Ask Lambda Legal - Transgender Health Care

I have put off going to the doctor’s office for a long time out of fear of mistreatment because I am trans. I have had terrible experiences in the past, so I avoid seeking care at all costs. And I hear that I won’t have coverage for the health care I need because of exclusions in my Medicaid plan, so why bother? What are my rights when I’m at the doctor’s office?
Although the last year has seen quite a few promising changes in health-care settings for transgender people, we have a long way to go before transgender people don’t have to worry about whether they will be treated with respect at the doctor’s office.

The statistics show that trans and gender-nonconforming (TGNC) people, particularly people of color, are frequently subjected to humiliating and degrading treatment in health-care settings. (See more details in Lambda Legal’s report “When Health Care Isn’t Caring” at Health Care).

However, the Affordable Care Act prohibits discrimination on the basis of sex, including gender identity, in any hospital or health program that receives federal funds. Additionally, many state and local laws ban discrimination related to gender identity in public accommodations. If you have been mistreated in a health-care setting, please contact Lambda Legal’s Help Desk. Also, be sure to bring a copy of “Creating Equal Access to Quality Health Care for Transgender Patients: Transgender-Affirming Hospital Policies” (available at Transgender Health Care) to your health-care provider as a resource.

Discrimination also can cause difficulties when transgender people seek coverage for health care. Although the Affordable Care Act has opened many doors for those who are uninsured, most plans still contain exclusions.

Over the summer, we saw some exciting progress on this front with the Department of Health and Human Services ruling that transgender people receiving Medicare may no longer be automatically denied coverage for sex-reassignment surgeries, and now a growing number of states are removing Medicaid exclusions -- Oregon, California, Massachusetts and Vermont, as well as Washington, D.C.

We recently received word from Connecticut officials that they are amending that state’s regulations to provide coverage. There has been a growing trend of state insurance commissioners taking a stand for transgender equality by issuing clarifying bulletins to remind private insurers that they cannot discriminate against state policy holders. 

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