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Gender Affirming Pelvic and Gonadal Procedures. If you are struggling to pay for therapy, consider asking for a sliding scale, looking for an in-network therapist, or seeking services through a local agency, college counseling center, or hospital. Most respondents (65%) believed that transitioning would eliminate or decrease their gender dysphoria symptoms, and 64% responded that they believed that transitioning would allow them to become their true selves. Start your search for a great therapist in Muskego, Wisconsin on Zencare. SEARCH OUR VAST DIRECTORY OF 50,000+ CONTRACTED PROVIDERS AND AVAILABLE COST INFORMATION The Carelon Behavioral Health directory is a listing of providers and locations that are contracted with Carelon Behavioral Health to offer all UniCare members access to robust behavioral health and substance use services. 2021; 50(8):3353-3369. International Classification of Diseases (ICD)-11 for Mortality and Morbidity Statistics (Version: 02/2022). Due to high demand and low availability, in-network providers often have long waitlists; to widen your options and start therapy sooner, you might also consider looking for an out-of-network provider. Butler RM, Horenstein A, Gitlin M, Testa RJ, et al. Before an individual undergoes these types of procedures, a thorough, multidisciplinary decision-making process should be utilized, one that involves adequate attempts at optimal hormonal therapy as well as successful completion of real-life experience in the experienced gender of the individual. 2018; 15(4):591-600. A strong preference for playmates of the other gender. We recommend that clinicians refer hormone treated transgender individuals for genital surgery when: (1) the individual has had a satisfactory social role change, (2) the individual is satisfied about the hormonal effects, and (3) the individual desires definitive surgical changes. 02. A prospective case-control study published by Ascha in 2022 investigated the impact of gender affirming mastectomy procedures in a population of transmasculine or nonbinary adolescents and young adults aged between 13 and 24 years (mean 18.6 years). As noted above, these aspects of the treatment process are critical to sufficiently prepare an individual for the social, physical, and mental ramifications of the decision to undergo gender affirming surgery. Depending upon the surgical result required, a period of hormone treatment may be required (e.g., sufficient clitoral virilization prior to metoidioplasty/phalloplasty) or preferred for psychological reasons, anatomical reasons, or both (breast growth and skin expansion prior to breast augmentation, softening of skin and changes in facial fat distribution prior to facial GAS) (de Blok et al., 2021). 1996; 54(4):413-418. Arch Sex Behav. Clinical guidelines approved by the Medical Policy & Technology Assessment Committee are available for general adoption by plans or lines of business for consistent review of the medical necessity of services related to the clinical guideline when the plan performs utilization review for the subject. Featured Results. Subjects were recruited via social media platforms. To determine if review is required for this Clinical UM Guideline, please contact the customer service number on the member's card. Updated Coding, Rationale and Discussion section. Updated Reference sections. J Sex Marital Ther. Multistep treatment concept of transsexual patients. 2003; 32(4):299-315. While the main focus of this paper is related to surgical outcomes, the authors reported on characteristics of the participating subjects and contributing factors to the reversal decisions. When services may be Reconstructive when criteria are met: Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.0 sq cm or less [when specified for nipple/areola reconstruction after breast surgery; includes codes 11920, 11921, 11922], Subcutaneous injection of filling material (eg, collagen) [includes codes 11950, 11951, 11952, 11954], Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia), Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs, Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet, Suction assisted lipectomy, head and neck, Suction assisted lipectomy, trunk [when specified as breast liposuction for breast reduction], Unlisted procedure, skin, mucous membrane and subcutaneous tissue [when specified as injection of a dermal soft tissue filler], Genioplasty [includes codes 21120, 21121, 21122, 21123], Augmentation, mandibular body or angle; prosthetic material, Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft), Reduction forehead [includes codes 21137, 21138, 21139], Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts), Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts), Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy [with or without bone