Oregon bans anti-trans health care discrimination

[MadelineB]

Oregon bans anti-trans health care discrimination
January 8, 2013
By Michael K. Lavers

http://www.washingtonblade.com/2013/01/08/oregon-bans-anti-trans-health-care-discrimination/

Transgender advocates have applauded new regulations that ban private health insurance companies in Oregon from discriminating against trans policy holders.

The guidelines the Oregon Insurance Division of the state Department of Consumer and Business Services announced on Dec. 19 specifically prohibit health care providers from discriminating against a policy holder based on their actual or perceived gender identity and expression. Under the guidelines, providers cannot deny coverage of hormone therapy, hysterectomies, mastectomies and other medically-necessary treatments for gender dysphoria and sex-reassignment surgery that are covered for non-trans policy holders.

The agency also prohibited insurance companies from denying coverage of a particular treatment simply because the policy holder is trans. The guidelines also expand Oregon's statewide mandate for mental health services to include trans Oregonians.

Lawmakers in 2007 approved a law that explicitly banned discrimination based on sexual orientation — they defined it to include gender identity and expression, but Basic Rights Oregon had sought clarification from the agency after it received complaints from trans policy holders.

"What this means is that trans Oregonians will have access to basic medically necessary care," Tash Shatz, trans justice program manager at Basic Rights Oregon, told the Washington Blade on Monday. "It's a huge victory for the transgender community in Oregon. It really represents a sea change in terms of this issue."
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OFFICIAL TEXT OF BULLETIN:

2012-01   Application of Senate Bill 2 (2007 Legislative Session) to Gender Identity Issues in the Transaction and Regulation of Insurance in Oregon

Link to the 11 page guidelines in PDF format: http://www.cbs.state.or.us/ins/bulletins/bulletin2012-01.pdf

[Ms. OBrien CVT]

But would it cover SRS?

[MadelineB]

It does not say specifically. The way I read it, if they cover a procedure for a reason that isn't gender related they have to cover it for a gender related reason too. Oregon doesn't spell out what has to be covered, only that the coverage cannot discriminate against gender diagnoses or deny based on gender.

This is new stuff and I am no attorney, but I would suggest two areas that might have a chance on appeal, based on this bulletin: as corrective surgery or as reconstructive surgery. One would have to show that the medically necessary service is indeed covered for at least one other condition under the same plan.

So lets say a ciswoman is born with a birth defect that caused the vagina never to form but they are normally female in every other way. If the plan would cover construction of a neovagina for that girl, then they would have to cover it for a transwoman with a medically necessity for the same service.

Or lets say a cisman had his penis destroyed by cancer and it had to be removed. If the plan would cover reconstructive surgery to create a new penis for the man, then they would have to cover it for a transman with a medical necessity for the same service.

In either case, if the plan was written to not cover that medical service for anyone regardless of the diagnosis or patient situation, then it wouldn't be covered as treatment for GD either.

This is my personal opinion and does not represent the opinions of this site, or my employer, or any other person.