Appeal Letter Citations

Prepared for USPATH 2019. Cite as:

Blasdel, G., & Jaffe, J. M. (2019, September). Supporting Your Patient in Appealing an Insurance Denial. Poster session presented at the United States Professional Association of Transgender Health, Washington, DC.

Appeal Citations

Please read the articles and cite specific sections from the references listed below. For those without institutional access to published literature, plug the DOI into:
https://sci-hub.tw

Standards of Care and Position Statements

Coleman, E., Bockting, W., Botzer, M., Cohen-Kettenis, P., DeCuypere, G., Feldman, J., … Zucker, K. (2012). Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7. International Journal of Transgenderism, 13(4), 165–232. https://doi.org/10.1080/15532739.2011.700873

Hembree, W. C., Cohen-Kettenis, P. T., Gooren, L., Hannema, S. E., Meyer, W. J., Murad, M. H., … T’Sjoen, G. G. (2017). Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, 102(11), 3869–3903. https://doi.org/10.1210/jc.2017-01658

Rafferty, J., COMMITTEE ON PSYCHOSOCIAL ASPECTS OF CHILD AND FAMILY HEALTH, COMMITTEE ON ADOLESCENCE, & SECTION ON LESBIAN, GAY, BISEXUAL, AND TRANSGENDER HEALTH AND WELLNESS. (2018). Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents. Pediatrics, 142(4), e20182162. https://doi.org/10.1542/peds.2018-2162

American Medical Association Policy Statements:

Removing Financial Barriers to Care for Transgender Patients H-185.950. (Res. 122 A-08; Modified: Res. 05, A-16)

Sexual Orientation and/or Gender Identity as Health Insurance Criteria H-180.980. (Res. 178, A-88; Reaffirmed: Sub. Res. 101, I-97; Reaffirmed: CMS Rep. 9, A-07; Modified: BOT Rep. 11, A-07; Reaffirmed: CMS Rep. 01, A-17)

WPATH Policy Statement

Gail, K. Position Statement on Medical Necessity of Treatment, Sex Reassignment, and Insurance Coverage in the USA. World Professional Association for Transgender Health (WPATH), (Dec. 21, 2016).

Cited for Adolescent Access to Surgery

Olson-Kennedy, J., Warus, J., Okonta, V., Belzer, M., & Clark, L. F. (2018). Chest Reconstruction and Chest Dysphoria in Transmasculine Minors and Young Adults. JAMA Pediatrics, 172(5), 431. https://doi.org/10.1001/jamapediatrics.2017.5440

Milrod, C., & Karasic, D. H. (2017). Age Is Just a Number: WPATH-Affiliated Surgeons’ Experiences and Attitudes Toward Vaginoplasty in Transgender Females Under 18 Years of Age in the United States. The Journal of Sexual Medicine, 14(4), 624–634. https://doi.org/10.1016/j.jsxm.2017.02.007

Schechter, L. (2018). 3.4 Gender Confirming Surgical Care in Adolescence: Evidence, Timing, Options, and Outcomes. Journal of the American Academy of Child & Adolescent Psychiatry, 57(10), S123–S124. https://doi.org/10.1016/j.jaac.2018.07.568

Waldman, R. A., Waldman, S. D., & Grant-Kels, J. M. (2018). The ethics of performing noninvasive, reversible gender-affirming procedures on transgender adolescents. Journal of the American Academy of Dermatology, 79(6), 1166–1168. https://doi.org/10.1016/j.jaad.2017.12.052

Cited for Facial Gender Confirmation Surgery

Lundgren, T. K., Isung, J., Rinder, J., Dhejne, C., Arver, S., Holm, L.-E., & Farnebo, F. (2016). Moving Transgender Care Forward within Public Health Organizations: Inclusion of Facial Feminizing Surgery in the Swedish National Treatment Recommendations. Archives of Sexual Behavior, 45. https://doi.org/10.1007/s10508-016-0830-3

Ainsworth, T. A., & Spiegel, J. H. (2010). Quality of life of individuals with and without facial feminization surgery or gender reassignment surgery. Quality of Life Research, 19(7), 1019– 1024. https://doi.org/10.1007/s11136-010-9668-7

Berli, J. U., Capitán, L., Simon, D., Bluebond-Langner, R., Plemons, E., & Morrison, S. D. (2017). Facial gender confirmation surgery—review of the literature and recommendations for Version 8 of the WPATH Standards of Care. International Journal of Transgenderism, 18(3), 264– 270. https://doi.org/10.1080/15532739.2017.1302862

Ascha, M., Swanson, M. A., Massie, J. P., Evans, M. W., Chambers, C., Ginsberg, B. A., … Gougoutas, A. J. (n.d.). Nonsurgical Management of Facial Masculinization and Feminization. Aesthetic Surgery Journal. https://doi.org/10.1093/asj/sjy253

