Queer Health: Obamacare and Transgender Health


Apparently I recently lost my abilities to function like an adult and forgot how to read a calendar, and completely missed last Saturday’s scheduled Queer Health post. So, here it is, a little late. And don’t worry, I have since regained my somewhat adult-like mind.

Back in July the Department of Health and Human Services (HHS) released a letter to the National Center for Lesbian Rights clarifying the department’s stance on sex-based discrimination. In the note, HHS describes Section 1557 of the Affordable Care Act (Obamacare), which states that publicly funded insurance companies are not allowed to deny benefits to people based on their gender. HHS, in a moment of awesome, stated that this anti-discrimination policy also extends to gender identity and even goes on to include “failure to conform to stereotypical notions of masculinity or femininity.”  Granted, framing the language in a way that makes gender-bending seem like a “failure” is less than ideal, but I think this is a case where we have to pick our arguments; it is now illegal for insurance companies to discriminate against trans* folk of all types, and that’s pretty damn amazing.

As amazing as this is, in truth it’s only one of many needed changes Obamacare brings to transgender health care. Now, not all of us feel the need for medical interventions, and not every trans* person feels that they have a medical condition; we all have different stories and narratives, but for those of us who feel the need to undergo medical treatment we now have a legal precedent to stand on. Many insurance companies have been covering our procedures for a while now (I know a guy who got his Gender Confirmation Surgery covered back in the ‘80s!), but there are still groups who cling to old ideals and who can make our lives much more complicated if they so desire. In fact, until the ACA was signed into law, some insurance companies listed being transgender as a pre-existing condition and could deny benefits to those who truly need them. However, with Obamacare in place and with reinforcement from HHS this kind of prejudice should, hopefully, be ending fairly soon.

However, insurance coverage is not the only piece of health care discrimination the ACA fixes. In August Think Progress reported on a trans* cancer patient named Jay Kallio who was repeatedly denied care by his doctors, and who received a much lower quality of care than your average patient. Not only was he subjected to systematic discrimination but because of his doctors’ bigotry they missed the “therapeutic window” of treatment, meaning it will be much more difficult for him to defeat this disease.  Under Obamacare, medical patients now have a federal Bill of Rights which should provide a legal recourse for patients like Kallio who end up with doctors that feel the need to exercise their “moral objections” instead of their Hippocratic Oath.

Regardless of your political leanings, the Affordable Care Act is an excellent piece of legislation for trans* folk who need medical treatments of any kind. Considering the fact that employment discrimination based on gender identity is still legal in 37 states (though a number of cities have adopted individual anti-discrimination laws in a number of those states), any support we can get from the federal government is a win in my book. We’ve still got a long way to go, but we’re getting there; we’ve just got to keep fighting until our voices are heard.

Queer Health is a bi-monthly feature that shares information about important health issues. Look for Queer Health every 2nd and 4th Saturday of the month.


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  1. Good news indeed. But I can’t wait for the day when the government realizes the prejudice and injustice involved not only in denying trans people access to health insurance in general, but in allowing companies to deny us coverage for trans-related care, which is, after all, a medically-necessary treatment for those of us with body dysphoria.

    The current situation is tantamount to saying that gay people are already equal because they have the same right to get straight-married as anyone.

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