Resentment I cannot express to anyone IRL

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Don't know, but I can't get my head around to organizing a move out-of-state. It's just like I can't ever clean my apartment (and it is a mess); I just don't have the capacity to do it on my own.

Well, I went to a bar with my mum to watch a football game. My dad came late, but by the time he came I had to use the restroom. Unfortunately, there were only men and women's restrooms and I didn't feel comfortable about using either, thanks to the lack of surgery and my parents' probable disapproval if I used the women's, so I decided to walk back to their home. My dad complained about my leaving so soon after arrival, as though I were snubbing him. How unfortunate. He forbids discussion of transgender issues so I can't tell him the real reason for my departure. Instead, he will think I snubbed him.

Are there any kind of organisations that could help with organising a move out of state? If you're in a bad state to get this kind of surgery, maybe there would be some kind of support group?

Also, now that you've said what the issue is, you could try talking in the LGBT section of the forum. Maybe you could find some help there?

I'm asking my voc rehab counselor if there are any she knows of.

With my dad, I took the middle ground. Told him I needed to do something. It helps that I did walk back to where he was.

I am angry and resentful, but in reality I can't keep it running that long and hard. It has a tendency to lift quite a bit.

Good luck.

Well, the voc rehab counselor says they provide assistance for relocation if it's for employment, but not if it's for health care.

If I may ask, who is your current health care provider? As of this year (2015) the impact of the ACA on trans health care blanket exclusions has been pretty dramatic (depending on whether your state did the medicare/aide expansion or not).

And that brings up the big questions: Your parents. How supportive are each of them? Are you fully out to them / living full time as yourself? Do they claim you as a dependent / do you live with them? Can your parents add you to their insurance (depends on your age & how it would affect other finances, benefits, etc)? And the really big one, are they willing to fight for your coverage? I'm sorry I have to ask these, I realize they can hurt.

Even if they aren't supportive, that *can* change if they are willing to talk to other parents of trans children / adult children.

My understanding is that the ACA has not had any effect. In some states, state regulators required removal of those blanket exclusions, but that only applies to the states colored at this link:

http://www.transequality.org/issues/res ... ance-rules

I just checked my current insurer's plans for next year, and all of the ones on the exchange still exclude trans stuff. Even though the insurer has a gender reassignment policy, it only applies to those plans that specifically INCLUDE it, which does not seem to apply to any of the plans on the exchange (I sampled it):

https://www.bcbst.com/mpmanual/Gender_Reassignment.htm ("THIS GENDER REASSIGNMENT ADMINISTRATIVE POLICY ONLY APPLIES TO PLANS/POLICIES THAT EXPRESSLY COVER GENDER REASSIGNMENT. THIS ADMINISTRATIVE POLICY DOES NOT PERTAIN TO, NOR APPLY TO, ANY OTHER INSURANCE POLICIES OR HEALTH PLANS ISSUED BY BLUECROSS BLUESHIELD OF TENNESSEE, INC. THROUGH ANY OTHER MEANS, EITHER PUBLIC OR PRIVATE.")

http://www.bcbst.com/sbc/plans.do?plan= ... &year=2016 (Look at Policy. Under "Reconstructive Surgery" -> "Exclusions," the exclusion "Surgeries and related services to change gender (transgender Surgery)" appears in every plan I've looked at, for bronze, silver, gold, and platinum plans and high and low deductable plans.)

I am aware of the proposed rule, but that's all it is: Proposed. It's not even clear if it would be able to do anything without years of litigation:

http://www.healthcaredive.com/news/ques ... re/405595/



I am 31, so that would be hard. I'm too old to be on their plan. I do not live with them and they now live in a different state from me. They're kinda supportive and I am full-time, but it's like it would be better not to push it. Maybe I can move to California with my grandma and uncle. Maybe not. I will need help. My grandma wants me to have a job when I come to live, but I'm on disability.

