Christina Wood, a 49-year-old transgender woman, moved from New Mexico to Oregon six years ago to access gender-affirming health care that she couldn’t find in her home state. Wood was able to receive certain surgeries to transition but faced challenges with electrolysis, a permanent hair removal treatment that wasn’t fully covered by Oregon’s Medicaid plan.
However, that is likely about to change with a new bill set to pass in Oregon that would expand insurance coverage for gender-affirming care to include facial hair removal and Adam’s apple reduction surgery. These procedures are currently considered cosmetic by insurers, but for transitioning women, they are critical to their mental health.
The bill is part of a wave of legislation in Democratic-led states that aims to protect transgender people’s rights amid a conservative movement seeking to ban or limit gender-affirming care, eliminate some rights and protections, and even bar discussion of transgender existence in classrooms. More than half a dozen states, from New Jersey to Colorado, have passed or are considering bills or executive orders around transgender health care and civil rights.
Gender-affirming care includes a wide range of social and medical interventions such as hormone treatments, counseling, puberty blockers, and surgery. Oregon’s bill would prohibit insurers and the state’s Medicaid plan from defining procedures like electrolysis as cosmetic when they are medically necessary to treat gender dysphoria. It would also shield providers and patients from lawsuits originating in states where such procedures are restricted.
The bill has sparked fervent debate, with hundreds of people submitting written testimony both for and against it, and an emotionally charged public hearing. While advocates for gender-affirming health procedures argue that they can be a matter of life or death, some opponents are concerned that young people may undergo certain physical transition procedures that are irreversible or transition socially in settings such as schools without their parents’ knowledge.
Legal experts warn that laws that protect gender-affirming care but lack strong enforcement mechanisms or funding to investigate violations may not result in meaningful change. Oregon already bars insurance companies from discrimination on the basis of gender identity, and the state agency overseeing health insurance rules already requires companies to cover procedures deemed medically necessary by a doctor to treat gender dysphoria.
Christina Wood, the transgender woman who moved to Oregon to complete her transition, says she is lucky to have had the resources and ability to move to a state with more protections than others. She feels that having a voice is crucial, and she plans to advocate for people in her situation.
In a world that can be scary for transgender people, the Oregon bill to expand gender-affirming care coverage is a sign of progress towards providing more equitable healthcare access.