May 17, 2023 - News

What's changing after Maryland expanded access to gender-affirming care

Illustration: Allie Carl/Axios

A new law in Maryland will expand access to gender-affirming care for the state’s low-income residents, including people under the age of 18.

Why it matters: Leading medical associations say gender-affirming care can be medically necessary for young transgender people and helps reduce their likelihood of dying by suicide.

The big picture: The law signed by Gov. Wes Moore earlier this month puts Maryland among the wave of blue states moving to protect such care, as Republican politicians around the country work to limit it.

  • Gender-affirming care refers to a range of social, psychological, behavioral, and medical interventions to affirm a person’s gender identity.

Background: Gender-affirming care is covered by Medicaid only for people over 18 years old and only for some services, including hormone therapy.

What’s new: Starting next year, all Medicaid enrollees in the state, including those under 18 years old, will be able to receive expanded gender-affirming care.

  • Medicaid will be barred from denying or limiting coverage if it’s prescribed by a doctor, consistent with clinical standards, and medically necessary.

The bill also expands the treatments covered by Medicaid to include:

  • Fertility preservation services
  • Hair and voice alteration
  • Alterations to the face, neck, or chest, or a combination of these treatments
  • Reversal of prior treatments

State of play: An estimated 24,000 adults in Maryland are trans, per a 2022 Williams Institute report. Some 6,000 of them are enrolled in Medicaid.

  • In 2022, 98 people statewide got gender-affirming treatment through Medicaid, according to the Williams Institute. Health officials expect that number to rise by about 25 people annually because of the new law.

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