Biden Approves Mandate for Gender-Affirming Care

By Ciara McAuliffe — Correspondent

The Biden administration became the first in history to approve mandates for gender-affirming care. Effective January 1st, 2023, private health plans in Colorado will be required to cover transition-related coverage. This includes hormone therapy, facial modifications, genital reconstructive services, breast reduction and constructions, and other procedures. 

Governor Jared Polis and Chiquita Brooks-LaSure, administrators of the federal Centers for Medicare & Medicaid Services, announced the change during an October 12th press conference. “We hope this marks a historic beginning and that other states look to Colorado as a model,” said Brooks-LaSure. 

This decision fulfills a pledge Biden made early on in his campaign to “expand access to high-quality healthcare for LGBTQ+ individuals” by “ensuring coverage for comprehensive care.” 

Widely praised by members of the LGBTQ+ community and its allies, the Biden administration’s decision also faced backlash from conservatives such as Roger Servino, a former Trump appointee who served as the health department’s civil rights chief. “This is a liberal administration and governor colluding to mandate coverage for a lifetime of cross-sex hormones and removal of healthy organs, including for minors.” 

“Their end game is clear, to push these dangerous experimental treatments on kids and unwilling families as a national insurance mandate,” added Servino. 

Brooks-LaSure and other officials see transition-related treatment as “life-saving,” citing evidence that supporting individuals in their transition can reduce the risk of suicide. A 2015 UCLA study on transgender individuals reports that “9% of respondents who wanted but did not recieve gender-affirming care reported past-year suicide attempts,” while “5% of repspondents who who wanted and recieved gender-affirming care reported past-year attempts.”

“People who need access to this care will not only be healthier because they are getting the care they need through a doctor, through a licensed healthcare provider, but also that that will have positive impacts on their health overall––as a result of being able to transition and be their full selves,” said Christy Mallory, legal director at the Williams Institute, a research institute based in the UCLA School of Law.

“I know, from personal experience, how important it is to feel safe, comfortable and heard by the providers who help us manage the most intimate and sometimes most painful healthcare needs that we have,” said Colorado Lt. Gov. Dianne Primavera. Primavera adds that we need to support patients and providers as we create a more inclusive and affirming healthcare system.

Beyond the borders of Colorado, Republican-led states have made efforts to restrict transgender people’s rights. Arkansas became the first state to ban gender confirming treatments for transgender youth. Many other states, one being Virginia, approved restrictions on transgender athletes. 

According to the Williams institute, “an estimated 32,000 trangender medicaid beneficiaries live in states with express bans that deny access to covered gender-affirming care.” Currently, eighteen states and D.C. have chosen to specifically include coverage for gender-affirming care under their Medicaid programs or are in the process of extending coverage, while 12 states exclude coverage for such care and 20 states have not expressly addressed coverage.

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