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Board rules Medicare can pay for sex reassignment surgery

[JURIST] The Departmental Appeals Board of Health and Human Services (DAB) [official website] on Friday revoked a National Coverage Determination (NCD) [December HHS Summary] barring Medicare payment for gender reassignment surgeries. The revoked NCD was issued in 1981 [HHS index] and refused to pay [advocacy backgrounder] for surgery as a treatment for gender dysphoria due to a lack of knowledge about the safety of the surgery. Citing modern studies on the effects of surgery as a treatment for gender dysphoria, the DAB held that the NCD, while reasonable in 1981, was no longer enforceable in light of today's knowledge. While the new NCD does not create a right to Medicare payments for such treatmenst, it does open the door [text] for individual analysis based on medical evidence of each applicant.

The rights and identity of transgendered individuals is a topic of debate in many states and countries, with supporters claiming that gender is not necessarily tied to the sex organs one is born with, while others assert [JURIST op-ed] that "sex is an objective, biological fact." In February the Thirteenth Texas Court of Appeals [official website] vacated [JURIST report] a lower court's holding that the transgender widow of a firefighter was a man at the time of her marriage, thus invalidating the union. In January the Supreme Court of Maine ruled that a school district had violated the rights of a transgender student when it tried to prevent [JURIST report] her from using the girl's bathroom. In November the group Privacy for all Students announced [JURIST report] it had obtained enough signatures to put an initiative on the November 2014 ballot to repeal the California law allowing school students to self-identify with a particular gender and to use the corresponding school facilities. In 2012 Alaska began [JURIST report] to allow transgendered individuals to begin changing their gender markers on their driver's license to more accurately reflect their gender. Just months earlier the Supreme Court denied [JURIST report] certiorari to decide the issue of whether transgendered prison inmates have a right to hormone therapy.

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