The New York State Department of Financial Services sent the state's insurance suppliers a letter last Thursday notifying those suppliers that they can no longer deny medically necessary treatment for gender dysphoria, a mental condition resulting from mistreatment when a people's gender assigned at birth does not match the gender they identify with.
Imagine being told that you don't have a right to be in the body you feel comfortable in. It's something that most of us can't imagine, but is the reality most transgender people face.
"It should be a siren call to realize it is beyond time to acknowledge that people have a right to be who they are.
When a person is fighting against their ability to be their true identity, it leads to all kinds of things. It leads to a breakdown, it leads to potential suicide.
--Matthew Crehan Higgins, Pride Center of Western New York
BC/BS of Western New York says the letter is just a reminder of existing state law.
Quite frankly, to call this out for a company like ours is surprising because certainly, under a medical necessity review, it would be something that would be covered for our insured members.
The reality is, it's your physician that determines what treatment you need
--Julie, Snyder, BC/BS
The rule, based on state laws requiring the diagnosis and treatment of psychological disorders, would open the door for transgender patients to obtain transitional operations as well as other treatments. Insurance companies have largely seen such surgeries as cosmetic in nature.
The Transgender Legal Defense and Education Fund says this makes New York the ninth state to require such coverage, joining California, Colorado, Connecticut, Illinois, Massachusetts, Oregon, Vermont and Washington, along with the District of Columbia.
An issuer of a policy that includes coverage for mental health conditions may not exclude coverage for the diagnosis and treatment of gender dysphoria.
--Governor Andrew Cuomo
Lee Albertorio, 30, says that when he sought a mastectomy,
he was denied by his insurance provider, which characterized the procedure as cosmetic.
This is part of who I am. This is going to make me comfortable, so I decided to go ahead and pay out of pocket using student loans and credit cards because I just needed that to get done at the time.
--Albertorio
Albertorio spent $6,500 in loans and credit card payments to obtain the mastectomy -- just one step in a transition estimated to cost $50,000.
Nobody should be in that position in order to embrace such a fundamental aspect of their personhood.
--State Senator Brad Hoylman (D), who brought up the issue in June
Respecting the rights and dignity of all New Yorkers is paramount. By taking this action, we are ensuring that principle rightfully extends to transgender people across our state and continuing New York's legacy as a progressive leader for the nation. I urge other states to follow our example on this issue, because discriminating against people on the basis of their gender identity simply should not be tolerated.
--Gov. Cuomo
One notes first that New York is on of three states that protects people aginst discrimination based on sexual orientation, but not discrimination based on gender identity.
Secondly, transgender advocates are calling for New York to cover such treatment with its Medicaid as well. A class-action lawsuit against the New York State Department of Health was filed in June challenging the Medicaid regulation which denies medically necessary treatment for transgender people.
Not everyone is cheering the change. Leslie Moran, spokesperson for the New York Health Plan Association, told the Times that although healthcare providers don't oppose the treatment, they worry that mandating coverage could lead to higher insurance rates across the board. This assertion was dismissed by the state's superintendent of financial services Benjamin Lawsky, however. Given the relative small number of people who require the surgery, he told the Times, he would be surprised if the new rules caused a noticeable rise in insurance premiums.
The changes could be a "slippery slope" for other treatments and services people argue are mental health-related.
--Moran
Actually, Ms. Moran, the law seems to do that.
And we are extremely concerned about denying rights to transgender people because of how that might affect "other people."
According to the Williams Institute, employers report zero or very low costs and yet substantial benefits, for them and their employees alike, when they provide transition-related health care coverage in their employee health benefit plans.
The Williams Institute estimates that there are 58000 transgender New Yorkers.
This is an absolute sea change in the way that insurance for transgender people will cover their health care needs. This essentially opens up an entire world of treatment for transgender people that was closed to them previously.
Transgender Medicaid recipients are some of New York’s most vulnerable citizens. They must be able to access medically necessary care. This action ordering insurance companies to stop discriminating against transgender people should immediately prompt the state to do the same thing and drop its own Medicaid exclusion. We call upon the governor and the Department of Health to make that change now.
--Michael Silverman, executive director of TLDEF
People [with gender dysphoria] are not able to be themselves, to be who they really are, which makes them much more prone to depression to suicide.
--Allison Steinberg. Empire State Pride Agenda
Steinberg also mentioned that private insurers had always paid for hormone treatments for women going through menopause, and therefore denying [transgender women] the same treatment was discriminatory.