Medical treatment

Rule to protect gender-affirming medical treatment comes into force on January 1

December 28, 2021

OLYMPIA, Wash. – A rule aimed at consolidating access to gender-affirming health care in Washington state goes into effect Jan. 1, 2022. Insurance Commissioner Mike Kreidler passed the rule Nov. 30, 2021, which enshrines into state law the Gender Affirming Treatment Act (SB 5313), passed by the Washington State Legislature in 2021.

The rule clarifies several aspects of existing law to ensure that medically necessary gender affirmation treatments are covered by health insurers. The wording of the rule previously allowed insurers to deny coverage in a way that subverted the intent of the law.

For example, insurers cannot deny gender-affirming hormone treatments because they are prescribed at different levels than they are for cisgender patients whose gender identity matches their sex assigned at birth.

“While the rule clarifications seem technical, the implications for transgender and gender-diverse people are significant,” Kreidler said. “Advocates have repeatedly told us that gender-affirming treatment saves lives. As an insurance regulator, I take seriously my duty to ensure that the laws and rules relating to insurance coverage are as inclusive as we would like and that insurers are unable to issue blanket denials based on unintended loopholes in the law.

Kreidler has a long history of protecting the rights of transgender and gender-diverse people to access health care, in accordance with state laws to protect them. It fined insurers millions of dollars for refusing treatment and issued technical assistance notices to make it clear to insurers what they should cover.

If you have been wrongfully denied coverage for medical services, you can file a complaint and we will investigate it for you, or you can file a complaint with your health insurance company.

Learn more about gender-affirming medical rights in Washington State.