Gender Dysphoria Treatment – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers medically necessary gender‑affirming medical and surgical treatments (e.g., chest surgery, breast augmentation, vaginoplasty/phalloplasty, orchiectomy, hysterectomy, thyroid cartilage reduction, voice therapy/surgery, pre‑op hair removal) when allowed by the member’s benefit plan, while excluding many cosmetic/ancillary procedures (facial feminization, body contouring, rhinoplasty, non‑genital hair removal), reproduction services, treatment outside the U.S., and certain plan/state‑specific exceptions. Coverage requires documented persistent Gender Dysphoria, capacity to consent, a favorable psychosocial evaluation, written assessments by Qualified Healthcare Professionals (one for breast/voice procedures; two independent QHPs for genital surgery), age thresholds (generally ≥18, with narrow exceptions), specified hormone‑therapy durations (typically 12 months for breast/genital, 6 months for voice masculinization) and 12 months of full‑time real‑life experience before genital surgery, with documentation if hormone therapy is contraindicated.