Hair Removal for Patients Undergoing Feminizing Surgeries in Oregon's Medicaid Program

    January 2021 in “ JAMA Dermatology ”
    Janelle Downing, Kimberly Yee, Geolani W. Dy
    TLDR Improved access to hair removal is crucial for transgender individuals before feminizing surgeries.
    This study examined the use of preoperative hair removal among transgender individuals assigned male at birth (MSAB) enrolled in Oregon's Medicaid program from 2015 to 2018. Of the 1,372 MSAB transgender beneficiaries, 167 (12.2%) had at least one hair removal claim covered by Medicaid. Among these, 32 (19.1%) underwent vaginoplasty, 29 (17.4%) received feminizing top surgery (FTS), and 106 (63.5%) had not yet received surgery. The study found that dermatologists provided hair removal services more frequently to those who had not yet undergone surgery. Electrolysis was often performed by clinicians outside of a medical setting, which is typically not covered by most insurance plans. The study highlighted the importance of coverage and access to preoperative hair removal services for individuals undergoing gender-affirming surgeries, as deemed medically necessary by the American Academy of Dermatology. Limitations included the inability to identify specific body sites for hair removal and the exclusion of phalloplasty due to small sample sizes.
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