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The Limited Coverage of Facial Feminization Surgery in the United States: A Literature Review of Policy Constraints and Implications

There is a literature gap regarding facial feminization surgery (FFS) access and coverage. Our goal is to compile information from previous studies and assess the current policy landscape for these surgeries in the US. We also explored why some policies do not cover them, identify states with better...

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Autores principales: Aristizábal, Alejandra, Escandón, Joseph M., Ciudad, Pedro, Manrique, Oscar J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455106/
https://www.ncbi.nlm.nih.gov/pubmed/37629353
http://dx.doi.org/10.3390/jcm12165308
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author Aristizábal, Alejandra
Escandón, Joseph M.
Ciudad, Pedro
Manrique, Oscar J.
author_facet Aristizábal, Alejandra
Escandón, Joseph M.
Ciudad, Pedro
Manrique, Oscar J.
author_sort Aristizábal, Alejandra
collection PubMed
description There is a literature gap regarding facial feminization surgery (FFS) access and coverage. Our goal is to compile information from previous studies and assess the current policy landscape for these surgeries in the US. We also explored why some policies do not cover them, identify states with better coverage, and determine the most covered procedures. PubMed, Medline, Embase, and Scopus were searched for studies that reviewed policies on FFS coverage. Studies on surgical techniques or other gender-affirming surgeries (GASs) that did not involve FFS were excluded. Seven studies were included for analysis. In 2014, the Department of Human Health Services (HHS) lifted the transgender exclusion policy, leading to an increase in policies regarding GASs for both private and state insurance. However, there are differences in medical necessity requirements among policies, which may not align with the World Professional Association for Transgender Health (WPATH) criteria. States that prohibit exclusion tend to offer better coverage for FFS. These states are mainly located in the western and northeast regions, whereas states in the southern and middle east regions have less coverage. Among the procedures, chondrolaryngoplasty is the most covered, while facial and cervical rhytidectomy are the least covered. To enhance transgender care, it is crucial to reach a consensus on how to offer coverage for facial feminization surgery. However, there is a lack of adequate research on this topic, and there is a need for resources and tools to assess the results of FFS procedures. One significant constraint of this study is that it does not provide a systematic review of the literature.
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spelling pubmed-104551062023-08-26 The Limited Coverage of Facial Feminization Surgery in the United States: A Literature Review of Policy Constraints and Implications Aristizábal, Alejandra Escandón, Joseph M. Ciudad, Pedro Manrique, Oscar J. J Clin Med Review There is a literature gap regarding facial feminization surgery (FFS) access and coverage. Our goal is to compile information from previous studies and assess the current policy landscape for these surgeries in the US. We also explored why some policies do not cover them, identify states with better coverage, and determine the most covered procedures. PubMed, Medline, Embase, and Scopus were searched for studies that reviewed policies on FFS coverage. Studies on surgical techniques or other gender-affirming surgeries (GASs) that did not involve FFS were excluded. Seven studies were included for analysis. In 2014, the Department of Human Health Services (HHS) lifted the transgender exclusion policy, leading to an increase in policies regarding GASs for both private and state insurance. However, there are differences in medical necessity requirements among policies, which may not align with the World Professional Association for Transgender Health (WPATH) criteria. States that prohibit exclusion tend to offer better coverage for FFS. These states are mainly located in the western and northeast regions, whereas states in the southern and middle east regions have less coverage. Among the procedures, chondrolaryngoplasty is the most covered, while facial and cervical rhytidectomy are the least covered. To enhance transgender care, it is crucial to reach a consensus on how to offer coverage for facial feminization surgery. However, there is a lack of adequate research on this topic, and there is a need for resources and tools to assess the results of FFS procedures. One significant constraint of this study is that it does not provide a systematic review of the literature. MDPI 2023-08-15 /pmc/articles/PMC10455106/ /pubmed/37629353 http://dx.doi.org/10.3390/jcm12165308 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Aristizábal, Alejandra
Escandón, Joseph M.
Ciudad, Pedro
Manrique, Oscar J.
The Limited Coverage of Facial Feminization Surgery in the United States: A Literature Review of Policy Constraints and Implications
title The Limited Coverage of Facial Feminization Surgery in the United States: A Literature Review of Policy Constraints and Implications
title_full The Limited Coverage of Facial Feminization Surgery in the United States: A Literature Review of Policy Constraints and Implications
title_fullStr The Limited Coverage of Facial Feminization Surgery in the United States: A Literature Review of Policy Constraints and Implications
title_full_unstemmed The Limited Coverage of Facial Feminization Surgery in the United States: A Literature Review of Policy Constraints and Implications
title_short The Limited Coverage of Facial Feminization Surgery in the United States: A Literature Review of Policy Constraints and Implications
title_sort limited coverage of facial feminization surgery in the united states: a literature review of policy constraints and implications
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455106/
https://www.ncbi.nlm.nih.gov/pubmed/37629353
http://dx.doi.org/10.3390/jcm12165308
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