D.C. Mayor Makes Major Move Expanding Trans Health Care

In a major win for transgender people, Washington, D.C., mayor Vincent Gray announced today that all health insurance policies regulated by the D.C. government will now be required to cover transition-related medical services, including gender-confirming surgeries. This new regulation will apply to Medicaid, D.C. government employee insurance policies, and plans purchased on D.C.'s health insurance exchange.

"Today, the district takes a major step towards leveling the playing field for individuals diagnosed with gender dysphoria," Mayor Gray said. "These residents should not have to pay exhorbitant out-of-pocket expenses for medically necessary treatment when those without gender dysphoria do not. Today's actions bring us closer to being One City that values and protects the health of all of our residents."

D.C.'s Department of Insurance, Securities, and Banking issued a bulletin explicitly instructing insurers to include coverage for the medically necessary treatment of gender dysphoria. In a press release, department officials say they consider "attempts by companies to limit or deny medically necessary treatments for gender dysphoria, including gender reassignment surgeries, to be discriminatory," adding that the department's position moving forward will be to require transition-related care to be listed as a covered benefit in all policies they regulate. Today's announcement follows up on a March 15, 2013, bulletin issued to health insurers within D.C. to remove gender identity-related discriminatory language from policies.

In keeping with today's announcement, the D.C. Department of Health Care Finance and Department of Human Resources also updated their policies. DHCF has taken the position that under D.C.'s Human Rights Act, it can no longer allow discrimination on the basis of gender identity and that treatment as outlined by the World Professional Association for Transgender Health Standards of Care falls within Medicaid coverage standards. DCHR has updated policies offered to district government employees to include this coverage, voiding documents, riders, or provisions inconsistent with today's announcement effective by each policy's next renewal period.

"This victory reaffirms growing agreement among advocates and the medical community that D.C.'s health care nondiscrimination laws require that insurance cover medically necessary transgender health care," National Center for Transgender Equality policy associate Andy Bowen said in a press release. "Critically important is that as more states follow the district's lead, we'll be better able to educate the medical community about respectfully and comprehensively meeting our health care needs."

Mara Keisling, NCTE's executive director, added, "The insurance bulletin means so much to transgender people. It means health care is affordable and means we can access that care without delay or limitation. Here in the nation's capital, transgender people won't be forced to choose between paying the bills or paying for health care."