graft], Reconstruction of mandibular rami and/or body, sagittal split [with or without internal rigid fixation], Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant), Graft, bone; nasal, maxillary or malar areas (includes obtaining graft), Graft, bone; mandible (includes obtaining graft), Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft), Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft), Rhinoplasty, primary [includes codes 30400, 30410, 30420], Rhinoplasty, secondary [includes codes 30430, 30435, 30450], Unlisted procedure, larynx [when specified as thyroid cartilage chondroplasty, tracheal shave, or voice modification surgery such as anterior glottal web formation, cricothyroid approximation, vocal cord shortening], Implantable breast prosthesis, silicone or equal, Alteration of bilateral breast, open approach; [with autologous tissue substitute, synthetic substitute, or nonautologous tissue substitute; includes codes 0H0V07Z, 0H0V0JZ, 0H0V0KZ], Excision of breast, bilateral [by approach; includes codes 0HBV0ZZ, 0HBV3ZZ, 0HBV7ZZ, 0HBV8ZZ], Replacement of nipple [by approach; includes codes 0HRW07Z, 0HRW0JZ, 0HRW0KZ, 0HRW3JZ, 0HRW3KZ, 0HRW37Z, 0HRWX7Z, 0HRWXJZ, 0HRWXKZ, 0HRX07Z, 0HRX0JZ, 0HRX0KZ, 0HRX3JZ, 0HRX3KZ, 0HRX37Z, 0HRXX7Z, 0HRXXJZ, 0HRXXKZ], Excision of right zygomatic bone, open approach, Excision of left zygomatic bone, open approach, Excision of right mandible, open approach, Supplement frontal bone, open approach; [with autologous tissue substitute, synthetic substitute, or nonautologous tissue substitute; includes codes 0NU107Z, 0NU10JZ, 0NU10KZ], Supplement nasal bone, open approach; [with autologous tissue substitute, synthetic substitute, or nonautologous tissue substitute; includes codes 0NUB07Z, 0NUB0JZ, 0NUB0KZ], Supplement zygomatic bone, open approach; [right or left, with autologous tissue substitute, synthetic substitute, or nonautologous tissue substitute; includes codes 0NUM07Z, 0NUM0JZ, 0NUM0KZ, 0NUN07Z, 0NUN0JZ, 0NUN0KZ], Supplement maxilla, open approach; [with autologous tissue substitute, synthetic substitute, or nonautologous tissue substitute; includes codes 0NUR07Z, 0NUR0JZ, 0NUR0KZ], Supplement mandible, open approach; [right or left, with autologous tissue substitute, synthetic substitute, or nonautologous tissue substitute; includes codes 0NUT07Z, 0NUT0JZ, 0NUT0KZ, 0NUV07Z, 0NUV0JZ, 0NUV0KZ], Alteration of upper jaw, open approach [with autologous tissue substitute, synthetic substitute, or nonautologous tissue substitute; includes codes 0W0407Z, 0W040JZ, 0W040KZ], Alteration of lower jaw, open approach [with autologous tissue substitute, synthetic substitute, or nonautologous tissue substitute; includes codes 0W0507Z, 0W050JZ, 0W050KZ], Supplement lower jaw, open approach [with autologous tissue substitute, synthetic substitute, or nonautologous tissue substitute; includes codes 0WU407Z, 0WU40JZ, 0WU40KZ], Supplement lower jaw, open approach [with autologous tissue substitute, synthetic substitute, or nonautologous tissue substitute; includes codes 0WU507Z, 0WU50JZ, 0WU50KZ]. 'right': '1.5rem' MPTAC review. Gender dysphoria in Adolescents and Adults*. MPTAC review. A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from ones assigned gender). Documentation** that the individual has completed a minimum of 12 months of successful continuous full time real-life experience in the new gender, across a wide range of life experiences and events that may occur throughout the year (for example, family events, holidays, vacations, season-specific work or school experiences). Lastly, early and adequate education regarding the risks and benefits of gender dysphoria treatment should be offered to individuals seeking gender affirming treatment. 2014; 11(1):288-298. Vandenbussche E. Detransition-related needs and support: a cross-sectional online survey. At the initial session, youll likely discuss the therapeutic process and determine goals for your personal growth. Added bilateral mastectomy to MN section with criteria. Revised text regarding educational and professional qualifications required for individuals submitting referral letters to include masters-level practitioners. Explore each potential therapist profile to learn more about their specialties, and watch an introductory video to get a sense of their personality. For many people, the most affordable way to seek mental health services is to look for a provider who is in-network with your insurance. Other reasons provided for detransitioning were alternatives were found that helped with dysphoria (45%), unhappiness with social transition (44%), and change in political views (43%). 