<p>One important skill I learned at Duke is to think critically about where information is coming from. The blog appears to have a political leaning and appears to be making it seem that the fee increase will be 0.3 percent of tuition and fees, when it actuality, it will be 0.3 percent increase in the premium for Duke student health insurance, which many of us opt out of because we are covered through our parent’s insurance. Straight from Duke Today, the official campus news source:</p>
<p>"For next year, the premium for students who choose to purchase this plan will increase by eight percent. Half of this increase is attributable to changes required under the Affordable Care Act, and half of the increase comes from benefit enhancements requested by students, one of which is gender reassignment surgery, a benefit that is already provided in many private-employer health insurance plans and at least 37 other student health insurance plans at public and private universities around the country.</p>
<p>The addition of gender reassignment surgery represents 0.3 percent of the premium increase for student health insurance, or about $5.25 for the average student who utilizes the plan.</p>
<p>This change has no impact on tuition, and no tuition or fees are used to subsidize the student health insurance plan."</p>
<p>Trust me, if it was a very large increase in fees and if it was expected to be subsidized through tuition, it would have been covered in the front page of the Duke student newspaper, The Chronicle, and debates would be going on in campus.</p>
<p>Don’t always trust what’s on the Internet, especially from blogs with political motivations. I’m surprised that a CC supermoderator didn’t look at this article more critically before posting it.</p>
<p>I’d suggest a different approach. There are about 3000 colleges in the US. If you believe a school’s health care insurance covering this is “ridiculous and unnecessary” use it as a criteria to eliminate the school from your list of 3000 potential schools … while others may consider such a policy a positive in creating their list.</p>
<p>I’m going to guess most if not all people in this thread are cisgender. That means you have no clue what it is like for a person to go through life living in the wrong body. It’s more than just being self-conscious. Trans people commit suicide at a much higher rate than cis people. So get a clue and suck it up. $20 to help students not kill themselves? Seems worth it.</p>
<p>I think maybe a balanced approach might be worth considering. </p>
<p>If such procedures constitute the standard of care and is deemed medically necessary by a physician being it a PCP or specialist, then I don’t see why medical insurance cannot cover it. After all, medical insurance will cover plastic surgery in cases of medical necessity such as for repairing a septum defect or after motor vehicle accidents. </p>
<p>However, if this was to be covered as an nonessential elective procedure (which considering this is health insurance I would highly doubt), then considerations need to be made as to whether this takes advantage of the fact that risk (and cost) is pooled by the plan subscribers. After all, there are plenty of medical procedures and therapies that, while marginally or even substantially efficacious, are nevertheless quite a bit more expensive than the existing standard of care.</p>
<p>If you don’t experience gender dysphoria, the surgery is unnecessary–for you. And if the surgery is unnecessary, paying for it would be ridiculous. That much I agree with. But I don’t necessarily agree that sex-change surgery is ridiculous or unnecessary in all cases. I’m frankly unsure where I stand on the question, and relieved that I have no need to give a definitive answer any time soon. And while I’m on the fence, I’m inclined to give more weight to the thoughts of people who’ve experienced gender dysphoria than to those of people who haven’t.</p>
<p>What I find interesting is that neither the purportedly conservative student reporters who reported this, nor anyone I’ve noticed in this thread (I admit, I’ve only skimmed) has expressed what I consider to be the truly conservative position on this question: Duke is a private university, and it can structure its student medical insurance to cover sex-reassignment surgery if it wishes. People who don’t like it are free to vote with their feet. If market forces pressure Duke to remove the coverage, then they will. And if Duke’s position in the academic marketplace enables it to keep this coverage in place, then it’s Duke’s prerogative to do so.</p>
<p>^ I would have to disagree that “the truly conservative position” is passivism. Respect for freedoms and liberty is admirable, but expressing one’s views and seeking change one way or another is the fundamental basis of engagement be it in politics, society, or academia regardless of one’s beliefs and opinions.</p>
<p>I dare say I was expressing a view: the view that I think adheres most closely to conservative, political principles. Let a private corporation act as it sees fit as long as it isn’t harming anyone, and let consumers avail themselves of the corporation’s services or not, as they see fit.</p>
<p>I’ll confess, I don’t actually like just leaving policy up to the markets to decide, but I’m…let’s say, “puzzled” by my perception that conservatives find that “leaving it up to the market” is a good thing when the outcome is likely to be the one that conservatives favor, and not such a good thing when the markets might allow an outcome they don’t like.</p>