Altman, K. (2012). Facial feminization surgery: current state of the art. Int. J. Oral Maxillofac. Surg. 41: 885-894 http://dx.doi.org/10.1016/j.ijom.2012.04.024

Ginsberg, B. A. (2017). Dermatologic care of the transgender patient. International Journal of Women’s Dermatology, 3(1), 65–67. https://doi.org/10.1016/j.ijwd.2016.11.007

Becking, A. G., Tuinzing, D. B., Hage, J. J., & Gooren, L. J. G. (2007). Transgender Feminization of the Facial Skeleton. Clinics in Plastic Surgery, 34(3), 557–564. https://doi.org/10.1016/j.cps.2007.04.009

Spiegel, J. H. (2011). Facial determinants of female gender and feminizing forehead cranioplasty. The Laryngoscope, 121(2), 250–261. https://doi.org/10.1002/lary.21187

Morrison, S. D., Vyas, K. S., Motakef, S., Gast, K. M., Chung, M. T., Rashidi, V., ... Cederna, P. S. (2016). Facial Feminization: Systematic Review of the Literature. Plastic and Reconstructive Surgery, 137(6), 1759. https://doi.org/10.1097/PRS.0000000000002171

Raffaini, M., Magri, A. S., & Agostini, T. (2016). Full Facial Feminization Surgery: Patient Satisfaction Assessment Based on 180 Procedures Involving 33 Consecutive Patients. Plastic and Reconstructive Surgery, 137(2), 438. https://doi.org/10.1097/01.prs.0000475754.71333.f6

Capitán, L., Simon, D., Kaye, K., & Tenorio, T. (2014). Facial Feminization Surgery. Plastic and Reconstructive Surgery, 134(4), 609–619. https://doi.org/10.1097/prs.0000000000000545

Nouraei, S. A. R., Randhawa, P., Andrews, P. J., & Saleh, H. A. (2007). The Role of Nasal Feminization Rhinoplasty in Male-to-Female Gender Reassignment. Archives of Facial Plastic Surgery, 9(5). https://doi.org/10.1001/archfaci.9.5.318

van de Ven, B. F. M. L. (2008). Facial feminisation, why and how? Sexologies, 17(4), 291–298. https://doi.org/10.1016/j.sexol.2008.08.008

Hage, J. J., Kanhai, R. C. J., Oen, A. L., van Diest, P. J., & Karim, R. B. (2001). The Devastating Outcome of Massive Subcutaneous Injection of Highly Viscous Fluids in Male-to-Female Transsexuals. Plastic and Reconstructive Surgery, 107(3), 734–741. https://doi.org/10.1097/00006534-200103000-00013

Cited for Tracheal Shave

Spiegel, J. H., & Rodriguez, G. (2008). Chondrolaryngoplasty Under General Anesthesia Using a Flexible Fiberoptic Laryngoscope and Laryngeal Mask Airway. Archives of Otolaryngology–Head & Neck Surgery, 134(7), 704. https://doi.org/10.1001/archotol.134.7.704

Cited for Laryngoplasty

Thomas, J. P., & MacMillan, C. (2013). Feminization laryngoplasty: assessment of surgical pitch elevation. European Archives of Oto-Rhino-Laryngology, 270(10), 2695–2700. https://doi.org/10.1007/s00405-013-2511-3

Nolan, I. T., Morrison, S. D., Arowojolu, O., Crowe, C. S., Massie, J. P., Adler, R. K., … Francis, D. O. (2019). The Role of Voice Therapy and Phonosurgery in Transgender Vocal Feminization. Journal of Craniofacial Surgery, 30(5), 1368–1375. https://doi.org/10.1097/scs.0000000000005132

Cited for Hair Restoration

Vogel, J. E., Jimenez, F., Cole, J., Keene, S. A., Harris, J. A., Barrera, A., & Rose, P. T. (2013). Hair Restoration Surgery: The State of the Art. Aesthetic Surgery Journal, 33(1), 128–151. https://doi.org/10.1177/1090820x12468314

Pathomvanich, D. (2010). Hair Restoration Surgery in Transsexual Males. In Hair Restoration Surgery in Asians (pp. 185–188). Springer Japan. https://doi.org/10.1007/978-4-431-99659-0_39

Gao, Y., Maurer, T., & Mirmirani, P. (2018). Understanding and Addressing Hair Disorders in Transgender Individuals. American Journal of Clinical Dermatology, 19(4), 517–527. https://doi.org/10.1007/s40257-018-0343-z

Cited for Voice Therapy

Söderpalm, E., Larsson, A., & Almquist, S.-Å. (2004). Evaluation of a consecutive group of transsexual individuals referred for vocal intervention in the west of Sweden. Logopedics Phoniatrics Vocology, 29(1), 18–30. https://doi.org/10.1080/14015430310021618

