Our Legal and Policy Work

Health

Transgender people, like all people, deserve skilled and compassionate health care. Knowledgeable care can mean the difference between life and death for members of our community. Improving our access to the health care system through changes in law, policy, and attitudes is a top priority for Transgender Law Center. We work to improve access to health care and the quality of that care through provider and community education, litigation, and policy research and advocacy. TLC has been a leader in efforts to secure non-discrimination in Medicaid and private insurance at the state level and in Medicare nationwide.

Legal Cases

Policy & Advocacy

Many transgender people face barriers to accessing affirming, affordable care. Whether the issue is a lack of educated providers or insurance companies denying life-saving care, gaps in public health policy are often the culprit. In the last few years, we’ve made major headway in eliminating these policy barriers. Here are some highlights and tools you can use.

In 2012, California became the first state to ban the widespread insurance practice of line-item exclusions for transition-related care. Since then, departments regulating health insurance in 15 more states have issued statewide non-discrimination bulletins, which eliminate the discriminatory practice of line-item exclusions for all transition-related care. These states are Colorado, Connecticut, the District of Columbia, Illinois, Massachusetts, Michigan, Minnesota, Nevada, New York, Oregon, Pennsylvania, Rhode Island, Vermont, and Washington. Some states, like California, have issued follow-up statements clarifying that no treatments can be categorically excluded, and that insurers must consider the medical necessity for each patient on a case-by-case basis. You can read the California Department of Managed Health Care’s clarification (“All-Plan Letter”) from 2015 here. To understand how these bulletins can help you, check out our guide to appealing health care denials.

In 10 states, Medicaid programs have explicit non-discrimination protections as well (California, Connecticut, the District of Columbia, Illinois, Massachusetts, Maryland, New York, Oregon, Vermont, and Washington).

In May 2016, the federal Department of Health and Human Services issued regulations on section 1557 of the Affordable Care Act, which is the non-discrimination section. These regulations included specific, detailed language that says discrimination based on gender identity is illegal under federal law. To read more about what this means for you, check out our fact sheet.

As old barriers fall, new ones emerge, and Transgender Law Center is dedicated to developing innovative solutions with our partners in clinical practice, advocacy, and government, so that victories in public policy translate to lived experience.

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