<p>It seems like the only justifications for adding this procedure are:</p>
<ol>
<li> Everybody else is doing it</li>
<li> It really won’t cost very much</li>
<li> Most students won’t have to pay for it anyway</li>
</ol>
<p>This sounds like reasoning that a juvenile would use to justify buying video games.</p>
<p>The core issue revolves around the morality of the procedure. There would be some psychological benefit for those students who are able to take advantage of it. However, the procedure offends a large constituency of the Duke community. Which side is able to more persuasively make their ethical case?</p>
<p>Based on the poor justifications in the article, as well as the way the Duke administration seems to be trying to slide it through, I would surmise that they believe their moral authority is rather weak.</p>
<p>This was a change requested by students. Duke did the right thing here.</p>
<p>I would think the most relevant criterion for inclusion of a procedure in a health insurance plan would be medical necessity, as determined by medical professionals and patients themselves - not online commentators such as ourselves.</p>
<p>If it does, I’m not sure I understand what your moral objection is. You object to sex reassignment on moral grounds? You may; that’s your right. But I’d contend that it’s not your place to interfere with my access to a legal product or service because you object to it on moral grounds. Nor is it government’s place to legislate my morals. Should states shut down their lotteries and outlaw casinos because some people find gambling morally objectionable? Shut down bars and liquor stores because Muslims and some Christians object to consuming alcohol?</p>
<p>Why are some posters discouraging rational debate here? It seems like no one cares to hear a different opinion, and I get pushed away with “who cares, it’s only $5.00 per student,” or “find another college if you don’t like it.”</p>
<p>As I am contemplating how I will be able to afford such high tuition (whether it be at Duke, Cornell, UNC-CH, or anywhere else I get accepted), I feel deeply bothered that they splurge on unnecessary luxuries like this.</p>
<p>By the way, Sikorsky, I am a Republican. I don’t understand where you get the idea that believing in free markets means shutting up and taking what the business gives you.</p>
<p>I don’t get that idea. But I do get the idea that, absent a compelling interest to do so, you don’t get to make a business do one thing or another. You let the business make its own decisions, and based on some combination of price, quality and those decisions, you decide whether to patronize that business or not.</p>
<p>For example, I find Chik-fil-A’s approach to “traditional marriage” and “traditional values” distasteful, and I don’t patronize Chik-fil-A. But Mayor Menino was all wet last summer when he was making noises about not letting Chik-fil-A open restaurants in Boston, and he was right to back down. As long as Chik-fil-A is operating within the law, I don’t get to tell Chik-fil-A how it must or may not operate, and neither does the Mayor of Boston. I just get to vote with my voice, my wallet and my feet.</p>
<p>Unions exist so that workers can exert economic pressure on employers to induce them to do what the workers want. Boycotts exist for a similar reason. And that’s why I’m urging that people who don’t like Duke’s decision should either boycott Duke’s student health plan or boycott Duke. In this way, they can exert economic pressure to urge Duke to choose what they want Duke to choose. </p>
<p>But allowing Duke to choose and then live with the consequence of its choice is, IMO, the conservative thing to do–not to tell Duke what it may or may not choose.</p>
<p>Okay, I know a 30-something transwoman who is saving for her surgery. 1) That surgery will be very very expensive. 2) The amount of psychological testing required to get a doctor to approve the surgery is extensive. Seriously, she has to go through so many doctors to essentially prove she’s a woman in a male body before they will give her the surgery. Point is, the entire procedure has to be justified extensively before a doctor will perform it. Often, you have to live as your gender for at least a year before a doctor will begin the transition process.</p>
<p>Muay, this isn’t an unnecessary luxury procedure. It’s a long, painful process to right what biology got wrong. It’s not like a nose job. It’s not for vanity. Would you object to the university health plan offering pills to a depressed student? This surgery is the ultimate medical solution to the depression caused by being in the wrong body. It is only $20. The medical fee was bound to go up anyway. At least this time it’s justifiable. You know, if someone had just told you, “Hey, the medical fee is going up $20 to try to keep people from killing themselves by using medical technology,” you would complain but you wouldn’t try to attack the people who need the coverage. Or would you be that selfish?</p>
<p>Patriotsfan, did I misread, or is the whole discussion in that message board predicated on the false premise that “the school raised tuition so we would pay for anyone who wants one [can get sex-change surgery]”?</p>