Lawmakers pass bill to protect right to medical care for transgender residents

OLYMPIA, Wash. — Washington state lawmakers on Monday approved a bill to prevent health insurers from denying coverage for gender affirming treatment, drawing a stark contrast with other state legislatures currently considering anti-transgender legislation.

“I’m extremely proud of Washington’s commitment to protecting our trans family members, friends, neighbors, and co-workers by passing bills like the Gender Affirming Treatment Act,” said bill sponsor Sen. Marko Liias of Lynnwood in a prepared statement. “Trans families are welcomed and supported here in Washington state.”

According to The New York Times, as of this week more than 80 bills had been introduced in state legislatures across the country that are aimed at restricting transgender youth, mostly related to medical care and participation in athletics.

Lawmakers in states including Mississippi, Tennessee, Arkansas, and South Dakota have passed bills restricting transgender youth participation in sports. After negotiations between South Dakota Gov. Kristi Noem and lawmakers failed, she issued executive orders with the same goal.

The Arkansas legislature also overrode Gov. Asa Hutchinson’s veto on a bill to ban gender affirming treatments for transgender yout

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Liias said in public testimony that he proposed the Washington state bill at the request of leaders in the transgender community.

Transgender residents are not able to access medically necessary care because it’s considered cosmetic or reconstructive by many health plans, he said, calling it an area of “profound discrimination.”

In contrast, the Washington state legislature has now passed Senate Bill 5313. If signed into law, it will keep health plans issued or renewed starting in 2022 from denying or limiting coverage for gender affirming treatment when prescribed to someone because of, related to, or consistent with their gender expression or identity, “is medically necessary, and is prescribed in accordance with accepted standards of care.”

Among other requirements, carriers won’t be able to apply categorical cosmetic or blanket exclusions to that treatment, according to a nonpartisan bill analysis, nor exclude care such as facial feminization surgeries and mastectomies as cosmetic when that care is prescribed as medically necessary gender affirming treatment.

The bill also requires the Insurance Commissioner to report on geographic access to gender affirming treatment across Washington state by Dec. 1, 2022.

Tweetie Fatuesi with UTOPIA Washington, which stands for United Territories of Pacific Islanders Alliance, was among the many who testified about their experience.

“As a trans woman of color, I have personally experienced the harsh rejection and mistreatment of care that is essential to my mental health and safety,” she said. Classifying such treatment as cosmetic, Fatuesi said, forces people to resort to unsafe alternatives — for instance, seeking that care via the black market or out of the country.

The bill passed through the Senate on a 30-17 vote and out of the House of Representatives on a 57-41 vote earlier this session. On Monday, the Senate concurred with changes made in the House.

The bill now heads to Gov. Jay Inslee’s desk for his consideration.

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