Gold card can cover some gender surgery

LGBTQ+ people who are members of the universal healthcare scheme can undergo gender-affirming surgery (GAS) if they are diagnosed with gender dysphoria by a psychiatrist, according to Dr Jadet Thammathataree, secretary-general of the National Health Security Office (NHSO).

He said the NHSO wanted to clarify an exception to the universal healthcare scheme, better known as the gold card, that means it does not cover cosmetic surgery, which has led to doubts about whether GAS falls into that category.

“The universal healthcare scheme in fact covers GAS for treatment purposes if patients are diagnosed with gender dysphoria,” he said.

The operation will be a treatment and a necessity for the patient, he said.

He gave one example dating back to 2020 when a hospital provided GAS for a patient. The NHSO approved the cost of the operation because it was considered a necessary treatment in that case.

About 100 people undergo gender-affirming surgery every year. If any are diagnosed with intersexuality and need to correct their atypical genitalia, they can use the benefits of the gold card, Dr Jadet said.

He said the key is to be diagnosed by a psychiatrist first. If the psychiatrist determines their untreated gender dysmorphia poses a psychological or emotional risk, they will likely approve the operation.

Gender-affirming surgery without a medical diagnosis is categorised as plastic surgery, he said.

The NHSO plans to provide a full-service package including mental care, hormonal treatment, facial feminisation procedures, breast surgery, and vaginoplasty soon.