NHSO Secretary-General Dr. Jadej Thammatacharee has confirmed that gender-affirming surgeries diagnosed with gender dysphoria and deemed medically necessary by doctors are covered under Universal Coverage.
 
However, he underscores the importance of consultations with experts to establish a comprehensive healthcare framework, ensuring inclusive care for the LGBTQ+ community.
 
Recently, questions have arisen regarding the inclusion of gender affirmation surgery and hormone therapy for LGBTQ+ individuals in the Universal Coverage Scheme.
 
According to the regulations, the UC scheme excludes cosmetic surgeries without medical justifications, leading to the rejection of many requests for gender-affirming surgeries categorized as cosmetic procedures.
 
Nevertheless, surgeries are extended to individuals diagnosed with intersexuality, as this condition necessitates treatment. Approximately 100 people undergo intersex surgeries annually.
 
For transgender individuals seeking gender-affirming surgeries, a medical assessment is necessary, emphasized Dr Jadej. If physicians determine that the surgeries are medically necessary, the UCS will cover them.
 
Dr. Jadej also noted that not everyone can claim the right to get gender-affirming surgeries under the UCS. There must be medical indications, and only when a physician diagnoses it as necessary will the NHSO support surgery cost reimbursements.
 
"In situations involving both physical and psychological incongruence and a necessity for gender-affirming surgeries, confirmation is required. This confirmation should not only come from the patient but also diagnosed by physicians," he stated.

He added that although the NHSO does not allocate benefits to explicit groups, it endeavors to establish an inclusive healthcare system for all.
 
This entails considering the specific services required by LGBTQ+ groups and integrating them into service packages. Some necessary services include hormone therapy and heart disease screening for individuals on long-term hormone usage.

As the need for gender-affirming surgeries increases, the NHSO is consulting with various specialists to define which aspects of the services can be considered treatment and how to determine suitable reimbursement rates.

Another crucial point of discussion is the readiness of the healthcare system to provide these services. Not every physician can perform gender-affirming surgeries or administer hormone therapy efficiently, Dr Jadej highlighted.

"The NHSO's primary role is to determine the reimbursement system for health services. However, to decide whether particular services be made available, we must consult experts, doctors, and health units to assess their readiness and the scope of services they can offer," he said.
 
“Discussions with experts are imperative to establish effective healthcare systems catering to the needs of all."