HRC Blog

Board Rules Medicare’s Policy of Excluding Coverage of Transition Related Care is Unreasonable

LogoThe U.S. Department of Health and Human Services Department Appeals Board today issued a ruling in an administrative challenge brought by the ACLU, Gay & Lesbian Advocates & Defenders, and the National Center for Lesbian Rights determining that Medicare’s policy of categorically excluding coverage of transition related care is unreasonable and contrary to contemporary science and medical standards of care. This is a long-awaited and welcome decision that will benefit the health and well-being of transgender patients on Medicare seeking care.

The ability to access complete gender-transition related health care is essential to  ensuring the health and well-being of transgender patients.  The Medicare policy denying this care ran counter to decades of extensive scientific and clinical research, which supports surgically altering an individual's primary and secondary sex characteristics as a safe, effective and medically necessary treatment for severe gender dysphoria. Before today's ruling, the government was denying doctors a critical tool toward ensuring the health and well-being of transgender patients. Thanks to today's ruling -- informed by the medical community itself, including the American Medical Association and the American Psychological Association -- individuals with gender dysphoria cannot have the door slammed in their faces when trying to access proper and necessary care.

Kudos to our colleagues at the ACLU, Gay & Lesbian Advocates & Defenders, and the National Center for Lesbian Rights for bringing this case forward -- and to the decade of leadership on this issue by many of our colleagues in the movement, including the National Center for Transgender Equality.

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