You know, since you often argue over the efficacy of "sex reassignment" surgery, with the therapist arguing that SRS is the greatest thing since sliced bread, it might be interesting to ask how he can account for the fact that the Centers for Medicare & Medicaid Services (CMS) recently decided not to establish a national policy on gender reassignment surgery. Why would that be, you might ask, since he claims that everyone in the medical community is in agreement that these are medically necessary procedures?
The question they sought to answer was: “Does gender reassignment surgery improve health outcomes for Medicare beneficiaries with gender dysphoria?”
The decision memo from the CMS basically left things status quo - requiring a case-by-case determination by the local Medicare Administrative Contractors (MACs). The CMS came to this conclusion after an apparently extensive review of the relevant literature indicated that
the clinical evidence on the procedure is inconclusive for Medicare beneficiaries with gender dysphoria.
The memo is not a quick or easy read in itself, and certainly most lay people aren't going to follow up by reading much of the primary literature. But it points out key problems with regard to study design, and gaps in the clinical evidence that need to be addressed.
https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=282