Blue States Leading the Way: How Trans Health Coverage is Improving

by Joshua Brown
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Christina Wood from New Mexico had to keep her identity as a transgender woman hidden for most of her life. So, six years ago, she moved to Oregon because she knew there was better healthcare available there which would help her express who she truly was.

When Wood, 49, arrived at her destination she was able to receive surgeries that would help her transition. However, the state’s Medicaid plan for people who don’t have much money wouldn’t pay for electrolysis (a procedure which permanently removes hair). This cost Wood nearly half her monthly salary but it was important in order to maintain good mental health.

” Having this facial hair or other body hair on my body does not make me feel like myself. When I look in the mirror, I don’t think of a feminine person. This makes me really stressed out – it causes a lot worry and fear because I’m living in a body that doesn’t seem to fit who I am.”

In Oregon, there will probably soon be a law passed that will allow insurance to cover gender-affirming care. This includes things like getting rid of facial hair and surgery to make your Adam’s Apple smaller. All these treatments are usually seen as just for looks but they can really help people who are changing genders feel more comfortable in their own bodies.

This year, many states have passed laws to protect transgender people and their rights. But some places have decided to take away these protections, even going so far as not allowing people to talk about this topic in schools. Michigan is one of the states fighting back by adding extra protections for LGBTQ people into anti-discrimination laws.

More than 6 states from all across America (New Jersey, Vermont, Colorado etc.) already passed or think about passing new laws and orders to protect transgender people. In Michigan, the Democratically elect Governor Gretchen Whitmer just signed a bill that prevents and stops discrimination against transgender people based on their gender identity and sexual orientation.

Rose Saxe from the American Civil Liberties Union LGBT and HIV Project said that transgender people are being treated unfairly by some. She continued by saying that preventing them from accessing health care like hormone treatments, counseling, puberty blockers, and surgery will make their lives more difficult. Gender-affirming care is an important way to help trans people receive proper treatment and support.

Oregon’s new law will stop insurance companies and the state’s medical plan from calling medical treatments like electrolysis “cosmetic” when they are needed to treat gender dysphoria. It also protects doctors and people in need of these treatments from getting into trouble with other states if they don’t allow them.

Democratic state Rep. Andrea Valderrama, the bill’s chief sponsor said that they take access to coverage seriously and it’s important to ensure things are not just legal but are also affordable and accessible. Blair Stenvick from the LGBTQ+ advocacy group Basic Rights Oregon explains electrolysis procedures need to be made available for safety reasons as well.

“Having facial hair can expose people to harassment,” Stenvick said, and being able to show themselves as a woman “helps people avoid being recognized as a transgender person, who may be especially targeted for attack.”

A lot of people are talking about a new bill in Oregon, with some people supporting and others opposing it. Last month there was a meeting at the Capitol building in Salem to discuss the bill. Now the House (which is controlled by Democrats) will vote on Monday and if it passes then it will go to the Senate (also dominated by Democrats). This new law in Oregon follows a national trend among states run by Democrats.

This year, four different states (Colorado, Illinois, New Jersey, and New Mexico) have made laws that protect people from having treatments banned because of gender-affirming reasons. Two other states (Washington and Minnesota) are also thinking about passing similar protections soon. Last year, California, Massachusetts and Connecticut already passed laws to give this type of protection as well.

Recently, politicians in Maryland passed a law to include more medical care options for people covered under Medicaid. The Governor in Maryland agrees and plans to sign this law. Politicians from Nevada are also taking action by trying to make sure transgender people get the health care they need and that prisoners who are transgender are treated fairly.

The future of this group of bills is uncertain since the Governor, Joe Lombardo, avoids the negative talk and rule changes against transgender people made by other people in the Republican Party in many other places. In just a little more than a month, lawmakers will decide if these bills pass or not, but even if they fail it has been seen that this debate about keeping transgender people safe will get attention from all over the country.

Sen. Melanie Scheible, who is part of Nevada’s LGBTQ+ Caucus and also the sponsor for this new bill, said that the governor’s office understands she isn’t trying to give them something just so she can criticize it later like a political stunt.

Some people are worried that young people might do things like getting surgery or changing who they are in schools without their parents knowing.

But others say that these changes can help to save peoples’ lives and be really important.

The medical director of the LGBTQI+ Program at Swedish Health Services in Seattle, Kevin Wang, stated that taking care of someone’s gender dysphoria can reduce their depression, anxiety and bad behaviours like self-harm. Studies have found out that transgender folks, including younger people, are more likely to think about or try suicide compared to other people.

Wang then said “This is not only about beauty but also about preventing future harm by having access to these services that could be life saving”.

Some lawyers, however, are warning that laws that try to protect people who want to change their gender but without enough money or rules in place to make sure it happens, may not lead to anything really different.

In Oregon, it is illegal for insurance companies to treat people differently based on their gender. Insurance companies must also pay for medical treatments that a doctor says are needed because of Gender Dysphoria, which is when a person’s gender identity does not match the one they were assigned at birth. Unfortunately, when insurance companies break this rule they don’t usually get punished.

Young asked, “Where are the people who will make sure this law is followed? Where are the lawyers to work on it? How are we going to pay for teaching insurance adjusters that they can’t do certain things?”

She went on to say, “It won’t be meaningful at all if we expect transgender people with not a lot of money to take their case to court.”

Christina Wood, who moved to Oregon recently, said she was glad that she had access to the resources and opportunity to move to a place where it is easier for her to become what she wants. She also added that although it’s hard times out here, she will not be deterred from fighting for people in her situation.

“When I was younger, I never had the chance to express myself. Christopher went through the same thing. But Christina can speak up for herself, and that’s what I want to do too.”

Rush and Stern are two people who are part of a program called Report for America Statehouse News Initiative. This program is like a volunteer service that puts journalists in local newsrooms so they can report on stories that don’t get enough attention.

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