Hawaii Lawmakers Advance Bill to Force Insurance Companies to Provide ‘Transgender’ Medical Treatment

Lawmakers in Hawaii have advanced legislation that will force insurance companies to cover “gender-affirming” medical treatment for people who claim to be “transgender” or the opposite of their biological sex.

Although HB 2405 has not received much media coverage, it has been touted on social media and is posted online.

The text of the legislation says it is necessary because people who want to undergo life-altering surgeries and other treatment are discriminated against by insurance companies:

The legislature finds that many transgender persons have experienced discriminatory treatment from health insurance providers when seeking coverage for gender‑confirming treatments.  Insurance policies often cover therapies and surgeries like feminizing or masculinizing hormone therapies, voice therapies, chest augmentations or reductions, and genital surgeries for other purposes but deny the same treatments for purposes of gender affirmation.

The legislature finds that these arbitrary assessments of medical necessity are not evidence-based and interfere with the patient-physician relationship.  They also place transgender persons who are denied treatment at higher risk of suicide and depression.

The legislature recognizes that, while federal health care guidelines previously prohibited health insurance and healthcare providers from discriminating on the basis of gender identity, these protections have been largely rolled back.

Accordingly, the purpose of this Act is to require health insurance companies to provide applicants and policy holders with clear information on the policy’s coverage of gender transition treatments and to prohibit insurance companies from discriminating on the basis of gender identity.

The procedures covered under the bill, which is sponsored by the majority Democrat Hawaii state legislature, include:

(1)  Hormone therapies;

(2)  Hysterectomies;

(3)  Mastectomies;

(4)  Vocal training;

(5)  Feminizing vaginoplasties;

(6)  Masculinizing phalloplasties;

(7)  Metaoidioplasties;

(8)  Breast augmentations;

(9)  Masculinizing chest surgeries;

(10)  Facial feminization surgeries;

(11)  Reduction thyroid chondroplasties;

(12)  Voice surgeries and therapies;

(13)  Electrolysis or laser hair removal; and

(14)  Smoking cessation therapies.

Rachel Levine, a former pediatrician chosen by President Joe Biden to be the assistant secretary for health for the U.S. Department of Health and Human Services — who is also a man living as a woman — said, “Gender-affirming care is a supportive, non-judgmental model of health care that allows patients to explore and, if they decide, to pursue medical affirmation procedures. It’s recommended by the American Academy of Pediatrics and the American Medical Association.”

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