As of July 13, Blue Cross Blue Shield (Blue Cross NC) has pledged to provide insurance for gender-affirming voice therapy and facial feminization procedures. Through the work of the Transgender Legal Defense and Education Fund (TLDEF), Equality NC, the LGBTQ Center of Durham and two transgender women with Blue Cross coverage, healthcare is becoming more inclusive to gender-expansive N.C. residents. 

These two women, Kathryn Vandegrift and Lauren (who does not want her last name publicized), were refused facial surgery by Blue Cross NC because it was not considered to be a matter of life or death. However, after discussions opened up with TLDEF, Vandegrift and Lauren, Blue Cross came to realize that, according to the World Professional Association for Transgender Health’s Standards of Health (WPATH), gender-affirming care is a necessity. 

Blue Cross now reasons that, since gender dysphoria typically heralds several mental and even physical issues, voice therapy and feminization surgery are integral to adequate healthcare. In addition to transgender persons, nonbinary individuals have shared that they too would benefit from affordable gender-related care. 

“Not being able to have the surgery I need has affected every aspect of my life. From my mental and physical health to my professional life, everything has suffered,” Lauren shares. “Without this coverage, which I am already paying for, I would not be able to afford the surgery that I need. I am so happy to know that I can finally start making plans for a brighter future for myself.”

Not the first, and hopefully not the last to incorporate transgender-related services into their policies, Blue Cross NC caters to countless college students and youth who will benefit from receiving affirming care. Other companies that have recently updated their policies include Aetna, Anthem, Cigna and Blue Cross Blue Shield Oregon. 

With local assistance for any healthcare-related discrimination, North Carolina residents may reach out to the TDLEF, the Duke Law Health Justice Clinic, Pillsbury Winthrop Shaw Pittman LLP or Harris, Wiltshire & Grannis LLP; who were all responsible for opening the conversation with Blue Cross NC. Any gender-expansive persons in the United States may also reach out to the U.S. Department of Health and Human Services, who have appointed the Office for Civil Rights as liaisons between the LGBTQ community and healthcare providers. 

 “Access to equitable healthcare is a lifesaving resource for trans and gender-nonconforming individuals, particularly Black and brown trans women who’ve already faced a long history of hostility in North Carolina,” adds Kendra Johnson, Executive Director of Equality NC.

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