Ban on transition-related care lifted for federal health care plans

Photo: Office of Personnel Management. Credit: Wikimedia Commons.

Photo: Office of Personnel Management. Credit: Wikimedia Commons.

The federal government will no longer exclude transition-related medical care for transgender workers from federal employee health care plans.

According to guidance issued Friday by the Office of Personnel Management (OPM), insurance companies that carry Federal Employee Health Benefits (FEHB) plans will no longer be required to enforce a blanket exclusion for trans-related medical care.

“There is an evolving professional consensus that treatment is considered medically necessary for certain individuals who meet established Diagnostic and Statistical Manual (DSM) criteria for a diagnosis of Gender Identity Disorder/Gender Dysphoria,” the letter states. “Accordingly, OPM is removing the requirement that FEHB brochures exclude ‘services, drugs, or supplies related to sex transformations’ in Section 6 of the FEHB plan brochure effective with the 2015 plan year.”

First reported by BuzzFeed, the change in policy comes two weeks after a longstanding ban that prohibited Medicare from covering transition-related medical procedures was struck down May 30 by an independent panel within the Department of Health and Human Services.

Today’s decision by OPM to open federal employee health care plans to the needs of transgender Americans has long been sought by advocates.

“Fixing the FEHB plans have been a priority for us for years,” National Center for Transgender Equality Executive Director Mara Keisling said in a statement. “First of all, it was a priority because transgender federal employees need healthcare, but also, this was one of the few remaining areas where the federal government was the actual discriminator, giving trans employees lesser benefits than non-trans employees.”

According to David Stacy, director of government affairs for the Human Rights Campaign, the decision by OPM marks an important step toward closing the gap in access to quality health care for transgender workers.

“HRC urges FEHB insurance carriers to include this essential coverage in their plans so that federal workers have access to medically necessary transition-related care,” Stacy said in a statement. 

Justin Snow is Metro Weekly's political editor and White House correspondent. He can be reached at jsnow@metroweekly.com.