Impact of Medicaid Expansion on Genital Gender-Affirming Surgery in New York State

Abstract

Approximately 1.6 million people identify as transgender in the United States. 1 Studies suggest a growing number of individuals undergo gender-affirming surgery (GAS), 2,3 a core component of transgender care which can alleviate distress associated with gender dysphoria and help align self-identified gender with physical appearance and function. Nonetheless, major barriers for accessing GAS persist, including lack of appropriate insurance coverage. 4 In 2015, New York State (NYS) Medicaid began covering gender-affirming care, including GAS. 5 As a government program aimed at providing health insurance for low-income individuals, this coverage decision was enacted to help increase access to critically needed gender-affirming care. For context, currently 26 states and Washington, DC, have Medicaid policies covering gender-affirming care, whereas 9 states (Arizona,