ESL Voices

“The new MassHealth guidelines will cover more services and remove some onerous requirements that have kept trans and gender-diverse communities from receiving services.”  D.  Ducar, The Boston Globe,  September 7, 2021

ESL Voices Lesson Plan for this post with Answer Key

Philip Steury- Adobe

Excerpt: Massachusetts leads the way in caring for the health needs of trans and gender-diverse people. By Dallas Ducar, The Boston Globe,  September 7, 2021, 

“The coronavirus pandemic has made it clear that Americans need better health care access, especially for those who are most marginalized. States should reassess what is considered medically necessary to expand equitable coverage and access — including for transgender and gender-diverse people.

On Sept. 3, MassHealth took that next step forward. It updated the state’s Guidelines for Medical Necessity Determination for gender-affirming care. MassHealth uses these guidelines to determine what care is deemed necessary and paid for. Gender-affirming services currently include services such as hair removal, surgery, pubertal blockade, and hormone therapies.

Expanding access to these services will improve mental health and save lives…These advances are landmark examples of how the government has led by example in advancing care for trans and gender-diverse individuals. The new MassHealth guidelines will cover more services and remove some onerous requirements that have kept trans and gender-diverse communities from receiving services… MassHealth has made a move in the right direction by recognizing the variability in gender-affirming care. It’s time for private payers to follow this same path. To be sure, there are concerns that individuals will join MassHealth or other insurers strictly for gender-affirming care and then leave. These arguments are scarecrow arguments and advance the idea that gender-affirming care is a lifestyle choice. The fact is, gender-affirming care is life-saving care.”

ESL Voices Lesson Plan for this post

NOTE: Lessons can also be used with native English speakers.

Level: Intermediate – Advanced

Language Skills: Reading, writing, and speaking. Vocabulary and grammar activities are included.

Time: Approximately 60 minutes.

Materials: Student handout (from this lesson) and access to news article.

Objective: Students will read and discuss the article with a focus on improving reading comprehension and improving oral skills. At the end of the lesson students will express their personal views on the topic through group work and writing.

I. Pre-Reading Activities

KWL Chart

The K-W-L chart is used to activate students’ background knowledge of a topic in order to enhance their comprehension skills.

Directions: Have students use the KWL chart to list the information they already know about the current  health care situation for Trans and gender-diverse people.  Later in the Post- Reading segment of the lesson, students can fill in what they’ve learned about the topic.

II. While Reading Activities

Word Inference

Directions: Try to infer the meanings of the words in bold taken from the article. You use a dictionary, thesaurus, and Word Chart for assistance.

1. The coronavirus pandemic has made it clear that Americans need better health care access,
2. Especially for those Americans who are most marginalized.
3. States should reassess what is considered medically necessary.
4. Medical coverage  should include transgender and gender-diverse people.
5. *These arguments are scarecrow arguments and advance the idea that gender-affirming care is a lifestyle choice.
6. MassHealth uses guidelines to determine what care is deemed necessary and paid for.
7. Unfortunately, coverage for gender-affirming services has been trailing behind the needs of the trans communities.
8. These advances are landmark examples.
9. MassHealth guidelines will cover more services and remove some onerous requirements.
10. Private insurers have attempted to apply a more restrictive model.

Grammar Focus: Word -Recognition

Directions: Students choose the correct word to complete the sentences taken from the article. They are to choose from the options presented.

Gender-affirming care/caring is only the first steps/step. When we cared/care for our most/more marginalized, we provide/providing better health cares/care overall. We all have/having some/any relationship to gendered/gender. We know that caring/care for the whole person allows four/for better health and decreases the overall costs.

Reading Comprehension

True /False/NA-Statements

Directions: Review the following statements from the reading.  If  a statement is true they mark it T. If the statement is  not applicable, mark it NA. If the statement is false  mark  it F and provide the correct answer. 

1. The coronavirus pandemic has made it clear that Americans need better health care access.
2. States do not have to reassess what is considered medically necessary to expand equitable coverage and access.
3. On Sept. 3, New York Medical Center took that next step forward. It updated the state’s Guidelines for Medical Necessity Determination for gender-affirming care.
4. Gender-affirming services currently include services such as hair removal, surgery, pubertal blockade, and hormone therapies.
5. Coverage in Massachusetts has continued to advance over the years:
6. In 2021, the attorney general’s office reminded providers that MassHealth gender-affirming surgeries are not covered.
7. Private payers, on the other hand, have traditionally relied on the World Professional Association for Transgender Health Standards of Care 7 to determine necessity.
8. According to WPATH, every trans and gender-diverse person has the same types of gender-affirming care needs.
9. According to WPATH, every trans and gender-diverse person has specific types of gender-affirming care, and types of social transition needed. There’s no one size fits all model.
10. MassHealth has made a move in the right direction by recognizing the variability in gender-affirming care.

III. Post Reading Activities

WH-How Questions

Directions: Have students use the  WH-question format to discuss or to write the main points from the article.

Who or What is the article about?

Where does the action/event take place?

When does the action/event take place?

Why did the action/event occur?

How did the action/event occur?

Discussion Questions for Comprehension /Writing

Directions: Have  students discuss the following questions/statements. Afterwards,  students share their thoughts as a class. To reinforce the ideas, students can write an essay on one of the topics mentioned.

1. How does MassHealth determine what care is necessary for gender-affirming care?
2. What new services are included for gender-affirming patients?
3. Name several advances that have occurred in Massachusetts Healthcare coverage over the years.
4. What gender-affirming healthcare advances have occurred on the national level?
5. Why is the Supreme Court’s 2020 Bostock decision so important?
6. What does WPATH stand for and what function does it serve?
7. Explain three new ideas that you have learned from reading this article. Was there anything that you did not understand? Was there any information left out of this article?

ANSWER KEY