OPM considering transgender care in future employee health plans


Federal employees may be one step closer to being able to access transgender care through their federal health insurance coverage.

The Office of Personnel Management is currently evaluating the exclusion of transgender care in the federal employee health benefit program, according to the agency.

But the agency said that no decision has been made yet and that when it does come to a decision it will be reflected in the coverage options for future health care plans.

While some company and local government health plans cover care for transgender policy-holders, the Federal government does not and specifically excludes transition-related care from coverage.

Transition-related care may include hormone replacement therapy, mental health services, and sexual reassignment surgery (SRS).  The costs of this care can easily reach into the tens of thousands of dollars, putting it beyond the reach of many who need it.

While OPM is evaluating the issue, HHS is considering whether the current policy of refusing to cover transition-related care is even legal.

In August the Health and Human Services Department issued a request for information regarding section 1557 of the Affordable Care Act – which prohibits discrimination on the bases of “race, color, national origin, sex, age, or disability in certain health programs and activities.

The agency wanted information on a variety of issues to better understand individuals’ experiences with discrimination in health programs or activities and covered entities’ experiences in complying with Federal civil rights laws.”

The agency specifically requested examples of covered discrimination on the basis of sex, ‘including discrimination on the basis of gender identity, sex stereotyping, or pregnancy.”

They received 162 comments before the comment period closed.

Read previous related post: Is the administration moving to include transgender care in federal health insurance coverage?


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  1. I am a Viet Nam era veteran, a Transgender woman, and an advocate on the North Shore of Mass. I am also the clerk of the board for NETA which I provided the link for. We just want a fair shake, being transgender can be resolved to a major degree by medically available technologies. Why is this birth defect excluded from generalized corrective surgures?

  2. Birth defects are structural or functional abnormalities present at birth that cause physical or mental disability. Unless there is physical gender abnormalities involving the sex organs, the surgery is not corrective, but elective and should not be covered by insurance.

  3. Pingback: 5 important federal items you may have missed this week - Fedline

  4. Gender disphiria has been with me all of my life. When you are hateful, prejudiced, and ignorant to other peoples plights you have nothing positive to contribute to society. Having already had facial feminization and breast augmentation surgeries, my doctors can alrady tell the difference in my mental, emotional and physical health. I am convinced as we further explore and map the human genome, we will find a genetic difference as a cause.

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