TLDEF Announces Initiative to Eliminate Transgender Health Care Discrimination

Announcing The Trans Health Project

(NEW YORK, NY - January 16, 2020) — Transgender Legal Defense & Education Fund (TLDEF) today announced the launch of a new initiative designed to combat the systematic and pervasive health insurance discrimination facing transgender people across the nation. The project builds upon the long-standing success of TLDEF’s Name Change Project, which partners with pro bono law firms to provide free legal name changes, focusing exclusively on the public and private health insurance discrimination impacting transgender people.

“An overwhelming number of transgender people are denied insurance coverage for life-saving care. Blanket exclusions are all too common, from employer-sponsored insurance to Medicaid, to state plans,” said TLDEF Executive Director Andy Marra. “Without access to medically necessary care, transgender people are more likely to experience social stigma, discrimination, and poverty. TLDEF’s new Trans Health Project seeks to remove barriers to health care and help transgender people lead safer and healthier lives.”

The Trans Health Project takes a comprehensive, systematic approach to expanding access to transgender-related health care by educating affected individuals about their legal rights; cultivating a robust movement to achieve health care equity; expanding enforcement of existing legal protections; and driving clinical policy changes among insurance carriers.

The primary activities will focus on developing a network of attorneys capable of challenging exclusions and medical necessity denials, launching a national health care helpline for transgender individuals and advocates to receive timely assistance, and educating individuals, transgender organizations, medical and mental health providers and billing offices.

The Trans Health Project will also engage in alternative dispute resolution and policy advocacy to establish positive precedent in priority areas including Medicaid, employee-sponsored health plans, and ending the ongoing categorical exclusions for common surgeries such as facial surgery and chest surgery for transgender minors.

TLDEF has retained attorney Noah Lewis to serve as Director of the Trans Health Project. Lewis will build on the work he began at Transcend Legal, which he founded in 2016. Transcend Legal, which will wind down its work, piloted approaches the Trans Health Project will now bring to scale at TLDEF. Lewis rejoins TLDEF full-time after previously serving as its Staff Attorney for five years.

“Currently there is no systematic approach to eliminating transgender health exclusions and TLDEF will serve as a critical resource for this work,” said Lewis. “There is an urgent need to ensure our victories translate into real change on the ground on a broad scale for so many who need care. Ultimately, the Trans Health Project will ensure that our progress is both meaningful and preserved by increasing the number of advocates who can both advance and enforce legal protections that opponents are now attempting to roll back.”

Transgender people face significant barriers to accessing medically-necessary care. According to the 2015 U.S. Transgender Survey, a quarter of transgender people have experienced a problem with their insurance in the past year related to their gender identity. In addition, a quarter of those who sought coverage for hormones were denied and nearly 60% were denied coverage for transition-related surgery. More than a third of transgender people did not see a doctor because of cost.

In 2019, TLDEF filed two federal lawsuits in North Carolina and Georgia challenging exclusions of transgender-related health care in public employee health care plans.

Updated on Jan 28, 2023