Oates, J., & Dacakis, G. (2015). Transgender Voice and Communication: Research Evidence Underpinning Voice Intervention for Male-to-Female Transsexual Women. Perspectives on Voice and Voice Disorders, 25(2), 48. https://doi.org/10.1044/vvd25.2.48

Mészáros, K., Csokonai Vitéz, L., Szabolcs, I., Góth, M., Kovács, L., Görömbei, Z., & Hacki, T. (2005). Efficacy of Conservative Voice Treatment in Male-to-Female Transsexuals. Folia Phoniatrica et Logopaedica, 57(2), 111–118. https://doi.org/10.1159/000083572

Hancock, A. B., & Garabedian, L. M. (2012). Transgender voice and communication treatment: a retrospective chart review of 25 cases. International Journal of Language & Communication Disorders, 48(1), 54–65. https://doi.org/10.1111/j.1460-6984.2012.00185.x

Carew, L., Dacakis, G., & Oates, J. (2007). The Effectiveness of Oral Resonance Therapy on the Perception of Femininity of Voice in Male-to-Female Transsexuals. Journal of Voice, 21(5), 591–603. https://doi.org/10.1016/j.jvoice.2006.05.005

Cited for Packers As Treatment For Gender Dysphoria

Hadj-Moussa, M., Agarwal, S., Ohl, D. A., & Kuzon, W. M., Jr. (2019). Masculinizing Genital Gender Confirmation Surgery. Sexual Medicine Reviews, 7(1), 141–155. https://doi.org/10.1016/j.sxmr.2018.06.004

Cited for Breast Augmentation

Weigert, R., Frison, E., Sessiecq, Q., Al Mutairi, K., & Casoli, V. (2013). Patient Satisfaction with Breasts and Psychosocial, Sexual, and Physical Well-Being after Breast Augmentation in Male-to-Female Transsexuals. Plastic and Reconstructive Surgery, 132(6), 1421–1429. https://doi.org/10.1097/01.prs.0000434415.70711.49

Wierckx, K., Gooren, L., & T’Sjoen, G. (2014). Clinical Review: Breast Development in Trans Women Receiving Cross-Sex Hormones. The Journal of Sexual Medicine, 11(5), 1240–1247. https://doi.org/10.1111/jsm.12487

Reisman, T., Goldstein, Z., & Safer, J. D. (2019). A REVIEW OF BREAST DEVELOPMENT IN CISGENDER WOMEN AND IMPLICATIONS FOR TRANSGENDER WOMEN. Endocrine Practice. https://doi.org/10.4158/ep-2019-0183

Cited for Denials of Nipple Grafts

Boskey, E. R., Jolly, D., Semnack, M. M., Tobias, A. M., & Ganor, O. (2019). Congruence Is Not Cosmetic. Plastic and Reconstructive Surgery - Global Open, 7(4), e2145. https://doi.org/10.1097/gox.0000000000002145

Nipple areolar complex reconstruction is an integral component of chest reconstruction in the treatment of transgender and gender diverse people. (2019). International Journal of Transgenderism, 20(1), 1–3. https://doi.org/10.1080/15532739.2019.1568343

Cited for Body Contouring

Morrison, Shane D., Wilson, Stelios, & Mosser, Scott. (2018). Breast and Body Contouring for Transgender and Gender Non-Conforming Individuals. Clinics in Plastic Surgery, Volume 45, Issue 3, 333 - 342. https://doi.org/10.1016/j.cps.2018.03.015

Cited for Facial Hair Removal

Cited for Hair Removal in Advance of Genital Surgery
Gao, Y., Maurer, T., & Mirmirani, P. (2018). Understanding and Addressing Hair Disorders in Transgender Individuals. American Journal of Clinical Dermatology, 19(4), 517–527. https://doi.org/10.1007/s40257-018-0343-z

Zhang, W. R., Garrett, G. L., Arron, S. T., & Garcia, M. M. (2016). Laser hair removal for genital gender affirming surgery. Translational Andrology and Urology, 5(3), 381–387. https://doi.org/10.21037/tau.2016.03.27

Suchak, T., Hussey, J., Takhar, M., & Bellringer, J. (2015). Postoperative trans women in sexual health clinics: managing common problems after vaginoplasty. Journal of Family Planning and Reproductive Health Care, 41(4), 245–247. https://doi.org/10.1136/jfprhc-2014-101091

Pigot GLS, et al. Effectiveness of Preoperative Depilation of the Urethral Donor Site for Phalloplasty: Neourethral Hair Growth and its Effects on Voiding. Eur Urol Focus (2019), https://doi.org/10.1016/j.euf.2019.04.005