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California's Department of Managed Healh Care (DMHC) issued guidelines last Tuesday to implement the state's Insurance Discrimination Act of 2006 with regards to transgender people.

Funny thing:  the state is insisting that INDA 2006 applies to us as well as other people.

This is an important step in protecting the health of all Californians, including transgender individuals.  No Californian should be denied care and treatment because of their gender identity or expression. Implementation of California’s Insurance Gender Non-Discrimination Act (IGNA) is a simple matter of fairness and equality in health care.

--California Assembly Speaker John Pérez

The guidelines can be simply stated:
If an insurance company authorizes a treatment for non-transgender individuals, it needs to extend that same doctor-perscribed treatment to the trans community.

The new directive applies to all HMOs and PPOs in the state.  In addition to the new guidelines, the DMHC will also now allow transgender patients to file complaints with a state review board over denial of care.

DMHC has an existing review process, but trans people were not able to access that process because of widespread discrimination in the healthcare system.  These guidelines now finally grant them that access.

--Masen Davis, executive director of the Transgender Law Center

In most of America it is de rigueur to deny insurance coverage for medical conditions on the basis of gender identity.
This one letter will save lives.  For years, transgender Californians have been denied coverage of basic care merely because of who we are.  Discriminatory insurance exclusions put transgender people and our families at risk for health problems and financial hardship. Now we can finally get the care we need.


A 2008 study conducted by the Transgender Law Center found that 15 percent of transgender patients were being denied gender-specific care such as pap smears and prostate exams because of our gender identity.

But Davis has pointed out that we are not just talking about gender-specific treatments here.

Insurance companies are in this business to make money.  So if there has been a treatment that has been requested, there has been a treatment denied.  Over the years, we have heard from thousands of transgender people who have been denied insurance or basic care.  This letter from the DMHC makes it clear:  To comply with existing law, health insurance companies can no longer deny care to transgender patients because of who they are.

I think it’s really important to realize almost every insurance company in the United States has a transgender exclusion stipulation.


California becomes the third state, after Oregon and Colorado, to offer healthcare protections to transgender individuals.
All of us need access to medical care and medically necessary procedures.


What can you do?  Try to get the wheels rolling for similar rulings or legislation in your state.
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