What Is Gender-Affirming Care?
Gender-affirming care supports a person’s gender identity.
What Does OHP Cover?
OHP now covers all treatments according to the
Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 (SOC 8).
Covered services include:
Non-surgical treatments
- Hair removal
- Hormone therapy
- Medical tattooing
- Mental health therapy
- Physical therapy
- Puberty blockers
- Speech therapy
Facial surgery
Surgery to make the face more masculine or feminine, such as:
- Blepharoplasty (eyelid surgery)
- Chondrolaryngoplasty (tracheal shave)
- Rhinoplasty (nose job)
- Hair transplant
Breast/chest surgery (top surgery)
- Breast reconstruction
- Liposuction (fat removal)
- Mastectomy (breast removal)
Gonadectomy (removing testes or ovaries)
Hysterectomy (uterus removal)Orchiectomy (removing testicles)Salpingo-oophorectomy (removal of ovaries and/or fallopian tubes)Genital surgery (bottom surgery)
Metoidioplasty (small penis construction)Phalloplasty (penis construction)Vaginoplasty (vagina construction or repair)Vulvoplasty (vulva construction)Body contouring
ImplantsLipofilling (fat transfer)Liposuction (fat removal)Monsplasty (mons reduction or “pubic lift”)Who Qualifies for Gender-Affirming Care?
OHP members who:
- Have marked and sustained gender dysphoria.
- Show they understand and consent for the treatment.
- Understand how the treatment will affect fertility.
- Have explored options to keep their fertility.
- For surgery, have completed at least six months of hormone treatment (or longer if needed for the surgery).
- Have a health care professional:
- Confirm that there are no other possible causes for gender dysphoria.
- Assess their mental and physical health and whether treatment would harm them.
- Discuss the risks and benefits of treatment.
Adolescents must also:
- Have mental health and medical professionals fully assess them.
- Have their parent(s) or guardian(s) take part in the assessment, unless this is harmful or not possible.
- Have entered stage 2 of puberty (when physical changes start).
- For surgery, have completed at least 12 months of hormone therapy (or longer if needed for the surgery).
To Get Gender-Affirming Care:
Start with your primary care provider (PCP). Your physician and mental health provider can refer you for services.
Don’t have a PCP? If you are in a coordinated care organization (CCO) that covers your physical health care, call your CCO.
If you are not in a CCO for your physical health care, try these resources: