Gender-Affirming Hormone Therapy in Wisconsin: Opportunity to Expand Access by Enabling Family Planning Providers to Bill Medicaid

There is an opportunity in Wisconsin to expand access to gender-affirming care for low-income, transgender people in our state. Rachel Dyer, a CORE researcher and a PhD student in the UW-Madison Department of Counseling Psychology, prepared a brief on this subject with support from CORE staff. In it, Dyer dives into the process and potential outcomes of updating Wisconsin’s Medicaid policy to expand specific family planning coverage.

Dyer compiles extensive research showing that gender-affirming hormone therapy, or GAHT, can improve the health and wellbeing of transgender people. GAHT is a safe and effective form of medical care that may be sought by transgender, nonbinary, two-spirit, gender nonconforming, and other gender diverse people. Like other forms of gender-affirming care, the purpose of GAHT is to support transgender people in feeling more aligned with their gender identity, namely by reducing sex characteristics that they were born with and inducing sex characteristics that align with their gender identity.

Wisconsin could efficiently expand access to GAHT by permitting family planning clinics to bill state Medicaid for GAHT services provided in their clinics. Because each state determines for itself what constitutes family planning and what services can be covered, Wisconsin has the ability to expand the interpretation of family planning to include important healthcare services that fall under the umbrella of GAHT. As a major form of regular and preventative healthcare, family planning providers have a unique capacity to provide gender-affirming services.

The reach of family planning clinics in Wisconsin also make them a useful choice for a site to provide GAHT; there are approximately 150 clinical sites in rural and urban communities across the state that already provide publicly-funded family planning services. Further, expanding Medicaid coverage to include GAHT services provided at these clinics would be of minimal cost to the state of Wisconsin.

To learn more about the importance of clinical provision of gender-affirming hormone therapy, and the opportunity to expand access via Medicaid coverage, check out our CORE Brief.