Obamacare Expanding Healthcare Access For Trans People


A growing number of low-income people who identify as transgender are finding that President Obama’s Affordable Care Act is making it easier for them to transition. One of Obamacare’s key components is the requirement that health care providers provide coverage for all people interested in purchasing policies, regardless of whether or not they have pre-existing conditions.

Previously gender identity disorder, the psychological description of a dysphoria associated with one’s birth sex and assigned gender, was frequently used both to disqualify people from purchasing health plans and as a justification for denying certain forms of coverage. By making health care generally more affordable and divorcing coverage from employers, Obamacare is removing many of the barriers that trans-identified people have traditionally had to deal with

“The system isn’t perfect — low-income people buying insurance through a state exchange will still have to pay monthly fees — but it’s an improvement over the current setup,” Transgender Law Center Project Health program manager Anand Kalra explained to the Advocate:

“[A]ll plans sold through state exchanges have to provide coverage for 10 ‘Essential Health Benefits,’ which include, among others, preventative care, reproductive health, prescription drugs, mental health care, and treatment for substance abuse.”

Increased access to a broader network of healthcare practitioners is a step in the right direction, but it doesn’t address all of the infrastructural healthcare difficulties faced by the the trans-community. There are far fewer general practitioners that specialize in trans-health issues. Moreover, while insurance companies can no longer out and out deny trans-identified people coverage simply for being trans, the approval process for many  medical procedures commonly associated with trans-people can be arduous.

"It is not a simple, easy, magical surgery," Devin Payn recounted to Kaiser Health News. "Trying to do this without insurance is a big risk. Things can go wrong … not having the money to pay for it would be awful."


  1. Atticus Bennett says

    Oh, how wonderful! And since we have always been told that the epidemic levels of depression, suicide and venereal disease in transgenders is the result of “discrimination,” this development should definitely result in reduced trans depression/suicide/STIs.

    Yeah, sure. We all know that they will be just as screwed up after Obamacare as they were before. Because their problem is NOT discrimination or lack of access to penis removal surgery. It is mental illness.

  2. Derrick from Philly says

    @ ATTICUS,

    “It is mental illness”

    Since you’re an expert on mental health could you please help a Towleroad regular by the name of Rick? He seems to hate Transwomen…even when he uses posting names such as “ENCHANTRA” or “MARYM” or “LEANNE” .

    Leanne is a mean b1tch.

  3. Thedrdonna says

    Atticus, how would you explain elevated rates of “depression, suicide and venereal disease” in LGB populations, in a way that doesn’t also claim we’re mentally ill? And, if you can do so without citing or alluding to minority stress (you know, the actual cause of those issues in the LGB and T populations), bonus points to you!

  4. Atticus Bennett says

    TheDrDonna – Thank you for the response. Suicide, depression, and STIs in LGBs are very well-studied, not just in the US but in Canada, Australia, and western Europe. There is very good evidence from multiple jurisdictions over time which shows that the rates of all 3 are overwhelmingly related to external conditions. Change the conditions and you improve LGB health dramatically.

    The transgender health landscape bears no resemblance to the LGB and not just b/c their rates are dramatically higher. Their problem is organic. Transgenderism itself either is a form of mental illness or is directly linked to other forms of mental illness. Despite a massive political lobbying effort, transgenderism remains in the DSM V, albeit under 2 new classifications. No alteration of external circumstances will significantly help, although some measures may yield modest or short-term improvements as to some parameters. Obamacare may help transgenders in the sense that it helps most people with greater access to care, but it won’t really get to the root of the problem, which is trans mental illness.

  5. Thedrdonna says

    Atticus, it’s apparent that you don’t really know what you’re talking about when it comes to trans issues, or, worse, possibly you’re intentionally mishandling the truth. Whether trans identities belong in the DSM is something of a contentious point even within the trans communities, and there was hardly a uniform, united push to have it removed. Since trans people usually require medical interventions to be able to transition, it’s important that the medical community be able to recognize that the issues associated can cause mental distress. Beyond that, your claims that the “mental landscapes” don’t match are a red herring: each group deals with their oppression differently, and you can hardly say that trans people are messed up because we’re mentally ill, but hand-wave away similar, if attenuated, issues in the LGB community because , well, you don’t really go into why. Also you ignore that trans rights are nowhere near as advanced as LGB rights and acceptance have become, and as a result the issues trans people face are probably more approximate to the issues LGB people faced in the 70s.

  6. Tyler says

    TheDrDonna said what I wanted to say far more eloquently than I would have, and has far greater patience for the trolls than I do.i

  7. Atticus Bennett says

    TheDrDonna –

    You were the one who injected LGBs into this and were equating one landscape with the other. I was responding to you, pointing out how they are not the same. Glad we agree.

