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Spade, Dean. “Medicaid Policy & Gender-Confirming Healthcare for Trans People: An Interview with Advocates.” Seattle Journal for Social Justice, Transgender Issues and the Law, 8 (Spring/Summer 2010): 497–510.


In this article, Dean Spade uses an interview format to document the experiences of transgender advocates from Washington, New York, and Minnesota in their fight for Medicaid coverage of gender-confirming health care and sex reassignment treatment for their clients. Spade begins by providing a short background of the status of Medicaid coverage for sex reassignment surgery. He details the obstacles faced by recipients in trying to obtain care, particularly that most private insurers, as well as Medicaid, do not cover gender-confirming health care.  He then explains the harms that result, including depression, and even suicide. Finally, he summarizes the general arguments advocates have used to advance coverage, including that gender-confirming healthcare is medically necessary, and that denial of this care is discrimination under Medicaid regulations. Spade then includes a Q & A with advocates, who provide snapshots of Medicaid trends in gender-confirming healthcare in their areas, the efforts and strategies they are using to address the trends, and the implications for these discussions for larger healthcare debates.  At only ten pages, this article is an easy and friendly way to learn about barriers to care for transgender individuals receiving Medicaid. It is useful for those working with transgender folks in a direct services context, as well as those interested in healthcare policy and trans rights.


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Legislation/policy   Health care   LGBTQ

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