Norfolk resident Rebecca Barwick’s health plan has put her in a difficult situation.
She’s a transgender woman, but her plan lists her as a man. That’s because, as she gets older, she may need to access prostate health services that are only available to men. Yet she might also need breast health services — which wouldn’t be available to her if she remains listed as a man.
“Quite frankly, this is an issue that endangers my life, because I cannot have access to the necessary services,” she said.
She made her case to the Senate Commerce and Labor Committee Thursday, as legislators considered a bill by Sen. George L. Barker, D-Fairfax, that would prohibit a health plan from denying coverage that they’d otherwise provide because a person’s sex assigned at birth or gender identity is different from “the one to which such health services are ordinarily or exclusively available,” a summary of the legislation reads.
Afton Bradley, a clinical care coordinator for the Virginia League for Planned Parenthood, said there have been several barriers to transgender individuals accessing the health care they need. The Affordable Care Act addressed some — like transgender people not being able to get insurance in the first place — but not all.
“There are a lot of medical and mental health-related services that are medically necessary for transgender individuals who experience gender dysphoria but often health plans don’t provide coverage for medically necessary procedures,” Bradley said.
The same problems that Barwick is facing would affect transgender men who still need to access women’s health services like pap smears. If they’re listed as men, their insurance won’t cover it.
Advocates like Bradley and Barwick don’t think insurance decisions should be made based on the basis of sex. If someone needs prostate health services, Barwick argues, they should just be able to get them, as well as breast health services, regardless of their registered gender.
Bradley says many transgender individuals also face barriers in accessing mental health because some insurers won’t reimburse if a clinician is treating gender dysphoria.
The legislation, which was carried in the House by Del. Debra Rodman, D-Henrico, would also prohibit health plans from discriminating in general against transgender individuals.
This week, both Rodman and Barker asked for their bills to be struck because, as Rodman told the House Commerce and Labor Committee, there is “peace in the valley,” and the state health plans agreed to create a work group and come to a solution between General Assembly sessions.
Barwick said she wished the bills had gone further, but that she’s not surprised by the decision.
“We have to count this as a win,” she said.