Can You Find Insurance Coverage for Transgender Procedures?

With over 700,000 transgender people in the United States alone, there’s an increasing demand for health care coverage that addresses specific needs such as hormone therapy. Medical care is expensive enough, even with the Affordable Care Act, that it can be impossible for people to get certain procedures without insurance coverage.

The transgender community faces higher rates of poverty than cisgender people, which makes something like hormone replacement therapy prohibitively expensive even at $30 a month. For individuals suffering severe body dysphoria, surgical intervention can quite literally save lives, preventing suicide. But is there a way to cover the cost of these procedures?

Affordable Care Act & Discrimination

Prior to the passing of the Affordable Care Act in 2010, there was no legislation that prevented insurance companies from discriminating against transgender individuals. People were forced to publicly identify themselves as their biological gender in order to receive treatment or coverage, and were denied treatment such as hormone replacement therapy.

While discrimination is still a problem that needs to be continually addressed, the ACA was presented in such a way as to allow the Department of Health and Human Services to interpret it as prohibitive of discrimination against transgender people. This offers transgender or others who don’t conform to gender norms to seek legal recourse if they’ve been discriminated against by medical professionals.

Private Insurance Coverage

There isn’t yet a comprehensive federal coverage plan that includes gender reassignment surgery, but private insurance companies have begun offering coverage for transgender procedures. This can include: hormone replacement therapy, breast reconstruction, breast reduction, rhinoplasty, blepharoplasty and even non-surgical treatment of gender dysphoria, including psychotherapy.
UnitedHealthcare, Care First, Harvard Pilgrim Health Care, Aetna, Amerigroup and other private insurance companies are improving their transgender services. It is possible to find insurance coverage for your transgender procedures—even facial reconstructions to lessen body dysphoria—but you need to ask your provider.