Health insurance and gender affirming treatment

A 2025 federal order could impact gender-related care for youth. This information will be updated regularly to include any changes. Washington law still protects transgender, nonbinary and gender identity related health care rights for all people including youth even with the federal bans and orders in place. There might be more limited options for care providers but gender affirming treatment is still protected in Washington. 

What is gender affirming treatment?

It is any care prescribed to treat any condition related to gender identity. Gender affirming treatment includes all treatment prescribed by your medical provider to treat gender dysphoria or gender identity related medical conditions.

Who can receive gender affirming treatment?

Gender affirming treatment can be provided to individuals who seek such treatment related to their gender identity. Some people who seek gender affirming medical treatment may identify as two spirit, transgender, nonbinary, intersex, or other gender identities.

Is gender affirming health care protected in Washington?

The Gender Affirming Treatment Act is a Washington law that protects the rights of insured individuals who are seeking coverage for gender affirming medical treatment. 

Insurance companies often try to deny coverage for treatment and medical care related to gender identity by categorizing the care as cosmetic even though it isn’t. They will also try to deny coverage by having a blanket ban on coverage for all gender identity related care. 

This law:

• Stops insurance companies from classifying the most commonly prescribed gender affirming care under the categories that result in coverage denials
• Stops insurance companies from determining that most gender affirming care is cosmetic
• Prohibits blanket bans on gender identity related care
• Protects reproductive health care rights from automatic denials
• Prohibits cosmetic determination for specific treatments if the treatments are otherwise covered by your plan for other people who don’t need the treatments for gender affirming reasons

This law doesn’t apply to self-funded insurance plans or groups. If you aren’t sure whether your insurance plan is self-funded, ask your employer.

The Washington Law Against Discrimination also provides protection for gender affirming health care. You can’t be denied coverage or have your coverage cancelled because of your gender identity or expression. You can’t have different rates, standards, or limits applied to you because of your gender identity or expression.

I am under 18. Do these rights apply to me too?

Yes. These rights apply to both youth and adults.

The January 2025 federal ban related to gender affirming care for youth shouldn’t impact your care in Washington state. Washington law still protects certain gender affirming care for people under 18 in Washington state. If you have experienced issues related to your gender affirming care since the federal ban, you can try to get legal help.

P-FLAG is challenging the January 2025 federal order with a lawsuit filed by the ACLU and Lambda Legal. If you need more information about these lawsuits and how they could impact you, you can try to contact:

• The non-emergency Legal Help Desk at Lambda Legal.
• The ACLU-WA online intake form.

I don’t use Apple Health. I have a private health insurance provider. Does the law apply to my health insurance too?

Yes, unless your plan is a self-funded plan. The law applies to all insurance carriers who provide health insurance in Washington except self-funded plans.  A self-funded plan can choose to offer coverage in accordance with this law but it doesn’t have to. Most other types of insurance plans must follow this law.

Your health plan carrier may limit coverage if it limits coverage for other similar non-gender related treatments. For example: If your health plan doesn’t otherwise provide coverage for hormones for non-gender related treatments, then your health carrier may also limit coverage for gender related hormone treatment. 

But your health carrier can’t provide coverage for hormone treatment for non-gender related issues and then deny coverage for gender-related hormone treatments. Treatment coverage must match.