Study finds trans Americans often denied gender-affirming hormones

A new study, published in the Annals of Family Medicine, found many transgender Americans are turning to non-prescription hormone medication after being denied gender-affirming treatment, or not being able to afford healthcare. While the Affordable Care Act (or Obamacare) aimed to extend healthcare access, the study found 10% of trans citizens are using non-prescription hormones. These hormones come with health risks as they are likely not checked for content, quality, formulation or dosing. Moreover, the treatment isn’t likely to be monitored by a professional.

Out of 27,715 respondents who said they wished to have access to gender-affirming hormones, 992 took non-prescription treatment, and a further 15% did not have health insurance. 21% with insurance also said their claims were denied. 24 US states explicitly require private insurance companies to cover gender-affirming treatment, and 9 states have complete exclusions for trans-related coverage under Medicaid.

Dr. Daphna Stroumsa, the lead author of the study, told NBC News: “The lack of coverage is a combination of insurance companies being discriminatory in rejecting claims, and in creating excessive layers of red tape for something that is very straightforward and actually cost-effective…We know gender-affirming hormones immensely improve mental health and lower the risk of depression.”

Cecilia Gentili, principal at Transgender Equity Consulting and trans activist, added that many are mistreated or misgendered by healthcare professionals, discouraging them from seeking prescription medication. She said: “Every time I go to someone who’s not my [regular] doctor, I get misgendered, I get uncomfortable questions…So if I’m not dying, I’m not going to the doctor.”