In recent days, my American readers have been focused on the abysmal care to our military veterans at a number of government hospitals, the mystery surrounding the prisoner swap with the Taliban and Sgt. Bergdahl, and the deepening concerns about the Mr. Obama’s foreign policy setbacks in Eastern Europe, the Middle East, and Asia.  But mostly unnoticed was a small item in which the Department of Health and Human Services (“HHS”) reversed a long-standing ban on gender reassignment surgery paid for by Medicare.  (Yes, really!)  Gender reassignment surgery is commonly referred to as a sex change operation.  Thus, taxpayer-paid sex change surgeries are now available for the elderly and disabled.

HHS has determined that it is “no longer reasonable” to expect older and disabled Americans to pay for their own sex change operations.  Instead, HHS now recognizes the surgery as “medically necessary” and “effective” treatment for people who cannot deal effectively with their own biological gender.  Mr./Ms. Denee Mallon, a 74-year-old Army veteran from Albuquerque, New Mexico, was the driving force behind the change in HHS policy, after he/she sued HHS for this special benefit.  In an emailed statement reported by ABC News, Mallon wrote:

Sometimes I am asked aren’t I too old to have surgery.  My answer is how old is too old?  When     people ask if I am too old, it feels like they are implying that it’s a “waste of money” to operate     at my age.  But I could have an active life ahead of me for another 20 years.  And I want to spend     those years in congruence and not distress.

(I wonder why he/she didn’t simply go to the Veterans Administration for the sex change operation?  After all, taxpayers we have been paying for sex change operations for military traitors and illegal immigrants throughout the Obama years.)  Each gender reassignment surgery can cost $50,000 or more.  Fortunately, Medicare has plenty of money to take care of the 10,000 seniors now retiring each day.  Gary Gates, a demographer with The Williams Institute, a think tank on LGBT issues at the University of California at Los Angeles, estimates that people who self-identify as “transgender” make up 0.3 percent of the U.S. adult population.  With over 49 million Americans now enrolled in Medicare, if Mr. Gates’ numbers are somewhat accurate, I would think that sex change operations for senior citizens and the disabled should not amount to more than 150,000 surgeries.  Thus, the new HHS policy clearly recognizes that it is a taxpayer responsibility to cover an elective body modification that reduces the mental, psychological, and physical risk arising from those suffering from gender confusion and dysphoria.

Technically, the HHS decision does not yet apply to Medicaid, which provides health coverage for individuals and families with low-incomes.  Although some states do not pay for sex change surgeries and the cost of sex hormones that transgendered people commonly take during their “transition,” other states evaluate such claims on a case-by-case basis.  However, as private health insurance companies and Medicaid programs often follow the federal government on what is considered medically necessary, this decision is likely to lead to sex change surgeries as a routinely covered insurance benefit.  After the HHS decision, Mallon said in a statement, “This decision means so much to me and to many other transgender people.  I am relieved to know that my doctor and I can now address my medical needs, just as other patients and doctors do.”  I am reminded of Mr. Obama’s response to a question at a town-hall meeting about one’s 100-year-old grandmother who received a pacemaker.  This was during the run-up to passage of Obamacare.  The questioner pointed out to Mr. Obama that her grandmother had badly needed a pacemaker, but had been turned down by a doctor because of her age.  A second doctor, noting the patient’s alertness, zest for life, and generally youthful “spirit,” inserted the pacemaker despite her advanced age.  Her symptoms, having been resolved, Grandma was doing well five years later.  The question for Mr. Obama was, “Under the Obama healthcare system, will an elderly person’s general state of health, and her “spirit,” be taken into account when making medical decisions – or will these decisions be made according to age only?”  Mr. Obama’s famous answer was clear: “it is really not feasible to take ‘spirit’ into account.  We are going to make medical decisions based on objective evidence, and not subjective impressions.  . . . Maybe you’re better off not having the surgery, but taking a pill.”  I guess he has now “evolved” on this as well.  I am glad that Mr./Ms. Mallon won’t have to just take a pill to deal with his dysphoria, or that he won’t have to pay for it either as those expenses are now foisted on taxpayers.  But as Tony Perkins from the Family Research Council observed, “While President Obama is busy financing senior sex changes, wounded veterans are dying for lack of medical care.”