New York officials have proposed authorizing coverage for transgender treatment under the state's Medicaid program for low-income New Yorkers.
Regulations proposed Wednesday would cover hormone therapy and gender reassignment surgery.
For surgery, patients would need a medical referral and to have counseling and document a year of hormone therapy and living in the gender role consistent with his or her identity.
They would have to be at least 18, or 21 if surgery means sterilization.
The proposal, subject to public comment, follows the state Department of Financial Services telling commercial insurers they may not deny medically necessary treatment for gender dysphoria — when someone's gender at birth is contrary to his or her identity.
Gov. Andrew Cuomo says the Medicaid proposal is "critical to safeguarding the principle of equal treatment."