Brandon Moyse | Not a quick, superficial fix

Is a nose job medically necessary? Sometimes. What about a sex change?

That has been the question raised recently by transgender individuals and their supporters. They contend that the University's lack of health care coverage for sexual-reassignment surgery violates Penn's non-discrimination policy.

I know I'm tackling an issue with which I have little personal experience. As a Canadian citizen, the concept of selecting a carrier and paying health-insurance premiums is completely foreign to me (what the heck is an HMO?). Moreover, I can't even begin to empathize with people diagnosed with gender-identity disorder, a mental condition where being transgender causes serious distress, which is something so far removed from me that it seems almost unbelievable.

That said, it is a recognized, albeit controversial, psychiatric disorder and one that requires treatment. Whether the University should cover that treatment is a different question, and one to which I firmly believe the answer is no. The benefits do not outweigh the costs.

According to Lesbian Gay Bisexual Transgender Center director Erin Cross, this whole outcry stems from an instance last year when an employee approached her, ready to have sexual-reassignment surgery, and wanted to know if the University covered it. Cross said it is the only time anybody has approached her ready to have the surgery.

Given that the worldwide prevalence of GID is around 1 in 10,000, and that Penn has 12,000 employees enrolled in its health-insurance plans (25,000 when dependents are counted), there are probably fewer than 10 people at Penn who would be eligible and willing to have the surgery. And as far as we do know, there's only one.

Like welfare and Social Security, health insurance is a cooperative enterprise into which enrollees pay premiums and receive money when needed. The healthy pay for the not-so-healthy. In the case of SRS, the cost - up to $50,000 for the surgery, never mind follow-up treatments - combined with the very low demand for the procedure means that adding coverage for it is economically inadvisable.

Without surgery, Cross argued, these individuals require intense psychiatric therapy because of their potentially suicidal tendencies. However, that therapy is already covered by the University's extensive coverage of treatment of mental-health disorders. The end result - treatment - is the same, so adding coverage and increasing costs are redundant. And there's no guarantee that SRS will be any more effective than counseling in improving one's mental health because surgery as complex as that can bring on a whole host of complications, both physical and mental.

There isn't much precedence behind insurance companies covering SRS. Mercer, one of Penn's consulting firms, pegged the number of employers that cover it at between 2 and 12 percent, depending on the survey. No other Ivy League universities cover it and only two universities in the whole country do - the University of Michigan and the University of California.

Part of the reason for the lack of coverage is the fact that SRS and GID are still relatively new. Geri Zima, the benefits manager of Penn's Division of Human Resources, likened SRS now to what gastric-bypass surgery was a few years ago - a new procedure that required some examination and defining as "medically necessary" before it was approved to be covered.

The University's plan is redesigned every year to meet employees' needs and to respond to trends from the previous year. Furthermore, there are a couple avenues that the LGBT Center or those in need of SRS can take to appeal Penn's benefits plan: There is both a benefits-appeal committee and a personnel-benefits committee that review complaints. Zima indicated that no formal appeal has been made regarding SRS.

Returning to the cost, the University covers, on average, 80 percent of the premium while employees pay the remaining 20 percent. If SRS were added, both the University and its employees would be accountable. Considering the current economic climate, when review of the plan rolls around in April, faculty and staff should not be asked to bear that extra cost. The University, already tightening its belt, has more pressing issues on which to spend its money.

Brandon Moyse is a College junior from Montreal. He is the former senior sports editor of The Daily Pennsylvanian. What Aboot It, Eh? appears on Thursdays. His email address is moyse@dailypennsylvanian.com.

Please note All comments are eligible for publication in The Daily Pennsylvanian.