Sigh. Could you have picked a *worse* state to live in? My heart goes out to you, Sister...

And yeah, too old to be a dependent & too far away. On the bright side, I'm glad your parents are not a direct hindrance. California would be ideal, if you could do it. Can't swing a dead cat here without hitting one of us...okay, that's not quite true. But we've led the nation in legal protections for over a decade & depending on where your relatives live, local support is more likely to be available. The only not-great areas are some conservative counties in the south part of the state, but even they have to comply with all of the state laws. Regional support, both legal and medical is pretty good too. What region does your grandmother live in? What is holding you back?

My uncle lives in Sacramento and my grandma lives in the Bay Area, both good areas.

I just emailed my uncle asking for help, but I don't think he will, after reviewing a message he wrote to me a year ago, right when I was awarded SSDI. He said that I was just playing "victim" too much and that I was not "really" disabled. This was disheartening, because he is one of the more liberal relatives of mine (hard to come by amongst my relatives) and is gay.

I asked him for help in getting to a place where my access to health care could not be discriminated against, but in light of what he wrote before he'd probably just say I was playing victim and I'd need to suck it up or something.

Spoke too soon. Called my uncle on the phone and he referred me to some local LGBT resources that might provide some help.

(does a very tiny, subtle happy dance)

That's a really good start. Even if the resources don't pan out, can you ask each of them if they know of others to try? Your state does appear to have some knowledgeable organizations in the two biggest cities.

I'm glad your uncle is responding, as he must have some vague idea what it is like to need allies. And you never know, maybe he was going through something difficult of his own a year ago?

Sacramento and the Bay Area *are* good areas! I'd even say quite possibly the best in the country. But then, I might be just a tiny bit biased.

(btw, strangely enough many online trans resource lists show your state as being one that *does* provide surgery coverage, but when I go to bcbst, the entire site server appears to be dysfunctional)

Do you mean Tennessee? What resources are those?

I'm not following. You have Obamacare now and they don't have plans that cover your surgery available in your state but they do have plans that cover it in other states? If that's what you are saying, what states cover it and would you be able to switch insurance when you move there and if so, how long would it take to get it?

Or maybe I misunderstood the whole thing.

(warning: link overload alert!)

The ACA mandates via section 1557 that health care insurance/providers cannot discriminate on the basis of sex per the CRA of '64. The legal reasoning that applies this to trans people started here:
https://www.aclu.org/cases/schroer-v-library-congress
went through
http://www.lambdalegal.org/in-court/cas ... umby-et-al
and really was cemented in
http://www.jacksonlewis.com/resources-p ... oc-decides
(which solidly applied Title VII, which had the effect of expanding out to other Titles, such as education & Title VI)

Here's how it applies to the ACA:
http://www.nwlc.org/resource/nondiscrim ... ction-1557
And Tennessee's Title VI compliance:
https://www.tn.gov/assets/entities/didd ... liance.pdf

Most resources (HRC, NCTE, etc) that list whether a state is compliant & offers GRS/SRS list TN as being compliant.

However, the question is does the state offer *policies* which are applicable to ACA compliance?

Anyway, OliveOilMom; yes, the solution if one lives in a state that won't set up an exchange or won't expand medicaid is to move to a state that does. California is one such state & has had laws on the books prohibiting transgender health care exclusions for a few years now. It's much easier here as there are Legislators who are on the side of trans people like Toni Atkins, Tom Ammiano and others, a governor who signs and we're home to several of the big transgender legal and equality organizations.

One of the groups that might know TN specifics is
http://www.tntjproject.org/home.html

But I went to
http://obamacarefacts.com/questions/is- ... -coverage/
and followed a link to
http://www.cheatsheet.com/personal-fina ... ?a=viewall
that indicates Tennessee does provide coverage via the ACA.

Right. Whether it's covered on plans on the health exchange seems to largely depend on the state. This is a map of states where regulators require coverage:

http://www.transequality.org/issues/res ... ance-rules