Dear Editor,

Recently I attempted to get individual health insurance by making several calls to some of the major health insurance agencies. As someone who identifies as a trans man — which means I was assigned female at birth but identify as a man — I encountered some roadblocks that were particularly troubling for me.

My conversations with the agents made it clear that there was no policy that existed to cater to my health needs or to trans bodies, in general. A trans man might have had top surgery (where the breasts have been removed,) but might still require certain reproductive health services, including pap smears. If a trans man selects ‘male’ on his health insurance application the system will automatically block a range of services that he might still need.

Currently there is no acknowledgement of gender identity on these forms, which would allow trans people to distinguish between sex and gender. For a trans woman — someone who was assigned male at birth but identifies as a woman — who might have had a vaginoplasty (lower surgery where she now has a vagina) and selects ‘female’ on her health insurance application form, the system will automatically block a range of services that she might need, including a prostate exam.

There exists in Jamaica a diverse group of people who are trans-identifying with varying healthcare needs and currently the service offering falls short, leaving trans people to make critical and possibly detrimental decisions about their health and well-being.

It is important that decision makers in the health insurance field, including policymakers and representatives in the Ministry of Health, take a look at their systems and catalogue of services and work with the trans community to learn more about how their needs can be met.

If we are invested in having a healthy and stable society, in alignment with one of the national outcomes in Vision 2030, we must ensure that all our citizens are meaningfully engaged so that healthy outcomes can be realised by those of us who are vulnerable and marginalised.

Neish McLean

Co-founder and executive director

TransWave Jamaica

neish@transwaveja.org