Brown University recently announced that its student health insurance plan will cover 14 gender reassignment surgeries beginning in August. Dartmouth may soon join Brown and a score of other universities nationwide, including Harvard University and Northwestern University, that have moved to increase coverage of these surgeries, according to Health Services director Jack Turco.
The Dartmouth Student Group Health Plan currently covers "top" surgery, or breast augmentation and mastectomy, as well as non-surgical hormone therapy, but Turco said he wants the plan to cover "bottom" procedures, which includes vaginoplasty, penectomy and scrotoplasty.
"I think everyone is hesitant to jump right in, but it doesn't make any sense to me at all to cover top surgery and not bottom," Turco said.
A committee including students and community members decides what is covered under the DSGHP. Turco, a committee member, said its job is to create a health care coverage plan that serves the needs of the College's students.
Turco plans to discuss extending gender reassignment surgery coverage at the next meeting to decide what will be included in next year's coverage, he said.
Gender reassignment surgeries cost anywhere between $15,000 and $20,000 significantly more expensive than hormone therapy.
Because insurance plans have only recently begun covering the more expensive procedures, many transgender individuals, especially students, do not opt for surgery, Turco said.
Since only a small portion of the student population will decide to transition, covering more expensive gender reassignment surgeries will not be a significant cost burden.
Breast augmentation and mastectomy are generally the most popular form of gender reassignment surgery, and several student patients have undergone the procedure.
Increased insurance coverage and societal awareness may encourage people to transition at a younger age, but Turco said he is unsure how many students will pursue procedures currently not covered by Dartmouth's health plan while at the College.
Women's and gender studies professor Michael Bronski said that Dartmouth should extend coverage for gender reassignment surgeries for ethical reasons.
"Any decisions that any of us make about anything is a matter of weighing different choices," Bronski said. "In the weighing of choice of will it cost more money or is it ethically right, I think, at least to me, the ethical choice trumps the other one."
Bronski said insurance costs would not increase dramatically if the only a small number of students had the surgery.
Covering a larger pool of surgeries would send a message that the College is committed to inclusion, diversity and student health.
"Health insurance policies are a really good way to gauge a number of issues, for universities, companies, for nonprofits," he said. "You can judge the ethics or bottom-line attitudes of organizations by the coverage they offer."
Men's Forum intern Gustavo Ruiz Llopiz '14 said that increasing gender reassignment surgery coverage would be consistent with the trend of increasing acceptance of transgender students over the last 10 years, as illustrated by the addition of gender-neutral spaces and bathrooms.
"Trans health should be at the forefront of the College's priorities," Llopiz said. "Trans rights in general are more often than not overlooked. As someone who has dealt with a portion of the trans population at Dartmouth, there is a need to have more trans health rights at the table."
Medical groups such as the American Psychiatric Association and the American Medical Association promote gender reassignment surgery as treatment for gender identity disorder.
The social climate has changed to become more accepting of transgender people, Turco said.
"Transgender is not anywhere near as uncommon as people in the past thought it was," he said. "A lot of individuals are making successful transitions, leading full social and professional lives, going to school and getting on with life. As that happens more and more, insurance will cover the surgery."