2020; 40(7):703-709. Conversely, for male-to-female (MtF) individuals, the use of estrogen GAHT has not been shown to provide significant benefits. The USTS survey includes data from 27,715 transgender respondents aged 18 years or older located in the U.S., its territories, and military. It should also be noted that the WPATH SOC8 have been created for a global audience and intended for use across a wide variety of cultures and healthcare systems. Clin Endocrinol (Oxf). When youre struggling with your mental health, it might be time to seek professional support in the form of counseling services, couples therapy, or psychiatric medication management. 'Align': 'right', 'AttachPosition': 'after', When multiple procedures are requested, each procedure should be considered separately as some procedures may be cosmetic and others may be reconstructive. UniCare Insurance Review & Ratings (2023) | USInsuranceAgents.com 2021; 137(3):e75-e88. Note: MHP is the Endocrine Societys abbreviation for mental health professional. for outpatient mental health. According to the literature on this issue, the predominant factor in requests for reversals are regret, which has been further associated with age greater than 30 at first surgery, personality disorders, early loss of both parents, social instability, preoperative male heterosexual sexual orientation, degree of social support, secondary transsexualism, early decision to undergo surgery and dissatisfaction with surgical results (Blanchard, 1989; Landn, 1998; Lawrence, 2003; Lindemalm, 1986 and 1987; Olsson, 2006). Facial feminization surgery changes perception of patient gender. Heart. ], Licensed Professional Counselor [L.P.C. Medical and social transition had been conducted by 65% of respondents and 31% had transitioned only socially. Standards of care for the health of transsexual, transgender, and gender nonconforming people. It should be noted that the surgical approach poses significant potential risks, including surgical complications, undesired pitch, dysphonia, weak voice, restricted speaking range, hoarseness, and vocal instability. For clients who have an insurance plan with a high deductible and low medical costs, therapy costs are often comparable when you see a therapist in- or out-of-network. 1986; 15(3):187-210. Group Insurance Commission FY2023 GIC Non-Medicare Health Plans Find information about the different non-Medicare health plans the GIC offers and choose the health plan that best fits your needs for benefits effective July 1, 2022 - June 30, 2023. The IPTW model results for Transgender Congruence Scale (TCS) found similar results, indicating a 7.78 point increase in TCS scores between groups in favor of the surgical group. Prospective quality-of-life outcomes after facial feminization surgery: an international multicenter study. Or, if you needhelp finding the right provider for you and your family, call262-928-2745to talk with one of our referral specialists. Referral Letters (Return to Clinical Indications). Technical Help Desk: 1-866-755-2680 Pharmacy Help Desk: 1-888-809-6084 Individuals & Families Customer Service For membership inquiries please contact us by email at: Individual.Membership@Unicare.com. Doctors who accept UniCare Insurance | Doctor.com 1998; 7(4):284-289. Obstet Gynecol. Alphabetized procedures in MN statements. Exp Clin Endocrinol Diabetes. Basic search as a guest Select a plan and find out if a doctor, hospital, or other care provider is in-network. We recognize that there may be compelling reasons to initiate sex hormone treatment prior to the age of 16 years in some adolescents with GD/gender incongruence, even though there are minimal published studies of gender-affirming hormone treatments administered before age 13.5 to 14 years. (Further information is available in the Discussion/General Information section of this document titled Gender Affirming Surgery in Individuals Under the Age of 18). Additional research is needed to understand the phenomenon of detransitioning, including its prevalence, and internal and external factors that play a role in the process, as well as how diagnostic and counseling support can be utilized to reduce harms, including unnecessary treatment, in individuals presenting with gender dysphoria symptoms. WHOQOL-100 before and after sex reassignment surgery in Brazilian male-to-female transsexual individuals. Gender affirming facial surgery in individuals with gender dysphoria is considered reconstructive when the procedure(s) is(are) intended to address a significant variation from normal appearance for the experienced gender. When neither voice therapy nor GAHT are capable of providing the desirable results, gender affirming voice modification surgery may be warranted. Hall R, Mitchell L, Sachdeva J. J Endocrinol Invest. 