Out of Reach: Sex Reassignment Surgery Not ‘Medically
Necessary’?  Cuba has approved free sex change operations for
transgender citizens . What a stark contrast to the reality here
in the United States.  June is LGBT Pride Month and, along with
the festivals and parades, we have an opportunity to learn about
the diversity within our community and the issues that impact
the lives of LGBT people. For many transgender people, the
process of transitioning is a long and expensive journey delayed
due to the lack of health insurance coverage for medically
necessary procedures.  First, a quick primer. "Transgender"
describes the state of a person’s gender identity, which may
match their assigned at birth. Other words transgender people
may use are female to male (FTM), male to female (MTF), and
genderqueer. After coming out, transgender people may undergo
psychological counseling for diagnosis, hormone replacement
therapy (HRT) to adjust their body to their new gender, medical
visits to support that therapy, and sex