Wash. State Ends Discrimination in Trans Health Care

Washington State insurance commissioner Mike Kreidler yesterday issued a clarification that all health insurance policies, both public and private, must cover transition-related care, and cannot discriminate against transgender residents of Washington.

Citing both Washington's 2006 nondiscrimination law and the Affordable Care Act, the Office of the Insurance Commissioner determined that blanket exclusions of transition-related care are illegal.

"Transgender people are entitled to the same access to health care as everyone else," said Kreidler in a Wednesday statement. "Whether specific services are considered medically necessary should be up to the provider to decide on behalf of their patient."

While the guidance, delivered in a letter sent to health insurers Wednesday, does not denote specific treatments that are covered, it does clarify that insurers are required to cover procedures that are part of a gender transition if those services are covered for cisgender (nontrans) policyholders. The commissioner's letter lists examples of such services, including hormone therapy, counseling services, mastectomy, breast augmentation and reduction, and general gender transition processes, which may not be legally denied to a transgender person seeking such treatment.

"Removing these outdated exclusions brings Washington up to date with the latest information from medical experts and will provide transgender Washingtonians with access to lifesaving and medically necessary health care," said Danielle Askini, member of the Coalition for Inclusive Healthcare and advocacy director of the Gender Justice League in a statement.

This news makes Washington the seventh state to explicitly offer care to transgender individuals, after Massachusetts announced a similar move last week, joining California, Colorado, Connecticut, Oregon, Vermont, and the District of Columbia in ensuring that transgender residents have access to medically necessary health care.

On a federal level, Medicare recently removed a long-standing blanket ban on transition-related coverage, leading some activists to assert that the fight for trans-inclusive health care is on a fast trajectory toward ultimate success in securing coverage for these medically necessary treatments.