New York State Should Cover True Cost of Gender-Affirming Care

Diana Mantilla-Raad is the associate director of prevention at TransLatinx Network.

New Yorkers of transgender experience are fortunate to live in a state that mandates Medicaid to cover transition-related care. While this mandate creates a useful framework for meaningful change, we must now focus on effective implementation. There is serious room for improvement within Medicaid.

As an agency by and for transgender, intersex, gender non-conforming, and non-binary (TIGNCNB) people, TransLatinx Network knows first hand all the challenges that TIGNCNB people face in accessing gender-affirming care. Gender-affirming care supports people in living healthy lives by engaging them in the full continuum of care, including primary care and sexual health services, and is essential to End the HIV/AIDS Epidemic.

TIGNCB people, particularly trans women of color and recent immigrants, face incredible barriers to living their healthiest, most authentic lives. In our practice, we regularly encounter clients who routinely face discrimination and have limited access to primary and mental health care, are unable to cover basic medical costs, and have difficulty navigating health and gender-affirming services, especially in terms of language barriers and lack of cultural competence from medical providers.

Medicaid Special Needs Health Plans help TIGNCB New Yorkers access the gender-affirming health care they need, but New York State makes it hard for them to do this. Reimbursement rates for gender-affirming services are inadequate to cover the true cost of gender-affirming care. The State must set rates that sufficiently cover actual costs, ensuring that any New Yorker seeking life-changing, gender-affirming care can access it. The time to act is now.

Diana Mantilla-Raad is the associate director of prevention at TransLatinx Network.