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Our job as parents is to listen and believe our children when they tell us who they are. This healthcare is life affirming and life saving.

Speaker 0 asks Speaker 1 for some history regarding their gender dysphoria to help with writing a letter. Speaker 1 explains that when they were in school, they wrote an essay expressing their discomfort with their biological sex and how they felt. However, people dismissed their feelings because they appeared to be male.

It's 2025, and insurance issues are worsening. During a surgery, I received a call from UnitedHealthcare demanding information about a patient who was currently under anesthesia for breast cancer surgery. They insisted I provide her diagnosis and justify her inpatient stay. I explained that she was asleep and needed to stay overnight, and I had already secured approval for the surgery. The representative admitted he wasn't familiar with her case and that I needed to speak to another department. This situation highlights the chaos and frustration surrounding insurance processes. It's simply out of control.

A client's psych history, including suicidal ideation or attempts, can be used as a persuasive essay piece to demonstrate the necessity of gender dysphoria treatment. By connecting the client's struggles to their gender dysphoria, it becomes clear why procedures are necessary. Framing the discussion as a persuasive essay adds a bit of fun and allows for more impactful language. This approach has been found to be helpful with clients.

Health insurance companies, particularly Blue Cross, are becoming more challenging in authorizing treatments. When physicians request authorization, they often face a peer-to-peer review process, where they must speak to an insurance-employed doctor who typically denies requests. Previously, these calls were scheduled to accommodate the physician's availability. Now, Blue Cross has changed its approach: they will only call once, without notice or identification of the number. If a physician is busy with patients or has their phone on do not disturb, they may miss this call, resulting in denied treatment authorization.

Gender affirmative care is deemed medically necessary, safe, and effective for transgender and non-binary individuals. Attacks on the LGBTQI+ community, particularly trans youth, are driven by an agenda unrelated to science and medicine. These politically and ideologically motivated assaults contradict the vast body of scientific evidence.

A family practice physician in San Diego recounts a bizarre experience where her patient's insurance denied a wheelchair request for a double amputee, citing a lack of documentation on how his walking was affected. This highlights the problematic prior authorization process, which often delays necessary treatments. One case involved Kathleen Valentini, whose MRI for hip pain was denied, leading to a delayed cancer diagnosis and ultimately an amputation. Reports show that 80% of doctors say patients abandon treatments due to prior authorizations, which can result in life-threatening situations. Insurance companies claim these processes prevent unnecessary procedures, but many argue they are more about profit than patient care. Legislative efforts are underway to reform prior authorization, but the system remains flawed, with some suggesting a return to a "pay and chase" model that allows doctors to make decisions without insurer interference.

In 2025, insurance is worsening. A surgeon was called during a bilateral deep and expander procedure by UnitedHealthcare, demanding information about a patient currently undergoing surgery. The representative needed the patient's diagnosis and justification for an inpatient stay. The surgeon explained the patient had breast cancer and was currently asleep, but the representative claimed that information was handled by a different department, despite the surgeon having received prior approval for the surgery. The surgeon emphasized the need for the patient to stay overnight and expressed frustration with the insurance situation, stating it is out of control.

No one is forced to provide medication to adolescents; doctors choose to treat their patients based on the best available evidence. Many young people have known their identities from a very young age and have suffered for years before finding relief. It's important to note that it is the parents who consent to these treatments, not the children themselves. As parents, witnessing our children's suffering is painful, and they are acting out of love and trust in the advice from the medical community. The situation in Tennessee has complicated this dynamic.

In order for therapies for gender dysphoria to become mainstream, the definition of the condition needs to change. In the past, transgenderism was considered a mental illness and treated as such. However, in 2013, the American Psychiatric Association changed the nomenclature from transsexualism or gender identity disorder to gender dysphoria. This change removed the term "transsexual" and shifted the focus away from pharmaceuticals and surgeries. Without these interventions, the condition is essentially reduced to being a transvestite or cross dresser. This was the understanding of the condition for many years.

