Thanks to the Affordable Care Act, transgender people like Devin Payne are able to obtain the health coverage they need. But obstacles to treatment endure.
BY Anna Gorman Kaiser Health News
August 26 2014
Devin Payne had gone years without health insurance — having little need and not much money to pay for it.
Then Payne realized she’s transgender. In her early 40s, she changed her name, began wearing long skirts, grew out her sandy blond hair and started taking hormones.
Although not all trans women get gender reassignment surgery, Payne said it was the right next step for her. For that, Payne, who is now 44, said she needed health coverage. “It is not a simple, easy, magical surgery,” said Payne, a photographer who lives in Palm Springs. “Trying to do this without insurance is a big risk. Things can go wrong … not having the money to pay for it would be awful.”
Payne learned in the fall that she might qualify for subsidies through the state’s new insurance marketplace, Covered California, because her income fell under the limit of $46,000 a year. She eagerly signed up in March for a Blue Shield plan for about $230 a month and began making preparations for the surgery that would change her life.
A “Preexisting Condition”
Among the less-talked-about implications of the Affordable Care Act is the relief it is providing to transgender people, many of whom are low-income and who have struggled to obtain health coverage.
Getting jobs that offer insurance often has been difficult for transgender people, and the cost of purchasing plans on the private market can be prohibitive. Some have been denied policies altogether after being diagnosed with “gender identity disorder,” often considered a preexisting condition.
Without insurance, many people were unable to afford the hormones, surgeries, and counseling needed to complete their transition. Nor would they have been covered in the event of complications.