As of 2023, a whopping 26 states lacked legal safeguards to prevent discrimination by private healthcare insurance companies against LGBTQ+ individuals. States like Tennessee and Mississippi have recently passed legislation permitting medical discrimination against LGBTQ individuals, specifically the transgender community. Tennessee Senate Bill 0001 and Mississippi House Bill 1125 fully ban gender-affirming healthcare for transgender minors. These states are only two of many whose legislators have lobbied for restrictions on gender affirming related healthcare access or passed legislation to effectuate such restrictions.
Generally, gender-affirming healthcare is a supportive form of healthcare that consists of an array of medical, mental health, and non-medical services for transgender and nonbinary people. Gender-affirming healthcare for minors can consist of treatments such as hormone therapies, puberty blockers, and, on the rare occasion, surgeries. Typically, this care has been covered by insurance. However, recently, some states have either begun to put restrictions in place regarding a minor’s ability to receive this kind of care or have allowed for private insurance companies to refuse to cover such care all together.
Critics of legislation prohibiting gender affirming care and insurance safeguards worry that misinformation about gender-affirming healthcare invited tighter restrictions on obtaining gender-affirming healthcare. For example, Vanderbilt Medical Center had to deny rumors that surgeons performed genital surgeries on minors because misinformation was being spread as an attempt to criticize them for providing gender-affirming care. In fact, Vanderbilt has only ever performed limited chest surgeries for minors, which is still a procedure which requires the patient be at least sixteen years old and obtain full parental consent. In other words, just because a minor has access to gender-affirming care this does not mean that child is able to get any significant surgery or treatment at the drop of a hat, without parental consent, as critics suggest.
In addition to the challenges to accessing care stemming from misinformation campaigns, proponents of LGBTQ rights have continuously emphasized that access to gender-affirming healthcare saves lives. This is critically important when transgender individuals suffer from high rates of suicide. Research shows that gender-affirming healthcare improves the overall mental health and well-being of gender diverse adolescents. In particular, transgender minors are subject to significant health disparities compared to their cisgender peers. Therefore, legislation banning such care is likely to enhance such disparities since transgender minors are being restricted access to healthcare that can be truly lifesaving.
As a society that, in recent decades, has made leaps and bounds in promoting LGBTQ rights, we should be grateful for the progress made thus far. However, at the same time we should still be aware that these recent restrictions could begin to substantially erode that hard won progress. We still have work to do. Until all states provide LGBTQ individuals with inclusive insurance protections, both through private insurers and state employee insurance benefits, the fight for such rights is far from over.