Author Topic: Gynecomastia, the NHS and a lot of sexual discrimination! How we got funding  (Read 1850 times)

Offline Dewberry

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Can I just begin my story by saying for the men in this forum who are worried about what women think of gynecomastia, it has never bothered me in the slightest. My partner is attractive, kind, funny and intelligent and that’s what is important to me not a little excess tissue. We’d all be a lot healthier mentally (women included) if we would stop aspiring to these images we see in the media of so called physical perfection, they don’t exist. The reason I supported my partner when seeking medical treatment for gynecomastia was because it was what HE wanted and gynecomastia was having a negative effect on his health.

My partner has suffered from unilateral gynecomastia since being a young teenager. But in recent years the mass got bigger and it became very painful and he became a lot more self-conscious about it and it started to really effect his mental health negatively.

I eventually convinced him to go to the doctors and he was immediately referred to the breast clinic. I sat in the room with him whilst the specialist examined him, asked him question upon question about his lifestyle, how it affected his quality of life, sex life etc. He did this with a female nurse and a female student standing in the room with other nurses walking in and out. I thought to myself does this doctor really expect him to open up and answer these kinds of personal questions in front of all these people? Needless to say it goes against Male psychology to expect a man to pour his heart out about how negatively a condition like gynecomastia was affecting his self-esteem and overall mental health.

I interjected and said to the doctor, you’re a man so I guess you can imagine from a male perspective how this affects him. The doctor nodded and said that he would support us in a request for funding corrective breast reduction surgery adding that it was a long process but he was a good candidate. We were then sent to the medical photography department so they could send some photos to support his case. He was so embarrassed but I said it will be worth it to get the surgery.

So then we waited, months later we eventually received a letter saying that his request for funding had been denied, that a condition such a gynecomastia was not covered on the NHS but we could appeal the decision. He was upset he felt like he’d let himself down like he should have said more during the consultation about how he was feeling. Well that’s the end of that, I’ll just have to grin and bear it. I said don’t give up we can appeal ring your GP to process the appeal. So he did, the GP said sorry if that’s their decision there is nothing I can do.

I was fuming! I felt like everyone was palming him off and that they’d put him through unnecessary suffering and embarrassment all for a condition they apparently didn’t cover on the NHS. He’s worked all his life, paid into the system so why the hell shouldn’t he be entitled to medical treatment he clearly needed! This can’t be right I thought, a friend of mine (a woman) had breast reduction surgery on the NHS, wasn’t the reduction of gynecomastia just the male equivalent of this treatment? I had felt that throughout this whole process that my partner’s gender had not been taken into account at all and now they were telling us that men couldn’t receive treatment for breast reduction on the NHS but women could? I compared the NHS web pages on breast reduction for women and men. Have a read yourself, they differ a lot, check out on the NHS website and search for:

Male breast reduction

Female Breast reduction

Note that it clearly outlines on the womens page the criteria for breast reduction on the NHS, but on the mens page….nothing. Note the psychological implications listed on the womens page, again on the mens page….nothing. I would argue that men with gynecomastia suffer from exactly the same psychological problems women with excess breast tissue do.
•   unwanted attention or harassment
•   self-consciousness
•   depression

I proceeded to write a case for appeal, outlining all of the above and basically accused the NHS of sexual discrimination. They wrote back to me saying they would re-open his case but would need us to:

•   provide photos….hold on, didn’t we already take photos to support his case at the hospital? Why were they asking for more if they had already evaluated his funding application based on the evidence we originally gave?

•   write about how the condition affected him physically and that they would not consider psychological or social circumstances. But hold on….on the women’s breast reduction page it says that the NHS will offer a psychological assessment to determine how her excess breast tissue is affecting her mental health. Do the NHS believe that men are creatures devoid of emotion, the UKs statistics on male suicide rates would beg to differ.

•   They wanted access to his medical files and his height and weight – I assume this was to determine how long he’d had the condition and whether he had been a drug/alcohol abuser in the past and whether or not he was obese. Again all this information should have been included in his case file, we knew his gynecomastia was not self-inflicted, he’d had it since puberty.

I replied, again outlining that gynecomastia has a significant effect on a man’s mental health (there are hundreds of studies to support this) and for the NHS to consider women’s mental health whilst ignoring men’s with similar medical disorders is clearly discriminatory. However I went along with their guidelines and my partner and I wrote about how his condition affected him physically. I outlined it affected his sleeping pattern if he slept on one side, sex life, and physical activity through sports.

I only wrote two letters of appeal and just over a month later we have received funding from the NHS for his corrective breast surgery. He is so happy and we saved thousands of pounds not going private.

In conclusion, if you are seeking funding for gynecomastia try an appeal based on the above information. Don’t take no for an answer, don’t assume your case was fairly assessed before the appeal stage. Highlighting sexual discrimination seemed to make them backtrack pretty damn fast!

Offline Dr. Elliot Jacobs

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Perseverance does pay off -- congratulations!

You have brought up an interesting point to be used in appealing insurance decisions -- the possible gender discrimination.  Perhaps we in the US can look at our insurance policies and compare criteria for acceptance for female breast reduction vs for male breast reduction.

Equality should reign!

Dr Jacobs

Dr. Jacobs 
Certified: American Board of Plastic Surgery
Fellow: American College of Surgeons
Practice sub-specialty in Gynecomastia Surgery
4800 North Federal Highway
Boca Raton, Florida 33431
561  367 9101
Email:  [email protected]
Website:  http://www.gynecomastiasurgery.com
Website:  http://www.gynecomastianewyork.c

Offline Paa_Paw

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About eight years ago a young man related a story about how he appealed the denial of coverage for surgery using a letter from a Psychologist as the main supporting evidence that Gynecomastia was needed. He won and the insurance paid for the surgery.

There are two important principles here. The first is that denial should not be considered final, there is an appeal process. Second is that the Psychological impact of a condition like Gynecomastia should not be overlooked as grounds for seeking surgery.

Too often, we are our own worst enemies. We accept denial as final when we should not; and fail to admit that there are psychological impacts when we should.
Grandpa Dan


 

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