Transgender Oregonians and Healthcare: Why OHP’s Coverage is Saving Lives

By Megan Bird, M.D., Legacy Medical Group-Women’s Specialties

With the recent announcement from the Oregon Health Plan (OHP) adding health coverage for transgender Oregonians, I have heard praise from my patients but confusion within our community. Many people don’t understand what transition-related care is and why it is important. As a physician at Legacy Health, treating transgender patients, I felt it necessary to discuss the importance of this decision by OHP, as well as why I believe transition-related care is valuable lifesaving care that is good for Oregon.
Several years ago, I received a call from a physician I worked with that had a transgender woman who needed hormones. This physician did not have an expertise in providing hormone therapy and asked if I could take over the care of her patient. I didn’t look at this case as a transgender care case but more providing hormone care for a patient in need. However, once it was known that I was providing care, more and more patients began to seek me out. Now, I provide gynecology care for all transgender patients: men, women, and gender queer patients. I provide hormone therapy, hysterectomy procedures for trans men and I provide post-operative care for patients who have had sex reassignment surgery.
Why transgender care, you ask? One consistent issue that I saw as patients came to see me was the gender dysphoria they were experiencing. The decision made by OHP centers around treatment of gender dysphoria. For transgender patients, the dissonance between the sex they are born at birth and the person they know they are inside creates significant unhappiness, distress, and discomfort. This discord can cause depression, anxiety, and other health issues that contribute to a horrifically high suicide attempt rate and high poverty rates among transgender people. By our best studies, up to 41 percent of transgender Oregonians will attempt suicide, compared to less than a percent for other Oregonians. Without appropriate treatment, many will self-treat with drugs and alcohol. Fearing rejection and mistreatment, they may avoid mental health help until they are in crisis, seeking medical care in emergency rooms. OHP agreed with the growing evidence that health coverage for transgender people saves lives and treatment helps Oregonians be happy and healthy.
Health coverage includes some transition-related care, although not all aspects. Covered services include mental health counseling and treatment, puberty suppression or delay for adolescents, hormone therapy and some surgical therapies. This coverage will help all Oregonians experience their gender safely and transition when needed.
I am excited that OHP now provides health coverage to transgender Oregonians. I have seen how transgender related health care transforms people–it is inspiring and reminds me why I became a doctor. I have seen these patients begin to have hope for their future and I am so fortunate to be a part of that hope. Over time I get to watch their anxiety improve; see them smile genuinely for the first time; see them comfortably interact as the gender that they are. They start to see a future where they are happy and healthy. It is truly incredible and I am so proud to be a part of this network of lifesaving care.
Legacy Medical Group-Women’s Specialties: (503) 415-4160