updated 02-14-2014

Health Care

U.S. Patient Protection and Affordable Care Act

According to the U.S. Dept. of Health and Human Services (HHS), the Affordable Care Act protects against discrimination based on gender identity. HHS has clarified that sex-based discrimination, which is prohibited by the Patient Protection and Affordable Care Act (ACA), includes discrimination on the basis of gender identity and sex stereotypes. Furthermore, HHS has made clear this includes discrimination against transgender people and discrimination based on how masculine or feminine a person presents.

* We suggest that you do not change your gender on your health insurance if you have not gone through full medical transition because you may need procedures or tests based on your birth sex. You can, however, have your name changed with your insurance.

U.S. Statistics

  • Over 27% of transgender/gender non-conforming people have been denied health care.
  • Nearly 21% of transgender people report being subjected to harsh or abusive language from a health care professional.
  • Over 20% of transgender people have been blamed by health care professionals for their own health care conditions.
  • Transgender people report the highest rates of discrimination and barriers to care among LGBT people.

Problems with Access to Health Care in Massachusetts

Transgender people in Massachusetts cite two main problems with accessing health care.

1. Locating providers who are knowledgeable about transgender people and health issues

  • Transgender people who do not live in urban areas have greater difficulty accessing health care because they often have to drive to Boston, which is inconvenient.
  • Referrals within the health care system can be problematic for transgender patients because they are not always safe.
  • An adult trans man who followed up on a referral for surgery said‚ “I assumed that since I was at [a trans-friendly medical center] it would be fine, and I had [had] other
    surgery there that was absolutely wonderful. He asked about the scars on my chest [from reconstructive surgery], and when I told him what they were, his mouth dropped open and bounced off the floor, and he said, ‘What are you talking about?’ That was it. I was packed up and sent away.”
  • Regardless of their ability to find appropriate health care providers, transgender individuals still face problems securing access to needed health care, like being turned away from emergency rooms.

2. Securing and paying for needed services

  • Transgender people say that they are afraid to disclose their transgender identity to insurers, for fear of facing exclusion in or loss of their health care coverage.

Even at the level of paperwork, standard forms can be barriers to health care for transgender individuals because they often only say “male” or “female.”

Resources

The National Center for Transgender Equality has put together a great resource on the Health Care Rights and Transgender People, which lists which laws protect trans access to health care, how to report rights violations, and additional resources.

In Changing the Game: What Health Care Reform Means for Gay, Lesbian, Bisexual, and Transgender Americans, the Center for American Progress has compiled important information regarding the state of health care in the United States, how the Affordable Care Act benefits transgender and LGB people, and action items to ensure the law is fully enacted in every state.

Fenway Transgender Health Services provides “primary medical and mental health care, and supportive services, that is are sensitive to the needs of people who identify on the transgender spectrum.”

The World Professional Association for Transgender Health‘s mission is “to promote evidence based care, education, research, advocacy, public policy, and respect in transgender health.”