Denial of Coverage for Gender-Affirming Care Declared Unlawful


SAN DIEGO, Calif., Jan. 6, 2021 (SEND2PRESS NEWSWIRE) — TransFamily Support Services ( ) today announced a milestone victory in the organization’s mission to build a world where all genders are accepted and treated equally. After calling on the California Department of Insurance to remove unjust barriers for accessing gender reassignment surgery, the department’s General Counsel has just declared that health insurance companies may no longer deny coverage for patient’s based solely on their age.

In an Opinion Letter issued on December 30, state-operated health insurers were ordered to ease policy limits on male chest reconstruction surgery for female-to-male patients undergoing gender-affirming care for gender dysphoria.

“The world is gaining an understanding around gender identity and learning the importance of treatment for those seeking it,” says TransFamily Support Services Founder, Kathie Moehlig. “Trans youth have the highest rates of attempted suicide, 50 percent more than their adolescent peers. To deny care sole based on age puts trans youth’s mental well-being at risk.”

Moehlig has dedicated her efforts for nearly a decade to ensure that transgender and gender non-conforming youth throughout the country feel supported at all stages of their transition process.

“The issuance of this letter by the California Department of Insurance is a critical move toward improving the lives of youth suffering with gender dysphoria,” adds Dr. Johanna Olson-Kennedy, MD, Medical Director from the Center for Transyouth Health and Development at the Children’s Hospital Los Angeles, and medical advisor to TransFamily Support and Services. Both Moehlig and Olson-Kennedy — along with all who support the issuance — acknowledge that the refusal of coverage violates state gender non-discrimination laws and regulations, and other coverage and nondiscrimination standards. “Determination of medical necessity being attached to a chronologic age undermines the complex decision making of youth, their families and their care teams,” continues Olson-Kennedy. “The work of TransFamily Support Services and the reiteration of the protected services by California Department of Insurance will reduce barriers to accessing gender-affirming services for transgender youth, and offer this vulnerable group of young people an improved opportunity to live authentically.”

A recent Cedars Sinai study found that gender dysphoria manifests in early childhood and can persist for years before patients undergo counseling and treatment — oftentimes resulting in a poor quality of life for transgender people throughout their lifetime. The study found that 73% of transgender women and 78% of transgender men surveyed first experienced gender dysphoria by age 7.

Taking the well-being of youth into account, the California Department of Insurance will now mandate that health insurance companies consider a patient’s specific clinical situation, holistically, in determining medical necessity and coverage for the treatment of gender dysphoria.

“There is no magical age for [gender-affirming surgery],” says Moehlig, who reiterates that this essential medical care can be carried out at earlier ages, determined by a case-by-case basis. “The importance of our work lies in the outcome of our youth feeling affirmed, emotionally healthy, and the world seeing them for who they genuinely are.”