Not every trans+ person chooses to seek medical assistance for transitioning – but some who wish to pursue hormone replacement and gender reassignment surgery are held back from pursuing treatment due to financial reasons.
Fortunately, changes in legislature have begun to make these treatments more accessible, but we still have a long way to go until trans+ people have affordable access to treatment.
Under the Americans with Disabilities Act of 1990, Gender Identity Disorder is acknowledged as a disability, and also expressly excluded from benefits. In other words, trans+ people are protected from discrimination under the ADA, but cannot draw disability benefits/SSI for being trans+. However, trans+ people may still qualify for SSI if they suffer from another disability, including Major Depression.
Because depression is disproportionately common in the trans+ community, some people may be able to qualify. The process of receiving SSI benefits for mental illness can be a difficult one, but it may be a good solution for those who struggle with daily activities as a result of long-standing major depression.
Insurance and Medicare
Many more insurance companies are coming to view sex realignment surgery as medically necessary, offering coverage for the procedure. As of January 2016, the Obama Administration mandated that all carriers participating in the Federal Employees Health Benefits Program must provide coverage for gender transition-related medical services, drugs and supplies. This means that all Federal employees are now covered for these expenses.
Medicare, too, now covers these expenses. So-called “transsexual surgery” had been barred from Medicare from 1989 to 2014, but that exclusion has since been appealed. Medicare now covers hormone therapy and sex reassignment surgery in addition to all routine preventative care regardless of gender markers – including mammograms, pelvic and prostate exams.
Not every private insurance company has followed suit, but it is becoming increasingly common – and as demand puts more pressure on insurance companies to catch up with the times.