    The fact that Ts are split on whether to remove “trans identities” from a manual of mental disorders is further support for what I said above. Also, it is simply untrue that “trans people usually require medical interventions to be able to transition.” Most trans people don’t transition or have any desire to do so. You seem to equate transgender with transsexual, a practice which will get you branded as a bigot in the trans activist community. However, I won’t reveal your secret to them.

  8. Thedrdonna says

    Atticus, again you reveal your ignorance. Although you’d like to paint the whole trans experience as being that of the most extreme Tumblr warriors, the vast majority of trans people, who live outside of our assigned-at-birth gender, are looking for two things: a society that won’t crap on us, and a medical system that will allow us to transition.

    It’s been demonstrated and found again and again that trans people who are able to transition are overwhelmingly positively affected, that all major issues like stress and mental health improve. It follows that the main contributors to adverse outcomes for trans folks are people who impede that, such as yourself. People who use the same arguments that were used against gay people, against people of color, against people with other religions, against women. People who want to paint the “other” as some inhuman, broken thing that cannot be mended.

  9. Atticus Bennett says

    TheDrDonna, I am not sure what you are talking about. The Tumblr warriors can be extreme and unrepresentative, but if you go around using transgender and transsexual interchangeably, you are going to get slammed as a bigot by just about everyone in the trans community, not just the Tumblr people.

    Remember, this is not a news story about transsexuals; it is a story about transgender people, of which transsexuals are only a small component.

  10. Thedrdonna says

    Actually, I think I’m far more qualified, as a member of the trans community (and note, I haven’t used either “transgender” or “transsexual” once during this thread) to speak about what the trans community is likely to find insulting. And, generally speaking, it’s people who are in the process of or have already transitioned who require these protections. Cross dressers do not face systematic barriers in their access to healthcare, which you would know if you had any actual experience in trans issues. This is why I was careful to use the phrasing “people who live outside of [their] assigned-at-birth gender”. Those are the people affected by these policies, and those are the people you are claiming are mentally ill. You know exactly what I’m saying and you know exactly what you’re doing: dismissing an entire class of people as deficient, and arguing against the treatments that are known to help us live our lives in peace. You’re an opponent of equity.

  11. Atticus Bennett says

    Well, thanks for admitting to your indifference to and your erasure of non-transsexual transgender people. “Trans” does not mean transsexual; it means transgender. And this Towleroad story was not about transsexuals, but about “low-income people who identify as transgender.” You decided that only transsexuals matter, that only their depression and suicide rates are worth talking about. To hell with the rest, I guess is your attitude.

  12. says

    TheDrDonna, ignore the troll. It’s the same troll as it is every day, who now (in yet another desperate attempt to get my attention) is using the name of my instagram account: AtticusBennett.

    Know this, DrDonna, he’s not even doing it because he has an issue with you, or with tradespeople. He’s doing it because he has a now-obviuosly and sickeningly unhealthy obsession with ME.

    Thats’ why he’s commented. That’s why he’s once again using a name associated with me. He’s a sad, unloved, deeply insecure internet troll – who has now made it clear that his day revolves around trying to get my attention.

    ignore the troll. and Andy Towle – for the love of GOD, block his damned IP address already. Your site is going downhill with this troll issue and it’s high time some responsibility and integrity was put into play and something was done about it.

  13. Thedrdonna says

    @Atticus (the fake one, apparently)
    From the story: “Obama’s Affordable Care Act is making it easier for them to transition. ”

    You: “Their problem is NOT discrimination or lack of access to penis removal surgery. It is mental illness.”

    I think it’s apparent who cares about the trans community.

  14. says

    TheDrDonna – like i said, it’s the same troll you and i (and everyone else) argues with everyday. Don’t waste time making points. He’s not hear to read them, he’s not even here to argue with YOU>

    His choice to use the name “Atticus Bennett” – my instagram handle – proves that he’s only here to get my attention. how f***ing pathetic is that, eh?

  15. Thedrdonna says

    I agree, pathetic. While I’m not certain that every anti-trans commenter here is an alias of the troll, their “logic” is usually feeble enough that it makes no difference whether they are one or many- it’s clear that the fundamental reason they’re opposing trans rights is they just hate trans folk.

  16. Derrick from Philly says

    @ “While I’m not certain that every anti-trans commenter here is an alias of the troll, their “logic” is usually feeble enough that it makes no difference whether they are one or many-…”

    You are exactly right. Even if we think that the racist, misogynistic, anti-Transgender, anti-Latino, anti…everybody except Straight White men– are coming from the same person it’s not necesssary to call him out. Just respond to the hateful comment no matter the posting name being used.

    THEDRDONNA, Your’re right, but…it’s very difficult for some of us to NOT undercover this CAD of Towleroad when he posts such mean (and almost dangerous) comments. Maybe one day Andy will make him unable to use all these aliases… one day.