone in the UK who's going through this process.

If you are thinking about harming yourself — get immediate crisis support. Connect to a crisis counselor 24/7, 365 days a year, from anywhere in the U.S via text, chat, or phone. The Trevor Project is 100% confidential and 100% free.

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It's not like Male pattern baldness or anything but when I was on Chemo for breast cancer I lost all my hair. It was heartbreaking for me and every day I avoid looking in the mirror because it makes me so sad and sick I almost throw up. I tried wearing a wig but it doesn't look convincing to me even if it does for other people. Also the feeling of the wig on my scalp makes my body feel gross and just reminds me of what I don't have anymore.

I know my hair will likely grow back but that's months from now and I need strategies on how to cope until then. Has anyone else been in this situation? How do you cope with something like this? It's just so hard.

Also this is my first post on Lemmy since I found my phone which was lost for months.

If you are thinking about harming yourself — get immediate crisis support. Connect to a crisis counselor 24/7, 365 days a year, from anywhere in the U.S via text, chat, or phone. The Trevor Project is 100% confidential and 100% free.

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Some things from me:

• Early on, darkening of the perineal raphe was quite a surprise (aka the "sack stripe"). It's not something I've seen mentioned in most HRT guides.
• How incredibly unreliable my own perception of how feminine I look is. People were treating me as a woman well before I could see even hints of it in my face.
• It's nice that women will sit next to me on the train now. As the carriage fills up I quite often find myself in the center of a cluster of women, which is very affirming.
• Makeup areas in bathrooms. I had no idea this was a thing, and they're great!

It sucks. I hate it. And I hate that I have no other choice.

I thought I passed pretty well and for a good bit now, and there where no indications that I didn't. I've been on HRT for over 1.5 years now and it has done a lot too.

Yet lately, especially at work, the misgendering has been getting worse and worse. Both from colleagues that knew me from back then and colleagues that are relatively new.

Why.... How... What changed.... I don't get it. What is that people actually think about me. I know what other people think of me doesn't change who I am but it's still just such a punch in the face every time.

Why couldn't it all just be different.... Why could I not have been born the way I want to.

Edit: I don't want to be trans, I don't want to hold the trans label and I don't even want anyone to remotely think about that. Not because I'm ashamed of it, just because I just want to live a normal fucking life the way I want to live.

If you are thinking about harming yourself — get immediate crisis support. Connect to a crisis counselor 24/7, 365 days a year, from anywhere in the U.S via text, chat, or phone. The Trevor Project is 100% confidential and 100% free.

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watched this the other day and hadn't really seen it mentioned before, so I thought I'd share it and see what others thought

EDIT: please heed the content warning at the beginning of the video 😊

I haven’t updated any of my documents yet, and I saw that the disgusting bill that’s pending in Indiana would make it impossible for trans people to change their gender marker. Although there has been an executive order stopping the department of health from processing court-ordered name changes there for the past year. I don’t think Indiana is ever going to do something that would help a trans person…

What are my options? Am I stuck with incorrect or mismatched documents forever?

A lil bit of positivity

I’m getting more confident in myself and starting to come out to more people, but I feel like I don’t know how to? It always feels awkward.

Obviously for some people it might need to be more of a conversation, but for friends that I know will be supportive, does it need to be anything more than a text saying “hey, fyi, I’m trans. This is my new name and pronouns”?

If you are thinking about harming yourself — get immediate crisis support. Connect to a crisis counselor 24/7, 365 days a year, from anywhere in the U.S via text, chat, or phone. The Trevor Project is 100% confidential and 100% free.

https://www.thetrevorproject.org/get-help/

Is it something that happens?

Not sure where to look for information or how to better phrase questions.

Sorry. Thank you for any guidance or advice you might be able to provide.