Is It Time for Medicaid to Cover Species Dysphoria?

Janice Hickok's Mom knew she that was different from other children as early as kindergarten.

"She kind of kept to herself," Belinda Fenwell-Hickok says. "She could be affectionate when she felt like it, but even then, when I'd lean over to give her a hug, she'd turn her shoulder and just, sort of, rub it against my leg and start to walk away."

The awkward behaviors multiplied, but Belinda says she was in denial...for years. She ignored the advice of friends, and eventually refused to return emails and text messages from the school guidance counselor.

Then came the virtually-inevitable moment.

"I walked into her bedroom one day," Belinda said, "and Janice had something hanging out of her mouth."

Even now, the memories cause her to well up with emotion -- nine years later.

"I just screamed, 'Janice, no! Spit him out. Spit him out!' But it was too late," she said. "Our pet hamster, Marvin, twitched a bit and just stopped moving. Janice let him drop to the carpet, and just strolled away like nothing had happened."

Now in her mid-40's, Belinda's careworn face makes her look 20 years older.

"Back in the 1990s," she explained, "nobody was talking about species dysphoria. How was I supposed to know she was a cat, trapped in the body of a girl."

Janice refused to speak to a reporter about her condition, although she has "come out" to most of her friends and family.

Experts believe that as many as one-in-317 humans, and nearly all domesticated cats and dogs, may have some degree of species dysphoria. As with many rare conditions, it was education that helpedĀ her Dad come to terms with who Janice is.

Chad Hickok has lived alone, visiting his daughter one weekend per month at a local kennel since his 10-year marriage to Belinda collapsed -- torn apart by the stress of what's clinically known as second-hand species dysphoria.

"The toll it takes on the family can be greater than the impact on the species-dysphoric individual," according to Jason Stenderweil, visiting professor of Species Identity at U.C. Berkeley. Dr. Stenderweil pioneered species-transition procedures, at a time when most academics and surgeons still classified the medical condition as a "mental illness or some kind of freakish hobby."

According to Janice's Mom, the ability to simply "be who she is" among her friends, co-workers and neighborhood cats, brings some measure of relief from the stress of their fight with the government.

For the past three years, Janice and her family have devoted thousands of hours to a fruitless effort to get Medicaid to cover the procedures she so desperately needs "to be whole." But no government-run health care program will pay for any of it -- from the physician-monitored dietary, fur-implant and quadrupedal-locomotion regimens, to the ultimate species re-assignment surgery and veterinary care. Surgery alone can cost upwards of $230,000, followed by tens of thousands of dollars in monthly maintenance therapy.

The family even lobbied their Congressman, who finally introduced a bill last month to amend Obamacare, requiring that employer-provided health insurance include diagnosis and the full range of treatments to allow species-dysphorics to live normal animal lives. The bill awaits consideration by the Appropriations Committee and the Agriculture Committee.

A White House spokesman said President Obama's position on government-funded species-dysphoria treatment is "currently evolving," but "whether someone who appears human might actually be a rabbit, or a tiger or a Galapagos tortoise is a question above the president's pay grade."

Meanwhile, Belinda is nearly at the end of her rope.

"I don't need someone to 'fix' Janice, forgive the expression," she said. "I need the federal and state governments to acknowledge that she has the same rights as any other American resident, to live out her brief lifespan as authentically as she can. And that takes money that we just don't have."