Sex-reassignment surgeries covered by national health insurance, says NHSO Secretary-General

After a social media debate on whether the gold card benefits can cover sex-reassignment surgeries, Dr Jadet Thammathacharee, Secretary-General of the National Health Security Office (NHSO), clarified on December 2, that these surgeries have been part of the national health insurance benefits since 2018, with no exclusion clause.

Dr Jadet explained that the announcement by the National Health Security Committee on the types and scope of public health services, 2022, clearly states that any beauty procedures without medical indication are not covered by the gold card benefits. However, in cases where there are medical indications, such procedures can be performed and claimed.

Dr Jadet cited an example of sex-reassignment surgery for an LGBTQ+ individual at Chulalongkorn Hospital last year.

“The issue of sex reassignment for the LGBTQ+ group is not a matter of benefits but there has never been a clear discussion about what can be done and how. And the hospital has never made a claim, so the NHSO does not know what needs to be done.

“So, we have invited related civil sectors to discuss the whole package, from health promotion, disease prevention, treatment, and full rehabilitation, because there will be everything from hormone use to sex change. Some hormones may not be in the main drug list, so we have to look at the details.”

For the point that medical indications need to be examined by a doctor or psychiatrist to determine whether an individual needs to transition, Dr Jadet pointed out that it is no longer considered a disorder but a characteristic of gender incongruity with the mind and body. If a doctor thinks that leaving it will cause mental health problems or issues with existence, it can be considered.

Sex-reassignment surgery

However, the cost of sex-reassignment surgery is quite high as it involves not just sex-reassignment surgery, but also other related procedures, reported Sanook.

The benefits must cover everything. The Royal Thai College of Obstetricians and Gynaecologists and the Association of Clinical Sexology and Sexual Medicine, which treat people with gender incongruity, are currently developing a guidebook on about eight to nine procedures that need to be done, such as cutting the Adam’s apple, facial surgery, chest surgery, sex organ surgery, Dr Jadet.

“We are letting the team make it a complete package for transgender people. Some issues already exist, but they are just scattered. We have never taken these into account as transgender issues. We will gather these packages to discuss anew. We will include what already exists and supplement what is not yet there. Then announce it as a package for this group. It is expected that it will be completed in about one to two months.”