For Consumers

Rule to protect gender-affirming medical treatment takes effect Jan. 1

Changes in the law prevent insurers from denying lifesaving medical care

Contact Public Affairs: 360-725-7055

December 28, 2021

OLYMPIA, Wash. – A rule to solidify access to gender-affirming health care in Washington state takes effect Jan. 1, 2022. Insurance Commissioner Mike Kreidler adopted the rule on Nov. 30, 2021, which sets into state law the Gender Affirming Treatment Act (SB 5313), passed by the Washington state Legislature in 2021. 

The rule clarifies several aspects of the existing law to ensure medically necessary gender-affirming treatments are covered by health insurers. The wording in the rule previously allowed insurers to deny coverage in a way that subverted the intent of the law. 

For example, insurers may not deny gender-affirming hormone treatments because they are prescribed at different levels than they are for cisgender patients whose gender identity corresponds with their sex assigned at birth.

“While the clarifications in the rule seem technical, the implications for transgender and gender-diverse people is significant,” said Kreidler. “Advocates told us over and over again that gender-affirming treatment saves lives. As the insurance regulator, I take seriously my duty to make sure laws and rules around insurance coverage are as inclusive as we intend them to be and insurers aren’t able to issue blanket denials based on inadvertent loopholes in the law.” 

Kreidler has a long history of protecting the rights of transgender and gender-diverse people to access health care, in line with state laws to protect them. He’s fined insurers millions of dollars for denying treatment and has issued technical assistance advisories to make it clear to insurers what they must cover. 

If you've been unfairly denied coverage for medical services, you can file a complaint and we'll look into it for you, or you can file an appeal with your health insurance company. 

Read more about gender-affirming medical rights in Washington state.