Social Security to Cover Gender Reassignment Surgery

Turkey’s Social Security Administration (SGK) sent out a statement to all its administrative units, saying that it covered several gender reassignment operations including protheses. 

bianet interviewed Prof. Dr. Şahika Yüksel and Transsicko blog writer Berk İnan on the issue. 

It turned out that all gender reassignment operations were under the insurance of Turkish state healthcare system, somewhat problematic as SGK officials declined to pay for expenses. Several trans people had to sue authorities to receive their surgery cost refunds.  

Prof. Dr. Şahika Yüksel and Transsicko blog writer Berk İnan agree that SGK’s statement made a positive effect, even though the consideration of authorities towards trans people still remained problematic. 

“The surgery that trans people go through are not for aesthetic or arbitrary reasons,” Yüksel told bianet. 

“These operations are absolutely necessary. Trans-sexuality is a rebirth and it must be covered by the healthcare provider. However, there has been issues on the matter for a while.” 

“In order to get surgery cost refunds, trans people have to sue authorities. However, this statement will set an example. 

“In addition to that, there are limited endocrinologists in the country and they can’t allocate adequate time for trans people. It is also problematic that public hospitals don’t have enough surgeons to execute these operations. 

“Genetics expert requirement is due to ignorance” 

Official regulations concerning gender reassignment operations demand applicants to go through at least 1 year of psychiatric consultation and two medical council approvals. The medical report is required to be drafted by a delegation of psychiatrists, endocrinologists, gynecologists, plastic surgeons, urologists and genetics. However, it is not clear whether hormone treatment expenses are covered within healthcare. 

Psychiatric consultation is required for those who are either not ready or have social issues or lack information regarding the process, Prof. Dr. Yüksel said. 

“However,” he continued, “It is not required for those who already made up their mind for gender reassignment operation. This adaptation period might take a few days to years. It can’t be the same for everyone.” 

He also protested that it was required to have a genetics expert in the delegation. 

“Intersexuality can be detected by genetic exams but the decision for transsexuality can’t be decided from a genetic exam. Not only that this is a waste of time, but it is also a sign that authorities have no idea.” 

“Public hospitals have more responsibilities now” 

Berk İnan, the owner of Transsicko blog, wrote that while he considered the healthcare coverage as important, he expressed hesitation on a variety of issues including whether or not SGK will cover hormone treatment and private surgeries, and how the implants will be chosen. 

“I have struggled for 15 months to go through surgery. Turkey’s full-time law pushed doctors to work in private hospitals. When I found the right doctor, he told me that it would happen the way that I was expected,” he said. 

“For instance, our friend from Diyarbakır has been transferred to Ankara just because he didn’t know the process. Another friend had the surgery at a private hospital, however she is still having issues with walking due to wrong positioning of her legs during penis surgery. She wanted to take legal action but apparently the hospital vanished all surgery records. Breast surgery is considered one of the easiest, but people sometimes lose their nipples during these surgeries. Turkey is far behind in these operations. 

“I know at least half a dozen people who chose Rüzgar Erkoçlar’s doctor. The information on Erkoçlar’s transgender surgery was shared without his consent.”

İnan also reminded that the authorities were supposed to inform and make inspections. 

“The lack of inspections doesn’t only result in victimizing people but also causes huge gaps in the coverage rates. So the latest information on coverage is a good opportunity for hospitals to be informed on transgender surgeries.”

Inan also urged those gender reassignment operation seekers to find the document “10463188/3878389” from SGK authorities. 

Trans-sexuality not disease  

Yüksel: Transsexuality has been categorized as “sexual disorders” under mental diseases. However, those who have already demanded for gender reassignment surgery and see it as a necessity don’t suffer from mental or sexual disorder. Therefore, it is problematic that it is considered both as mental and sexual disorder.

İnan: Hospitals use the “we have no information” card very often, they don’t want to take any responsibilities. I find SGK’s statement important regarding the information of authorities. Only a handful of hospitals are aware of the gender reassignment process and operations in 81 departments across Turkey. ” (ÇT/BM)

* For more information, support and consultation, please contact Trans Consulting Center at 0312 232 3858 or [email protected].