1997; 36(7):872-880. Health Insurance for Providers | Unicare.com - Anthem before the deductible is met; to verify whether your specific plan covers therapy sessions and at what rate, Updated Coding section with additional codes for facial and chest surgery. Access a full range of health services from ProHealth Care. JAMA Pediatr. Deleted criteria requiring Demonstrable knowledge of the required length of hospitalizations, likely complications, and post-surgical rehabilitation requirements of various surgical approaches. association between gender confirmation treatments and perceived gender congruence, body image satisfaction, and mental health in a cohort of transgender individuals. Finally, 79% of respondents reported some amount of regret, 49.5% reported strong regret, and 64.6% reported that they would not have chosen to transition had they known what they knew at the time of the survey. 12%, and 10%, respectively). MPTAC review. A strong desire to be treated as the other gender (or some alternative gender different from ones assigned gender). The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning. MPTAC review. The medical necessity criteria above for pelvic and gonadal procedures are based on several sources, including the WPATH SOC8, published peer-reviewed studies, and expert opinion. (2 |). Wernick JA, Busa S, Matouk K, Nicholson J, Janssen A. Fisher M, Lu SM, Chen K, et al. Group Insurance Commission | Mass.gov While this document does not address the medical necessity of gender-affirming hormone therapy (GAHT), GAHT plays an important role in the gender transition process by altering body hair, breast size or development, skin appearance and texture, body fat distribution, the size and function of sex organs, and other characteristics, including voice deepening. Checklist of items required (If any item from the list is not included, submission may be delayed or dismissed) 2010; 72(2):214-231. 2016; 13(6):988-993. 1-31 of 90 providers who match your search criteria. Then, make a list of priorities for your ideal therapist: do they match your identity, or have expertise in a specific area like anxiety or depression? Register now Why UniCare UniCare is a health benefits company with deep, long-standing roots right here in the Commonwealth of Massachusetts. Added new statement regarding nipple reconstructions following mastectomy. J Psychosom Res. and individuals who have Unicare may wish to find therapists who are in-network with their health insurance. Biomed Res Int. 2017; 23(12):1437. Unicare : Dental Provider - Anthem Updated Discussion and Reference sections. Having trouble with the site? Murad MH, Elamin MB, Garcia MZ, et al. Revised criteria regarding hormone therapy requirements. Additionally, the available literature also demonstrates significant benefits related to quality of life and overall well-being. before your health insurance starts to cover costs. Young adult psychological outcome after puberty suppression and gender reassignment. WebMD does not provide medical advice, diagnosis or treatment. Book a free initial call to find the right therapist for you! 1063 points 102 comments. Deleted the criteria requiring 12 months of continuous living in desired gender role from the reproductive organ procedures criteria set. A strong preference for cross-gender roles in make-believe play or fantasy play. Contrary to Turban, external forces such as discrimination (23%), financial concerns (17%), and online sources (29%) were less prevalent reasons cited for detransitioning. Contact us Group Insurance Commission Address GIC Print Forms and Member Correspondence Mailing Address PO Box 556 Randolph, MA 02368 Directions Street Address John W. McCormack Building 1 Ashburton Place, Suite 1619 Boston, MA 02108 Directions Phone Main Phone (617) 727-2310 M-F 8:45 a.m.-5 p.m. TDD/TTY 711 Fax Operations (617) 227-2681 Common therapy goals include learning effective coping strategies to deal with negative feelings, increasing self-awareness, and gaining a deeper understanding and insight into relationship patterns. Providers | UniCare State Indemnity Plan - Anthem Quality of life and hormones after sex reassignment surgery. Additionally, the WPATH SOC8 provides the following recommendations regarding the credentials for mental health professionals who work with adults presenting with gender dysphoria: 5.1- We recommend health care professionals assessing transgender and gender diverse adults for physical treatments:5.1.a- Are licensed by their statutory body and hold, at a minimum, a masters degree or equivalent training in a clinical field relevant to this role and granted by a nationally accredited statutory institution.5.1.b- For countries requiring a diagnosis for access to care, the health care professional should be competent using the latest edition of the World Health Organization's International Classification of Diseases (ICD) for diagnosis. Capitn L, Simon D, Kaye K, Tenorio T. Facial feminization surgery: the forehead. Pre-operative permanent hair removal treatments to these areas may be warranted to prevent post-operative complications. Clarified hair removal MN statement.
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