Oregon Health Plan to cover medical care for trans youth

TransActive Executive Director Jenn Burleton has spent the past year working to secure life-saving medical coverage for trans children. Photo by Erin Rook, PQ Monthly
By Erin Rook, PQ Monthly

While trans activists wait to see how the recent Oregon Insurance Division decision will affect federally-managed insurance programs (Medicare and Medicaid), they have secured a significant victory for trans and gender non-conforming children and youth.

TransActive Education & Advocacy announced Jan. 11 that the Oregon Health Plan and its Healthy Kids Program will begin covering medically-necessary care for young people experiencing gender dysphoria on Oct. 1, 2014, making Oregon the first state to ensure coverage of trans kids under Medicaid.

In addition to mental health counseling and pediatric evaluation, the state plan includes procedures, medication, and follow-up monitoring related to the suppression of puberty. For transgender children, pubertal changes that contradict gender identity can be traumatic to experience and difficult to reverse later in life.

“Pubertal suppression provides transgender adolescents the option of avoiding unwanted, irreversible, and deeply distressing changes that come with birth-sex pubertal development,” TransActive Executive Director Jenn Burleton said in a release. “Far too often trans adolescents experience increased suicidal ideation as a result of these changes and the indifference of others about the impact these changes have on trans youth.”

But treatments, while effective, aren’t cheap. Out-of-pocket costs for pubertal suppression treatment can reach $1,000 a month, Burleton says, making it impossible for many families to afford this life-saving care.

“Thanks to this common sense, safe, and medically-recommended action by the Oregon Health Plan, lives will be saved,” Burleton said. “TransActive is extremely grateful to have been able to play a part in this victory.”

Specifically, the OHP will cover hormonal treatment to delay the onset or continuation of puberty in gender questioning children and adolescents no earlier than Tanner stage 2-3. A comprehensive mental health evaluation is required, and ongoing psychological care is recommended.

The policy change comes after more than a year of meetings with the OHP Values-based Benefits Subcommittee, TransActive’s Advisory Board, and the Basic Rights Oregon Trans Justice Working Group. The advisory board is comprised of a number of healthcare advocates and experts including Burleton, Aubrey Harrison, Heidi Allen, Ph.D. (Columbia University), Carol Blenning, M.D. (Family Practice-Oregon Health & Science University), Bruce Boston, M.D. (Chief-Pediatric Endocrinology, Oregon Health & Science University), Sheryl Rindel, LPC, NCC (Client Services Program Manager, TransActive), and Karin Selva, M.D. (Pediatric Endocrinology, Randall Children’s Hospital).

Based in Portland, TransActive is the only organization providing comprehensive support service for trans and gender non-conforming children and their families in the United States. For more information, visit transactiveonline.org.