Insurance companies in California must cover mastectomies for transgender children and teens under a new rule by the state’s Department of Insurance.
California Insurance Commissioner Ricardo Lara on Dec. 30 directed the Department of Insurance to clarify that under existing California law, health insurance companies “may not deny coverage for male chest reconstruction surgery for female-to-male patients” based “solely on a patient’s age,” the department said in a news release.
A 2018 study in JAMA Pediatrics reported that biological females in California as young as 13 had undergone mastectomies as part of their transition. The state has few restrictions on such surgeries, which are called “top surgeries” within the LGBT community.
“For far too long, individuals diagnosed with gender dysphoria have had to battle a host of challenges to get access to gender-affirming care in order to be their true selves,” Lara said. “Social stigma, misconceptions about gender dysphoria and its treatment, and outdated medical criteria create barriers to necessary medical care that can lead to tragic results for individuals with gender dysphoria, especially for our transgender youth.”
The Department of Insurance said it issued the clarifying rule in response to an inquiry from San Diego’s TransFamily Support Services, which said female-to-male patients under 18 had been denied insurance coverage.
Insurance companies, the department said, are forbidden from placing age limits on mastectomies.
“Imposing strict age limits on coverage of male chest reconstruction surgery when it is requested to treat gender dysphoria but not other medical conditions, such as breast cancer or trauma, constitutes discrimination in health coverage based on age, sex, gender identity, gender expression, sexual orientation, and health conditions in violation of state and federal law,” the department said. “... The use of rigid age criteria in determining medical necessity, and thus insurance coverage, for female-to-male chest reconstruction surgery does not allow consideration of each individual’s unique clinical situation, contrary to the generally accepted standards of care for transgender health and the requirements of state and federal law.”
The new rule has many critics.
The California Family Council bemoaned the new rule in a statement on its Facebook page: “If your daughter, no matter how young, says she is a boy and wants her breasts removed, California's Insurance Commissioner says private insurance companies must pay for it.”
Several commenters on the California Family Council Facebook page also criticized the rule.
“No one under 18 should be having any kind of permanent treatments,” one person wrote. “Kids at that age, will change their minds an average of three times. Whoever is allowing, encouraging, promoting this behavior on minor children, should be prosecuted by the law for condemning these kids to a permanent lifestyle, they may or may not agree to for the balance of their lives. This is flat-out evil.”
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Michael Foust has covered the intersection of faith and news for 20 years. His stories have appeared in Baptist Press, Christianity Today, The Christian Post, the Leaf-Chronicle, the Toronto Star and the Knoxville News-Sentinel.