Implementation of a state-level insurance policy that prohibits discrimination based on gender identity or gender expression can increase access to gender-affirming surgical care, based on a recent study by The Ohio State University Wexner Medical Center and College of Medicine.
The research examined the impact of the California Insurance Gender Nondiscrimination Act, which prohibits insurers from refusing to cover the fee of medically needed care based on a patient’s gender identity or gender expression. The policy applies to all health plans within the state.
The evaluation included 25,252 transgender and gender diverse patients in California in addition to in Arizona and Washington, which haven’t implemented similar insurance policies. Researchers found a 12.1% increase within the likelihood of patients having gender-affirming surgery in California than in Arizona or Washington. The findings were published today within the Journal of the American Medical Association.
Gender-affirming surgery of the face, chest or genitals is taken into account medically needed for transgender and gender diverse patients in addition to a cheap health intervention, said Dr. Adrian Diaz, a general surgery resident within the Department of Surgery and senior creator of the study. A minimum of 1.6 million Americans discover as transgender or gender-diverse with about 60% expressing interest in gender-affirming surgery, based on the study.
This research has the potential to have an ideal impact on the transgender and gender-diverse community since it demonstrates the facility that state legislatures have in implementing nondiscriminatory insurance policies and improving access to gender-affirming surgical care.”
Dr. Adrian Diaz, general surgery resident within the Department of Surgery and senior creator of the study
Studies show that without access to gender-affirming surgical care, patients have higher rates of HIV infection, depression, substance abuse, suicidal ideation and unemployment.
“With the recent national trend of states passing restrictive state-level policies limiting access to gender-affirming care, we felt it was necessary to grasp the effect of already implemented state-level protective, nondiscriminatory policies. This kind of research helps inform state legislatures of potential polices that may create a more equitable healthcare environment inside their states,” said Dr. Anna Schoenbrunner, a cosmetic surgery resident within the Ohio State Department of Plastic and Reconstructive Surgery and first creator of the study.
Researchers noted their findings were just like what happened after implementation of the Women’s Health and Cancer Right Act in 1999, which mandated insurance coverage for breast reconstruction and symmetry procedures following mastectomy. After passage of the act, a study found utilization of breast reconstruction increased by 31% the yr of implementation and 36% the next yr in states without previous laws mandating the insurance coverage.
Source:
The Ohio State University Wexner Medical Center
Journal reference:
Schoenbrunner, A., et al. (2023). Association Between California’s State Insurance Gender Nondiscrimination Act and Utilization of Gender-Affirming Surgery. JAMA. doi.org/10.1001/jama.2023.0878.