Arizona bill would require insurance coverage for 'detransition' surgery

PHOENIX — A state lawmaker wants to require insurance companies to pay the medical costs for people who decide to “detransition’’ from their sex-change therapy and surgery.

Sen. Janae Shamp, a registered operating room nurse, said there are medical codes doctors can use to bill insurance companies for patients’ gender changes.

What’s missing, she said, are any codes for the medical procedures to reverse that. The result is there is no way for doctors to get reimbursed by the insurers, said Shamp, a Republican from Surprise.

Shamp brought California resident Chloe Cole to a press conference Thursday to detail how Cole believes both she and her parents were misled by doctors into approving hormonal treatments for her when she was 13 and giving the go-ahead to have her breasts removed two years later. Only afterwards, Cole said, did she realize that was a mistake for her.

Senate Bill 1511 is designed to provide a path — and payment — to reverse the procedure on anyone in Arizona who wants to reverse the process, Shamp said.

“There are dozens of medical billing codes for gender-affirming care,’’ the senator said. “But there’s not one single for patients seeking to cease gender-transition therapies and reclaim their God-given gender.’’

Separately, Sen. T.J. Shope, R-Coolidge, has introduced SB 1451, which would bar providing any hormone therapy without parental consent “if the practice is performed for the purpose of changing a minor’s appearance or body to no longer correspond to the minor’s biological sex.’’

Latest in a series of bills

The measures are the latest in a series of efforts by Arizona lawmakers to wrestle with issues relating to transgender individuals and procedures.

Two years ago the Republican-controlled Legislature voted to outlaw gender-transition surgery for minors, including if there is parental consent. A broader measure to also ban hormone therapy failed to get Senate approval, however.

The same year, Arizona enacted a law that spells out school sports must be designated as male, female or co-ed. It specifically says teams designated for women or girls “may not be open to students of the male sex,’’ and is written to deny participation to those who were born male but identify as female.

More recently, GOP lawmakers tried, unsuccessfully, to designate who can use which restroom and to forbid teachers from referring to a student by their preferred pronoun if it doesn’t match the sex they were assigned at birth.

“Will affect my marriage”

Shamp said her legislation is designed for people like Cole, now 19, who told reporters of the ongoing problems she is having since undergoing transition.

“I’m experiencing joint pain from the puberty blockers,’’ Cole said. She said pain in her pelvic region “has been slowly getting worse over time.”

“And my breasts, I know I will never have them back,’’ she said.

“I know those scars always will be there,’’ Cole continued. “And even if I chose to get them reconstructed, implants or tissue, nothing could ever bring the function or shape or sensation back.’’

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“It will affect my marriage in the future,’’ she said.

Shamp said that’s what’s behind her measure. “This is about having access to care for detransitioning which they don’t have at this point.”

That gap, she said, is “unheard of in the medical world.’’

“And that means we have political ideology directing it,’’ she said. “And that has to stop.’’

Insurance mandates

Her legislation spells out that if an insurance policy provides coverage for gender transition procedures it also must cover gender detransition.

It’s not just about having the proper billing codes. Another provision says any doctor, health-care institution or any other licensed health-care provider that performs gender transition “must agree to provide for the performance of gender detransition procedures.’’

Cole has testified in other states on behalf of more far-reaching legislation to deny gender-affirming care for minors in the first place.

Shamp said her legislation is separate than that question of whether Arizona should allow sex-change procedures to be performed on minors, with or without parental consent.

“We’re not addressing that today,’’ she said.

“God makes no mistakes”

She said that, at least as far as this measure goes, her personal opinions about sex-change procedures are irrelevant.

“I’m here to represent all of the children that have gotten bad advice, have been pushed into procedures and pushed into situations based on a political ideology and the fact that we don’t even have it set up in order to take care of their basic health-care needs,’’ Shamp said. “And that is repulsive to me and that is why we’re here.’’

But she does have an opinion.

“I believe that God makes no mistakes,’’ she said when asked if it is possible someone could be born into a body that doesn’t match the gender with which they identify.

Shamp’s proposal has yet to be assigned to a committee for a hearing.