They testify during a periodic review of
prioritized medical conditions and treatments
by Patrick O'Neill
SALEM - Oregon health planners will organize a task force to determine if sex-change operations are effective in treating gender-identity disorders.
A subcommittee of the Oregon Health Services Commission decided Friday that it needed more scientific data before deciding whether to include the surgeries on the list of treatments covered by the Oregon Health Plan, the state's health insurance program for the poor.
Five Portland transsexuals who testified during the session said afterward
that they were cautiously optimistic about the plan to form a task force.
During often-emotional testimony Friday, the five-member subcommittee heard
the transsexuals argue in favor of taxpayer-financed sex-change operations,
which cost about $10,000.
But members of the subcommittee said they didn't have enough information to
make a recommendation to the full commission. The subcommittee members were
unsure about the effect of surgery on the underlying psychological roots of
The task force has not yet been named. But subcommittee members recommended
that it be composed of transsexual advocates as well as experts in gender-
Dr. Eric Walsh, one of the subcommittee members, said he found "a lot of
uncertainty" among medical experts about the effectiveness of transsexual
surgeries. He said he reviewed 145 medical journal articles about
transsexualism and found widespread disagreement about the usefulness of the
Dr. Andrew Glass, chairman of the subcommittee, told the group that "it isn't clear that everyone is agreed on the outcomes (of the surgeries). What we're trying to do is develop a scientific way to address these issues."
Glass predicted that it would take six to nine months for the task force to
complete its study.
The discussion about sex-change surgery is part of the commission's mandate to review periodically review the prioritized list of medical conditions and
treatments that form the heart of the Oregon Health Plan, which covers 270,000
The list of 745 ailments and treatments, ranked in order of importance, is
used as a way for legislators to decide how much money to spend on health care
for the poor. The more money there is to spend on health care, the more items
on the list can be covered. The covered items now include the first 574
treatments, with sex-change operations listed at number 688.
The discussion of sex-change surgery came as a result of demands by Olivia
Jaquay to have her operations covered by the health plan. Jaquay, who was born
a man, has had surgery to turn her into a woman. She has paid for the surgery
herself but needs one more minor operation to complete the process.
Jaquay said after the meeting that she's cautiously optimistic.
"I don't trust them," she said of subcommittee. "But I hope something good
comes out of it."
Vincent Irelan, who was born a woman but whose sexual identity is that of a
man, said he would take advantage of state-financed sex-change operations "in
an instant" if they were available.
Irelan who was born blind, was accompanied by Oslo, his black Labrador guide dog.
Irelan, who wears men's clothing, said he wants surgical removal of his
breasts, which he binds close to his chest, aggravating a medical condition.
During testimony, the witnesses said sex-change procedures are far more than elective cosmetic surgery.
Margaret O'Hartigan, acting director of the Filisa Vistima Foundation, a
transsexual advocacy organization, said that for her, surgery was a life-
saving medical procedure. O'Hartigan, who was born a man, underwent surgery
more than 20 years ago in Wisconsin, which provides the treatment for low-
income people at taxpayer expense.
"Before surgery, I was surviving through prostitution and welfare and made
repeated suicide attempts," she said. "Since obtaining surgery, I've supported
myself as a typist and secretary and have never attempted suicide again."
Rachel Koteles, who was born a man and who has undergone surgery, said her
gender-identity disorder led to a string of suicide attempts, beginning at age five.
Koteles, a supervisor at a software company, said health commission staff
members have exaggerated the possibility that Oregon would be flooded by
transsexuals seeking surgery if the procedures were approved.