The Future of Transgender Coverage

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Abstract
In tandem with the growing visibility and acceptance of transgender people in the United States, we have seen a rapid increase in insurance coverage for health care services related to gender transition. Despite ongoing court battles over federal nondiscrimination protections for transgender people and uncertainty over the future of the Affordable Care Act (ACA), this trend is likely to continue: Medicare, many state-regulated private plans, some state Medicaid programs, and an increasing number of employer-sponsored plans now cover transition-related care for transgender people. These changes are driven by a growing expert consensus on the medical necessity of gender transition, new legal interpretations prohibiting insurance discrimination against transgender people, and mounting evidence that transgender-inclusive coverage is cost-effective.