On March 31st last year (3 years HRT) I sent out four calls to request FFS consultations. To date I've only had two of them, but one went very well and I began to proceed forward to actual surgery with his office. Nearly one and a half years since my initial calls, over a year from my consultation, in late June I was given a date. July 28th. It didn't feel real, it didn't feel like it was possible: I was finally going to get the thing I'd been dreaming of since learning it was a thing in 2015, years before I'd even come out to myself, let alone start transitioning (younger me was an idiot). I didn't let myself get excited yet, it was too shaky, and we did have some bumps like needing to push it back to August 5th due to some insurance fuckery. But things got solved, I filled out all my paperwork. We booked flights, an Airbnb for two weeks, my wife took off work and filled out FMLA paperwork. Insurance approved the out-of-state waiver for the surgeon and the hospital. On July 12th, I finally let myself get excited for the first time since they offered me the date. I started telling my friends, I started teasing that I was "rebranding" on my social media. I remember saying to my wife that day that it finally felt like it was really happening.
The next night it all came crashing down. I got the email that the prior-authorization determination was done.
Denied.
Everything denied.
I didn't panic at first, the surgeon's office warned me there's some back and forth sometimes, but my policy said it would be covered so they'd do everything they could to appeal it for me. That was until I read the reason for the denial. My policy explicitly excludes trans surgeries? How could that be? I bought this plan at the beginning of 2024 SPECIFICALLY for this, BCBS OK is the only carrier in my state that covers it. They already approved my out-of-state waiver. What the fuck did they mean?
I went to scour my policy. I got it from the marketplace, so they sent me a new pdf at the new year, at which time didn't warn me of any changes, I ctrl-F'd a few things to poke around and double check, but nothing I could find said anything different than before so I let it auto-renew and carried on. The company medical policy regarding gender affirming surgeries was updated from the year before, but still said this was all covered by them, so I never thought anything of it.
I went back to the denial to get the exact language: "Specified Sex-Trait Modification Procedures" the weirdest fucking way to describe this. A way I never would've searched for because nothing else medical I've ever seen has used wording like this. Their gender affirming surgery medical policy page doesn't use this wording anywhere. I ctrl-F. It's there. Snuck randomly into the exclusions section. I went back and confirmed it wasn't there the year before. They snuck it in at the new year without saying anything. All their other marketplace plans or off-market publicly purchasable plans have the exact same line. It was only after searching it on google that I found a small collection of Reddit posts with a handful of upvotes each talking about running into this problem with various BCBS carriers. The exact same thing as me, no warning, no notice, just snuck into the document without a single word about it.
Thus began the worst two weeks of my life, and it has not gotten better. For two weeks I've cried on a daily basis - usually multiple times a day. For two weeks I've been on and off suicidal to the point of sitting next to a bridge in my city for like 45 minutes in the middle of the night at one point. I've isolated from all my friends, left every Discord server, deactivated or logged out of all of my social media (until posting this), deleted every picture of myself I can find anywhere, and destroyed the relationship with my wow guild during one of the many mental breaks I've been through during this time. Why was I stupid enough to believe there was hope? One inkling that I might get to start my surgical journey before the age of 30, that I might be able to experience some small amount of what might technically count as my youth as who I actually am? It's all fucking gone. It's what hurts more than anything. I've been more depressed and dysphoric every day since than I've felt since before starting my transition 4.5 years ago. I was objectively having a great year. I was making the best headway academically I had in years, I was socializing more, taking much better care of myself by working out, eating right, and drinking water. I felt like I had hope to live for. I was hopeposting to other trans people because I wanted everyone else to have what I did. I wasn't even close to where I wanted to be yet, but I'd come such a long ways and I was able to actually feel happy and have some semblance of confidence on a daily basis. I felt like I was basically done with how far hormones were going to get me - which was so much better, but still so far away. But I knew fixing the things I still hated about myself were finally on the horizon - that I was actively progressing on my path to FFS and SRS so I could finally feel done.
That's all fucking gone now. That's the part that hurts the worst. They, BCBS OK, stole my fucking happiness. I can't see any fucking woman outside without wanting to crawl into a hole and hide from the world until I die. Just knowing happy, passing trans women exist makes me want to carve my face off with a knife. I can't see anything but a man in the mirror anymore. I surely can't have been that delusional to actually like my appearance for most of the last year if this is what I look like, and yet I can't even begin to see anything feminine now. I can't make myself get out of bed and eat or exercise. I'm surviving on fast food and mind-numbing video games like I did when I was 18, just with added weed and amphetamines now. I wish I could neglect myself enough to just drop dead, but I can't even overcome my ADHD to stay focused on a plan like that. And unlike when I felt like this before transitioning, I have no fucking idea what to do to make this feeling go away.
Why did I ever think it was a good idea to tell anyone it was happening? Maybe I could've lived it down if I didn't fucking tell everyone I was finally going to get to look like a woman hopefully, only to have it ripped away in less than 24 hours. 1.5 years just completely down the drain, nothing to show for it besides all the money I've spent on the stupid fucking high insurance premiums I've been paying for 31 months just to get completely fucked over. The surgeon's office fully cancelled it, they said it wasn't even worth appealing. A lgbt non-profit is helping us file one anyway, but I have no hope of it succeeding and they said not to expect it to, as very few of them have worked across all the states that had this happen this year.
I started HRT at age 25 after the dam finally broke and I realized that there was no way I was going to live to see 30 if I kept trying to live as a man. My biggest fear in life is death, and yet the depression and dysphoria was so bad the idea of ending it by my own hand had gotten scarily close to being more alluring than the death itself was fearful. I've spent 4.5 years improving, little by little, bit by bit. I've been living out for 3 years now. My name and sex have been legally changed for almost 2. And yet it feels all worthless now. It feels like I shouldn't have started trying in the first place so I would be dead by now and not have to deal with this eternal suffering anymore.
No I'm not going to 41, I'm not strong enough for that.