Clinics need to gather better data and conduct research to ensure children and young people receive proper care. The lack of data on outcomes for those who have undergone medical transition is concerning. The Tavistock clinic's failure to provide meaningful data was highlighted in a court case. It is crucial to collect data to improve treatment practices and ensure all individuals receive quality care.

Because let's be clear. This is life affirming and life saving health care. When our children tell us who they are, it is our job as grown ups to listen and to believe them. That's what it means to be a good parent. Because let's be clear. This is life affirming and life saving health care. When our children tell us who they are, it is our job as grown ups to listen and to believe them. That's what it means to be a good parent. Because let's be clear. This is life affirming and life saving health care. When our children tell us who they are, it is our job as grown ups to listen and to believe them. That's what it means to be a good parent.

It's 2025, and insurance issues are worsening. During a surgery, I received a call from UnitedHealthcare demanding information about a patient who was under anesthesia. They wanted to know her diagnosis and if her inpatient stay was justified. I explained that she was asleep and had breast cancer, but the representative claimed he wasn't informed and directed me to another department. I emphasized that she needed to stay overnight and that I had already received approval for the surgery. This situation highlights how out of control insurance has become.

If you're a patient, it's important to know that your doctor, insurance company, and healthcare providers can financially benefit from labeling you as sicker. For example, clinics receive incentives for achieving vaccination targets, which can lead to significant payments based on the percentage of vaccinated patients. Additionally, if a patient is classified as diabetic based on an A1C reading of 6.8, even without treatment, the clinic can mark them as diabetic. This classification helps the clinic meet performance metrics, as they only need to keep the A1C below a certain threshold to receive credit. This creates a financial incentive for providers to label more patients as diabetic, regardless of actual treatment.

Speaker describes tasks that felt unconscionable: nurses often battle insurance coverage and must call to obtain a prior authorization, telling the insurer the medication is medically necessary; 'the medication bounced back as not being covered... I would have to call the insurance and get a prior authorization.' She recalls advocating for children, including 'to sterilize themselves.' A doctor asked her to teach a patient how to administer an intramuscular injection so he could inject himself with a prescribed medication—estrogen. She discovered the patient was 'a male dressing up as a female, embracing a false gender identity.' After checking the chart and seeing the estrogen order, she says, 'I can't believe this. ... I've literally taught him how to erase himself with estrogen.' This became a breaking point, as she felt anger, devastation, and sadness for patients 'believing a lie about their identity, about who God's made them to be.'

Transgender Inc., the market for sex reassignment surgeries and hormone replacement therapies, is a lucrative industry worth billions of dollars. The number of transgender individuals has doubled in the past decade, with over 1.6 million in the United States alone. However, there is a lack of long-term studies on the efficacy and consequences of these procedures and pharmaceutical products, especially for minors. The medical community, influenced by organizations like WPATH, has shifted the perception of transgenderism from a mental illness to a subjective reality that can be affirmed through surgeries and drugs. The profit-driven nature of this industry, coupled with the cultural and political push for transgender acceptance, has led to a lack of critical examination and oversight.

