Gay & Lesbian Advocates & Defenders

New England's leading legal rights organization dedicated to ending discrimination based on
sexual orientation, HIV status and gender identity and expression.

How to Help Share Your Story Health Insurance Survey

Survey: Insurance Coverage of Transition-Related Health Care

Thank you for telling us about your experience with health care coverage related to your transition.
All the information you provide to GLAD will be kept confidential.

Please Share Your Story

GLAD is collecting stories about people’s experiences with health insurance coverage related to gender transition, to help us determine how we can best address legal concerns in this area.

Please note: because GLAD's work is focused in New England, we are specifically interested in stories from people in the six New England states.

Thank you for sharing your story. All information you provide to GLAD will be kept completely confidential. We do ask that you provide contact information so that we can follow up with you if necessary. Fields marked with an * are required.

If you would rather not fill out this survey online but would like to tell us your story, you can call GLAD’s Legal InfoLine at 617-426-1350, and talk to someone on the phone.

How are you insured?

MassHealth, Medicaid, or CommonwealthCares
Medicare
Private Insurer
No Insurance
Other

Are you currently employed?

Yes No

If yes, can you tell us what you do and for how long you’ve been doing it?

If no, what were the dates of your last employment?

Do you consider yourself to be:

Male-to-female
Female-to-male
I identify in a different way (please explain)

Select any of the following that apply to you:

Ctrl+Click to select multiple (Apple+Click for Mac)

If you have consulted a medical doctor about surgery related to transitioning,
please list the surgery/ies:

If you have had surgery related to transitioning, please list the surgery/ies:

Have you tried to use your insurance to cover any of the
medical costs of your transition?

Yes No

If yes, what have you tried to have covered?

Were you successful in getting your insurance to cover transition-related care?

Yes No

If you were denied, can you describe what happened?

Contact Information

Please include contact information so that we may follow up with you. Your information will be kept completely confidential.

Your Information

First Name*
Last Name*
Birth Date MM/DD/YY
If we need to contact you, may we identify ourselves as GLAD? Yes No

May We Contact You?

Mailing address
City
State*
Zip
Phone*
Email address*

Share Your Story

Stories Matter

The more people know their LGBT and HIV+ family, friends, and neighbors, the more likely they are to support our rights and help us work toward full equality.

We have come far in our fight for equal justice under law. But we still must work to educate our communities about the reality of LGBT people’s lives.

Gay & Lesbian Advocates & Defenders

Survey: Insurance Coverage of Transition-Related Health Care

Please Share Your Story

How are you insured?

Are you currently employed?

Do you consider yourself to be:

Select any of the following that apply to you:

If you have consulted a medical doctor about surgery related to transitioning,please list the surgery/ies:

If you have had surgery related to transitioning, please list the surgery/ies:

Have you tried to use your insurance to cover any of themedical costs of your transition?

Were you successful in getting your insurance to cover transition-related care?

Contact Information

Your Information

May We Contact You?

Share Your Story

Stories Matter

If you have consulted a medical doctor about surgery related to transitioning,
please list the surgery/ies:

Have you tried to use your insurance to cover any of the
medical costs of your transition?