Shifting Federal Policies Threaten Health Coverage For Trans Americans

Wren Vetens was promised a significant discount on the cost of her gender confirmation surgery if she paid in cash upfront, without using her health insurance. Yet after the surgery, Vetens received an explanation of benefits saying the hospital had billed her insurer nearly $92,000.

With the country on course to expand the rights of transgender Americans, college student Wren Vetens introduced herself as a woman for the first time in January 2016, at the annual meeting of the American Astronomical Society. After being raised as a boy and grappling with her gender identity for years, she says it felt liberating to be referred to as “she.”

Vetens, who is now 24, began taking hormones to develop female characteristics that spring, as the Obama administration unveiled a landmark rule barring most health care providers from discriminating based on gender identity, under peril of losing federal funding.

That summer, as she prepared to start a Ph.D. program in physics at the University of Wisconsin, state officials there voted to allow transgender public employees — including graduate students working as teaching assistants — to obtain coverage for hormone therapies and surgery, in compliance with the Obama administration’s anti-discrimination rule.