NY regulator tells insurers to cover transgender treatment considered medically necessary

Health Care Associated Press

New York's financial regulators have advised health insurers statewide to cover transgender treatment deemed to be medically necessary.

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The guidance Thursday from the Department of Financial Services says commercial insurers may not deny such treatment for gender dysphoria — when someone's gender at birth is contrary to how they identify.

Department Superintendent Ben Lawsky says it sends the message that discrimination against transgender people won't be tolerated.

According to the department, the current edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders classifies gender dysphoria as a mental disorder, which therefore should be covered.

While insurers retain the right to review coverage requests as they do with any others of medical necessity, regulators say consumers have the same appeal rights provided under state law.