Gender Dysphoria Treatment - State Guidelines

Coverage is state-specific: Colorado EHB-regulated plans list many feminization/masculinization procedures as medically necessary (facial feminization including bone remodeling, rhinoplasty, blepharoplasty, jaw/chin procedures, breast/chest surgeries, electrolysis, etc.), Mississippi prohibits coverage of “gender transition procedures” for persons under 18 and excludes certain DSD-related and other services, and CA/NY/OR insured plans are exempt from utilization management. Key requirements: Washington must review any otherwise excluded gender‑affirming care case‑by‑case with a medical director and experienced provider, Virginia requires only one letter of support for minors 15–17 seeking surgery, and Colorado limits electrolysis (CPT 17380) to eight 30‑minute units per day.

"Coverage for treatment of gender dysphoria, including gender reassignment surgery and related services (state-specific requirements apply)."