Michigan Medicine strives to be a safe, welcoming place for transgender individuals and to provide excellent health care regardless of gender. The goal of this video is to improve the comfort and competency of frontline staff in caring for transgender individuals. We will start by talking about gender identity, challenges the transgender community has faced in the health care system, and Michigan's policies regarding gender non-discrimination. The second half of this training is job specific. To discuss gender identity, it is important to understand the difference between sex and gender. Sex refers to one's reproductive organs, native hormones, and chromosomes, while gender identity refers to one's internal sense of gender, a person's basic sense of being a man or boy, a woman or girl, or another gender. Gender identity can be expressed by how individuals present themselves socially, including clothing, physical characteristics, speech, and mannerisms. All people, whether they are transgender or cisgender, meaning not transgender, have a gender identity and expression. Transgender is a term for individuals whose gender identity differs from the gender identity typically associated with their sex assigned at birth. There are many identities that fall under the umbrella of transgender. Transgender men, trans men, or trans masculine refer to people who are assigned female sex at birth but identify as men or masculine. Transgender women, trans women, or trans feminine refer to people who were assigned male sex at birth but identify as women or feminine. Other individuals may identify as genderqueer, agender, genderfluid, two spirited, bigender, or another identity that does not fit neatly into the categories of men or women. All major American medical societies, including the American Medical Association and American Psychological Association, endorse gender affirming care as the standard of care for transgender individuals. This means caring for people in a way that supports their gender transition and gender identity. Transgender people may undergo any one of a number of gender affirming medical interventions, including hormonal therapies like estrogen, testosterone, or hormone blockers, and surgical treatment to change body contours or genitalia. However, it is important to note that one does not have to undergo any medical or surgical treatment to be transgender. Some people are easily read as the gender they affirm while others are visibly gender non conforming or androgynous appearing.

No doctor is being forced to provide medication to adolescents; they are choosing to treat their patients based on the best available evidence. Many young people have known their identities from a very young age and have suffered for years before finding relief. It's important to note that it is the parents who consent to this treatment, driven by love and concern for their suffering children. Parents are following the advice of medical professionals and doing what they believe is best for their kids. The situation in Tennessee has created challenges for these families.

If you're a patient, your doctor, insurance company, clinic, and hospital can all benefit financially if you are classified as sicker. For example, insurance companies offer incentives for clinics to increase vaccination rates, rewarding them with payments based on the percentage of patients vaccinated. Additionally, if a patient is labeled as diabetic based on an A1C test result, even without treatment, the clinic can receive benefits. Maintaining a patient's A1C below certain thresholds can also improve the clinic's ratings. This system creates financial incentives for healthcare providers to classify patients in ways that may not always align with their actual health status.

I won't be a gatekeeper or judge someone's eligibility for care. My role is to provide a letter for them to access the care they need, regardless of how they identify.

I often see youth who have already undergone medical interventions due to a backlog in mental health support. Children may not fully understand the impact of these interventions, making it challenging to discuss. It can be especially difficult for young adolescents starting puberty suppression. We aim to make kids happy in the moment, but it's crucial to consider the long-term effects on their development. This is a growing challenge in our field that requires further exploration.

You want to talk to her? I can get her on the call. We're dealing with a lot of denials—about 50 a week. My name is Julie, the practice manager. We’ve faced backlash from insurance companies like Aetna and Cigna for speaking out on social media. Patients describe their struggles with chronic pain and the impact on their lives. After starting treatment, one patient felt relief, only to face insurance denials for necessary infusions. We work hard to appeal these decisions, spending countless hours on cases. Even experienced administrators find the process exhausting. However, we’ve had success in getting approvals after appeals. Patients deserve better; insurance companies shouldn’t dictate their quality of life. The health insurance system in the U.S. is fundamentally flawed and needs change.

Lesson 4: Maintain professional distance from interest groups. Clinicians report influence from trans support groups like Mermaids on youth gender clinics. Requests for clinician changes by Mermaids' head, Susie Green, were sometimes granted. Green had direct contact with GIDS and referred children to them. Clinics struggle to resist pressure from patient groups. Similar dynamics seen in other countries. Groups have their views, but may not align with children's best interests or evidence.

I just had a frustrating call with an insurance company regarding a patient's care. The insurance doctor questioned why I ordered certain treatments for a baby, despite established guidelines. I had the guidelines in front of me, but she didn't even have her password to access them. After explaining the medical necessity, she reluctantly agreed to approve the request but suggested that maybe the baby didn’t need such intensive care. I firmly stated that we take infant health very seriously. It’s disheartening to see some doctors prioritize insurance profits over patient care. There should be a clear line drawn when it comes to the value of human life in medicine.