Federal Employee Healthโ Benefits program to End Coverageโ of Gender-Affirming Care
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Washington, D.C. – August 20, 2025 โฃ – In a significant policy โshift, the Officeโ of Personnel Management (OPM)โข announced it will eliminate coverage for “chemical and โsurgical modification of an individual’s sex traits through medical โคinterventions,” includingโค gender transition services, within the Federal Employee โHealth Benefits (FEHB) program โคbeginning with the 2026 plan โคyear. โคThis decision impacts millions of โfederal employees, โretirees, and their families who rely on the FEHB for healthcare coverage.
Background and Policy Changes
The OPM’s โrecent directive reverses earlier guidance issued this year that allowed carriers to continue offering gender-affirming care to individuals over theโ age ofโข nineteen, โขwhile eliminating it for those under nineteen. Thatโข previous guidance stemmed โfrom two โคexecutive โคorders issued during the trump โคadministration: โ”Defending Women from Gender Ideology Extremism and restoring Biologicalโ Truth to the โFederal Government” and “Protecting Children from Chemical and Surgical Mutilation.” This latest noticeโฃ removes any carrier discretion, enacting a completeโ prohibition on coverage for gender-affirming care for โall agesโค under the FEHB program.
This change represents a departure from the evolving landscape of healthcare coverageโฃ for transgender individuals,and raises questions about โaccess to essential medical care for federal employees and their families. The Williams Institute at โฃUCLA School of Law estimates that approximately 1.6 million adults in the United States identify asโฃ transgender [[1]],highlighting the potential impact of this policy.
Exceptions to โthe New Policy
While comprehensive gender-affirming care will โขno longer be covered, the OPM outlined several key exceptions toโ the new policy:
- Mental Health Services: Counseling forโข individuals experiencing gender dysphoria will continue to beโ covered, provided โคit is indeed deliveredโ by a licensed mental healthโค professional or aโค qualifiedโ faith-based counselor.
- Ongoing Treatment: Individuals currently undergoing hormoneโ therapy or surgical treatment for diagnosed gender dysphoria will be eligible for continued coverage. Specific details will be outlined in each plan brochure and assessed on a case-by-case basisโค by โขthe respectiveโค carrier.
- Non-Gender Related Hormone Therapy: Hormone treatments prescribed for conditions unrelated to gender โaffirmation, such as cancer or tumor prevention, will remain eligible for coverage.
The OPM also directed carriers toโ update their online provider directories to removeโฃ listings for healthcare providers โคoffering services related to “chemical and surgical modifications of an individual’s sex traits.”
Did You No? The FEHB program isโ theโ largest โคemployer-sponsored health insurance programโฃ inโค the United States, covering over 8.7 million people as ofโ 2024.
Impactโข and Concerns
Advocacy groups have expressed strong concerns regarding the OPM’s decision,arguing itโข will create significant barriers to โฃhealthcare access โฃfor transgenderโค federal employees and their families. Critics contend that denying coverage for medically necessary care is discriminatory โand harmful. The World Professional Association for Transgender Health (WPATH)โ Standards of โCare outline evidence-based guidelinesโ for gender-affirming care [[2]],and this decision potentially conflicts with those established standards.
What impact will this decision have on the well-being of transgender federal employees? โHow will this โpolicy affect the recruitment โขand retention ofโค diverse talent within the federal workforce?
Pro Tip: Federal employees with questions about their health benefits should consult โขtheir agency’s human resources department or contact โthe OPM directly.
Key Dates and Decisions
| Date | Event |
|---|---|
| Earlier โ2025 | OPM issues guidance allowing carriersโค to continue gender-affirming care for those overโ 19. |
| August 20, 2025 | OPMโ announces the elimination ofโข coverage for gender-affirming care under theโ FEHB โprogram, effective โ2026. |
| 2026 | New policy takes effect; gender-affirming care no longer covered under FEHB. |
The debate surroundingโข gender-affirming care is โคa rapidly evolving โarea of healthcare and publicโ policy.Historically,โค access to such care has been limited by insurance coverage and societal stigma. recent years have seen increasing โrecognition of the medicalโฃ necessity of gender-affirming care for individuals experiencing gender โdysphoria, with major medical organizations like the American Medical Association issuing statements of support. However, political and legal challenges continue to โขshape the landscape of access to theseโค services.
Frequently Asked โQuestions
- what is gender-affirming care? gender-affirming care encompasses a range of medical, psychological, and social services designedโ to support individuals in aligning their gender expression with their gender identity.
- Who is affected by this OPM decision? This decision impacts federal โขemployees, retirees, and their families who are enrolled in the Federal Employee Health Benefits (FEHB) โprogram.
- What does thisโค mean โขfor current treatment plans? Individuals โคcurrently undergoing gender-affirming care may be eligible for โcontinued coverage, but โขdetails โขwill varyโ by plan.
- Are there any resources available for federal employees? Yes, federal employees can contact their agency’s human resources โฃdepartment or the OPM for more information.
- What is gender โคdysphoria? โค Gender dysphoria is theโ distress a person experiencesโข when their gender identity andโ sex assigned atโ birth do not align.
This is a developing story. We will continue to provide updates as more information โขbecomes available.
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