To the Editor Canner et al¹ reported that the number of gender-affirming surgeries performed in the United States has been increasing since 2000. To conduct this research, the authors identified hospitalizations for gender-affirming surgical procedures by the presence of diagnosis codes for either transsexualism or gender identity disorder within the discharge record. However, in the 2000s, clinicians avoided using these codes because insurance companies commonly implemented blanket exclusion policies prohibiting reimbursement for gender-affirming services. Instead, clinicians would often use a broader category of codes, such as unspecified endocrine disorder or unspecified disorder of genital organs, when caring for transgender individuals to prevent burdensome and invasive disputes between insurers and patients.

致Canner等人¹报告指出，自2000年以来，在美国进行的确认性别手术的数量一直在增加。为了开展这项研究，作者通过在变性者内部存在变性欲或性别认同障碍的诊断代码，确定了住院确认性别手术的方法。放电记录。但是，在2000年代，临床医生避免使用这些代码，因为保险公司通常实施一揽子排除政策，禁止为确认性别的服务提供报销。取而代之的是，临床医生在照料跨性别者以防止保险人与患者之间繁重的侵入性纠纷时，通常会使用更广泛的代码类别，例如未指定的内分泌失调或未指定的生殖器官失调。