Challenging Insurance Exclusions for Gender Affirming Medical Care
Update April 23, 2020: Victory! The Connecticut Commission on Human Rights and Opportunities issued a milestone ruling prohibiting all employers and insurers from denying coverage for any treatments related to gender transition. This ruling follows a national trend of striking down discriminatory exclusions for gender affirming medical care.
“We applaud the Commission for recognizing the critical healthcare needs of transgender people and calling out the discrimination inherent in health plans that deny care,” said Ben Klein, Senior Attorney at GLBTQ Legal Advocates & Defenders. “Exclusions that categorize doctor-prescribed procedures as “elective” or “cosmetic” contradict a robust body of scientific evidence and can only be explained by stereotypes and bias towards transgender people. This ruling will ensure that critical healthcare decisions can be made as they should be, between patients and their doctors, and will allow Connecticut residents access to life-saving care.”
GLAD filed a brief in conjunction with Professor Kevin Barry of Quinnipiac University School of Law on behalf of Connecticut resident Rylie Robillard, the Connecticut Women’s Education & Legal Fund, and the National Center for Transgender Equality. The brief was supported by expert testimony from Randi Ettner, PH.D, one of the nation’s preeminent experts on gender affirming medical care.
February 20, 2020: GLAD filed a petition in the State of Connecticut’s Commission on Human Rights and Opportunity, challenging health plans that categorically exclude facial feminization surgery and other procedures for people with gender dysphoria. The filing comes after Rylie Robillard, a transgender woman, was told her medical provider-recommended facial feminization surgery is considered cosmetic, and her procedure was denied. The brief argues that the categorical denial of this medical care discriminates on the basis of gender identity and expression, sex, and disability.
These coverage exclusions contradict a robust body of scientific evidence that can only be explained by stereotypes and bias towards transgender people. We are working to ensure that health insurers provide all medically-necessary gender affirming surgeries, so that critical health care decisions can be made between patients and doctors.
From the filing:
“Gender dysphoria is a serious medical condition that requires treatment. People with gender dysphoria, however, continue to be subjected to pernicious discrimination in access to vital healthcare. Many insurance and employer-sponsored health benefit plans, for example, continue to deny coverage for medically necessary and recognized treatments, most notably facial feminization surgeries, breast augmentation, and other treatments that bring the body into congruence with a person’s affirmed gender to eliminate gender dysphoria.
“The categorical exclusion of these procedures as per se cosmetic, and therefore never medically necessary, is wholly out-of-step with authoritative medical standards of care and the significant and well-designed body of research establishing their efficacy in alleviating or eliminating gender dysphoria.”