NEJM Perspective Podcast on the Future of Transgender Insurance Coverage

Posted by • May 19th, 2017

In this episode of the NEJM Perspective Audio Interview series, Kellan Baker, a senior fellow at the Center for American Progress, speaks with NEJM Managing Editor Stephen Morrissey on the past and future of insurance coverage for transgender people. As a small, poorly understood population, transgender people frequently encounter discrimination that includes mistreatment by health care providers, rejection by employers, and harassment in restrooms and other places of public accommodation. These experiences exacerbate health disparities such as high rates of depression, anxiety, exposure to violence, and HIV infection.

However, as Baker explains, it was not always this way. As early as the 1960s, American universities and hospitals began making strides towards providing equal care to all people, regardless of gender identity. This progress continued into the 1980s, but was halted when an exclusion on gender transition related coverage was introduced to the Medicare and Medicaid programs. These exclusions often left gender dysphoria patients without coverage, but were approved in part because they allowed employers to lower the cost of employee insurance coverage.

In recent years, pressure has been placed on health care providers, insurance companies, and government agencies to recognize gender dysphoria as a medical condition, and progress has been made toward standardized services related to gender transition. Baker acknowledges the progress, but says the highly bipartisan landscape of today has left transgender people without a solid way of getting the coverage they need.

Baker gives us a glimpse into how he believes recent events surrounding the topic — including court cases, independent research studies and examples of government intervention in insurance coverage provided by large employers — will shape the future of how transgender people are able to safely and cost-effectively go through gender transition. To listen to the full podcast, click here.

To listen and to more interviews in our archive and subscribe to our Perspective Audio Interview series, click here.

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