A transgender flag being waved at LGBT gay pride march
A transgender flag being waved at LGBT gay pride march
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Humanize California Insurance Commissioner Orders Health Insurance to Pay for Minors’ Transgender Mastectomies

Originally published at National Review

I missed this when it happened in December, but it is worth noticing now. California’s Insurance Commissioner has decided that health-insurance companies must pay for the removal of the healthy breasts of biological minor girls with gender dysphoria, just as they would if the surgery was required for cancer or a serious injury. From the Department’s press release:

Insurance Commissioner Ricardo Lara directed the Department of Insurance to issue a General Counsel Opinion Letter clarifying that under existing California law, health insurance companies may not deny coverage for male chest reconstruction surgery for female-to-male patients undergoing gender-affirming care for gender dysphoria based solely on a patient’s age.

“For far too long, individuals diagnosed with gender dysphoria have had to battle a host of challenges to get access to gender-affirming care in order to be their true selves,” said Commissioner Lara. “Social stigma, misconceptions about gender dysphoria and its treatment, and outdated medical criteria create barriers to necessary medical care that can lead to tragic results for individuals with gender dysphoria, especially for our transgender youth . . .

Additionally, imposing strict age limits on coverage of male chest reconstruction surgery when it is requested to treat gender dysphoria but not other medical conditions, such as breast cancer or trauma, constitutes discrimination in health coverage based on age, sex, gender identity, gender expression, sexual orientation, and health conditions in violation of state and federal law.

“Chest reconstruction surgery” is as euphemistic as euphemisms get.

This rule raises a potential and pronounced issue of religious freedom. What if an order of, say, nuns, doesn’t want to be complicit in the mastectomies of healthy breasts in minors, and instructs its health insurance not to cover such a thing? Lawsuit, baby! After all, this is the state that sued the Little Sisters of the Poor over the order’s refusal to cover contraception as against Catholic moral teaching.

Will the Biden administration impose this rule nation-wide? No doubt about it in my mind. After all, California attorney general Xavier Bacerra–who sued the Little Sisters — has been nominated to become Secretary of Health and Human Services.

Wesley J. Smith

Chair and Senior Fellow, Center on Human Exceptionalism
Wesley J. Smith is Chair and Senior Fellow at the Discovery Institute’s Center on Human Exceptionalism. Wesley is a contributor to National Review and is the author of 14 books, in recent years focusing on human dignity, liberty, and equality. Wesley has been recognized as one of America’s premier public intellectuals on bioethics by National Journal and has been honored by the Human Life Foundation as a “Great Defender of Life” for his work against suicide and euthanasia. Wesley’s most recent book is Culture of Death: The Age of “Do Harm” Medicine, a warning about the dangers to patients of the modern bioethics movement.
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