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Frequently Asked Questions Benefits for LGBT Federal Employees and Annuitants

I am interested in learning about what medical insurance is recognizing “gender dysphoria”—will medical coverage be broadened to cover surgery or even regular check-ups?

Beginning in 2011 (Carrier letter 2011-12), OPM emphasized that transgender individuals should be provided appropriate preventive services in accordance with their individual medical status.  For example, an individual who transitions from female to male may still need pap smears if they have not undergone a hysterectomy.

Effective January 1, 2016, no carrier participating in the Federal Employees Health Benefits Program may have a general exclusion of services, drugs or supplies related to gender transition or “sex transformations.”

All plans complied with the OPM directive to remove blanket exclusions.  There are plans in every state that will offer mental health services, hormone therapy, and gender re-assignment surgery.

Plans differ in their covered services and procedures.  Members seeking specific services should consult plan brochures posted by state at www.opm.gov/insure.

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