Dr. Javad Sajan, Challenges & Innovations in Trans Healthcare

Author(s): Scott Douglas Jacobsen

Publication (Outlet/Website): The Good Men Project

Publication Date (yyyy/mm/dd): 2025/05/07

Dr. Javad Sajan is a Seattle-based plastic surgeon specializing in cosmetic and reconstructive procedures for the face and body. He is the founder of Allure Esthetic, where he offers services including breast augmentation, tummy tucks, rhinoplasty, and gender-affirming surgeries such as FTM top surgery and facial feminization. Sajan highlighted several challenges transgender patients face in accessing gender-affirming healthcare. Key issues include limited insurance coverage and a scarcity of experienced providers. Additionally, not all surgeons offer the full spectrum of gender-affirming surgeries, necessitating patients to seek multiple specialists. Regional disparities significantly impact access; for instance, while Washington mandates insurance coverage for such procedures, other states lack comprehensive policies, leading to potential travel burdens for patients. 

Scott Douglas Jacobsen: What are the primary challenges transgender patients face in trying to get gender-affirming healthcare?

Dr. Javad Sajan: Insurance coverage and finding providers with adequate experience. Also, not all surgeons who perform gender-affirming procedures perform all gender affirming surgeries (for example, someone may only perform top surgery or only bottom surgery).

Jacobsen: Do these challenges differ by region?

Sajan: Absolutely, especially in today’s political climate. Even though gender affirming care for adults is technically accessible in all states, it may still involve significant travel, and patients deserve to have the choice between providers. While Washington (where I practice) requires insurance to cover gender-affirming procedures, this is not always full encompassing, and not everyone who needs gender-affirming surgery will qualify. Several other states do not have any requirements or procedures concerning insurance coverage for gender affirmation.

Jacobsen: What legal protections exist–and do not and need to exist–for transgender individuals to access reasonable levels of gender-affirming procedures?

Sajan: It varies widely by state. However, the process should be led by the patient and their medical team without legal or major financial barriers.

Jacobsen: What are the typical arguments against provisions of gender-affirming procedures of varying levels of evidence and reasonableness?

Sajan: Many argue that people may regret their gender affirming surgery or that they actually just need mental health treatment. All surgeries have some level of regret associated with them, and gender-affirming surgeries notably have a low regret rate among all surgeries. Additionally, many providers do require a letter of support from a mental health professional, and most surgeons will do their own evaluations of the patient’s mental stability. 

Jacobsen: How have healthcare policies met the needs of transgender patients?

Sajan: In states where gender affirming care must be at least partially covered by insurance, this has helped many patients access care. However, there is still a long way to go.

Jacobsen: Do insurance coverage and healthcare funding impact patients’ odds of attaining gender-affirming surgeries?

Sajan: Yes, significantly.

Jacobsen: What are the immediate direct effects of the current social and political climate on gender-affirming care, i.e., equitability, accessibility, quality of care, etc.?

Sajan: Many patients feel more hesitant to seek care that would improve their quality of life (and in some cases, save their life). It also leads to unqualified providers or non-medical professionals offering treatments that can increase complications and make what are safe, well-tolerated procedures much riskier.

Jacobsen: What technical innovations or policy changes could enhance the quality and accessibility of transgender healthcare?

Sajan: Insurance coverage seems like the natural first step. Education for providers on gender affirming care and how best to support patients would also help improve this. Finding ways to reduce scarring, especially after FTM top surgery, would also improve the quality of the results and likely make the procedure less invasive. Most patients do not qualify for the current scar reduction surgical techniques regularly performed.

Jacobsen: Thank you for the opportunity and your time, Dr. Sajan.

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#genderAffirmingSurgery #healthcareAccess #insuranceCoverage #surgicalInnovation #transgenderPatients

Study Ordered by Utah Republicans Finds Gender-Affirming Care Benefits Trans Youth

them.us/story/utah-gender-affi…

"Rate of regret after Gender-affirming surgery is approximately 1%. Other life decisions, such as having children and getting a tattoo have regret rates of 7% and 16.2%, respectively."

americanjournalofsurgery.com/a…

Trans women and fairness in sports

Transgender Athletes Could Be At A Physical Disadvantage, Research Shows

forbes.com/sites/lindseyedarvi…

Specific claims of unfairness are self debunking if the source is at all honest about the situation.

For example trans marathon runner Glenique Frank finished 6,159th in the female category but you would get an entirely different impression if you didn't read past the headlines in the daily mail: archive.ph/udkN7

Similarly, Riley Gaines's fairness grievance was literally a tie for fifth place.

Nobody's placement changes if Lia Thomas didn't compete and again, the complaint was that a trans women dared to perform equally to a cis women athlete.

Then there's the chess controversy which is so ridiculous and misogynist that I don't need to dignify it with a debunking. It's just sexism dressed up as concern for cis women.

Miscellaneous

Critically appraising the cass report: methodological flaws and unsupported claims

doi.org/10.1186/s12874-025-025…

Further citations to research on the subject of transgender healthcare thanks to this archived reddit comment by tgjer web.archive.org/web/2019082319…

#transgender #transRights #TransAthletes #LGBTQ #GenderAffirmingCare #GenderAffirmingSurgery #trans #TransWomen

From 21, I looked into getting a breast reduction but I never had the money. My ADHD meant I spent impulsively and get into debt, ruining my credit rating. Circumstances last year meant that I came into money. Almost immediately, I researched plastic surgeons and booked a consultation.
https://medium.com/prismnpen/my-breast-reduction-affirmed-my-non-binary-identity-afe7b2c3f1ce?sk=f7807388c2e3fa53340248b50e49d249

#LGBTQ #Nonbinary #GenderAffirmingSurgery

Gender Affirming Care Under Threat: Supreme Court Ruling News

https://janetannelogan.com/2025/06/18/gender-affirming-care-under-threat-supreme-court-ruling-news/

#GenderAffirmingSurgery, #HRT, #Politics, #Spoonie, #Trans, #Transgender, #USPol

The lovely Anna Akana has once again shown herself to be a true ally to the trans community by doing another video in support of trans people  

Her latest video is about how truly low gender-affirming surgery is for trans people, and even highlights the ridiculous loops that trans people have to go through to get there.

https://youtu.be/rm8hisesV44

Definitely recommend her content  

#trans #transgender #TransRights #TransRightsAreHumanRights #GenderAffirmingSurgery #allyship #SocialJustice #AnnaAkana #ContentCreator #queer #LGBTQ+ #LGBTQIA+

Oh, I have more news. I have a consultation for an orchi on May 28th at a Urology clinic that is about 30 minutes away.

My logic is A) an #orchi is much harder to fuck up than a #vaginoplasty and B) the waitlist for an orchi will be so much shorter, so I could feasibly get one in before Medicaid is gutted so as #trans healthcare is no longer covered by it. If I had the time on my hands, I'd go for a full-depth bottom with a doc who knows what they're doing, but I don't trust that there will be the time for that under this #fascist hellhole.

As such, I'll settle for an #orchi and go for a vaginoplasty at a later time. Either when I'm in a blue state or in a completely different country. I'm slowly learning I'm more of a #top -leaning #switch than I initially thought....and I guess THAT equipment is nifty for that purpose.

#trans #update #genderaffirmingcare #genderaffirmingsurgery #transbian #transgender #transsexual #transgirl #translesbian #transfemme #transfeminine #transfem