NCPA - National Center for Policy Analysis

Should Insurers Pay To Treat Sexual Dysfunctions?

March 14, 2001

If treatments for infertility and impotency are covered by health insurance, what about other sexual disorders? For instance, the city of San Francisco's employees' health insurance will now cover sex-change operations for employees, their spouses or domestic partners suffering from gender identity disorder. Eventually, as with some other so-called lifestyle disorders, there may be pressure to require private employers or other government health insurance programs to include coverage for this treatment.

While psychologists and psychiatrists have treated this disorder, which is characterized by feelings that "one was meant to be a person of the opposite sex," as a mental condition, a new study finds organic differences in the brains of transsexuals that may account for the disorder.

According to a study by Dutch researchers published in the Journal of Clinical Endocrinology and Metabolism based on post-mortem examination of the brains of identified transsexuals, the number of neurons transsexuals had in a particular region of the brain that typically differs by gender was found to be similar to the gender they thought they should be, rather than the physiological gender they were born with.

  • The transsexuals include both those who had undergone a sex change operation and those who hadn't, allowing researchers to discount the effects of any hormonal changes due to surgery or drug therapy.
  • Those brain regions - called the BSTc - have a large, reliable sex difference in the number of neurons, with human males averaging about twice as many neurons within the BSTc as do females.
  • The BSTc is involved in emotions and bodily responses to them.

While the study did not determine what causes the difference in transsexuals, some neuroendocrinologists suggest it justifies insurance payments for sexual reassignment treatments.

Source: Robert Sapolsky (Stanford University), "Sex-identity myths dispelled," USA Today, March 14, 2001.

For text


Browse more articles on Health Issues