Coverage of Gender-Affirming Care Banned for Federal Workers

Gender-affirming care will no longer be covered for federal workers in 2026, according to a letter the Trump administration sent to insurance carriers.

The notice from the Office of Personnel Management informs insurers participating in the Federal Employees Health Benefits or Postal Service Health Benefits programs that “chemical and surgical modification of an individual’s sex traits” will no longer be covered.

The announcement, dated Aug. 15, cements the administration’s expected move to halt gender-affirming care following President Donald Trump’s January executive order to enforce laws based on a person’s biological sex. The exclusion likely tees up legal challenges under Title VII of the 1964 Civil Rights Act and Section 1557 of the Affordable Care Act, both of which contain anti-discrimination protections.

“This discriminatory policy denying medical care to government employees and their dependents is not only cruel—it is illegal,” Omar Gonzalez-Pagan, Lambda Legal counsel and health-care strategist, said in a statement. “The federal government cannot simply strip away essential healthcare coverage from transgender employees while providing comprehensive medical care to all other federal workers.”

OPM previously informed insurers that it would not be covering gender-affirming care for individuals under the age of 19. For those over 19, the agency said then that plans “may propose to cover, but are not required to cover, transgender surgeries or hormone treatments for the purpose of gender transition.”

The Aug. 15 letter said the policy now “applies regardless of age.” Counseling services for people with gender dysphoria are exempted, and can include faith-based counselors.

The policy makes an additional exception for those “mid-treatment within a surgical and/or hormonal regimen.”

OPM also said insurance plans “must not list or otherwise recognize providers for the purposes of providing chemical and surgical modification of an individual’s sex traits” in their provider directories.