Transgender Health Care Just Got a Major Boost From the U.S. Government
It’s been a landmark year for transgender awareness in American culture, but despite a number of magazine covers and TV shows featuring transgender celebrities, one crucial thing has remained out of reach: access to affordable health care.
On Tuesday, the U.S. government took a significant step toward transition-related health care when it ordered its insurance carriers to cover services, drugs, or supplies related to gender transition, including sex reassignment surgery, for federal employees. The new coverage will take effect on Jan. 1, 2016.
A letter from Office of Personnel Management Health Care Director John O’Brien states that the coverage is in line with “the evolving professional consensus that treatment may be medically necessary to address a diagnosis of gender dysphoria,” or the distress that may accompany the transition from one gender to another. Not every transgender person requires medical transition or suffers from gender dysphoria, but some advocates see its recognition by medical professionals as a requisite for health insurance companies to cover transition-related treatment, according to GLAAD.
The decision was applauded by advocates including the Human Rights Campaign and the National Center for Transgender Equality, whose executive director, Mara Keisling, issued a statement calling it “a huge step toward ending one of the last remaining ways the federal government itself discriminates against transgender people.” But she cautioned that the fight isn’t yet over, and the federal decision may face resistance from insurance carriers. “We know that plans will still try to exclude some necessary services, and we will keep pushing to eliminate all insurance discrimination against trans people,” she wrote.
Until a year ago, providers of health benefits to federal employees were prohibited from covering transgender-related health care. That ban was lifted last June, allowing insurers to choose whether or not to provide such coverage. Now they are required to. In May 2014, the Department of Health and Human Services struck down a ban on Medicare coverage of transition-related health care for all Americans, including gender reassignment surgery.
So, Why Should You Care? The government’s recognition of transition-related care as necessary medical treatment is a health benefit that will extend to the government’s roughly 2.7 million federal employees. In a study conducted by the National Center for Transgender Equality, nearly half of transgender people reported postponing necessary medical care because they couldn’t afford it. Those not receiving a federal paycheck must still pay out of pocket for transition-related care, but Washington’s move is a symbolic nudge. In addition to issues of access and affordability, transgender people also face heightened levels of discrimination: One in five reported being refused medical care because of transgender or gender-nonconforming status.