Health insurance rights and access to health care for trans people: The social construction of medical necessity.
Health care rights for transgender and/or nonbinary people have dramatically expanded in recent years, including in insurance coverage for the treatments and procedures they need. Yet, trans people themselves still identify health insurance problems as a top priority for research and policy change b...
| Published in: | Law & Society Review Vol. 55; no. 4; pp. 539 - 563 |
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| Main Authors: | , , |
| Format: | Article |
| Published: |
Cambridge University Press
Dec2021
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| Subjects: | |
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=153951832&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 153951832 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00239216 LSR jtl: Law & Society Review issn: 00239216 maglogo: N pubinfo: dt: Dec2021 vid: 55 iid: 4 pid: 15979 pub: Cambridge University Press artinfo: ui: 153951832 10.1111/lasr.12575 ppf: 539 ppct: 24 formats: fmt: – @attributes: type: T – @attributes: type: P size: 893KB tig: atl: Health insurance rights and access to health care for trans people: The social construction of medical necessity. aug: au: Kirkland, Anna Talesh, Shauhin Perone, Angela K. affil: Institute for Research on Women and Gender (IRWG), University of Michigan, Ann Arbor Michigan,, USA Arthur F. Thurnau Professor of Women's and Gender Studies, University of Michigan, Ann Arbor Michigan,, USA Political Science, Sociology, and Health Management & Policy (by courtesy), University of Michigan, Ann Arbor Michigan,, USA School of Law, University of California, Irvine, Irvine California,, USA Sociology and Criminology, Law & Society, University of California, Irvine, Irvine California,, USA Law & Graduate Studies Program, University of California, Irvine, Irvine California,, USA School of Social Work & Department of Sociology, University of Michigan, Ann Arbor Michigan,, USA su: Right to health Health insurance Transgender people Health services accessibility Gender affirming care Health insurance exchanges Transgender rights sug: subj: Right to health Health insurance Transgender people Health services accessibility Direct individual life, health and medical insurance carriers Direct group life, health and medical insurance carriers Gender affirming care Health insurance exchanges Transgender rights ab: Health care rights for transgender and/or nonbinary people have dramatically expanded in recent years, including in insurance coverage for the treatments and procedures they need. Yet, trans people themselves still identify health insurance problems as a top priority for research and policy change because of significant difficulties gaining and using coverage. Wrangling over coverage determinations happens through multiple types of interactions, bureaucratic, interpersonal, and medical. When these interactions become difficult, it is because key terms such as medical necessity are both powerful and indeterminate. This study examines how trans people and health care intermediaries navigate the health insurance process and contest the meaning of medical necessity in coverage determinations. These disputes constitute the ground‐level reality for instantiating health care rights to gender affirming care. Relying on analysis of contract language and 32 interviews with people who sought gender‐affirming care and allied professionals, we find that health insurance policy language, interpretation, and implementation often create disadvantages and barriers for trans people who attempt to access care. Our study highlights how the contested life of insurance policy terminology produces a reality for rights but also details the mechanisms through which insurance‐mediated care is a socially contested and negotiated process pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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