Insurance Coverage And Discrimination

* individuals, both male. * Male A born w/ congenital heart defect that requires a specific type of surgical implant to correct it. * Male B also has a congenital heart defect that requires a surgical implant. However, because a unique anatomical variation in his heart standard implant designed for other males will not fit. In this scenario: * Insurance co. covers standard implant for Male A, as it is deemed medically necessary and is designed for his anatomy. * The insurance co. denies coverage for a custom-made implant for Male B, stating that policy only covers the standard implant and that Male B's anatomy is "outside the scope of what we cover for males.: *. Both are seeking the same outcome: corrective heart implant. *. Both are the same sex: both are male. Now lets add that both are legally male. Both have birth certificates which have M(AMAB), both have similar anatomy biologically. Is this denial sex based discrimination?

so can you explain how the anatomical variations wouldn't be sex based

gender discrimination i dont understand how that got brought up nor how it relates since i said its sex based and male is a sex terminology not man which is gender based

then when or in what scenario would it be considered sex based

so then can you explain how or what sex means in terms of discrimination because i thought sex has to do with anatomy

i still don't understand

what does biological classification mean

So person A is classified as male because of characteristics that define male however their heart has a defect. Person B also has for these same characteristics which characterize them as male but their heart also has defect but was formed in a way which requires specific care. Anatomy among other factors like chemistry genetics, etc. play a part in defining sex. I don't know why you bring gender up still cuz unless you want to bring that in and talk about it is irrelevant. Because male A has a defect with his heart that is already considered an anatomical difference what you are saying is neither person a nor b should have insurance cover a surgery and especially person b because their anatomical difference is far more complicated then person a but regardless of any of that its not sex based since women should also not get treated for this?

the surgery for person a, does it have a treatment? yes how about b? no person a is male, person b is also male. It is the characteristics of his sex which are anatomical but also part of his sex

okay but then lets state that this is something a body part that only men have

can tou explain you have no supporting evidenve for might lean towards sex-based considerations, but it still hinges on anatomical specifics.

when would it be considered sex alone cuz as far as i am aware sex by nbature includes anatomical factors

whats biological sex though

yes please tell me how anatomical factors which is part of biological sex isnt considered sex based when it comes to the example

yes my scenario which applies to something in real life is medically necesaary

do men need a penis to live

so then an erectile device isnt medically necessary

okay so the heart defect how is this different because its not medically necessary to live a longer life is it?

yes

what if there is no standard of care or the care for that specific thing is not given the same consideration as other issues of the same nature how then can someone truly get the treatment that will allow them for a better qol

so. what u are saying is they have to deal with it and sucks to suck

why don't they say that to the other people who are getting treatment instead of giving them the treatment

so my situation of discrimination is just a feeling

so what you are saying its not discrimination but rather my feelings

so if i were to express that both males which still are legally male both have M assigned on their birth certificates, both identify strictly as men as far as gender goes, and both have characteristics that would physically categorize them as male. Now person A was historically assigned male and person B historically assigned female. Now the medically necessary factors are still criteria that Male A and Male B meet under the policy however erectile dysfunction treatment which is far and plenty for male historically born male pharmacedical pills, therapy, erectile device are offered. For males who have a historically afab designation do not have viagra, or other pills as a treatment, and the erectile device being offered as a treatment for males is cruxed on the anatomical specifics of historically male males. And just to mention females do not nearly have the amount of resources for sex dysfunctional problems which is another huge topic completely but nevertheless its still lacking.

question is sex based discrimination only possible if it has to do with one sex versus the other?

I don't understand how you don't see this is sex based discrimination because of anatomical differences. The anatomical differences are being judged against what the insurer defines as “standard” for a male.

tell me when would something ever be considered straightforward sex discrimination. You are acting as if legal sex discrimination cant ever be a multifacted thing

thats a poor example you arent being specific so of course its going to"hold up"